BJGP Open最新文献

{"title":"A primary care intervention to expedite cancer diagnosis: protocol for the ThinkCancer! phase III trial.","authors":"Daniel Walker, Stefanie Disbeschl, Kausthuba Raman, Annie Hendry, Clio Evans, Benjamin Cotterell, Nic Nikolic, Richard Evans, Nia Goulden, Rachel Evans, Bethany Fern Anthony, Victory Ezeofor, Isobel McFadzean, Nefyn Howard Williams, Katherine Brain, Julia Hiscock, Andrew Carson-Stevens, Rhiannon Edwards, Janice Rose, Elfyn Jones, Richard Neal, Clare Wilkinson","doi":"10.3399/BJGPO.2026.0029","DOIUrl":"https://doi.org/10.3399/BJGPO.2026.0029","url":null,"abstract":"<p><strong>Background: </strong>Five-year cancer survival rates in the United Kingdom (UK) compare poorly with other high-income countries and a comparatively late stage of cancer diagnosis is a key driver. Primary care referrals led to 58.6% of cancer diagnoses in the UK in 2020, making general practice the ideal setting for targeted interventions focusing on improving early cancer diagnosis. ThinkCancer! is an innovative, team-based, theoretically-driven, complex behavioural and educational intervention aimed at reducing primary care cancer diagnostic delays.</p><p><strong>Aim: </strong>The aim of this phase III randomised control trial is to assess the effectiveness and cost-effectiveness of the ThinkCancer! intervention compared with usual primary care. An embedded case note review will characterise patients with the longest intervals to referral.</p><p><strong>Design & setting: </strong>General practices will be randomised on a 1:1 ratio to either receive the ThinkCancer! Intervention, or to continue with usual care.</p><p><strong>Method: </strong>Data will be collected from 12 months pre-randomisation to 26 months post-randomisation. Primary outcome measures include the primary care interval (PCI), incremental cost per day reduction in PCI and budget impact of the ThinkCancer!</p><p><strong>Intervention: </strong>Secondary outcome measures include referral rates, conversion and detection rates, cancer stage at diagnosis and the guideline interval. A process evaluation will assess intervention implementation. Qualitative interviews will explore patient and carer experiences of urgent suspected cancer referral, and an embedded case note review will explore factors which contribute to the longest primary care intervals for patients with different cancer types.</p><p><strong>Results: </strong>The trial began in December 2022 with findings expected December 2027.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HATCHing plans: a qualitative study of how discharge communication can support expert generalist management.","authors":"Nicholas Boddy, Joanne Reeve, Rachel A Spencer, P John Clarkson, Anthony J Avery","doi":"10.3399/BJGPO.2026.0012","DOIUrl":"https://doi.org/10.3399/BJGPO.2026.0012","url":null,"abstract":"<p><strong>Background: </strong>Standardisation has improved hospital discharge summaries. However, problems remain for recipient GPs, such as inadequate detail for whole-person continuing care. Hospital authors often lack sufficient understanding of expert generalist practice in community post-discharge settings and so may over-rely on generic information standards or simplified summary template headings.</p><p><strong>Aim: </strong>To explore how expert generalist GPs practically use discharge information, including the challenges they face, to shape new understanding of what discharge communication should look like.</p><p><strong>Design & setting: </strong>A qualitative exploration of GP perspectives on challenging post-discharge management scenarios.</p><p><strong>Method: </strong>Fifteen semi-structured interviews of GPs and GP trainees were conducted with use of a mock vignette and the think aloud method. Thematic analysis was informed by the '4Es of expert generalism'.</p><p><strong>Results: </strong>An interpretive process of 'Holistic Adjustment To Context after Hospital discharge' (HATCH) was found to underpin expert generalist GP decision-making in this transitional care phase. The sub-processes of rationalisation and integration exemplified the use of the expert generalist interpretive paradigm. Insufficient communication of explanation and context surrounding key hospital decisions was found to hinder the HATCH process and risk the quality and safety of post-discharge care. GPs could remediate such situations, but this still had hidden risks and costs.</p><p><strong>Conclusion: </strong>Understanding the HATCH process and how contextual and explanatory information supports it emerged as key steps for authors to further improve discharge summaries. Adaptations to information standards and summary templates are key opportunities to address this issue, alongside incorporation into AI software and updated training for all parties.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Designing a 'Deep End' childhood immunisation intervention: a pre-implementation qualitative study.","authors":"Amber Sacre, Adam Todd, Clare Bambra, Sarah Sowden","doi":"10.3399/BJGPO.2025.0110","DOIUrl":"10.3399/BJGPO.2025.0110","url":null,"abstract":"<p><strong>Background: </strong>Childhood vaccination uptake is declining in England. Efforts are required to prevent further decline and safeguard against outbreaks of vaccine-preventable diseases (VPDs). Individuals in areas of high socioeconomic disadvantage can face greater barriers to vaccination and, subsequently, be at an increased risk of lower uptake and VPDs.</p><p><strong>Aim: </strong>To conduct a pre-implementation evaluation of a proposed childhood 'catch-up' immunisation pilot intervention targeted at North East and North Cumbria 'Deep End' (NENC DE) Network general practices.</p><p><strong>Design & setting: </strong>The NENC DE is a network of general practices serving populations experiencing high levels of socioeconomic disadvantage. The proposed intervention would provide additional staffing capacity (one administrator and two vaccination-trained nurses) to be used discretionally by each NENC DE practice; tasks could include offering an in-home roving vaccination service or identifying children not vaccinated to schedule.</p><p><strong>Method: </strong>Semi-structured qualitative interviews were employed, and a purposive and snowball sampling approach was adopted. Fifteen interviews were conducted in 2023 - the initial commissioning phase of the intervention. Transcripts were analysed using the framework method.</p><p><strong>Results: </strong>The proposed intervention was received with intrigue, especially the roving service, which would reduce some practical access barriers for families. Success could be measured by an increase in childhood vaccination uptake, hopefully among the most vulnerable children. However, concerns regarding physical space and staff safety were raised.</p><p><strong>Conclusion: </strong>We encourage the NENC DE intervention providers to ensure the service remains flexible and customisable. Further research will be required to assess its impact and effectiveness when underway.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The GP Evidence website: focus-group evaluation study of a new point-of-care information resource.","authors":"Julian Stephen Treadwell, Joanna C Crocker, Kamal R Mahtani","doi":"10.3399/BJGPO.2025.0109","DOIUrl":"10.3399/BJGPO.2025.0109","url":null,"abstract":"<p><strong>Background: </strong>The GP Evidence website is a new point-of-care information resource aimed at GPs, providing quantitative information on the benefits and harms of treatments for common long-term conditions (LTCs), an identified gap in clinicians' knowledge.</p><p><strong>Aim: </strong>To explore whether the clinical content in GP Evidence can be accessed and understood by GPs in a way that can be integrated into their clinical thinking and decision making.</p><p><strong>Design & setting: </strong>Online questionnaire and focus group with British GPs.</p><p><strong>Method: </strong>Online focus groups were undertaken. Within these, participants were first invited to consider hypothetical treatment decisions based on fictional clinical vignettes, they were then asked to give individual responses about their anticipated consultation and treatment intentions in an online survey. This was followed by an online semi-structured focus group discussion. Qualitative data were analysed thematically, and quantitative data presented as summary statistics.</p><p><strong>Results: </strong>In the main, the clinical content of GP Evidence was easily understood by GPs. Changes in intended prescribing and discussions with patients were described, as well as increases in confidence. Some barriers to use were identified mainly relating to competing system pressures.</p><p><strong>Conclusion: </strong>This study confirms the usability of GP Evidence and suggests it has potential to introduce new information and influence practice. This could support shared decision making and person-centred practice. It is a preliminary study with limitations, and further research is needed to assess its impact in real-world settings.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145439209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-item Patient Enablement Instrument (PEI-Q2) as a feedback tool in primary health care: a qualitative study among Finnish primary care physicians.","authors":"Ida Tiihonen, Tuomas H Koskela, Aapo Tahkola, Elina Tolvanen","doi":"10.3399/BJGPO.2025.0126","DOIUrl":"10.3399/BJGPO.2025.0126","url":null,"abstract":"<p><strong>Background: </strong>In Finland, the gathering of patient feedback using patient-reported outcome measures, such as the Patient Enablement Instrument (PEI), is recommended to assess the quality of care. However, knowledge of how this feedback could be utilised by the individual primary care physician (PCP) is sparse.</p><p><strong>Aim: </strong>To explore PCPs' experiences of the single-item PEI (PEI-Q2) as a feedback tool.</p><p><strong>Design & setting: </strong>Qualitative study in Finnish primary health care.</p><p><strong>Method: </strong>Semi-structured focus group interviews were conducted with 14 PCPs in June 2023 in Central Finland after they had received feedback with the PEI-Q2. The data were analysed using thematic analysis.</p><p><strong>Results: </strong>PCPs regarded patient enablement as an important indicator of care quality in primary health care. The feedback provided through the PEI-Q2 was generally perceived as encouraging and motivating, prompting requests for its regular use. However, several PCPs found the feedback challenging to interpret. Feedback with the PEI-Q2 was seen as a promising tool for managerial benchmarking. Additionally, PCPs suggested that the utility of the PEI-Q2 feedback could be enhanced by incorporating supplementary contextual information such as open-ended feedback.</p><p><strong>Conclusion: </strong>From the PCPs' viewpoint, the PEI-Q2 appears to be a potential tool for delivering patient feedback. While it can serve as a measure for assessing quality of care, it should be complemented with other patient-reported feedback tools to enhance its overall applicability and usefulness. In addition, educational guidance on interpreting the measure's results is recommended.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building stronger primary care with AI: from innovation to implementation.","authors":"Heidi Smith, Lucy Smith, Yousef Yousef, Hajira Dambha-Miller","doi":"10.3399/BJGPO.2025.0285","DOIUrl":"10.3399/BJGPO.2025.0285","url":null,"abstract":"","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence ethics: automation of medical publishing.","authors":"Patrick Burch, Hajira Dambha-Miller","doi":"10.3399/BJGPO.2026.0048","DOIUrl":"10.3399/BJGPO.2026.0048","url":null,"abstract":"","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Point-of-care ultrasound for undifferentiated and musculoskeletal presentations in UK primary care: a scoping review protocol.","authors":"Peter A Brookes, Carolyn A Chew-Graham, Aaron Poppleton","doi":"10.3399/BJGPO.2025.0189","DOIUrl":"10.3399/BJGPO.2025.0189","url":null,"abstract":"<p><strong>Background: </strong>Point-of-care ultrasound (PoCUS) is increasingly used internationally yet remains emergent in UK primary care. While momentum is growing, variation in application and infrastructure persists. Undifferentiated and musculoskeletal (MSK) symptoms, common and diagnostically complex in general practice, may particularly benefit from PoCUS. International evidence suggests PoCUS improves diagnostic accuracy, reduces referrals to specialist care and enhances patient satisfaction. However, UK-specific evidence on PoCUS use, clinician training, governance, and implementation is sparse. With national priorities shifting towards community-based, technology-enabled care, understanding current PoCUS use is increasingly important.</p><p><strong>Aim: </strong>To systematically map the current use of PoCUS in UK primary care for undifferentiated and MSK presentations, identifying clinical applications, user profiles, implementation contexts, and gaps in the literature.</p><p><strong>Design & setting: </strong>A scoping review of peer-reviewed and grey literature pertaining to UK primary and community care settings, including general practice, urgent care, community diagnostic hubs, and related contexts.</p><p><strong>Method: </strong>Following the JBI (formerly known as Joanna Briggs Institute) framework and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, comprehensive searches will be conducted across MEDLINE, Embase, CINAHL, Web of Science, and relevant grey literature sources. Eligible studies include those involving healthcare professionals using PoCUS in adult UK primary care. Data will be charted, synthesised descriptively and thematically, and findings presented narratively with visual mapping.</p><p><strong>Conclusion: </strong>This review will provide a comprehensive overview of PoCUS use in UK primary care, highlighting how and where it is applied, by whom, and to what effect. The findings will offer practical insights to support implementation and shape future research and service development.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic inequalities in primary care research: how can we make research more equitable? A quantitative and qualitative service evaluation.","authors":"Alison Janes, Helen Riding, Shona Haining, Morag Burton, Hilary Allan, Sarah Sowden","doi":"10.3399/BJGPO.2025.0082","DOIUrl":"10.3399/BJGPO.2025.0082","url":null,"abstract":"<p><strong>Background: </strong>Health research should reflect contexts where interventions are needed to provide evidence generalisable to practice. There is concern that socioeconomically disadvantaged populations with poorer health and care outcomes are underrepresented in research, potentially exacerbating health inequalities. Evidence on the relationship between socioeconomic deprivation and general practice research involvement is limited.</p><p><strong>Aim: </strong>To explore the relationship between socioeconomic deprivation, general practice research involvement, and recruitment.</p><p><strong>Design & setting: </strong>Quantitative analysis of routine data and qualitative interviews with clinical and non-clinical general practice staff in the North East and North Cumbria (NENC) area of England.</p><p><strong>Method: </strong>Analysis of general practice and National Institute for Health and Care Research (NIHR) Clinical Research Network (now the Regional Research Delivery Network [RDN]) data to understand associations between neighbourhood deprivation and research recruitment. Semi-structured interviews with GPs and practice managers or administrators explored barriers and facilitators to research involvement and patient recruitment in disadvantaged areas. Interviews were recorded, transcribed, and thematically analysed.</p><p><strong>Results: </strong>Research recruitment was lower among practices (<i>n</i> = 358) with more deprived populations (χ²(4) = 7520.8, <i>P</i><0.001), and significantly lower among 'Deep End' practices in areas of blanket socioeconomic disadvantage (<i>P</i><0.001). Eleven GPs and four practice managers or administrators were interviewed. Barriers included greater difficulty recruiting patients, resource pressures, limited financial benefit, and awareness. Supporting factors were research designed to meet needs of socioeconomically disadvantaged populations that was accurately costed, remunerated, and resourced, with concise, practically focused communications.</p><p><strong>Conclusion: </strong>To support equitable general practice research participation, research should be relevant for and designed to meet the needs of socioeconomically disadvantaged populations, and be accurately costed and remunerated. Targeting additional resource at practices in socioeconomically disadvantaged areas could incentivise equitable research participation.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of digital technology among patients with multiple long-term conditions: a qualitative systematic review.","authors":"Laura Jefferson, Ana Castro Avila, Eleonora Uphoff, Ibrahim Otour, Faraz Siddiqui, Karen Bloor","doi":"10.3399/BJGPO.2025.0043","DOIUrl":"10.3399/BJGPO.2025.0043","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of multiple long-term conditions (MLTCs) is increasing internationally. More common in older people and those from disadvantaged communities, MLTCs can generate substantial treatment expenditure, presenting a global challenge for healthcare systems. Digital technologies offer an opportunity to support self-management in the community, reducing pressures on patients and healthcare systems.</p><p><strong>Aim: </strong>To appraise and synthesise qualitative literature exploring patients' experiences of using digital technology to manage MLTCs.</p><p><strong>Design & setting: </strong>Systematic review of international literature.</p><p><strong>Method: </strong>We searched MEDLINE, CINAHL, PsycInfo, Embase, and PubMed (to October 2023), with backward and forward citation searches (January 2024) for studies exploring patients' experiences of managing MLTCs using digital technologies. We used Critical Appraisal Skills Programme (CASP) for quality assessment.</p><p><strong>Results: </strong>Fourteen reports (13 studies) were included, predominantly from North America. We included studies exploring patients' experiences of internet use for health information, peer-support videoconferencing, electronic personal health records, and apps or digital systems for home telemonitoring. Three themes explored (1) patients' lived experience, (2) key components of digital technologies, and (3) potential benefits of well-designed digital technology. Patient experiences with digital health technologies are influenced by their health literacy, trust in providers, and existing self-management practices. Patients need simple, patient-centred, and user-tested digital health tools. If successful, they may empower patients, and improve access and communication with healthcare professionals. Poorly designed tools risk disengagement. Healthcare professionals need training and capacity to support collaborative use.</p><p><strong>Conclusion: </strong>Digital technologies may empower patients' self-management. Patient-centred design is key to support potential benefits, making sure not to exacerbate patient and healthcare professional burden and inequalities.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}