BJGP Open最新文献

{"title":"Continuity of care and mortality in patients with type 2 diabetes: a cohort study.","authors":"Eero H Mellanen, Timo Kauppila, Hannu Kautiainen, Mika T Lehto, Ossi Rahkonen, Kaisu H Pitkälä, Merja K Laine","doi":"10.3399/BJGPO.2024.0144","DOIUrl":"10.3399/BJGPO.2024.0144","url":null,"abstract":"<p><strong>Background: </strong>How GP continuity of care (GP-CoC) affects mortality in patients with type 2 diabetes (T2D) is unclear.</p><p><strong>Aim: </strong>To examine the effect of having no continuity of care (CoC) and GP-CoC on mortality in primary health care (PHC) patients with T2D.</p><p><strong>Design & setting: </strong>A cohort study in patients aged ≥60 years with T2D, which was conducted within the public PHC of the city of Vantaa, Finland.</p><p><strong>Method: </strong>The inclusion period was between 2002 and 2011 and follow-up period between 2011 and 2018. Six groups were formed (no appointments, one appointment and Modified, Modified Continuity Index [MMCI] quartiles). Mortality was measured with standardised mortality ratio (SMR) and adjusted hazard ratio (aHR). GP-CoC was measured with MMCI. Comorbidity status was determined with Charlson Comorbidity Index (CCI).</p><p><strong>Results: </strong>In total, 11 020 patients were included. Mean follow-up time was 7.3 years. SMRs for the six groups (no appointments, one appointment, MMCI quartiles) were 2.46 (95% confidence interval [CI] = 2.24 to 2.71), 3.55 (95% CI = 3.05 to 4.14), 1.15 (95% CI = 1.06 to 1.25), 0.97 (95% CI = 0.89 to 1.06), 0.92 (95% CI = 0.84 to 1.01) and 1.21 (95% CI = 1.11 to 1.31), respectively. With continuous MMCI, mortality formed a U-curve. The inflection point was at a MMCI value of 0.65 with corresponding SMR of 0.86. Age and CCI aHR for death between men and women was 1.45 (95% CI = 1.35 to 1.58).</p><p><strong>Conclusion: </strong>Patients with no CoC had the highest mortality. In patients having care over time, the effect of GP-CoC on mortality was minor and mortality increased with high GP-CoC.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142093870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lyme disease in UK primary care: a knowledge, attitude, and practice survey.","authors":"Lucy Delaney, Amanda Semper, Neil French, John Sp Tulloch","doi":"10.3399/BJGPO.2024.0092","DOIUrl":"10.3399/BJGPO.2024.0092","url":null,"abstract":"<p><strong>Background: </strong>Lyme disease (LD) cases in the UK most commonly present within the primary care setting. Despite an upward trend of incidence, little is known regarding GP experience with diagnosis and treatment.</p><p><strong>Aim: </strong>This study aims to describe baseline primary care clinician Knowledge, Attitude and Practice (KAP) in Scotland and England.</p><p><strong>Design & setting: </strong>Online KAP survey on LD for UK-based practising GPs.</p><p><strong>Method: </strong>An online KAP questionnaire was developed for use in UK primary care. The survey was distributed through UK-based research networks, professional societies, and via social media.</p><p><strong>Results: </strong>A total of 191 complete responses were analysed (England <i>n</i> = 130, Scotland <i>n</i> = 61). The Scotland-based responder group had more relevant consultations in the previous 3 years. Responders from Scotland demonstrated a greater awareness that erythema migrans (EM) is pathognomonic for LD and that serological testing of this patient group is not indicated. Less common cardiac and neurological symptoms were not as well associated with LD by both responder groups for the former and England-based responders for the latter. Prescribing according to the National institute for Health and Care Excellence (NICE) guidance was identified in 70% of Scotland and 42% of England-based GP responses.</p><p><strong>Conclusion: </strong>Targeted resources may improve clinician confidence on exposure risk, symptom recognition, testing limitations and treatment dose and duration. Scotland-based responders' better survey performance potentially reflects greater clinical exposure and public awareness of the disease, due to high endemicity within the nation.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of a GP's perception of a patient request for antibiotics on antibiotic prescribing for respiratory tract infections: secondary analysis of a point-prevalence audit survey in 18 European countries.","authors":"Julie Domen, Rune Aabenhus, Anca Balan, Emily Bongard, Femke Böhmer, Valerija Bralić Lang, Pascale Bruno, Slawomir Chlabicz, Annelies Colliers, Ana García-Sangenís, Hrachuhi Ghazaryan, Anna Kowalczyk, Siri Jensen, Christos Lionis, Tycho M van der Linde, Lile Malania, Jozsef Pauer, Angela Tomacinschii, Akke Vellinga, Ihor Zastavnyy, Herman Goossens, Christopher C Butler, Alike W van der Velden, Samuel Coenen","doi":"10.3399/BJGPO.2024.0166","DOIUrl":"10.3399/BJGPO.2024.0166","url":null,"abstract":"<p><strong>Background: </strong>Illness severity, comorbidity, fever, age, and symptom duration influence antibiotic prescribing for respiratory tract infections (RTI). Non-medical determinants, such as patient expectations, also impact prescribing.</p><p><strong>Aim: </strong>To quantify the effect of a GP's perception of a patient request for antibiotics on antibiotic prescribing for RTI and investigate effect modification by medical determinants and country.</p><p><strong>Design & setting: </strong>Prospective audit of general practices in 18 European countries.</p><p><strong>Method: </strong>Consultation data were registered of 4982 patients presenting with acute cough and/or sore throat. A mixed-effect logistic regression model analysed the effect of GPs' perceptions of a patient request for antibiotics. Two-way interaction terms assessed effect modification. Relevant clinical findings were added to subgroups of lower RTI (LRTI), throat infection, and influenza-like-illness (ILI).</p><p><strong>Results: </strong>A GP's perception of a request for antibiotics meant they were four times more likely to prescribe antibiotics (odds ratio [OR] 4.4, 95% confidence interval [CI] = 3.4 to 5.5). This effect varied by country: lower in Spain (OR 0.06), Ukraine (OR 0.15), and Greece (OR 0.22) compared with the lowest prescribing country. The effect was higher for ILI (OR 13.86, 95% CI = 5.5 to 35) and throat infection (OR 5.1, 95% CI = 3.1 to 8.4) than for LRTI (OR 2.9, 95% CI = 1.9 to 4.3). For ILI and LRTI, GPs were more likely to prescribe antibiotics with abnormal lung auscultation and/or increased or purulent sputum and for throat infection, with tonsillar exudate and/or swollen tonsils.</p><p><strong>Conclusion: </strong>GPs' perceptions of an antibiotic request and specific clinical findings influence antibiotic prescribing. Incorporating exploration of patient expectations, point-of-care testing, and discussing watchful waiting into the decision-making process will benefit appropriate prescribing of antibiotics.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013425","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":"Mental health care and pragmatic shared decision making in general practice: an interview study.","authors":"Désanne Noordam, Monique Heijmans, Janneke Noordman, Tim Olde Hartman, Sandra van Dulmen","doi":"10.3399/BJGPO.2024.0111","DOIUrl":"10.3399/BJGPO.2024.0111","url":null,"abstract":"<p><strong>Background: </strong>Healthcare providers in general practice are expected to deliver mental health care to patients through shared decision making (SDM). It is unclear whether they perceive their SDM to be affected by challenging circumstances in mental healthcare; for example, how waiting time for therapy plays a role.</p><p><strong>Aim: </strong>To explore how healthcare providers and patients in general practice engage in SDM, given the challenging circumstances in mental health care.</p><p><strong>Design & setting: </strong>A qualitative interview study in seven Dutch general practices.</p><p><strong>Method: </strong>Semi-structured interviews were conducted with GPs (<i>n</i> = 9), practice nurses mental health (PNMHs; <i>n</i> = 8), and patients who sought mental health care (<i>n</i> = 18). The interviews were deductively and inductively thematically analysed.</p><p><strong>Results: </strong>The participants mainly reported on SDM regarding treatment in secondary mental health care. The PNMHs explained they lack an overview of available treatments and waiting times in facilities. The PNMHs therefore instruct patients to also search for options themselves. Most patients found this approach burdensome, especially those new to mental health care. These patients were said to often express no strong treatment preferences and rely on advice by their healthcare providers. The GPs and PNMHs explained that in such cases, they often adopt a pragmatic approach and, for example, refer indecisive patients to facilities with little waiting times.</p><p><strong>Conclusion: </strong>The healthcare providers and patients in general practice report that they adapt their approach to SDM in reaction to the circumstances in mental health care. Further exploration of how SDM is implemented and shaped by challenging circumstances across different healthcare settings is needed.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584431","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":"Attainment of medical student learning outcomes following general practice speciality trainee supervision: a pilot study.","authors":"Julie Carson, Anna Frain, Heidi Emery, Edward Tyrrell, Daniel Crowfoot, Gurvinder Sahota, Emma Wilson, Jaspal Taggar","doi":"10.3399/BJGPO.2024.0264","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0264","url":null,"abstract":"<p><strong>Background: </strong>Innovative training approaches are needed to address the lack of capacity in primary care for undergraduate medical student clinical placements. Near-Peer Teaching (NPT) by General Practice Speciality Trainees (GPSTs) is one possible solution.</p><p><strong>Aim: </strong>Compare the attainment of intended learning outcomes (ILOs) for students taught by GPSTs and qualified General Practitioners (GPs).</p><p><strong>Design & setting: </strong>Quantitative pilot study of medical students undertaking clinical training in GP at Nottingham University.</p><p><strong>Method: </strong>Year 3 GPSTs were trained to supervise first-year graduate entry medical students undertaking 6 half-day GP visits (2022-2023). Using Likert-scale post-training questionnaires, self-reported attainment of ILOs was compared for supervision provided to students by GPSTs and GPs. Secondary outcomes included student, GPST and GP views about NPT.</p><p><strong>Results: </strong>Of 112 medical students, 7 were supervised by GPSTs and 105 by GPs. 101 students responded [7 (100%) from GPST supervision; 94 (90%) from GP supervision]. There was no significant difference between groups in attainment of 7 ILOs with significantly greater attainment for students supervised by GPSTs for receiving feedback [<i>P</i>=0.018] and self-reflection [<i>P</i>=0.015]. GPSTs reported improved organisation, communication, feedback skills, and desire for future student supervision. Medical students and GPs reported enthusiasm for future NPT by GPSTs.</p><p><strong>Conclusion: </strong>Attainment of ILOs during undergraduate GP placements was at least equivalent when students were supervised by GPSTs compared with GPs. GPSTs are an important group for building supervisory capacity for undergraduate education and this study adds confidence in enabling GPST supervision of undergraduates.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040402","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":"Primary care performance in a Ugandan rural district: a cross-sectional descriptive study.","authors":"Innocent Kabahena Besigye, Robert James Mash","doi":"10.3399/BJGPO.2024.0105","DOIUrl":"10.3399/BJGPO.2024.0105","url":null,"abstract":"<p><strong>Background: </strong>To strengthen primary health care (PHC), there is a need to measure its performance. Global recommendations emphasise patient involvement in the improvement of services.</p><p><strong>Aim: </strong>To measure primary care performance in one rural Ugandan district.</p><p><strong>Design & setting: </strong>A cross-sectional survey of Tororo District where the Ugandan Primary Care Assessment Tool (UG-PCAT) was administered across a sample of 51 facilities. There were four levels of health facilities (health centre [HC] II, HC III, HC IV, and general hospital).</p><p><strong>Method: </strong>A sample of 488 users was obtained from each of the four levels while including all primary care providers and managers at the health facilities. Data were collected in REDCap software, and analysed using Statistical Package for Social Sciences (version 23).</p><p><strong>Results: </strong>Only 35.1% of users had a strong affiliation with their PHC facility. Overall, the primary care score suggested that performance was acceptable to the majority of users (58.9% rating performance at least acceptable). Ongoing care was rated by users as very poor (<25% of people rating it at least acceptable). Comprehensiveness (services available) was rated poor by users (<u><</u>50% finding it at least acceptable). Users rated first-contact access and coordination (information systems) acceptable (51-75% finding them at least acceptable). Person-centredness and comprehensiveness (services provided) were rated good by users (>75% rating them as acceptable or more). Providers and users differed significantly (<i>P</i> value <0.05) in their scoring across all domains, with providers usually more positive. Performance significantly improved as the PHC level increased (<i>P</i> value <0.05).</p><p><strong>Conclusion: </strong>Primary care performance in the study district was suboptimal. The UG-PCAT identified primary care functions that needed improving and may be a useful tool to measure PHC performance across the region.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591837","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":"Risk factors for poor prognosis in adult outpatient urinary tract infection: meta-analysis.","authors":"Peter K Kurotschka, Felix Kannapin, Andreas Klug, Maria Chiara Bassi, Ildikó Gágyor, Mark Ebell","doi":"10.3399/BJGPO.2024.0298","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0298","url":null,"abstract":"<p><strong>Background: </strong>Risk factors for poor prognosis in outpatient urinary tract infection (UTI) vary across studies and clinical guidelines.</p><p><strong>Aim: </strong>To review the evidence on risk factors for poor prognosis in adults' UTI.</p><p><strong>Design&setting: </strong>Systematic review and meta-analysis.</p><p><strong>Method: </strong>Five databases and citations of included studies were searched. Two reviewers independently screened studies, abstracted data, and assessed risk of bias (RoB). Random-effects meta-analysis of relative risks and adjusted odds ratios (aORs) were performed for risk factors reported by≥3 studies.</p><p><strong>Results: </strong>Thirty-five cohort studies including 1 532 790 adults with cystitis or pyelonephritis (PN) were included. Ten were at moderate to high RoB. Increasing age was the only independent predictor of re-consultation (aOR 1.18 per decade). Hospitalization was associated with high procalcitonin (aOR 5.12), increasing age (aOR 3.51 if≥65 years; aOR 1.27 per decade), hypotension (aOR 3.29), fever>38°C (aOR 2.08), elevated C-reactive protein (aOR 1.62), creatinine≥1.2 mg/dL (aOR 1.56), male sex (aOR 1.41) and diabetes (aOR 1.34). In the only study on mortality, among patients aged≥65 with cystitis, this outcome was associated with no antibiotics, older age, hospitalization or antibiotics in prior month, higher comorbidity index, and smoking.</p><p><strong>Conclusions: </strong>Age, male sex, elevated CRP and diabetes are predictors of adverse outcomes in both, patients with cystitis and PN. Elevated PCT, creatinine, hypotension and fever predict hospitalization in patients with PN only. These findings support risk stratification and patient management, but further studies are needed to consolidate knowledge on risk factors, especially for patients with cystitis.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015495","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":"Perception of antimicrobial stewardship interventions in Swiss primary care: a mixed-methods survey.","authors":"Simeon Schaad, Jelena Dunaiceva, Arnaud Peytremann, Sophie Gendolla, Lauren Clack, Catherine Plüss-Suard, Anne Niquille, Anna Nicolet, Joachim Marti, Noémie Boillat-Blanco, Aline Wolfensberger, Yolanda Mueller","doi":"10.3399/BJGPO.2024.0110","DOIUrl":"10.3399/BJGPO.2024.0110","url":null,"abstract":"<p><strong>Background: </strong>With most antibiotic prescriptions occurring in primary care, antimicrobial stewardship (AMS) interventions must be known, welcomed, and used by primary care physicians (PCPs).</p><p><strong>Aim: </strong>The main objective of this study was to evaluate the present awareness about, use of, and perceived acceptability, appropriateness, and feasibility of a broad range of interventions.</p><p><strong>Design & setting: </strong>A cross-sectional survey was distributed to Swiss PCPs from December 2023 to February 2024.</p><p><strong>Method: </strong>The survey focused on eight AMS interventions: shared decision-making tools, factsheets for physicians, Swiss Federal Office of Public Health (FOPH) information material, national antibiotic guidelines website, audit and feedback, communication skills training, as well as the use of point-of-care C-reactive protein (POC-CRP) and procalcitonin (POC-PCT) to guide prescription. PCPs' perceived acceptability, appropriateness, and feasibility were assessed using 5-point Likert scales. General expectations regarding AMS were evaluated via qualitative analysis of free-text answers.</p><p><strong>Results: </strong>Out of 7456 potentially eligible primary care physicians, 355 PCPs answered at least one question (response rate 4.7%). PCPs were most aware of biomarkers to guide antibiotic prescription in respiratory tract infections (RTIs), such as POC-PCT (67.6%) and POC-CRP (61.1%); the FOPH awareness campaign (57.3%); and the national guidelines website (52.7%). All interventions were rated as acceptable, appropriate, and feasible, with respective mean scores out of five of 3.89, 3.91, and 3.81.</p><p><strong>Conclusion: </strong>Despite the high perceived acceptability, appropriateness, and feasibility of AMS interventions available for RTIs, their real-life impact may be hindered by insufficient awareness. Additional promotion of those tools could increase their uptake by physicians.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802560","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":"Treatment patterns and burden of uncomplicated urinary tract infection in England: a retrospective cohort study.","authors":"Mark H Wilcox, Dave Heaton, Aruni Mulgirigama, Ashish V Joshi, Viktor Chirikov, Daniel C Gibbons, David Webb, Xiaocong L Marston, Myriam Na Alexander, Fanny S Mitrani-Gold","doi":"10.3399/BJGPO.2024.0214","DOIUrl":"10.3399/BJGPO.2024.0214","url":null,"abstract":"<p><strong>Background: </strong>Uncomplicated urinary tract infections (uUTIs) are common bacterial infections.</p><p><strong>Aim: </strong>To evaluate the burden of uUTI in England for 1) potential determinants of disease progression; 2) extent and impact of antimicrobial prescribing non-concordant with treatment guidelines; and 3) healthcare burden and economic costs.</p><p><strong>Design & setting: </strong>Retrospective cohort study utilising patient data (January 2017-February 2020) from the Clinical Practice Research Datalink (CPRD) linked to English Hospital Episode Statistics.</p><p><strong>Method: </strong>Female patients aged ≥12 years with a new uUTI between 2018 and 2019, ≥14 months' continuous CPRD enrolment (≥12 months baseline, ≥2 months follow-up), and ≥1 oral antibiotic prescription ±5 days of uUTI diagnosis were included. Baseline characteristics were described in patients with or without disease progression (hospitalisation for acute pyelonephritis, bacteraemia, or sepsis). Treatment non-concordance with current English guidelines was assessed. Burden (all-cause and urinary tract infection-related healthcare resource use [HCRU] and costs) was evaluated in a 1:1 age and comorbidity-matched uUTI-free cohort.</p><p><strong>Results: </strong>Of 120 519 patients, 207 (0.2%) had disease progression requiring hospitalisation (during index uUTI episode); determinants included older age, index uUTI home consultation, prior hospitalisation, and medications prescribed for comorbid conditions in the prior 12 months (<i>British National Formulary</i> classes: cardiovascular system, eye, and other drugs and preparations). Non-concordant treatment was observed in 43.5% of patients. All-cause HCRU burden and costs were significantly higher in patients with uUTI versus age and comorbidity-matched controls (<i>P</i><0.001) at 28 days (£160.06 versus £37.63) and in the 12-month follow-up (£1206.77 versus £460.97).</p><p><strong>Conclusion: </strong>All-cause HCRU burden and costs were significantly higher in patients with uUTI versus matched controls (<i>P</i><0.001). Hospitalisation for acute pyelonephritis, bacteraemia, or sepsis following uUTI was uncommon.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819530","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":"General Practice Community Pharmacist Consultation Service: an exploratory patient survey.","authors":"Julia Gauly, Catherine Grimley, Jeremy Dale, Paramjit Gill, Helen Atherton","doi":"10.3399/BJGPO.2024.0204","DOIUrl":"10.3399/BJGPO.2024.0204","url":null,"abstract":"<p><strong>Background: </strong>The General Practice Community Pharmacist Consultation Service (GPCPCS) was established to allow patients with certain minor illnesses to be referred to a community pharmacy for assessment and treatment.</p><p><strong>Aim: </strong>To explore patients' experiences of the GPCPCS.</p><p><strong>Design & setting: </strong>An online survey in two regions of England.</p><p><strong>Method: </strong>Twenty-five general practices invited patients to take part in an exploratory survey. Descriptive statistics were used for the analysis.</p><p><strong>Results: </strong>The response rate was 5.1% (72/1423). Prior to contacting their general practice, 14.1% (9/64) of patients had tried to speak to a pharmacist. Most responders accepted the GPCPCS referral (77.3%, 51/66); received a pharmacy consultation on the same day (80.0%, 40/50); and were largely satisfied with the amount of time the pharmacist spent with them (82.5%, 33/40), the consultation format (68.3%, 28/41), and the privacy provided during the consultation (80.9%, 38/47). However, most responders (56.5%, 39/69) felt poorly informed by the general practice on why they were being advised to speak to a pharmacist and did not feel that it was appropriate that they had been advised to speak to a community pharmacist (54.2%, 39/72). Only 33.3% (16/48) felt that their consultation fully met their health needs and 27.1% (13/48) of patients described being re-referred from pharmacy back to their general practice.</p><p><strong>Conclusion: </strong>In this exploratory study patients were largely accepting of the GPCPCS. Improvements in terms of explaining GPCPCS to patients, selecting patients appropriate for referral to the service, and the appointment process may be of benefit.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839826","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}