BJGP Open最新文献

{"title":"Qualitative evaluation of a molecular point-of-care testing study for influenza in UK primary care.","authors":"Charis Xuan Xie, Uy Hoang, Jessica Smylie, Carole Aspden, Elizabeth Button, Cecilia Okusi, Rachel Byford, Filipa Ferreira, Sneha Anand, Utkarsh Agrawal, Matthew Inada-Kim, Tristan Clark, Simon de Lusignan","doi":"10.3399/BJGPO.2024.0112","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0112","url":null,"abstract":"<p><strong>Background: </strong>Influenza contributes to the surge in winter infections and the consequent winter pressures on the health service. Molecular point-of-care testing(POCT) for influenza might improve patient management by providing rapid and accurate clinical diagnosis to inform the timely initiation of antiviral therapy and reduce unnecessary admissions and antibiotics use.</p><p><strong>Aim: </strong>To explore factors that influence the adoption or non-adoption of POCT in English general practices and provide insights to enable its integration into routine practice workflows.</p><p><strong>Design & setting: </strong>A qualitative implementation evaluation was conducted in ten general practices within the English national sentinel network (Oxford-RCGP Research and Surveillance Centre), from April to July 2023.</p><p><strong>Method: </strong>Using the nonadoption, abandonment, scale-up, spread, and sustainability framework, data collection and analysis were conducted across ten practices. We made ethnographic observations of the POCT workflow and surveyed the practice staff for their perspectives on POCT implementation. Data were analysed using a mix of descriptive statistics, graphical modelling techniques and framework approach.</p><p><strong>Results: </strong>Ethnographic observations identified two modes of POCT integration into practice workflow: 1) clinician POCT workflow - typically involving batch testing due to time constraints, 2) research nurse/healthcare assistant POCT workflow - characterised by immediate testing of individual patients. Survey indicated that most primary care staff considered the POCT training offered was sufficient, and these practices were ready for change and had the capacity and resources to integrate POCT in workflows.</p><p><strong>Conclusion: </strong>General practices should demonstrate flexibility in the workflow and workforce they deploy to integrate POCT into routine clinical workflow.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564684","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":"NHS national data opt-outs: trends and potential consequences for health data research.","authors":"John Tazare, Alasdair D Henderson, Jessica Morley, Helen A Blake, Helen I McDonald, Elizabeth J Williamson, Helen Strongman","doi":"10.3399/BJGPO.2024.0020","DOIUrl":"10.3399/BJGPO.2024.0020","url":null,"abstract":"<p><strong>Background: </strong>The English NHS data opt-out allows people to prevent use of their health data for purposes other than direct care. In 2021, the number of opt-outs increased in response to government-led proposals to create a centralised pseudonymised primary care record database.</p><p><strong>Aim: </strong>To describe the potential impact of NHS national data opt-outs in 2021 on health data research.</p><p><strong>Design & setting: </strong>We conducted a descriptive analysis of opt-outs using publicly available data and the potential consequences on research are discussed.</p><p><strong>Method: </strong>Trends in opt-outs in England were described by age, sex, and region. Using a hypothetical study, we explored statistical and epidemiological implications of opt-outs.</p><p><strong>Results: </strong>During the lead up to a key government-led deadline for registering opt-outs (from 31 May 2021-30 June 2021), 1 339 862 national data opt-outs were recorded; increasing the percentage of opt-outs in England from 2.77% to 4.97% of the population. Among females, percentage opt-outs increased by 83% (from 3.02% to 5.53%) compared with 76% in males (from 2.51% to 4.41%). Across age groups, the highest relative increase was among people aged 40-49 years, which rose from 2.89% to 6.04%. Considerable geographical variation was not clearly related to deprivation. Key research consequences of opt-outs include reductions in sample size and unpredictable distortion of observed measures of the frequency of health events or associations between these events.</p><p><strong>Conclusion: </strong>Opt-out rates varied by age, sex, and place. The impact of this and variation by other characteristics on research is not quantifiable. Potential effects of opt-outs on research and consequences for health policies based on this research must be considered when creating future opt-out solutions.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140029193","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 practitioners' decision making managing uncomplicated urinary tract infections in women: a qualitative study.","authors":"Peter K Kurotschka, Juliane Hemkeppler, David Gierszewski, Luca Ghirotto, Ildikó Gágyor","doi":"10.3399/BJGPO.2023.0224","DOIUrl":"10.3399/BJGPO.2023.0224","url":null,"abstract":"<p><strong>Background: </strong>To be effective, interventions aimed at increasing the appropriateness of antibiotic use in primary care should consider the perspectives of prescribing physicians.</p><p><strong>Aim: </strong>To explore the decision making of general practitioners (GPs) when managing uncomplicated urinary tract infections (uUTIs) in women.</p><p><strong>Design & setting: </strong>A qualitative study using semi-structured interviews with 22 GPs in Bavaria and Baden-Württemberg (southern Germany).</p><p><strong>Method: </strong>Verbatim transcripts were analysed through inductive qualitative content analysis.</p><p><strong>Results: </strong>We generated the following three main themes: factors facilitating the decision making; factors complicating the decision making; and consultation modalities. According to participants, following evidence-based recommendations makes the prescription decision smoother. GPs' and patients' prior experiences and beliefs guides decisions towards certain antibiotics, even if those experiences and beliefs contradict evidence-based recommendations. Patient expectations and demands also condition antibiotic prescribing, favouring it. Organisational constraints, such as time pressure, the day of the week (for example, before weekends), and a lower cost of antibiotics for patients than alternative treatments favour the decision to prescribe antibiotics. Diagnostic and prognostic uncertainty complicates decision making, as does scepticism towards evidence-based recommendations. Discordance within the patient-doctor relationship contributed to this complexity. Regarding consultation modalities, a more in-depth consultation and shared decision making were seen as helpful in this process.</p><p><strong>Conclusion: </strong>We identified different factors as intervening against or for a straightforward management decision when dealing with women with uUTIs. They reveal the complexity behind the GPs' decision making. Providing GPs with easy-to-apply guidance while removing economic constraints to allocate sufficient consultation time, and supporting shared decision making may help GPs appropriately manage uUTIs in women.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139997670","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":"Family medicine and general practitioner supervisor wellbeing: a literature review.","authors":"Shaun Prentice, Helen Mullner, Jill Benson, Margaret Kay","doi":"10.3399/BJGPO.2023.0230","DOIUrl":"10.3399/BJGPO.2023.0230","url":null,"abstract":"<p><strong>Background: </strong>Research examining general practice supervisor wellbeing has often been conducted within the context of trainee wellbeing and educational outcomes.</p><p><strong>Aim: </strong>To consolidate the current literature regarding the wellbeing of GP supervisors through a 'supervisor-wellbeing' lens.</p><p><strong>Design & setting: </strong>Literature review of original research studies on Embase, Ovid MEDLINE, and Ovid PsycINFO from inception to December 2022.</p><p><strong>Method: </strong>The Embase, Ovid MEDLINE, and Ovid PsycINFO databases were systematically searched from inception to December 2022. Original research studies were eligible if they explored any aspect of wellbeing or burnout (that is, construct conceptualisations, risk and protective factors, implications, or interventions) among GPs involved in educating GP trainees. Reporting quality of included studies was assessed using the QualSyst tool. Results from included studies were narratively synthesised.</p><p><strong>Results: </strong>Data from 26 independent samples were reviewed. Burnout was generally conceptualised using the Leiter and Maslach model. Wellbeing was poorly defined in the literature, largely being conceptualised in personal psychological terms and, to a lesser extent, professional satisfaction. Risk and protective factors were identified and grouped as individual (for example, satisfaction with capacity to teach) and external (for example, autonomy, collegial relationships, resource availability) factors. GP supervisors' wellbeing appeared to affect their job performance and retention. This review identified only two studies evaluating interventions to support GP supervisors' wellbeing.</p><p><strong>Conclusion: </strong>The present review highlights a lack of conceptual clarity and research examining interventions for GP supervisor wellbeing. It provides guidance for future research designed to maximise the wellbeing of GP supervisors and support the wellbeing of trainees.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140120988","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":"Practice visitations in primary care to improve performance of cardiovascular risk management: an observational study.","authors":"Geert Hjm Smits, Michiel L Bots, Monika Hollander, Ardine de Wit, Sander van Doorn","doi":"10.3399/BJGPO.2023.0213","DOIUrl":"10.3399/BJGPO.2023.0213","url":null,"abstract":"<p><strong>Background: </strong>Despite programmatic protocolised care and structured support, considerable variation is observed in completeness of registration and achieving targets of cardiovascular risk management (CVRM) between individual GPs in the Netherlands.</p><p><strong>Aim: </strong>To determine whether completeness of registration and achieved targets of cardiovascular risk factors improves with practice visitation.</p><p><strong>Design & setting: </strong>Observational study utilising the care group's database (2016-2019), comparing changes in registration and achieved targets in non-visited practices and visited practices.</p><p><strong>Method: </strong>We compared completeness scores of registration and scores of targets achieved before visitation and 1 year after visitation. Data were analysed on patient level and GP level. Separate analyses were performed among GPs who were ranked in the lower 25% of score distributions.</p><p><strong>Results: </strong>We observed no clinically relevant improvements in completeness of registration and targets achieved in 2017, 2018, and 2019 that could be attributed to visitations in the previous year, both on individual patient level and on aggregated level per general practice. In practices ranked in the lower 25% of the distribution, improvements over time were clinically relevant and larger than the overall changes. Yet, these findings were irrespective of the number of practice visitations.</p><p><strong>Conclusion: </strong>Practice visitations in our setting did not seem to lead to improvements in practice performance, nor in completeness of registration of risk factors or in reaching predefined target goals for cardiovascular risk factors.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140120989","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":"GP access for inclusion health groups: perspectives and recommendations.","authors":"Aaminah Verity, Victoria Tzortziou Brown","doi":"10.3399/BJGPO.2024.0021","DOIUrl":"10.3399/BJGPO.2024.0021","url":null,"abstract":"<p><strong>Background: </strong>General practice has seen the widespread adoption of remote consulting and triage systems. There is a lack of evidence exploring how inclusion health populations have been impacted by this transformation.</p><p><strong>Aim: </strong>This study aimed to explore the post-pandemic GP access for inclusion health populations, through the lens of those with lived experience, and identify practical recommendations for improving access for this population.</p><p><strong>Design & setting: </strong>A mixed-methods study exploring the direct experience of people from inclusion health groups trying to access GP care in 13 practices in east London.</p><p><strong>Method: </strong>A mystery shopper exercise involving 39 in-person practice visits and 13 phone calls were undertaken. The findings were reflected on by a multidisciplinary stakeholder group, which identified recommendations for improvements.</p><p><strong>Results: </strong>Only 31% of the mystery shopper visits (<i>n</i> = 8) resulted in registration and the offer of an appointment to see a GP for an urgent problem. None of the mystery shoppers was able to book an appointment over the phone but <i>n</i> = 10/13 felt that they would be able to register and make an appointment if they followed the receptionist's instructions. Most mystery shoppers felt respected, listened to, and understood the information provided to them. Just under half of the practices (46%, <i>n</i> = 6) received positive comments on how accessible and supportive their spaces felt. Practice- and system-level recommendations were identified by the stakeholder group.</p><p><strong>Conclusion: </strong>Ongoing GP access issues persist for inclusion health populations. We identified practice- and system-level recommendations for improving access for this vulnerable population.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050567","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-based interventions for secondary prevention of opioid dependence in chronic non-cancer pain patients on pharmaceutical opioids: systematic review.","authors":"Clare French, David M Troy, Sarah Dawson, Michael Dalili, Matthew Hickman, Kyla Thomas","doi":"10.3399/BJGPO.2024.0122","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0122","url":null,"abstract":"<p><strong>Background: </strong>Globally almost one third of adults with chronic non-cancer pain (CNCP) are prescribed opioids. Prevention of opioid dependence among these patients is a public health priority.</p><p><strong>Aim: </strong>Synthesise the evidence on the effectiveness of primary care-based interventions for secondary prevention of opioid dependence in CNCP patients on pharmaceutical opioids.</p><p><strong>Design & setting: </strong>Systematic review of randomised controlled trials (RCTs) and comparative non-randomised studies of interventions from high-income countries.</p><p><strong>Method: </strong>We searched five databases for studies on non-tapering secondary prevention interventions such as tools for predicting dependence, screening tools for early recognition of dependence, prescribing/medication monitoring, and specialist support. We examined multiple outcomes, including reduction in opioid dosage. Primary analyses were restricted to RCTs with data synthesised using an effect direction plot. Risk of bias was assessed using the Cochrane risk of bias (RoB2) tool.</p><p><strong>Results: </strong>Of 7,102 identified reports, 18 studies were eligible (8 RCTs). Most used multiple interventions/components. Of the seven RCTs at low risk of bias or 'some concerns', five showed a positive intervention effect on at least one relevant outcome, four of which included a nurse care manager and/or other specialist support. The remaining two RCTs showed no positive effect of automated symptom monitoring and optimised analgesic management by a nurse care manager/physician pain specialist team, or of a mobile opioid management app.</p><p><strong>Conclusion: </strong>We identify a clear need for further adequately powered high quality studies. The conclusions that can be drawn on intervention effectiveness are limited by the sparsity and inconsistency of available data.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535587","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":"Chronic disease medication management at home. A quantitative survey among 180 patients.","authors":"Sabine Bayen, Yolaine Haegeman, Nassir Messaadi, Marc Bayen, Maurice Ponchant, Anthony Haro, François Quersin, Matthieu Calafiore","doi":"10.3399/BJGPO.2024.0027","DOIUrl":"https://doi.org/10.3399/BJGPO.2024.0027","url":null,"abstract":"<p><strong>Background: </strong>In France, 40% of people aged over 16 (20 million) report having at least one chronic disease requiring long-term treatment. Compliance is estimated to be 50% on average.</p><p><strong>Aim: </strong>To study the practical management of oral treatments at home by people living with one or more chronic diseases.</p><p><strong>Design & setting: </strong>Thirty general practitioners in France were invited by e-mail to enrol ten consecutive patients with chronic diseases.</p><p><strong>Method: </strong>A quantitative, descriptive, observational, cross-sectional study was carried out using standardised questionnaires to assess the socio-demographic profile of doctors and patients and the management of oral medication at home.</p><p><strong>Results: </strong>Twenty general practitioners collected 180 questionnaires: 69.4% said they did not find taking their medication a problem; 42.8% used a pillbox; 79.4% said they knew 'all' their medications. 61% reported forgetting to take their medication.</p><p><strong>Conclusion: </strong>More than half of patients are non-adherent. Personalised reminders could reduce unintentional medication non-adherence.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535586","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":"Symptomatic diagnoses in primary care: an observational cohort study.","authors":"Mika T Lehto, Timo Kauppila, Hannu Kautiainen, Merja K Laine, Ossi Rahkonen, Kaisu H Pitkälä","doi":"10.3399/BJGPO.2023.0234","DOIUrl":"https://doi.org/10.3399/BJGPO.2023.0234","url":null,"abstract":"<p><strong>Background: </strong>Among primary health care patients, it is sometimes impossible to assign a definitive diagnosis for the patient's reported or observed symptoms. Therefore, symptomatic diagnoses are often used.</p><p><strong>Aim: </strong>The aim of the present study was to examine the proportion of symptomatic diagnoses among primary health care patients. We also explored which symptomatic diagnoses were most frequently recorded as well as their age and gender distribution.</p><p><strong>Design & setting: </strong>This is a register-based study in the public primary health care of the city of Vantaa, Finland.</p><p><strong>Method: </strong>Diagnoses were entered according to the 10th revision of the International Classification of Diseases (ICD-10). The data consisted of every diagnosis entered into the electronic health record between January first 2016 and December 31st 2018. Both absolute numbers and relative proportions of various symptomatic diagnosis recordings (chapter 'R') were reported.</p><p><strong>Results: </strong>Of all the recorded diagnoses (N=503,001), the proportion of R-diagnoses was 13.5% (N=67,905). Diagnoses of symptoms and signs involving the digestive system and abdomen (R10-19) (4.1% of all; n=18,550), the circulatory and respiratory systems (R00-09) (3.9%; n=17,426), general symptoms and signs (R50-69) (3.4%; n=15,165), and the skin and subcutaneous tissue (R20-23) (2.2%; n=9,812) were the most prevalent. Age was also a major factor determining how the symptomatic diagnoses were distributed between women and men. Overall, the symptomatic diagnoses were more common among women than men (14.1% and 12.4%, respectively). The major symptomatic diagnosis categories, including symptoms and signs involving the digestive system and abdomen, the skin and the subcutaneous tissue, and general symptoms and signs, were more predominant among women, while symptoms and signs involving the circulatory and respiratory systems were more common among men.</p><p><strong>Conclusion: </strong>A symptomatic diagnosis code was recorded in about one eighth of the GP appointments, although there were significant sex differences in the prevalence within and between diagnosis groups.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141427818","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 contact, clinical management and suicide risk following discharge from inpatient mental health care.","authors":"Rebecca Musgrove, Matthew J Carr, Nav Kapur, Carolyn A Chew-Graham, Faraz Mughal, Darren M Ashcroft, Roger T Webb","doi":"10.3399/BJGPO.2023.0165","DOIUrl":"https://doi.org/10.3399/BJGPO.2023.0165","url":null,"abstract":"<p><strong>Background: </strong>Evidence is sparse regarding service usage and the clinical management of people recently discharged from inpatient psychiatric care who die by suicide.</p><p><strong>Aim: </strong>To improve understanding of how people discharged from inpatient mental health care are supported by primary care during this high-risk transition.</p><p><strong>Design & setting: </strong>A nested case-control study utilising interlinked primary and secondary care records in England for people who died within a year of discharge between 2001 and 2019, matched on age, sex, practice-level deprivation and region with up to 20 living discharged people.</p><p><strong>Method: </strong>We described patterns of consultation, prescription of psychotropic medication and continuity of care for people who died by suicide and those who survived. Mutually adjusted relative risk estimates were generated for a range of primary care and clinical variables.</p><p><strong>Results: </strong>Over 40% of patients who died within 2 weeks and 80% who died later had at least one primary care consultation. Evidence of discharge communication from hospital was infrequent. Within-practice continuity of care was relatively high. Those who died by suicide were less likely to consult within two weeks of discharge, AOR 0.61 (0.42-0.89), more likely to consult in the week before death, AOR 1.71 (1.36-2.15), to be prescribed multiple types of psychotropic medication, (AOR 1.73, 1.28-2.33), to experience readmission and have a diagnosis outside of the 'Severe Mental Illness' definition.</p><p><strong>Conclusion: </strong>Primary care clinicians have opportunities to intervene and should prioritise patients experiencing transition from inpatient care. Clear communication and liaison between services is essential to provide timely support.</p>","PeriodicalId":36541,"journal":{"name":"BJGP Open","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311847","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}