The European Journal of General Practice最新文献

{"title":"Survey of general practitioners' awareness, practice and perception of social prescribing across Europe.","authors":"S. Evers, Joyce Kenkre, T. Kloppe, D. Kurpas, Juan M Mendive, Ferdinando Petrazzuoli, Josep Vidal-Alaball","doi":"10.1080/13814788.2024.2351806","DOIUrl":"https://doi.org/10.1080/13814788.2024.2351806","url":null,"abstract":"BACKGROUND\u0000Social prescribing (SP) is a patient pathway by which healthcare professionals connect patients with other sources of support, groups, or activities within their community. The awareness, practice, and perception of SP among GPs across Europe remains unclear.\u0000\u0000\u0000OBJECTIVES\u0000To explore the awareness, practice, and perception of GPs on SP in the WONCA Europe region.\u0000\u0000\u0000METHODS\u0000An anonymous, cross-sectional online survey was distributed through a snowballing system, mailing lists, and at three international conferences in 2022/2023 to explore GPs' awareness, practice, and perception of SP. The questionnaire in English contained 21 open and closed questions.\u0000\u0000\u0000RESULTS\u0000Of the 208 participating GPs from 33 countries, 116 (56%) previously heard of 'social prescribing' and 66 (32%) regularly referred patients to community activities through a formal system. These 66 GPs reported different funding sources and varied activities, with an average of four activities and physical exercise being the most prevalent. Among them, 25 (38%) knew about national or local SP awareness campaigns. Of these 25, 17 (68%) agreed that SP increases their job satisfaction and 21 (84%) agreed that it has a positive impact on their patients. Variations in SP awareness and referral practice were evident across and within countries.\u0000\u0000\u0000CONCLUSION\u0000Despite disparities in awareness and referral practice as well as a diversity of activities and funding sources, most GPs who actively referred patients and were informed about SP campaigns agreed that SP positively impacts them and their patients.","PeriodicalId":383035,"journal":{"name":"The European Journal of General Practice","volume":"6 6","pages":"2351806"},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140963888","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":"Person-centred care and its outcomes in primary care. Selected Abstracts from the 96th EGPRN Meeting, Split–Croatia, 11–14 May 2023","authors":"Mine Kaya Bezgin","doi":"10.1080/13814788.2023.2248374","DOIUrl":"https://doi.org/10.1080/13814788.2023.2248374","url":null,"abstract":"Background: The environment and furniture of a medical workplace can influence both patient and health team satisfaction and healthcare structures projected carefully are an important point for humanisation of care. Several studies have been performed in hospital settings but only a few in primary care. Research question : How do family physicians choose to equip their practice? What do they think about their practice equipment and furniture? Methods : We designed a qualitative pilot study inspired by the photovoice methodology. We collected data through an anonymous online survey using a snowball sampling approach. In the first part of the survey, we collected socio-demographic variables. In the second part, we asked participants to upload: first, one or two pictures of their practices and explain what they liked or not and what they would have changed, second, a picture of the most important thing in their opinion in the practice adding the explanation why they made that choice. Written answers were analysed using thematic analysis, while participants ’ characteristics through descriptive statistics. A pilot analysis of the visual material is ongoing. Results : In the survey, 140 GPs participated but we obtained only 30 complete responses (79.17% dropout rate). With the thematic analysis of the written responses, we identified five main themes: environment and atmosphere, customisation, furniture and objects, collaboration, hygiene. Each theme contains sub themes that describe positive and negative aspects. Conclusion : The participants ’ answers suggested helpful tips for setting up a GP practice. It is important to create a wel-coming environment, being careful in choosing colours and furniture and not forgetting to add plants. The practice should include a space for a bedvisit and a proper privacy and a space for consultation. Finally, a customised environment, including personal objects, resulted central for GP motivation.","PeriodicalId":383035,"journal":{"name":"The European Journal of General Practice","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130899696","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":"Research on integrated community care: Focus on general practitioners, patients and the population. Selected abstracts from the 95th EGPRN conference Antwerp, Belgium, 20–23 October 2022","authors":"","doi":"10.1080/13814788.2023.2171395","DOIUrl":"https://doi.org/10.1080/13814788.2023.2171395","url":null,"abstract":"care professionals in Europe have applied these methods. Through the examples, it will (1) emphasise the relevance of separating the complex intervention from the strategies used to facilitate its uptake or dissemination, (2) demonstrate the value of examining processes as well as multi-level outcomes in its evaluation, and (3) highlight the importance of explor-ing contextual factors that influence the real-world effective- ness of complex interventions.","PeriodicalId":383035,"journal":{"name":"The European Journal of General Practice","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115956348","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":"Optimising the organisation of family medicine practice. Selected abstracts from the 94th EGPRN conference, Istanbul, Turkey, 12–15 May 2022","authors":"M. Akman","doi":"10.1080/13814788.2023.2171394","DOIUrl":"https://doi.org/10.1080/13814788.2023.2171394","url":null,"abstract":"Background: During the pandemic, not only SARS-CoV-2 infections and their complications have an impact on public health. The management of non-communicable diseases such as diabetes mellitus can be affected too. Patients may not receive the same quality of care because of pandemic. Research question: To determine the impact of the pandemic on quality and outcome of diabetes care. Method(s): Retrospective comparison of two cohorts in a primary care setting in Switzerland. Adult patients (>=18 years) with a diagnosis of diabetes mellitus and with at least one consultation with a general practitioner, between 17 March 2018 and 16 March 2019 (cohort 1) and 17 March 2019 and 16 March 2020 (cohort 2), were included and observed for two years (until 16 March 2020 and 16 March 2021, respectively). Quality indicators and outcomes of diabetes care at patient and practitioner level, were compared before and during the COVID-19 pandemic. Result(s): A total of 27,043 patients and 191 practices were included, 23,903 in cohort 1 and 25,092 in cohort 2. The fraction of patients lost to follow-up attributable to the pandemic was 28% [95% Confidence Interval: 25%, 30%]. At patient level, regular measurements of weight, Hemoglobin A1c (HbA1c), blood pressure and serum creatinine were less frequent during the pandemic. At the practitioner level, fewer patients reached the target of an HbA1c value <=7% and a blood pressure value of <140/90mmHg during the pandemic. However, more patients had an LDL-cholesterol value of <2.6 mmol/l. Although higher HbA1c values were observed in the months after lockdown, values converged to the same level for both cohorts by the end of the follow-up period. Conclusion(s): A considerable quality drop in diabetes mellitus care could be observed during the pandemic (17 March 2020-16 March 2021). However, HbA1c values converged to the same level for both cohorts at the end of the observation period. Thus, the long-term effect on relevant outcomes has not yet been visible.","PeriodicalId":383035,"journal":{"name":"The European Journal of General Practice","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130209951","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":"Fostering clinical research in general practice and family medicine. Selected abstracts from the 93rd EGPRN conference Halle, Germany, 14–17 October 2021","authors":"","doi":"10.1080/13814788.2023.2171393","DOIUrl":"https://doi.org/10.1080/13814788.2023.2171393","url":null,"abstract":"The topic of conducting clinical studies in the outpatient setting has been controversial for some time. This from a structural point of view on different levels. First, the question of which studies should be used is whether RCTs are preferred or whether it is better to collect real-world data to derive real-world evidence. Then on the organisational level. How should private practices be enabled to carry out studies of high quality and with the highest possible frequency? Feasibility currently correlates with a compara-tively high expenditure of time and personnel, which meets a thin personnel cover with only short treatment times for patients. Similarly, a strongly inhomogeneous IT landscape in practices, inhomogeneous organisational structures within the medical profession and professionally inhomogeneous guidelines, indicators, etc. are identified as obstacles to the implementation of studies. In addition, there is still a high wall between inpatient and outpatient care. This is an almost fatal situation because relevant and reli-able care data are collected daily but are rarely available for valid evaluation. The goal set out in the Geneva Declaration of sharing medical knowledge for patients ’ benefit and healthcare promotion will be difficult to achieve in its best form. However, another aspect is left out of the discussion. This is the increasing integration of innovative, sometimes disruptive changes in the healthcare market as part of the digital revo-lution, which also has the power to change the physician market permanently; this is entirely independent of the different designs and structures in the various healthcare sys- tems. In Germany, telemedicine, electronic patient files and electronic prescriptions are frequently mentioned, but these are no longer innovations; these tools have already been in use in other healthcare systems for a long time. However, they are indispensable for implementing further innovations, platforms and digital applications (digital printing, use of soft artificial intelligence, etc.). None of these innovations can do without accompanying evaluation and the discussion about reimbursement will always be decided","PeriodicalId":383035,"journal":{"name":"The European Journal of General Practice","volume":"110 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122591839","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":"Adapting patients' oncological treatment through remote participation of general practitioners in multi-disciplinary consultation meetings: A feasibility study.","authors":"Vladimir Druel,&nbsp;Laetitia Gimenez,&nbsp;Paul Tachousin,&nbsp;Nathalie Boussier,&nbsp;Eric Bauvin,&nbsp;Grosclaude Pascale,&nbsp;Odile Beyne-Rauzy,&nbsp;Marie-Eve Rougé Bugat","doi":"10.1080/13814788.2021.2003775","DOIUrl":"https://doi.org/10.1080/13814788.2021.2003775","url":null,"abstract":"<p><strong>Background: </strong>The general practitioner (GP) is central to managing patients with cancer, whose numbers are increasing worldwide. The GP's involvement requires better coordination between involved partners, in particular oncologists and GPs.</p><p><strong>Objectives: </strong>To conduct a feasibility study of remote participation of GPs in multi-disciplinary consultation meetings (MCMs). We analysed participation, participants' satisfaction, and their impact on therapeutic decisions.</p><p><strong>Methods: </strong>We conducted a feasibility study in the regional cancer centre of Toulouse, France. All patient cases discussed in the MCMs for myelodysplasia from 1 January to 31 March 2016 were included. Cases of patients aged over 18 years, with a diagnosis of myelodysplasia and registered with a GP were included if patients gave informed consent. One investigator collected the data provided by GPs during three telephone or video calls: before, during, and after the MCM, respectively.</p><p><strong>Results: </strong>Of 86 patient cases discussed during three months of MCMs, 44 were eligible for GP participation; 27 GPs participated in discussions of 27 patient cases. The GP's participation in the MCM led to a change in management in five cases, with four times treatment intensifications and once de-intensification. Medical, social, family-related, and psychological domains were discussed with input from the GPs. Overall, all participants were satisfied with the MCMs.</p><p><strong>Conclusion: </strong>Remote participation of GPs in MCMs is feasible and may result in adapting oncological and haematological management for patients. This patient-centred approach requires a specific organisation that, when implemented, satisfies the needs of all participants.</p>","PeriodicalId":383035,"journal":{"name":"The European Journal of General Practice","volume":" ","pages":"15-22"},"PeriodicalIF":3.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a9/b5/IGEN_28_2003775.PMC8865098.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39810318","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":"Experiences of patients with fibromyalgia at a Finnish Health Centre: A qualitative study.","authors":"Aleksi Varinen,&nbsp;Tiina Vuorio,&nbsp;Elise Kosunen,&nbsp;Tuomas H Koskela","doi":"10.1080/13814788.2022.2085683","DOIUrl":"https://doi.org/10.1080/13814788.2022.2085683","url":null,"abstract":"<p><strong>Background: </strong>Fibromyalgia is a functional syndrome. Despite recent findings, there is still considerable uncertainty about its diagnostic process.</p><p><strong>Objectives: </strong>This study aimed to explore patients' experiences with fibromyalgia during the diagnostic process in primary health care. Moreover, we tried to determine how diagnostic consultation could be improved.</p><p><strong>Methods: </strong>This study is based on data from patients with fibromyalgia in a primary health care study conducted in Nokia, Finland. Patients with fibromyalgia were identified from electronic medical records. Focus-group participants with fibromyalgia diagnoses were selected using a purposive sampling method to gather a maximum variation sample. Qualitative thematic analysis was used for the coded data from four focus-group discussions in 2018. A description of the coding tree was provided and researchers organised the codes. Finally, all researchers identified themes from the data.</p><p><strong>Results: </strong>The main unifying entities were the uncertainty and contradictions fibromyalgia patients faced on several occasions. Physicians sometimes offered other diagnoses - like depression - as an explanation for the symptoms, or used repetitive tests to eliminate other possible diagnoses. Furthermore, patients expressed their wishes for a holistic, empathetic, and up-to-date approach to their symptoms.</p><p><strong>Conclusion: </strong>In our interviews, a good doctor-patient relationship and continuity of care were necessary, as were the physician's attitude and knowledge of fibromyalgia. Our findings also suggest avoiding repeated or unnecessary rule-out tests and the overdiagnosis of psychiatric disorders is necessary.</p>","PeriodicalId":383035,"journal":{"name":"The European Journal of General Practice","volume":" ","pages":"157-164"},"PeriodicalIF":3.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40121166","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":"Familial colonoscopic screening: how do French general practitioners deal with patients and their high-risk relatives. A qualitative study.","authors":"Isabelle Ingrand,&nbsp;Nicolas Palierne,&nbsp;Pauline Sarrazin,&nbsp;Yvan Desbordes,&nbsp;Clara Blanchard,&nbsp;Pierre Ingrand","doi":"10.1080/13814788.2022.2089353","DOIUrl":"https://doi.org/10.1080/13814788.2022.2089353","url":null,"abstract":"<p><strong>Background: </strong>Screening of colorectal cancer (CRC) can reduce incidence and mortality. First-degree relatives (FDRs) of patients with CRC or advanced adenoma before the age of 65 (index patients) are at increased risk of CRC; however, the guidelines for screening of FDRs by colonoscopy are poorly followed.</p><p><strong>Objectives: </strong>The present study, conducted in the context of the COLOR3 interventional study project, aimed to explore the positioning of general practitioners (GPs) in familial CRC screening in France.</p><p><strong>Methods: </strong>From February 2020 to April 2021, 35 semi-structured interviews with GPs of index patients and/or their FDRs were conducted by telephone. The full-data transcribed corpus was subjected to horizontal thematic analysis.</p><p><strong>Results: </strong>Knowledge and compliance with the guidelines vary greatly between GPs. Although initiating the diagnostic process, GPs do not consider themselves as actors in the flow of information concerning familial risk. Their accompaniment of index patients in this role varies. GPs should overcome barriers to implementing colonoscopic screening for FDRs. They underline the importance of exploring family history, but they lack the time and doubt the reliability of the information given by FDRs.</p><p><strong>Conclusion: </strong>Challenges include circumventing gaps in knowledge, adherence to guidelines and improving family history updates. The GPs interviewed suggested personalised guidelines in specialists' reports to initiate information campaigns raising awareness of familial risk, and to enhance coordination between organised screening and familial screening.</p>","PeriodicalId":383035,"journal":{"name":"The European Journal of General Practice","volume":" ","pages":"182-190"},"PeriodicalIF":3.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9272923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40478067","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":"Digital technologies in primary care: Implications for patient care and future research.","authors":"Ana Luísa Neves,&nbsp;Jako Burgers","doi":"10.1080/13814788.2022.2052041","DOIUrl":"https://doi.org/10.1080/13814788.2022.2052041","url":null,"abstract":"<p><p>Digital health is the convergence of digital technologies with health, healthcare, living, and society. Contrasting with the slow trend during the last decades, in the last few years, we have observed an expansion and widespread adoption and implementation. In this paper, we revisit the potential that digital health presents for the delivery of higher quality, safer and more equitable care. Focussing on three examples - patient access to health records, big data analytics, and virtual care - we discuss the emerging opportunities and challenges of digital health, and how they can change primary care. We also reflect on the implications for research to evaluate digital interventions: the need to evaluate clear outcomes in light of the six dimensions of quality of care (patient-centredness, efficiency, effectiveness, safety, timeliness, and equity); to define clear populations to understand what works and for which patients; and to involve different stakeholders in the formulation and evaluation of the research questions. Finally, we share five wishes for the future of digital care in General Practice: the involvement of primary healthcare professionals and patients in the design and maintenance of digital solutions; improving infrastructure, support, and training; development of clear regulations and best practice standards; ensuring patient safety and privacy; and working towards more equitable digital solutions, that leave no one behind.</p>","PeriodicalId":383035,"journal":{"name":"The European Journal of General Practice","volume":" ","pages":"203-208"},"PeriodicalIF":3.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9278419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40492055","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":"GPs' involvement in specialised palliative home care: A mixed methods study in Germany.","authors":"Sophie Peter,&nbsp;Anna Maria Volkert,&nbsp;Lukas Radbruch,&nbsp;Roman Rolke,&nbsp;Raymond Voltz,&nbsp;Holger Pfaff,&nbsp;Nadine Scholten","doi":"10.1080/13814788.2022.2139824","DOIUrl":"https://doi.org/10.1080/13814788.2022.2139824","url":null,"abstract":"<p><strong>Background: </strong>General practitioners (GPs) are important providers of palliative home care (PHC). To deliver adequate palliative care, cooperation with specialised PHC teams is necessary. Specialised PHC is a type of care for severely ill patients by specialised providers. Little is known about the involvement of German GPs in specialised PHC.</p><p><strong>Objectives: </strong>To analyse GPs' experience with realised and desired involvement in specialised PHC. Realised involvement means GPs took part in specialised PHC patients' care. Desired involvement is GPs' hoped-for cooperation with specialised PHC teams: GPs could state whether they want to stay involved, be informed, or provide medical services themselves after referral to specialised PHC.</p><p><strong>Methods: </strong>Mixed methods design (focus group with 6 GPs; survey of 445 GPs in North Rhine, Germany, about their experiences in PHC/specialised PHC): Qualitative data was interpreted using content analysis. The authors developed a questionnaire and performed descriptive analysis based on qualitative results.</p><p><strong>Results: </strong>GPs are mostly satisfied with specialised PHC teams' care, although they report cooperation is not always optimal. GPs describe a high satisfaction with quality of care by specialised PHC teams. However, physicians with higher PC knowledge are less satisfied with specialised PHC. Also, GPs are often less involved in specialised PHC than they wish, especially when they have a higher PC qualification.</p><p><strong>Conclusion: </strong>In general, GPs are satisfied with the quality of care provided by specialised PHC teams but GPs do not always perceive cooperation as optimal. Involvement of GPs in specialised PHC needs to be improved.</p>","PeriodicalId":383035,"journal":{"name":"The European Journal of General Practice","volume":" ","pages":"224-233"},"PeriodicalIF":3.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9665080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40683927","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}