The European Journal of General Practice最新文献_第3页

The EGPRN Research Strategy for general practice in Europe EGPRN在欧洲的全科实践研究战略

The European Journal of General Practice Pub Date : 2022-06-06 DOI: 10.1080/13814788.2022.2080815

C. Collins

{"title":"The EGPRN Research Strategy for general practice in Europe","authors":"C. Collins","doi":"10.1080/13814788.2022.2080815","DOIUrl":"https://doi.org/10.1080/13814788.2022.2080815","url":null,"abstract":"Abstract The European General Practice Research Network (EGPRN) has recently published an updated research strategy with the overall aim being to promote relevant research of the highest quality within general practice/family medicine (GP/FM). The Research Strategy indicates a global direction and serves as a basis for more detailed plans in individual countries that will take into account the characteristics of a country, its specific needs and the level of current research capacity. This paper aims to provide a summary of the EGPRN Research Strategy. The Research Strategy suggests that it is necessary to consider what the knowledge deficits are and to set research priorities. Research capacity building (RCB) is required at all levels. Research in GP/FM will also have to reflect the changes in the profession. An innovative and sustainable-oriented approach to conducting research is needed. Use of existing toolkits and engagement with patient platforms and representative groups are necessary to ensure meaningful user involvement. Knowledge transfer and exchange (KTE) is an important component to ensure a process of exchange between researchers and knowledge users. Working to improve leadership, to support the creation of a research culture in GP/FM and to increase national and international networking are considered as fundamental to ensuring a portfolio of high-quality research and for improving the impact of GP/FM research. The recommendations in the Research Strategy are based on a review of the literature on general practice research from 2010 to 2019 and are set in the context of a theoretical framework.","PeriodicalId":383035,"journal":{"name":"The European Journal of General Practice","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129946142","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}

引用次数: 5

Integrating general practitioners into crisis management would accelerate the transition from victim to effective professional: Qualitative analyses of a terrorist attack and catastrophic flooding 将全科医生纳入危机管理将加速从受害者向有效专业人员的转变:对恐怖袭击和灾难性洪水进行定性分析

The European Journal of General Practice Pub Date : 2022-05-27 DOI: 10.1080/13814788.2022.2072826

Bernard Clary, Bélinda Baert, G. Bourrel, M. Amouyal, B. Lognos, Agnès Oude-Engberink, E. Million

{"title":"Integrating general practitioners into crisis management would accelerate the transition from victim to effective professional: Qualitative analyses of a terrorist attack and catastrophic flooding","authors":"Bernard Clary, Bélinda Baert, G. Bourrel, M. Amouyal, B. Lognos, Agnès Oude-Engberink, E. Million","doi":"10.1080/13814788.2022.2072826","DOIUrl":"https://doi.org/10.1080/13814788.2022.2072826","url":null,"abstract":"Abstract Background In 2018, Trèbes, 6,000 inhabitants with nine general practitioners (GPs) in southern France, experienced two tragedies; a terrorist attack in March, in which four people were killed, and a catastrophic flood in October, in which six people died and thousands more were affected. Objectives We aimed to obtain a substantive theory for improving crisis management by understanding the personal and professional effects of the two successive disasters on GPs in the same village. Methods This qualitative study conducted complete interviews with eight GPs individually, with subsequent analyses involving the conceptualisation of categories based on grounded theory. Results The analysis revealed that GPs underwent a double status transition. First, doctors who experienced the same emotional shock as the population became victims; their usual professional relationship changed from empathy to sympathy. The helplessness they felt was amplified by the lack of demand from the state to participate in the first emergency measures; consequently, they lost their professional status. In a second phase, GPs regained their values and skills and acquired new ones, thus regaining their status as competent professionals. In this context, the participants proposed integrating a coordinated crisis management system and the systematic development of peer support. Conclusion We obtained valuable information on the stages of trauma experienced by GPs, allowing a better understanding of the effects on personal/professional status. Thus, the inclusion of GPs in adaptive crisis management plans would limit the effects of traumatic dissociation while increasing their professional effectiveness.","PeriodicalId":383035,"journal":{"name":"The European Journal of General Practice","volume":"324 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124576488","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}

引用次数: 0

General practitioners' attitude towards cooperation with other health professionals in managing patients with multimorbidity and polypharmacy: A cross-sectional study 全科医生对与其他卫生专业人员合作管理多病多药患者的态度:一项横断面研究

The European Journal of General Practice Pub Date : 2022-05-20 DOI: 10.1080/13814788.2022.2044781

H. Carrier, Anna Zaytseva, A. Bocquier, P. Villani, M. Fortin, P. Verger

{"title":"General practitioners' attitude towards cooperation with other health professionals in managing patients with multimorbidity and polypharmacy: A cross-sectional study","authors":"H. Carrier, Anna Zaytseva, A. Bocquier, P. Villani, M. Fortin, P. Verger","doi":"10.1080/13814788.2022.2044781","DOIUrl":"https://doi.org/10.1080/13814788.2022.2044781","url":null,"abstract":"Abstract Background Cooperation between general practitioners (GPs) and other healthcare professionals appears to help reduce the risk of polypharmacy-related adverse events in patients with multimorbidity. Objectives To investigate GPs profiles according to their opinions and attitudes about interprofessional cooperation and to study the association between these profiles and GPs’ characteristics. Methods Between May and July 2016, we conducted a cross-sectional survey of a panel of French GPs about their management of patients with multimorbidity and polypharmacy, focussing on their opinions on the roles of healthcare professionals and interprofessional cooperation. We used agglomerative hierarchical cluster analysis to identify GPs profiles, then multivariable logistic regression models to study their associations with the characteristics of these doctors. Results 1183 GPs responded to the questionnaire. We identified four profiles of GPs according to their declared attitudes towards cooperation: GPs in the ‘very favourable’ profile (14%) were willing to cooperate with various health professionals, including the delegation of some prescribing tasks to pharmacists; GPs in the ‘moderately favourable’ profile (47%) had favourable views on the roles of health professionals, with the exception for this specific delegation of the task; GPs from the ‘selectively favourable’ profile (27%) tended to work only with doctors; GPs from the ‘non-cooperative’ profile (12%) did not seem to be interested in cooperation. Some profiles were associated with GPs’ ages or participation in continuing medical education. Conclusion Our study highlights disparities between GPs regarding cooperation with other professionals caring for their patients and suggests ways to improve cooperation.","PeriodicalId":383035,"journal":{"name":"The European Journal of General Practice","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129660932","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}

引用次数: 2

Chronic hepatitis C: Diagnosis and treatment made easy 慢性丙型肝炎:诊断和治疗变得容易

The European Journal of General Practice Pub Date : 2022-05-17 DOI: 10.1080/13814788.2022.2056161

N. Abu-Freha, Binil Mathew Jacob, Ali Elhoashla, Z. Afawi, Talab Abu-Hammad, Foad Elsana, S. Paz, O. Etzion

{"title":"Chronic hepatitis C: Diagnosis and treatment made easy","authors":"N. Abu-Freha, Binil Mathew Jacob, Ali Elhoashla, Z. Afawi, Talab Abu-Hammad, Foad Elsana, S. Paz, O. Etzion","doi":"10.1080/13814788.2022.2056161","DOIUrl":"https://doi.org/10.1080/13814788.2022.2056161","url":null,"abstract":"Abstract Background Hepatitis C Virus (HCV) is a common cause of chronic liver disease and its ensuing complications. In the last years, there has been a revolution of the treatment for patients with HCV regarding efficacy, simplicity, safety and duration of treatment. The role of the family physician is vital in all steps of care: screening, diagnosis, linkage to treatment, treatment and follow-up. Objectives This review aims to summarise the family physician and the important updated recommendations for diagnosis and treatment of patients with chronic HCV. Methods The updated recommendations were reviewed and summarised in a short and simple review. Results Patients with any risk factor for HCV should first be screened for HCV antibodies. In the case of positive antibodies, reflex testing for RNA polymerase chain reaction (PCR) should be done without waiting for genotype. For patients with positive PCR, fibrosis assessment should be conducted using laboratory panels (Fibrosis-4 index (FIB-4) or aspartate aminotransferase to platelet ratio index (APRI)); if advanced fibrosis is suspected, additional non-invasive fibrosis assessment is needed, such as fibrotest or liver elastography. Naïve non-cirrhotic or compensated cirrhosis (Child-Pugh-Score A) could be treated with pangenotypic drugs, Glecaprevir/pibrentasvir (Maviret) for eight weeks, or Sofosbuvir/velpatasvir (Epclusa) for 12 weeks. Conclusion Patients without advanced fibrosis and comorbidities can be treated by the educated family physician. However, patients with comorbidities, cirrhosis or coinfection (HIV, Hepatitis B Virus (HBV)) should be referred to the liver clinic. In case of screening patients with risk factors or likelihood of dormant HCV, health organisations should provide the appropriate resources, logistics, finances and workforce.","PeriodicalId":383035,"journal":{"name":"The European Journal of General Practice","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125030041","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}

引用次数: 8

Family history tools for primary care: A systematic review 用于初级保健的家族史工具:系统回顾

The European Journal of General Practice Pub Date : 2022-05-05 DOI: 10.1080/13814788.2022.2061457

Špela Miroševič, Z. Klemenc-Ketiš, B. Peterlin

{"title":"Family history tools for primary care: A systematic review","authors":"Špela Miroševič, Z. Klemenc-Ketiš, B. Peterlin","doi":"10.1080/13814788.2022.2061457","DOIUrl":"https://doi.org/10.1080/13814788.2022.2061457","url":null,"abstract":"Abstract Background Many medical family history (FH) tools are available for various settings. Although FH tools can be a powerful health screening tool in primary care (PC), they are currently underused. Objectives This review explores the FH tools currently available for PC and evaluates their clinical performance. Methods Five databases were systematically searched until May 2021. Identified tools were evaluated on the following criteria: time-to-complete, integration with electronic health record (EMR) systems, patient administration, risk-assessment ability, evidence-based management recommendations, analytical and clinical validity and clinical utility. Results We identified 26 PC FH tools. Analytical and clinical validity was poorly reported and agreement between FH and gold standard was commonly inadequately reported and assessed. Sensitivity was acceptable; specificity was found in half of the reviewed tools to be poor. Most reviewed tools showed a capacity to successfully identify individuals with increased risk of disease (6.2–84.6% of high and/or moderate or increased risk individuals). Conclusion Despite the potential of FH tools to improve risk stratification of patients in PC, clinical performance of current tools remains limited as well as their integration in EMR systems. Twenty-one FH tools are designed to be self-administered by patients.","PeriodicalId":383035,"journal":{"name":"The European Journal of General Practice","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123558700","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}

引用次数: 6

Improved health status of severe COPD patients after being included in an integrated primary care service: A prospective cohort study 纳入综合初级保健服务后改善严重COPD患者的健康状况:一项前瞻性队列研究

The European Journal of General Practice Pub Date : 2022-04-12 DOI: 10.1080/13814788.2022.2059070

C. De Jong, J. V. van Boven, M. D. de Boer, J. Kocks, M. Berger, T. van der Molen

{"title":"Improved health status of severe COPD patients after being included in an integrated primary care service: A prospective cohort study","authors":"C. De Jong, J. V. van Boven, M. D. de Boer, J. Kocks, M. Berger, T. van der Molen","doi":"10.1080/13814788.2022.2059070","DOIUrl":"https://doi.org/10.1080/13814788.2022.2059070","url":null,"abstract":"Abstract Background Chronic obstructive pulmonary disease (COPD) is a prevalent lung disease. It is assumed that severe patients will receive better treatment in specialised care centres but the prevalence of severe COPD in primary care is high. Integrated primary care services combine input from several sources and advice from pulmonologists to provide general practitioners with support needed to improve diagnosis and treatment of patients with COPD. Objectives To evaluate patient-reported outcomes and costs of managing patients classified as GOLD D in an integrated primary care service over 12 months. Methods Patients were included in this 1-year prospective cohort study if they met the 2014 GOLD D criteria, were aged ≥ 40 years and gave written informed consent for this study. Recruitment took place through the patients’ general practitioners. The primary outcome was health status, assessed with the Clinical COPD Questionnaire (CCQ) and COPD Assessment Test (CAT). Secondary outcomes included self-reported exacerbations, quality-adjusted life years and health(care)-related costs. Results Forty-nine patients were included. At baseline, the mean CAT score was 15.9 and the median CCQ score was 1.7. After 12 months, scores had improved by 2.3 (95% confidence interval, 0.8–3.7) and 0.4 (95% confidence interval, 0.2–0.7), respectively. Percentage of patients with ≥2 exacerbations in the past 12 months also decreased from baseline (77.6%) to 12 months (16.7%). Changes in mean quarterly costs were small. Conclusion An integrated service for COPD based in primary care may improve the health status of patients with a large burden of disease while not increasing health care costs.","PeriodicalId":383035,"journal":{"name":"The European Journal of General Practice","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127752713","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}

引用次数: 2

Stop smoking advice by practice assistants after routine cervical screening in general practice: A qualitative exploration of potential barriers and enablers 全科常规子宫颈普查后执业助理的戒烟建议:对潜在障碍和促进因素的定性探讨

The European Journal of General Practice Pub Date : 2022-04-08 DOI: 10.1080/13814788.2022.2053105

M. B. Mansour, M. Crone, H. V. van Weert, N. Chavannes, K. V. van Asselt

{"title":"Stop smoking advice by practice assistants after routine cervical screening in general practice: A qualitative exploration of potential barriers and enablers","authors":"M. B. Mansour, M. Crone, H. V. van Weert, N. Chavannes, K. V. van Asselt","doi":"10.1080/13814788.2022.2053105","DOIUrl":"https://doi.org/10.1080/13814788.2022.2053105","url":null,"abstract":"Abstract Background Cervical screening could be an appropriate routine moment to provide female smokers with tailored stop smoking advice. In Dutch general practice, cervical smears are performed by practice assistants. Objectives This study was performed in preparation for a randomised trial to identify potential barriers and enablers for a brief stop smoking strategy performed by trained practice assistants after routine cervical screening. Methods Between December 2016 and March 2017 three focus group meetings were held with ten practice assistants, three nurses, and six general practitioners to explore their views and expectations towards the proposed approach. We analysed data using thematic analysis. Identified factors are presented within the framework of the Social-Ecological Model. Results Potential barriers and enablers were identified at individual, interpersonal, and workplace levels. Practice assistants, nurses and GPs did not consider assistants to have a role in stop smoking care. They believed it is feasible to register smoking status but had reservations towards providing advice by assistants, for which knowledge and skills are needed. Practice assistants’ own beliefs about smokers and smokers’ response to stop smoking advice might influence how assistants and smokers interact. An explanation of why advice is given could help, provided assistants have enough time and experience with the smear. The nurses’ availability and general practitioners’ view on prevention might affect the delivery of the strategy by the assistant. Conclusion At individual, interpersonal, and workplace levels, several factors could influence the provision of a stop smoking strategy by a practice assistant.","PeriodicalId":383035,"journal":{"name":"The European Journal of General Practice","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131410716","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}

引用次数: 0

The impact of an intensive care unit admission on the health status of relatives of intensive care survivors: A prospective cohort study in primary care 重症监护病房入院对重症监护幸存者亲属健康状况的影响:一项初级保健前瞻性队列研究

The European Journal of General Practice Pub Date : 2022-04-07 DOI: 10.1080/13814788.2022.2057947

Rick Naaktgeboren, M. Zegers, Marco Peters, Reinier P. Akkermans, Hans J. G. Peters, M. van den Boogaard, F. A. van de Laar

{"title":"The impact of an intensive care unit admission on the health status of relatives of intensive care survivors: A prospective cohort study in primary care","authors":"Rick Naaktgeboren, M. Zegers, Marco Peters, Reinier P. Akkermans, Hans J. G. Peters, M. van den Boogaard, F. A. van de Laar","doi":"10.1080/13814788.2022.2057947","DOIUrl":"https://doi.org/10.1080/13814788.2022.2057947","url":null,"abstract":"Abstract Background Relatives of intensive care unit (ICU) survivors may suffer from various symptoms after ICU admittance of their relative, known as post-intensive care syndrome-family (PICS-F). Studies regarding PICS-F have been performed but its impact in primary care is unknown. Objectives To explore health problems of relatives of ICU survivors in primary care. Methods This is an exploratory prospective cohort study in which we combined data from two hospitals and a primary care research network in the Netherlands. ICU survivors who had been admitted between January 2005 and July 2017 were identified and matched by sex and age with up to four chronically ill (e.g. COPD, cardiovascular disease) patients. In both groups, relatives living in the same household were identified and included in this study. Primary outcome was the number of new episodes of care (International Classification of Primary Care-2) for up to five years. Hazard ratios (HRs) for the total number of new episodes were calculated. Results Relatives of ICU survivors (n = 267, mean age 38.1 years, 41.0% male) had significantly more new care episodes compared to the reference group (n = 705, mean age 36.3 years, 41.1% male) 1–2 years (median 0.11 vs. 0.08, HR 1.26; 95% confidence interval (CI) 1.03–1.54) and 2–5 years (median 0.18 vs. 0.13, HR 1.28; 95%CI 1.06–1.56) after ICU discharge. No differences were found in the period before ICU admission. Conclusion Relatives of ICU survivors present more morbidity in primary care than relatives of chronically ill patients up to five years after ICU discharge.","PeriodicalId":383035,"journal":{"name":"The European Journal of General Practice","volume":"143 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131612181","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}

引用次数: 7

Help-seeking behaviour in primary care of men and women with a history of abuse: A Dutch cohort study 有虐待史的男性和女性在初级保健中的求助行为:一项荷兰队列研究

The European Journal of General Practice Pub Date : 2022-04-05 DOI: 10.1080/13814788.2022.2054985

Anieck M Lomans, A. Uijen, R. Akkermans, T. Lagro-Janssen, D. Teunissen

{"title":"Help-seeking behaviour in primary care of men and women with a history of abuse: A Dutch cohort study","authors":"Anieck M Lomans, A. Uijen, R. Akkermans, T. Lagro-Janssen, D. Teunissen","doi":"10.1080/13814788.2022.2054985","DOIUrl":"https://doi.org/10.1080/13814788.2022.2054985","url":null,"abstract":"Abstract Background Previous studies show an association between a history of abuse and higher care demand. However, studies in general practice regarding help-seeking behaviour by patients (mainly male patients) with a history of abuse are scarce. Objectives To analyse help-seeking behaviour in general practice of men and women with a history of abuse. Methods A cohort study using data from a Dutch primary care registration network from 2015 to 2019. We included all patients aged ≥ 18 years who indicated on a questionnaire that they did or did not have a history of abuse. We analysed differences in contact frequency, types of contact, reason for encounter and diagnoses between men and women with or without a history of abuse. Results The questionnaire had a response rate of 59% and resulted in 11,140 patients, of which 1271 indicated a history of abuse. Men and women with a history of abuse contact the general practitioner (GP) 1.5 times (95% CI 1.42–1.60) more often than men and women without a history of abuse, especially for psychological (rate ratio 1.97, 95% CI 1.79–2.17) and social (rate ratio 1.93, 95% CI 1.68–2.22) problems. Moreover, when diagnosed with a psychological or social problem, patients with a history of abuse contact the GP twice more often for these problems. Conclusion Compared to men and women without a history of abuse, men and women with a history of abuse visit their GP more often, particularly for psychological and social problems.","PeriodicalId":383035,"journal":{"name":"The European Journal of General Practice","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130359978","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}

引用次数: 1

General practitioners’ perspectives on discontinuation of long-term antidepressants in nursing homes 全科医生对养老院停用长期抗抑郁药的看法

The European Journal of General Practice Pub Date : 2022-03-30 DOI: 10.1080/13814788.2022.2038131

Ellen Van Leeuwen, S. Anthierens, M. V. van Driel, A. De Sutter, Evelien van den Branden, T. Christiaens

{"title":"General practitioners’ perspectives on discontinuation of long-term antidepressants in nursing homes","authors":"Ellen Van Leeuwen, S. Anthierens, M. V. van Driel, A. De Sutter, Evelien van den Branden, T. Christiaens","doi":"10.1080/13814788.2022.2038131","DOIUrl":"https://doi.org/10.1080/13814788.2022.2038131","url":null,"abstract":"Abstract Background Long-term use of antidepressant drugs (AD), much longer than recommended by guidelines, in nursing homes (NH) is common. NH home residents may have a relatively higher risk of adverse events. Moreover, in an NH setting nursing staff and relatives are intensively involved in the decision-making process. In many countries, General Practitioners’ (GPs) provide care for residents in NHs. Little is known about GPs’ perspectives on discontinuation of long-term AD in NH residents. Objectives To explore GPs’ views of discontinuing long-term AD in NH residents. Methods An exploratory qualitative study, with semi-structured interviews, was conducted with a purposive sample of 20 Belgian GPs. Interviews, conducted over six months in 2019, were analysed by thematic analysis. Results Twenty interviews were conducted until data saturation. The first theme, ‘reluctance to rock the boat: not worth taking the risk’, describes that GPs perceive discontinuation as an unpredictable risk without clear benefits. GPs’ main concern was the risk of destabilising the fragile balance in an older patient. Second, ‘it takes at least three to tango’, captures the unspoken alliance between GPs, nursing staff and relatives and suggests that agreement of at least these three partners is required. The third, ‘Opening the door: triggers to discontinue’, points to severe health problems and dementia as strong facilitators for discontinuation. Conclusion Discontinuation of long-term AD in NHs is a complex process for GPs. More evidence and attention to the role nursing staff and relatives play are needed to better guide the discontinuation of AD in older NH patients.","PeriodicalId":383035,"journal":{"name":"The European Journal of General Practice","volume":"323 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122779827","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}

引用次数: 1