The British journal of general practice : the journal of the Royal College of General Practitioners最新文献

{"title":"Experience and impacts of violence and abuse by patients and the public towards general practice staff: a qualitative study.","authors":"Shihning Chou, Edward Tyrrell, Emma Rowe, Julie Bryant","doi":"10.3399/BJGP.2025.0685","DOIUrl":"10.3399/BJGP.2025.0685","url":null,"abstract":"<p><strong>Background: </strong>General practice (family medicine) experiences more violence and abuse by patients and the public than in general hospital settings. Qualitative accounts on how violence and abuse are experienced and perceived remain limited in both breadth and depth.</p><p><strong>Aim: </strong>To explore direct and indirect experiences of violence and abuse that general practice staff have encountered from patients and the public, and the perceived impact on staff wellbeing and their practice.</p><p><strong>Design and setting: </strong>This qualitative study was the second part of a mixed-methods project, following an online nationwide survey of England. Participants were invited to an interview at the end of the survey.</p><p><strong>Method: </strong>Data were collected via semi-structured interviews conducted between August and December 2023. Quantitative survey responses were extracted to describe the characteristics of participants, their experience of violence and abuse, and feelings of safety and support at work. Interviews were transcribed and thematically analysed following the framework approach.</p><p><strong>Results: </strong>Twenty-three general practice staff members participated, including 17 women and six men. Fifteen participants were in non-clinical roles and eight were clinicians. Six themes were identified: violence and abuse through direct interactions, violence and abuse beyond direct interactions, increased risk, individual impacts, occupational impacts, and impacts on care and services.</p><p><strong>Conclusion: </strong>Violence and abuse by patients and the public include a wide range of behaviours. It has profound and, in some instances, longstanding impacts on staff, including a persistent sense of being unsafe and disruption to their personal or social lives. It also affects clinical services through staff turnover and reduced service capacity.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148650518","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":"Non-antibiotic interventions to prevent recurrent urinary tract infections in women: overview of systematic reviews of randomised controlled trials.","authors":"Miriam Santer, Sascha Miller, Susannah Fraser, Nick Francis, Mark Lown, Taeko Becque, Fiona Tenters, Luke Hanna, Ingrid Muller","doi":"10.3399/BJGP.2026.0055","DOIUrl":"10.3399/BJGP.2026.0055","url":null,"abstract":"<p><strong>Background: </strong>Recurrent urinary tract infections (rUTIs), that is, ≥2 urinary tract infections (UTIs) in the past 6 months or ≥3 in the past 12 months, are common, have a substantial impact on quality of life, and cause major antibiotic use.</p><p><strong>Aim: </strong>To identify non-antibiotic interventions for prevention of rUTIs that have been assessed in systematic reviews, exploring their effectiveness, acceptability, and adherence.</p><p><strong>Design and setting: </strong>An overview of systematic reviews of randomised controlled trials (RCTs) on non-pharmaceutical and pharmaceutical (non-antibiotic) interventions for preventing rUTIs in women.</p><p><strong>Method: </strong>Medline, Embase, CINAHL, Google Scholar, and Cochrane from January 2014 to May 2025 were searched for systematic reviews of RCTs assessing the effectiveness of community-based non-antibiotic interventions for preventing UTI in women aged ≥16 years with rUTIs. Studies in intensive care units, relating to people with indwelling catheters, or comparing different oral antibiotic regimens were excluded. There were no limitations regarding outcome measures or language.</p><p><strong>Results: </strong>In total, 27 systematic reviews met inclusion criteria evaluating probiotics (<i>n</i> = 9), D-mannose (<i>n</i> = 7), vaginal oestrogen (<i>n</i> = 7), cranberry (<i>n</i> = 6), methenamine hippurate (<i>n</i> = 3), herbal medicine (<i>n</i> = 3), increased fluid intake (<i>n</i> = 2), systemic oestrogen (<i>n</i> = 4), acupuncture (<i>n</i> = 2), and vaccines (<i>n</i> = 2). Eight examined combination strategies. Cranberry and methenamine hippurate use are supported by systematic reviews, as is vaginal oestrogen among postmenopausal women, although questions remain around dose, duration, and treatment adherence. Reviews of probiotics, D-mannose, herbal medicine, acupuncture, and vaccines concluded that stronger evidence is needed. Increased fluid intake benefits women with low intake, but further research is needed on optimal intake. There was little information on treatment adherence or acceptability for many interventions.</p><p><strong>Conclusion: </strong>For effective interventions, questions remain about promoting adherence (vaginal oestrogen), or optimal preparation (cranberry), or duration (methenamine). For other interventions a stronger evidence base is needed.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148146109","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":"Equity and impact of social prescribing in type 2 diabetes prevention: cross-sectional and cohort study using national primary care data.","authors":"Sara Calderón-Larrañaga, Bernardo Meza-Torres, Simon de Lusignan, Rohini Mathur, Sarah Finer, Daniel Stow","doi":"10.3399/BJGP.2025.0748","DOIUrl":"10.3399/BJGP.2025.0748","url":null,"abstract":"<p><strong>Background: </strong>Social prescribing has expanded rapidly in English primary care since 2019 to support the prevention and management of long-term conditions. However, evidence on its equity of access and effectiveness for type 2 diabetes (T2D) prevention is limited.</p><p><strong>Aim: </strong>To examine the reach, equity of access, and potential impact of social prescribing on T2D prevention among adults at high risk.</p><p><strong>Design and setting: </strong>Observational study using routinely collected data from the Oxford-RCGP Research and Surveillance Centre, including >1800 general practices in England (January 2019 to November 2023).</p><p><strong>Method: </strong>Cross-sectional analyses using multivariable logistic regression examined factors associated with social prescribing referral among adults at high risk of T2D. Cohort analyses estimated the association between social prescribing referral and incident T2D, adjusting for baseline covariates. Calendar-period-stratified Cox models were used to capture programme roll-out and COVID-19 changes. Exploratory time-since-index analyses tested if effects varied over time.</p><p><strong>Results: </strong>Among 2 326 400 adults at high-risk of T2D, 271 582 (11.7%) developed T2D over a median 3.7 years (interquartile range [IQR] 1.44-4.83). Referrals to social prescribing increased 9.5-fold from 0.3% (<i>n</i> = 3897/1 479 172) in 2019-2020 to 2.5% (<i>n</i> = 47 883/1 917 187) in January-November 2023, and were more common among women (adjusted odds ratio (aOR) 1.42, 95% confidence interval [CI] = 1.40 to 1.43), those living in more deprived areas (aOR 1.89, 95% CI = 1.86 to 1.93), current smokers (aOR 1.71, 95% CI = 1.68 to 1.73), people with obesity (aOR 1.19, 95% CI = 1.17 to 1.21), depression/anxiety (aOR 2.52, 95% CI = 2.49 to 2.54), and multimorbidity (aOR 1.45, 95% CI = 1.43 to 1.47). By calendar year, social prescribing was associated with an increased risk of T2D in 2019 (adjusted hazard ratio [aHR] 1.67, 95% CI = 1.20 to 2.32) but became protective by 2023 (aHR 0.84, 95% CI = 0.79 to 0.89). By follow-up, social prescribing was associated with an increased risk of T2D within 0-2 years post-referral (aHR 1.09, 95% CI = 1.04 to 1.15) but was protective after ≥3 years (aHR 0.88, 95% CI = 0.80 to 0.97).</p><p><strong>Conclusion: </strong>Social prescribing reached those with greater health and social need. The protective association against T2D emerged as services matured post-COVID-19 and with longer follow-up, potentially reflecting cumulative engagement, although activity data were unavailable.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148146118","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":"Impact of local enhanced incentive schemes on the performance of general practices within the UK: a systematic review.","authors":"Matthew Conroy, Emma McManus, William Whittaker, Peter Bower, Michael Anderson","doi":"10.3399/BJGP.2025.0377","DOIUrl":"10.3399/BJGP.2025.0377","url":null,"abstract":"<p><strong>Background: </strong>To drive improvements in healthcare quality and to reduce inequalities, pay-for-performance (P4P) schemes have become widespread internationally. In recent years, most local commissioning bodies in the UK have developed their own local general practice incentive schemes.</p><p><strong>Aim: </strong>To examine the use and effectiveness of local incentive schemes and their alignment to the national Quality and Outcomes Framework.</p><p><strong>Design and setting: </strong>Systematic review of quantitative studies related to local incentive schemes with a P4P structure within UK general practice published after 2004.</p><p><strong>Method: </strong>Searches were conducted via Ovid across the Embase and MEDLINE databases. Risk of bias was assessed using the Cochrane Effective Practice and Organisation of Care criteria and a narrative synthesis was undertaken.</p><p><strong>Results: </strong>In total, 17 studies were identified, which were focused on 14 local incentive schemes. All studies were from England, except one from Scotland. Five studies included only tailored indicators, and seven studies included both aligned and tailored indicators. Quality assessment suggested the current evidence was of mixed quality. All studies that reported on process measures (<i>n</i> = 15) demonstrated positive impacts, but health outcome measures were only evaluated in nine studies showing inconsistent findings. Eight studies addressed impact on health inequalities and no studies addressed cost-effectiveness, patient-reported outcomes, or experience measures.</p><p><strong>Conclusion: </strong>There is an emerging evidence base that local incentive schemes in general practice lead to improvements in process measures, although methodological quality of studies is mixed. Future studies should utilise more robust methods to evaluate effectiveness and examine impacts on health inequalities, cost-effectiveness, and variation by practice.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407828","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":"Unpacking barriers to and facilitators for research leadership for Black primary care researchers: a qualitative study.","authors":"Rupinder Kaur Bajwa, Manpreet Bains, Christian D Mallen, Joe Kai, Adwoa F Agyemang-Benneh, Ralph K Akyea","doi":"10.3399/BJGP.2026.0175","DOIUrl":"10.3399/BJGP.2026.0175","url":null,"abstract":"<p><strong>Background: </strong>Individuals of Black heritage comprise 6.2% of the general practice workforce in the UK. Representation is even lower in primary care research. The understanding of why this misrepresentation exists is limited.</p><p><strong>Aim: </strong>To explore representation of researchers of Black heritage at various career stages within primary care, alongside factors influencing retention and career advancement.</p><p><strong>Design and setting: </strong>Qualitative study with 18 researchers of Black heritage and seven primary care senior academic leaders (current or former heads of primary care departments in UK universities).</p><p><strong>Method: </strong>Online, one-to-one, semi-structured interviews. Interviews were digitally audio-recorded, transcribed, and analysed using thematic analysis.</p><p><strong>Results: </strong>Participants recognised significant underrepresentation of researchers of Black heritage in primary care research. Key barriers to career progression and retention included systemic and structural inequities, racism, and exclusionary academic culture. Facilitators included proactive leadership, tailored training and support for researchers (including international scholars), mentorship, sponsorship, and safe networking spaces. Participants offered recommendations to improve representation and career progression: training for leaders to recognise bias, discrimination, and inequity; leadership development opportunities; tailored career support for researchers of Black heritage; and targeted assistance for international researchers navigating UK academic systems. Visibility of Black role models in academic primary care was seen as essential to attracting and inspiring future researchers.</p><p><strong>Conclusion: </strong>These findings highlight key areas for change to foster a more inclusive and equitable research environment in primary care.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148650535","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":"Fighting to be heard: a thematic analysis of parent perspectives on safety in UK general practice.","authors":"Thomas Purchase, Harriet Dorothy Quinn-Scoggins, Isobel J McFadzean, Lauren Donovan, Isabel Hope, Eleanor Clarke, Kate J Lifford, Nicholas Hodson, Jillian Beggs, Philippa Rees, Andrew Carson-Stevens","doi":"10.3399/BJGP.2025.0651","DOIUrl":"10.3399/BJGP.2025.0651","url":null,"abstract":"<p><strong>Background: </strong>Children are particularly vulnerable to healthcare-associated harm. Parents play a vital but under-recognised protective role in paediatric patient safety. Parent perceptions of and contributions to safety improvement efforts within hospital settings are well documented, but little is known about parent experiences and perspectives in primary care.</p><p><strong>Aim: </strong>To explore diverse parental perspectives on paediatric safety in primary care and identify target areas for improvement.</p><p><strong>Design and setting: </strong>This qualitative study in UK primary care was conducted through online (<i>n</i> = 2) and in-person (<i>n</i> = 2) workshops with parents, taking place between 24 June and 8 July 2024.</p><p><strong>Method: </strong>Workshops were structured around a descriptive analysis of paediatric patient safety incident reports in general practice. Parents discussed and reflected on their own experiences in relation to the findings. Transcripts and field notes were analysed thematically to identify key themes.</p><p><strong>Results: </strong>Parents (<i>n</i> = 33) from varied backgrounds, including under-served communities, participated. Three major themes were identified: <i>responsibility of care</i>, highlighting perceived unclear roles between parents and healthcare teams; <i>navigating the system</i>, where parents described the need to 'fight' for care and the challenges of understanding healthcare processes; and <i>communication and language</i>, emphasising the difficulties of being heard, especially among ethnic minority parents and those lacking the confidence to speak up.</p><p><strong>Conclusion: </strong>Parent perspectives on paediatric safety in primary care have highlighted key areas for practices, researchers, and safety improvement teams to target system change and intervention development. Engaging parents as co-designers in these efforts could enhance trust, reduce risk, and improve safety outcomes for paediatric patients.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148166795","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":"Patient, pharmacist, and GP perspectives on identifying and managing polypharmacy: a qualitative study.","authors":"Jung Yin Tsang, Thomas Blakeman, Matthew Sperrin, Tomazo J Kallis, Rupert A Payne, Darren M Ashcroft","doi":"10.3399/BJGP.2025.0793","DOIUrl":"10.3399/BJGP.2025.0793","url":null,"abstract":"<p><strong>Background: </strong>Polypharmacy is a global priority owing to potential harms, including adverse drug events, hospitalisations, and high treatment burden. Overall, these outcomes have shown little improvement despite numerous interventions, indicating that current approaches to identify and manage polypharmacy remain insufficient.</p><p><strong>Aim: </strong>To understand how polypharmacy is identified and managed in everyday primary care from patient, pharmacist, and GP perspectives.</p><p><strong>Design and setting: </strong>Qualitative semi-structured interviews were conducted with 12 patients and 12 professionals (seven clinical pharmacists and five GPs) across Greater Manchester, UK.</p><p><strong>Method: </strong>Reflexive thematic analysis was undertaken, which was supported by normalisation process theory and constant comparison as sensitisation tools.</p><p><strong>Results: </strong>Polypharmacy was widely seen as important work but, in practice, inconsistent case-finding and unclear purposes for polypharmacy medication reviews were reported. Patients viewed medications as essential tools to sustain biopsychosocial elements of life, contrasting with practitioners' clinical priorities to mitigate potential harm. Polypharmacy work routinely contained layers of hidden complexity, which was often overwhelming and placed a heavy emotional burden on patients and professionals. Both patients and professionals required training and experience to effectively manage these complexities. Although a protocol-driven approach was sufficient for simple medication issues, only a longer-term approach, predicated on trust, continuity, relationships, and open discussions encouraging healthy conflict, appeared to engage with deeper complexities.</p><p><strong>Conclusion: </strong>Polypharmacy work is fraught with complexity and uncertainty, lacking standardised case-finding and clear purpose for both patients and professionals. Better models of care are needed to meet this challenge, encouraging a shift beyond a biomedically dominated protocol-driven approach to a more longitudinal and relational approach.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379601","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 cardiovascular risk reduction after pregnancy complications: a qualitative systematic review.","authors":"Victoria Jane Hodges, Saminah Shareef, Carolyn A Chew-Graham, Pensée Wu, Modurodoluwa Adetola, Caroline Anne Mitchell","doi":"10.3399/BJGP.2026.0110","DOIUrl":"10.3399/BJGP.2026.0110","url":null,"abstract":"<p><strong>Background: </strong>Adverse pregnancy outcomes (APOs) affect approximately 30% of pregnancies and confer lifelong elevated cardiovascular disease (CVD) risk. Behavioural interventions may mitigate this risk.</p><p><strong>Aim: </strong>To systematically review qualitative literature on women's experiences of behavioural change for cardiovascular risk reduction following APOs, with a focus on health equity.</p><p><strong>Design and setting: </strong>Qualitative systematic review, limited to high-income countries with universal access to health care.</p><p><strong>Method: </strong>A systematic search of PubMed, Embase, and CINAHL from inception to March 2025 identified primary studies. Thematic synthesis followed Thomas and Harden's three-stage approach. Themes were mapped onto the COM-B (Capability, Opportunity, Motivation-Behaviour) framework to theoretically ground and structure analysis.</p><p><strong>Results: </strong>Eighteen studies involving 339 women met inclusion criteria. Women who were minority ethnic formed the majority in only two studies. Demographic data regarding socioeconomic status, ethnicity, or both were absent from five. Experiences shaping behaviour change aligned with COM-B domains. Delayed physical and psychological recovery after APOs reduced women's capability to initiate changes. Competing demands, including childcare, household responsibilities, and work, restricted opportunity to focus on long-term cardiovascular health. Opportunities improved when behaviour changes were easily integrated into family life and offered shared benefits. Motivation was strengthened by awareness of increased CVD risk, the responsibilities of parenthood, and personalised advice from healthcare professionals. Tailored, proactive follow-up supported engagement, especially for minority ethnic and socioeconomically disadvantaged groups.</p><p><strong>Conclusion: </strong>Prevention of CVD after APOs requires structured, system-level support to prioritise family-based behaviour change. High-risk groups are underrepresented in research; coproducing interventions with these groups may help to avoid widening health inequalities.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148146099","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":"'I have no idea who does the bone thing': a qualitative exploration to improve osteoporosis care.","authors":"Anne Heaven, Nicola Kime, Shabana Shafiq, Nicola Harrison, Janine Connor, Jessica Faye Johansson, Elizabeth Teale, Christine Sharp","doi":"10.3399/BJGP.2026.0003","DOIUrl":"10.3399/BJGP.2026.0003","url":null,"abstract":"<p><strong>Background: </strong>The Women's Health Strategy for England highlighted the systemic underrepresentation of older women in health care. Over half of women >80 years are estimated to have osteoporosis, contributing to 180 000 fractures annually in the UK, with substantial personal and economic costs, despite clinically effective treatments and national guidelines being available.</p><p><strong>Aim: </strong>To use insights from the experiences of older women and primary healthcare professionals to develop strategies to improve osteoporosis care.</p><p><strong>Design and setting: </strong>A community-based qualitative study in England, UK.</p><p><strong>Method: </strong>Interviews were undertaken with 30 community-dwelling older women (aged ≥70 years) diagnosed with osteoporosis and 31 healthcare professionals including GPs, physiotherapists, pharmacists, practice nurses, a healthcare assistant, and a community matron. We reviewed findings iteratively with our coproduction group using a constructivist grounded theory approach.</p><p><strong>Results: </strong>Healthcare professionals acknowledged osteoporosis as clinically important but described limited knowledge and understanding. However, older women assumed expertise and proactive engagement from clinicians. Older women normalised symptoms as part of ageing, frequently prioritising other comorbidities. Most were unclear about their diagnosis, prognosis, or treatment plans. Self-management was expected but inadequately supported. There was little routine engagement with the wider primary care team. Digital communication further limited older women's engagement/re-engagement.</p><p><strong>Conclusion: </strong>Osteoporosis remains poorly understood and inadequately managed in older women who face barriers, including multimorbidity, digital exclusion, and low self-efficacy. Many older women accept care gaps owing to limited awareness and lack of meaningful interaction with healthcare professionals. Improved care navigation and greater involvement of the wider primary care team could enhance engagement and support better self-management.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379591","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":"Clarifying urgent care: towards conceptual coherence and international alignment.","authors":"Ivan Koay","doi":"10.3399/bjgp26X746589","DOIUrl":"10.3399/bjgp26X746589","url":null,"abstract":"","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":"76 771","pages":"450"},"PeriodicalIF":5.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122864","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}