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

{"title":"Desire paths in patient care.","authors":"Maiedha Raza","doi":"10.3399/bjgp26X746685","DOIUrl":"10.3399/bjgp26X746685","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":"466"},"PeriodicalIF":5.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122909","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":"How much evidence is needed before additional testing is incentivised at scale?","authors":"Martha Mc Elwenspoek, Tracey Stone, Jonathan Decker, Penny Whiting, Jessica Watson","doi":"10.3399/BJGP.2026.0357","DOIUrl":"10.3399/BJGP.2026.0357","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":"441-443"},"PeriodicalIF":5.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122939","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":"Cancer risk in patients with four non-specific symptoms: a decade of research and implications for practice.","authors":"Charlotte Williamson, Anjali Behal, Becky White, Meena Rafiq, Samantha Harrison, Brian D Nicholson","doi":"10.3399/BJGP.2026.0088","DOIUrl":"10.3399/BJGP.2026.0088","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":"472-476"},"PeriodicalIF":5.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122842","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":"Medicine and the media: why my uncle's 1985 message matters now more than ever.","authors":"Simon Smail","doi":"10.3399/bjgp26X746721","DOIUrl":"10.3399/bjgp26X746721","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":"467"},"PeriodicalIF":5.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122989","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":"Stop coaching breathing: treat hyperventilation by talking patients back to normal ventilation.","authors":"So Sakamoto","doi":"10.3399/bjgp26X746673","DOIUrl":"10.3399/bjgp26X746673","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":"464-465"},"PeriodicalIF":5.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123009","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":"Minor illnesses teach clinical restraint.","authors":"Max J Cooper, Jason Heath","doi":"10.3399/bjgp26X746541","DOIUrl":"10.3399/bjgp26X746541","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":"448"},"PeriodicalIF":5.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149123039","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":"General practice follow-up after hospital discharge in older adults: retrospective record analysis in UK primary care.","authors":"Naomi Klepacz, Annabelle Long, Zakia Shariff, Simon Ef Spencer, Hema Mistry, Frances Griffiths, Jeremy Dale, Rachel A Spencer","doi":"10.3399/BJGP.2025.0627","DOIUrl":"10.3399/BJGP.2025.0627","url":null,"abstract":"<p><strong>Background: </strong>Most hospital admissions are for older patients, who are more likely to be medically complex. Primary care risks after hospital discharge and readmission trajectories are relatively unexplored.</p><p><strong>Aim: </strong>To estimate the frequency and nature of errors and harms linked to discharge summary processing in general practice for patients aged ≥65 years; and to explore associations with readmission and healthcare utilisation, using a novel primary care data source.</p><p><strong>Design and setting: </strong>Retrospective cohort study using electronic health records (EHRs) from seven purposively sampled general practices in the West Midlands, UK.</p><p><strong>Method: </strong>EHRs of patients aged ≥65 years discharged between October 2022 and October 2023 were reviewed. Outcomes included post-discharge healthcare utilisation and costs, frequency and type of discharge actions, error rates (failures to complete requested actions), harms (severity, attribution, and preventability), and 90-day readmissions. Multivariable logistic regression identified predictors of errors, harms, and readmission.</p><p><strong>Results: </strong>Within the cohort of 263 discharged patients, 186 (70.7%) accessed post-discharge care; with 47 out of the 263 patients (17.5%; 95% confidence interval = 13.7 to 23.0) having related readmissions within 90 days. In total, 551 actions were requested in 160 discharge summaries. For those patients who required an action, 20.6% experienced error and 4.4% experienced harm. Most harms resulted in hospital readmission and three out of eight were preventable in primary care. Error and harm disproportionately affected patients who had dementia or a recorded carer.</p><p><strong>Conclusion: </strong>General practice should review their processes for responding to patient discharge information in order to improve patient safety post-discharge. Further research into tools to assist practices with transitions is warranted.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":"e828-e835"},"PeriodicalIF":5.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611619","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":"Optimising personal continuity in general practice: process evaluation of a toolkit.","authors":"Lex Jj Groot, Annemarie A Uijen, Henk J Schers, Jako S Burgers, Martin Smalbrugge, Henriëtte E van der Horst, Otto R Maarsingh","doi":"10.3399/BJGP.2025.0401","DOIUrl":"10.3399/BJGP.2025.0401","url":null,"abstract":"<p><strong>Background: </strong>Personal continuity - having a GP who knows and follows the patient - is a core value of general practice, yet changes in society and health care have challenged its provision. Therefore, we developed TOOL-kit: an intervention to opTimise persOnal cOntinuity for oLder patients in general practice, a multi-component intervention aimed to optimise personal continuity for patients aged ≥65 years.</p><p><strong>Aim: </strong>To evaluate TOOL-kit's implementation and identify barriers and facilitators influencing its delivery.</p><p><strong>Design and setting: </strong>This mixed-methods study was embedded in the main effect trial (August 2020 to April 2022).</p><p><strong>Method: </strong>Implementation was assessed via 3-monthly surveys and 93 interviews with GPs and practice staff (<i>n</i> = 221) from 31 general practices. Based on Saunders' paradigm, it was evaluated on the process indicators of recruitment and reach, fidelity (adherence to protocol), dose delivered (extent of improvement plans), and dose received (goal achievement, sustained organisational change). Barriers and facilitators were evaluated on the intervention, staff, organisational, and sociopolitical levels.</p><p><strong>Results: </strong>Of 31 practices, 23 adhered to protocol. TOOL-kit was delivered at a (very) low dose in 17 of 31 practices. At study end, 55% of practice goals were met. After 24 months, 19 of 31 practices had observed sustained positive effects regarding personal continuity. A good-quality improvement infrastructure facilitated TOOL-kit implementation, while work pressure and staff shortages, exacerbated by COVID-19, were seen as the main barriers for implementation.</p><p><strong>Conclusion: </strong>Despite implementation challenges, TOOL-kit was able to enhance work procedures and improve the focus on personal continuity within practice. Fostering practices' quality improvement infrastructure and decision-making processes could improve implementation.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":"e807-e817"},"PeriodicalIF":5.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147439176","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":"Sustaining a career in general practice: a qualitative study of experienced GPs in South West England.","authors":"Nada F Khan, Bethan M Treadgold, John Campbell","doi":"10.3399/BJGP.2025.0674","DOIUrl":"10.3399/BJGP.2025.0674","url":null,"abstract":"<p><strong>Background: </strong>General practice in the UK faces a growing retention crisis, with many experienced GPs reducing hours or leaving patient care amid rising workload and system strain. Understanding what sustains GP careers is crucial to stabilising the workforce.</p><p><strong>Aim: </strong>To explore how experienced GPs' career intentions have evolved since the 2016 ReGROUP study and to identify factors influencing decisions to stay, reduce, or leave clinical work.</p><p><strong>Design and setting: </strong>A qualitative interview study was undertaken with experienced GPs in South West England, and analysed using the Job Demands-Resources (JD-R) model.</p><p><strong>Method: </strong>We conducted 19 semi-structured interviews with GPs who had previously completed the ReGROUP survey. Transcripts were analysed thematically with input from public and professional stakeholders.</p><p><strong>Results: </strong>GPs described escalating clinical and administrative workloads, moral distress, and reduced control as key pressures driving burnout and exit. Hybrid access models, secondary care workload transfer, and punitive regulatory processes intensified strain. Retention was supported by clear workload boundaries, continuity of care, supportive practice systems, portfolio careers, and collective advocacy. Some GPs maintained engagement by reshaping their roles or practice structures to regain control and sustain meaning.</p><p><strong>Conclusion: </strong>Retention depends not only on reducing workload but also on restoring the conditions that make being a 'good GP' feel possible, through continuity, manageable demand, and supportive organisational culture. Creating space for flexibility, autonomy, and role redesign may help sustain experienced GPs and strengthen workforce resilience.</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":"e836-e846"},"PeriodicalIF":5.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611624","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":"Primary care practitioners' experiences managing urinary tract infections: a qualitative evidence synthesis.","authors":"Henrike Kleuser, Francine Toye, Felix Kannapin, Luca Ghirotto, Sandra Parisi, Alice Serafini, Maria Chiara Bassi, Ildikó Gágyor, Peter K Kurotschka","doi":"10.3399/BJGP.2025.0561","DOIUrl":"10.3399/BJGP.2025.0561","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infections (UTIs) are common in primary care. Qualitative studies suggest that the way primary care practitioners (PCPs) manage UTIs may be influenced by a complex interplay of factors.</p><p><strong>Aim: </strong>To explore the views, perceptions, and experiences of PCPs in the management of UTIs.</p><p><strong>Design and setting: </strong>Qualitative evidence synthesis of studies set in general practice internationally.</p><p><strong>Method: </strong>Four databases were systematically searched from inception to 28 June 2024, and forward citation searching of included studies was undertaken. Braun and Clarke's reflexive thematic analysis was used to synthesise findings and the Critical Appraisal Skills Programme (CASP) checklist was applied to assess the quality of studies.</p><p><strong>Results: </strong>In total, 3956 records were identified and 190 publications reviewed in full. Thirty-two qualitative studies reporting on 677 PCPs were included, generating the following themes: 1) I am confident; 2) … until patient X presents; 3) I am a victim of an overstretched healthcare system; 4) I must weigh up the benefits and impact of antibiotic treatment; and 5) it all comes down to our relationship. Using the CASP checklist, the quality of research was rated as high.</p><p><strong>Conclusion: </strong>PCPs felt confident in managing UTIs, but uncertainty arose when patient X (children, men, older patients, those with recurrent UTIs) presented and PCPs perceived consultations as more complex. This analysis highlights the persistent and complex clinical challenge of assessing the risks and benefits of prescribing antibiotics. Chronic underfunding, staff shortages, and conflicting provider-patient expectations further complicated care, particularly when patients fall outside the ordinary (patient X).</p>","PeriodicalId":520790,"journal":{"name":"The British journal of general practice : the journal of the Royal College of General Practitioners","volume":" ","pages":"e847-e858"},"PeriodicalIF":5.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849157","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}