European Journal of General Practice最新文献

{"title":"Strengthening Primary Health Care in Europe: A Delphi study towards accessibility, equity and continuity of care.","authors":"Ileana Gefaell Larrondo, Sara Ares-Blanco, Marina Guisado-Clavero, José Joaquín Mira, Clara Pérez Esteve, Limor Adler, Sherihane Bensemmane, Milena Kostić, Achim Mortsiefer, Ferdinando Petrazzuoli, Raquel Gómez-Bravo, Pilar Astier-Peña","doi":"10.1080/13814788.2026.2619226","DOIUrl":"10.1080/13814788.2026.2619226","url":null,"abstract":"<p><strong>Introduction: </strong>Strengthening Primary Health Care (PHC) is essential for building resilient and equitable health systems, but PHC faces barriers in implementation, resource allocation, and political prioritisation. This study aimed to develop a strategic roadmap to enhance PHC by identifying core values, priorities, and actionable strategies through expert consensus.</p><p><strong>Methods: </strong>A two-round Delphi study was conducted with 210 stakeholders from 35 countries, including PHC professionals, policymakers, and public health experts. Participants evaluated the importance, feasibility, and policy prioritisation of key PHC values. Quantitative data were analysed using descriptive statistics.</p><p><strong>Results: </strong>The response rate was 81.4% (171/210) in round one and 73.5% (97/132) in round two. The majority of participants (89%) had a background in medicine. A consensus (>80% agreement) was reached in the first round regarding PHC values. Key recommendations included increasing investment in PHC workforce development, particularly in underserved areas; strengthening health information systems and integrating telehealth solutions; enhancing PHC governance models to support multidisciplinary collaboration and citizen-centred care; and adapting processes to improve chronic care management, end-of-life support, and standardised assessment frameworks. In the second round, when participants assessed the feasibility of these recommendations, agreement levels ranged from 61 to 92%. When asked about the policy prioritisation of these measures, agreement dropped, ranging from 22 to 51%.</p><p><strong>Conclusions: </strong>This study highlights that PHC stakeholders perceive a critical need to align health policies with the core values of PHC, while addressing systemic barriers to implementation. Future efforts should focus on bridging the perceived gap between expert recommendations and political prioritisation to achieve sustainable PHC improvements.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2619226"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13003879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast cancer screening in Europe and the role of general practitioners: A 32-country comparative survey.","authors":"Dimitra Iosifina Papageorgiou, Emmanouil Smyrnakis, Michael Harris, Ilze Skuja, Zlata Ožvačić Adžić, Gergana Apostolova, Sherihane Bensemmane, Mette Brekke, Krzysztof Buczkowski, Nicola Buono, Jako Burgers, Jelena Danilenko, Cecilia Högberg, Didem Kafadar, Tuomas Koskela, Norbert Kral, Roland Kraxner, Lucas Küppers, Delphine Legoff, Mercè Marzo-Castillejo, Anina Pless, Natalia Ponzel, Aida Puia, Rūta Radzevičienė-Jurgutė, Patrick Redmond, Kristi Särgava, Marij Petek Šter, Marika Sulashvili, Peter Vedsted, Xénia Wöstmann, Marija Zafirovska, Ricardo Zaidan, Robert Hoffman","doi":"10.1080/13814788.2026.2689646","DOIUrl":"10.1080/13814788.2026.2689646","url":null,"abstract":"<p><strong>Introduction: </strong>Breast cancer is the commonest cancer in women, and screening can allow earlier-stage diagnosis. While there are European recommendations on the age-range and frequency of breast cancer screening, participation in these programmes varies substantially, and this could be due to differences in how they are organised and implemented. The role that primary healthcare professionals play in the process is unclear.We aimed to describe the breast cancer screening programmes in European countries and investigate how primary healthcare professionals are involved in this screening process.</p><p><strong>Methods: </strong>A cross-sectional survey in 32 countries. Key informants with relevant expertise answered online questions about the characteristics of their screening programmes and general practitioners' (GPs') roles in this. Responses were refined through an iterative consensus process. Data were examined to identify patterns in GP engagement.</p><p><strong>Results: </strong>We found important differences between European breast cancer screening systems. While most had population-based screening, four countries relied on opportunistic screening. In 15 countries GPs had little or no involvement in the process of breast cancer screening, and in 13 countries GPs had some involvement, including identifying eligible patients, issuing referrals, and following-up results. Screening uptake rates tended to be higher in countries with well-established population-based screening programmes which give little or no GP involvement. Few countries linked GP engagement to incentives or performance measures.</p><p><strong>Conclusion: </strong>Countries with lower screening uptake should consider either enhancing GP involvement or transitioning to a structured, population-based screening system. Further research should explore how best to integrate primary care within national screening strategies.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2689646"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13295072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction.","authors":"","doi":"10.1080/13814788.2025.2610158","DOIUrl":"10.1080/13814788.2025.2610158","url":null,"abstract":"","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2610158"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146088032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What affects unplanned hospital admissions in older adults according to primary healthcare professionals? A focus group study.","authors":"Jet H Klunder, Eline C M Kooijmans, Karlijn J Joling, Otto R Maarsingh, Hein P J van Hout","doi":"10.1080/13814788.2026.2650928","DOIUrl":"10.1080/13814788.2026.2650928","url":null,"abstract":"<p><strong>Background: </strong>Unplanned hospital admissions are distressing for older persons and are associated with a high risk of adverse outcomes and a burden on health systems. Understanding the risk and protective factors for unplanned admissions can help to design new preventive interventions in primary care.</p><p><strong>Objectives: </strong>To explore primary healthcare professionals' experiences on factors affecting unplanned hospital admissions in community-dwelling older adults and identify opportunities for preventive interventions.</p><p><strong>Methods: </strong>We performed a focus group study with a purposive sample of Dutch primary healthcare professionals. Four focus groups were conducted with a total of 22 primary healthcare professionals comprising 10 general practitioners (GPs) and 12 other primary healthcare professionals. All focus groups were recorded, transcribed, and thematically analysed.</p><p><strong>Results: </strong>Factors affecting unplanned admissions were grouped into characteristics of the patient, the healthcare professional, and healthcare organisation. Patient-related risk factors included the presence of chronic conditions, health-seeking behaviour, the presence and capacity of an informal caregiver, and cultural expectations of healthcare. Continuity of care, advance care planning, and professional experience as a GP were identified as mitigating professional-related factors for unplanned admissions. Organisational factors that potentially contributed to unplanned admissions were poor informational continuity, suboptimal care coordination, and lack of alternatives to hospitalisation.</p><p><strong>Conclusion: </strong>Unplanned hospital admissions in older adults were perceived to be influenced by patient, healthcare professional, and healthcare organisation-related factors. Strategies such as ensuring broad access to patients' clinical information and treatment wishes, improving personal continuity of care, and structural provision of advance care may contribute to reduce unplanned admissions.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2650928"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13159591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EGPRN primary care research at a crossroads advancing research on interprofessional collaboration and on integrated, equitable and complex care. An EGPRN Keynote Paper from the Autumn 2025 Plovdiv Conference.","authors":"Paul Van Royen","doi":"10.1080/13814788.2026.2708494","DOIUrl":"10.1080/13814788.2026.2708494","url":null,"abstract":"<p><p>Primary healthcare is facing unprecedented complexity, driven by multimorbidity, social vulnerability, health inequities, rapid digitalisation, and shifting professional roles.</p><p><p>This opinion paper argues that strengthening primary care requires a fundamental reorientation of both research agendas and professional education. We propose a shift towards innovative, theory-informed methodologies capable of capturing how care works in practice, for whom, and under which conditions. Priority research domains include integrated care, interprofessional teamwork, the biopsychosocial health interface, care for vulnerable and superdiverse populations, and the responsible implementation of digital and AI-supported tools.</p><p><p>To capture these dynamics, we advocate for innovative methodologies including longitudinal mixed-methods designs, pragmatic cluster trials, realist evaluation, implementation science, network analysis, and complexity science approaches. Participatory and practice-based research models are essential to ensure relevance and reduce research waste. Finally, we emphasise the need to embed research literacy, interprofessional learning, and digital competence within transformative education for future family physicians.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2708494"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interprofessional collaboration in primary care in Germany - collective irresponsibility, one-way-street or colourful bouquet of services? A qualitative study with stakeholders from various professions.","authors":"Johanna Mink, Attila Altiner, Simon Schwill","doi":"10.1080/13814788.2026.2671561","DOIUrl":"10.1080/13814788.2026.2671561","url":null,"abstract":"<p><strong>Background: </strong>Interprofessional collaboration (IPC) in outpatient care can improve patient outcomes and satisfaction, health prevention and economics. German primary care (PC) is challenged by an ongoing demand for health care professionals to extend services. PC in Germany is regularly provided by general practitioners and medical assistants. Models on how to establish interprofessional primary care (IPPC) are scarce.</p><p><strong>Objectives: </strong>Aim of the study was to explore stakeholders' suggestions on IPC in German PC to support development of an IPPC model.</p><p><strong>Methods: </strong>Professionals from various nation-wide institutions and associations with professional backgrounds in general practice, medical assistance, nursing, physician assistance, social work and specialist medicine as well as from health insurance and law, were recruited. Semi-structured interviews were performed. Deductively identified main categories included strategies for implementing IPC on system-level, organisational-level, team-level and individual-level and were coded in sub-categories inductively.</p><p><strong>Results: </strong>On system-level professionals predominantly named accountability, funding and remuneration. On organisational level documentation systems, the necessity of coordination and the availability of qualified personnel were discussed. On team-level interviewees focussed on the necessity of a mutual understanding of roles and responsibilities, clear and collaborative distribution of tasks and team leadership as well as patient integration and health literacy support. On individual-level the acceptance of new roles and professions was pointed out.</p><p><strong>Conclusion: </strong>To establish IPPC in Germany, remuneration and accountability need to be addressed. Models of IPPC need to integrate suggestions explored, a step-by-step approach for general practitioners to enable change-management and longitudinal support to promote adapted leadership and sustainable implementation.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2671561"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147984363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new way of thinking? Exploring professionals' perspectives on the sustainability of interprofessional team meetings: A focus group study.","authors":"Jelena Slowig, Darcy Ummels, Emmylou Beekman, Marloes van Bokhoven, Albine Moser","doi":"10.1080/13814788.2026.2708526","DOIUrl":"10.1080/13814788.2026.2708526","url":null,"abstract":"<p><strong>Background: </strong>Interprofessional collaboration is essential to address the complex challenges in primary care. One widely used method for this purpose is interprofessional team meetings. Although the benefits are generally known, maintaining these meetings after their introduction remains challenging.</p><p><strong>Objective: </strong>To understand the aspects influencing the sustainability of interprofessional team meetings.</p><p><strong>Methods: </strong>An exploratory qualitative study was conducted with professionals (<i>n</i> = 39) from seven interprofessional teams that met regularly to coordinate elderly patient care. Data were collected through seven focus group discussions. Content analysis was applied, guided by the Consolidated Framework for Sustainability, to identify barriers, facilitators, and needs.</p><p><strong>Results: </strong>Common barriers included unclear networks, lack of shared goals, and limited time, whereas facilitators involved strong team dynamics, clear structures, and flexibility. These findings point to five key needs: (i) adaptive team composition in response to patient care issues, (ii) shared ownership within interprofessional teams, (iii) shared meetings' aims and work agreements, (iv) a balanced structure with clear procedures, supportive tools and room for flexibility, (v) and a satisfactory perceived quality of the meetings.</p><p><strong>Conclusion: </strong>This study shows that nurturing team dynamics, tailoring organisational structures, and embedding ongoing evaluation are essential beyond patient care. This may need a new way of thinking to enhance the sustainability of interprofessional team meetings in primary care.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2708526"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telehealth and access to acute primary care in Europe: Balancing opportunity and equity.","authors":"Linda Huibers","doi":"10.1080/13814788.2026.2662775","DOIUrl":"10.1080/13814788.2026.2662775","url":null,"abstract":"","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2662775"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary health care policy advocacy in Europe: A cross-sectional study of family medicine associations.","authors":"Raquel Gómez-Bravo, Sara Ares-Blanco, Nick Mamo, Marina Guisado-Clavero, Sandra León-Herrera, Veronika Rasic, Ana Luisa Neves, Andreé Rochfort, Alex Harding, Eva Hummers, Radost Asenova, Ferdinando Petrazzuoli, Aaron Poppleton, Jose Miguel Bueno Ortiz, Shlomo Vinker, Maria Pilar Astier-Peña, Thomas Frese","doi":"10.1080/13814788.2026.2625572","DOIUrl":"10.1080/13814788.2026.2625572","url":null,"abstract":"<p><strong>Background: </strong>Policy advocacy (PA) in European healthcare has a strong tradition promoting evidence-based policies. Key organisations, including the European Observatory on Health Systems and Policies, the WHO's Evidence-Informed Policy Network, and the OECD play pivotal roles in integrating research into policymaking.</p><p><strong>Objectives: </strong>To assess the involvement of European Family Medicine (FM) Associations in PA, identify key issues, and explore interactions with governmental and institutional bodies related to Primary Health Care (PHC)-defined as first-contact, continuous, comprehensive, and coordinated care provided by general practitioners/family doctors (GPs), in line with the WHO Alma-Ata and Astana declarations-and perceived challenges in PHC advocacy.</p><p><strong>Methods: </strong>An exploratory descriptive, cross-sectional study was conducted among WONCA Europe Member Organisations and GPs involved in PA. Data collected between November 2023 and February 2024. Content analysis was performed to identify themes related to advocacy priorities.</p><p><strong>Results: </strong>Responses were received from 12 member organisations across 12 countries and 37 participants from 17 countries. Key concerns included workforce shortages, high workloads, inadequate infrastructure, and insufficient financial compensation. Public visibility, gender equality, and the integration of FM into university curricula were also highlighted. Eleven respondents reported active engagement with national governments in policy discussions.</p><p><strong>Conclusion: </strong>Respondents highlighted the need for a more unified strategy to address common PHC challenges across Europe. WONCA Europe's Working Party on PA supports national efforts through exchange of best practices, research support, and promoting FM at national and European levels. Continued research and advocacy were viewed as essential for sustaining effective and equitable PHC in Europe.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2625572"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12934329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Writing letters to general practice': A qualitative interview study exploring the career sustainability of female general practitioners in Ireland.","authors":"Ivana Keenan, Aileen Barrett, Megan Brown, Claire Collins","doi":"10.1080/13814788.2026.2686540","DOIUrl":"https://doi.org/10.1080/13814788.2026.2686540","url":null,"abstract":"<p><strong>Background: </strong>Female general practitioners (GPs) often encounter diverse challenges in sustaining a career in general practice, in addition to those experienced by their male counterparts, which may have implications for workforce planning and retention in Ireland.</p><p><strong>Objectives: </strong>To explore the experiences and expectations of female GPs regarding a sustainable career in general practice.</p><p><strong>Methods: </strong>Rooted in a constructivist paradigm, this qualitative study was conducted in Ireland. Thirteen online semi-structured interviews were conducted using 'Love and Breakup Letter' methodology as an elicitation prompt to facilitate discussion. Narratives were explored thematically.</p><p><strong>Results: </strong>Participants viewed their GP role as an integral part of their identity. A career in general practice was found to be fulfilling, with a constant stream of new learning opportunities. The unique context of establishing long-term relationships with patients and having a supportive peer network was the primary motivation for pursuing and staying in this career. Yet, despite these benefits, dissatisfaction with the primary care system, competing family responsibilities and gender-driven challenges added further complexity to sustaining their careers. The incompatibility between work and family life has led many to adapt their careers, reducing clinical hours and pursuing diverse GP careers, to regain balance and manage competing demands.</p><p><strong>Conclusion: </strong>The career of a GP was treasured among women who chose this profession; however, system changes are needed to ensure the ideals of sustained and satisfying GP careers are upheld. Equipping GP graduates with skills to diversify their careers and promoting a strong peer-support network and mentoring opportunities are recommended.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2686540"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}