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":2.5,"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":"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":"https://doi.org/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":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","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":"https://doi.org/10.1080/13814788.2026.2662775","url":null,"abstract":"","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2662775"},"PeriodicalIF":2.5,"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":2.5,"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":"The role and utility of artificial intelligence and machine learning for diagnostic prediction in general practice.","authors":"Liesbeth Hunik, Annemarie A Uijen, Jacqueline K Kueper, Amanda L Terry, Tim C Olde Hartman, Twan van Laarhoven, Henk J Schers","doi":"10.1080/13814788.2026.2620908","DOIUrl":"10.1080/13814788.2026.2620908","url":null,"abstract":"<p><p>Diagnostic prediction models are commonly used in general practice to support clinical decision-making. Traditionally, these models have been developed using statistical methods such as logistic regression. While these approaches have proven useful, they often produce average risk estimates that may not fully account for the complexity of individual patients. In recent years, the use of machine learning (ML), a subfield of artificial intelligence (AI), has grown in healthcare. We examine the similarities and differences between traditional statistical methods and AI/ML approaches for diagnostic prediction in general practice. Using examples from daily practice, we explore how ML techniques can add value, particularly in handling large, complex datasets such as those derived from electronic health records. We also discuss key challenges that hinder the adoption of AI/ML in general practice, including interpretability, data quality, external validation, clinical relevance, implementation and legal issues, and practical usability. We provide recommendations to overcome these challenges. The potential of AI/ML can only be realised if tools are developed collaboratively with GPs, focused on real-world clinical problems, and rigorously validated in practice settings. GP associations, GPs, patients, and primary care scientists should take an active role in the development, validation, and implementation of AI/ML-based diagnostic prediction tools for general practice.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2620908"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108436","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":"10.1080/13814788.2026.2633044","DOIUrl":"10.1080/13814788.2026.2633044","url":null,"abstract":"","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2633044"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277668","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":"An interprofessional approach to treat bodily distress disorder in Swiss primary care - a quality improvement study.","authors":"Stefania Di Gangi, Julia Hennemann, Emanuel Brunner, Oliver Senn, Stefan Büchi","doi":"10.1080/13814788.2025.2599579","DOIUrl":"10.1080/13814788.2025.2599579","url":null,"abstract":"<p><strong>Background: </strong>Managing bodily distress disorder (BDD) requires an interprofessional, holistic therapeutic approach, which can be challenging to implement in routine care.</p><p><strong>Objectives: </strong>The aim was to evaluate a care pathway for patients with BDD involving general practitioners (GPs) and physiotherapists.</p><p><strong>Methods: </strong>Participants were patients aged 18 years or older with BDD symptoms and the PHQ-15 (Patient Health Questionnaire 15-Item) score > 9. The treatment consisted of patient education by GPs about BDD and stress, sleep interventions, physical exercises and support to develop an active lifestyle (> 150 min per week of moderate-intensity physical activity), as measured with the Physical Activity Vital Sign (PAVS). Patient outcomes (PHQ-15 and PAVS) were compared at baseline and after six months. A survey assessed the perspectives of both patients and health professionals about the treatment.</p><p><strong>Results: </strong>A total of 70 patients treated by 11 GPs and 6 physiotherapists were involved. Comparing outcomes at baseline vs. after six months (median [IQR]): PHQ-15 decreased, 14 [11, 17] vs. 8 [5, 12], <i>p</i> < 0.001; PAVS increased, 60 [30, 120] vs. 120 [60, 180], <i>p</i> < 0.001; GP confidence (scale 0-100) in treating BDD increased, 50 [38, 66] vs. 82 [66, 85], <i>p</i> = 0.005. Feedback from patients, GPs and physiotherapists about the intervention was positive.</p><p><strong>Conclusion: </strong>The interprofessional care pathway for patients with BDD had a positive impact on patient outcomes, GP treatment confidence, and was well-received by both patients and health professionals. It can be adapted across primary care systems and tailored to local contexts to improve the quality of care.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2599579"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12784638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936401","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 care providers' perspectives of experiences with transgender and gender diverse adults: A scoping review.","authors":"Kate Lauren Keaney, Marie Claire Van Hout, Geoff McCombe, Nandakumar Ravichandran, John Broughan, Walter Cullen, Des Crowley","doi":"10.1080/13814788.2026.2657083","DOIUrl":"10.1080/13814788.2026.2657083","url":null,"abstract":"<p><strong>Background: </strong>As a minority group, transgender and gender diverse (TGD) individuals may experience healthcare stressors due to stigma, transphobia and healthcare staff who lack the knowledge about their specific needs, impacting primary care entry and attendance. Extant literature is concentrated on TGD individuals' perspectives of primary care with the main message being that it is inadequate.</p><p><strong>Aim: </strong>To explore the primary care provider (PCP) perspective of experiences with adult TGD patients.</p><p><strong>Methods: </strong>A scoping review was conducted using Arksey and O'Malley's five-step framework to map and de-scribe the literature relating to PCP perspectives' of experiences with TGD adults. Four databases were searched: PubMed, Embase, PsycINFO and CINAHL Plus. The process was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The final dataset (<i>n</i> = 22) were charted and analysed thematically.</p><p><strong>Results: </strong>Following application of exclusion criteria and removal of duplicates, twenty-two studies across five countries were included in the review. Studies include qualitative studies, surveys, mixed methods studies, a retrospective review and a pilot study with a pre- and postintervention analysis. Key themes identified related to the attitudes of PCPs towards TGD individuals, education of PCPs on TGD health issues and the barriers/facilitators to caring for TGD patients from a PCP perspective.</p><p><strong>Conclusion: </strong>The review highlights the need for improved access to TGD-specific education. Future research should explore the best way to provide this to PCPs, inform implementation into relevant policies and include a broader range of countries to strengthen global applicability.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2657083"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730707","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":"Towards best practice recommendations: Perspectives from Australian GPs to inform the use of general practice data for research - A modified Delphi study.","authors":"Heidi Green, Justin Beilby, Chris Degeling, Carolyn Adams, Felicity Flack, Lucy Carolan, Belinda Fabrianesi, Anthony Brown, Alberto Nettel Aguirre, Allison Clarke, Christian Jung, Annette Braunack-Mayer","doi":"10.1080/13814788.2025.2601396","DOIUrl":"10.1080/13814788.2025.2601396","url":null,"abstract":"<p><strong>Background: </strong>General practice medical records offer significant potential for secondary use in research, policy and public health. In Australia, these data remain underused due to concerns around privacy, governance and ethical use. Understanding the perspectives of GPs is essential to developing best practice recommendations for responsible data use.</p><p><strong>Method: </strong>A three-round modified Delphi study was conducted with 22 Australian GPs with experience in research and/or data sharing. Participants rated and commented on 11 recommendations derived from community juries, with consensus defined as ≥75% agreement. Feedback summaries and thematic analysis informed subsequent rounds.</p><p><strong>Results: </strong>Consensus was reached on 10 of 11 recommendations. The panel supported ethical approval, transparency, protection of the doctor-patient relationship and remuneration for practices contributing data. An opt-out approach to consent was endorsed under strict conditions, with clear distinctions made between vulnerable and non-vulnerable populations. The panel also supported the establishment of a governance body and researcher cybersecurity training. However, no consensus was reached on community involvement in research design, despite its growing recognition as best practice by funding bodies.</p><p><strong>Conclusion: </strong>This study highlights the need for a nationally agreed remuneration model for general practices that contribute data, clearer ethical guidance for engaging vulnerable populations and reform of statutory frameworks to support responsible data use. The lack of consensus on community involvement is concerning, especially as initiatives such as the Australian Institute of Health and Welfare (AIHW) and Primary Health Networks (PHN) partnership advance national data standards. Bridging this gap is essential to align professional practice with public expectations and ensure inclusive, ethically robust research.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2601396"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12794724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936387","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}