European Journal of General Practice最新文献

{"title":"Survey of general practitioners' awareness, practice and perception of social prescribing across Europe.","authors":"Sinah Evers, Joyce Kenkre, Thomas Kloppe, Donata Kurpas, Juan M Mendive, Ferdinando Petrazzuoli, Josep Vidal-Alaball","doi":"10.1080/13814788.2024.2351806","DOIUrl":"10.1080/13814788.2024.2351806","url":null,"abstract":"<p><strong>Background: </strong>Social prescribing (SP) is a patient pathway by which healthcare professionals connect patients with other sources of support, groups, or activities within their community. The awareness, practice, and perception of SP among GPs across Europe remains unclear.</p><p><strong>Objectives: </strong>To explore the awareness, practice, and perception of GPs on SP in the WONCA Europe region.</p><p><strong>Methods: </strong>An anonymous, cross-sectional online survey was distributed through a snowballing system, mailing lists, and at three international conferences in 2022/2023 to explore GPs' awareness, practice, and perception of SP. The questionnaire in English contained 21 open and closed questions.</p><p><strong>Results: </strong>Of the 208 participating GPs from 33 countries, 116 (56%) previously heard of 'social prescribing' and 66 (32%) regularly referred patients to community activities through a formal system. These 66 GPs reported different funding sources and varied activities, with an average of four activities and physical exercise being the most prevalent. Among them, 25 (38%) knew about national or local SP awareness campaigns. Of these 25, 17 (68%) agreed that SP increases their job satisfaction and 21 (84%) agreed that it has a positive impact on their patients. Variations in SP awareness and referral practice were evident across and within countries.</p><p><strong>Conclusion: </strong>Despite disparities in awareness and referral practice as well as a diversity of activities and funding sources, most GPs who actively referred patients and were informed about SP campaigns agreed that SP positively impacts them and their patients.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2351806"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11104702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140960774","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":"Looking beyond effectiveness: Integration of social science research within international infectious disease research in primary care.","authors":"Sibyl Anthierens","doi":"10.1080/13814788.2024.2416432","DOIUrl":"https://doi.org/10.1080/13814788.2024.2416432","url":null,"abstract":"<p><strong>Background: </strong>As researchers in primary care, we want to drive change in practice and conduct research that sparks meaningful transformation. These changes can only happen if our research work resonates in a meaningful way with the people who they are designed for, i.e. the healthcare professionals and the patients.</p><p><strong>Viewpoint: </strong>This viewpoint stems from first-hand insights gained as a social scientist engaged in trials and primary care research amidst epidemics and pandemics. Some examples stemming from the EU Funded GRACE INTRO, RECOVER and Prudence trial illustrate these experiences. I outline how primary care can effectively address the pressing challenges it encounters, whether as researchers, members of the public, or healthcare professionals, and how to integrate successfully social sciences within clinical primary care research.</p><p><strong>Conclusion: </strong>As interdisciplinary researchers, social scientists and medical researchers can work together under certain conditions, i.e. equal status, adequate resources, and seamless integration within trial structures.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2416432"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512995","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":"Screening tools assessing mental illness in primary care: A systematic review.","authors":"Bernadette Neulinger, Christopher Ebert, Kirsten Lochbühler, Antje Bergmann, Jochen Gensichen, Karoline Lukaschek","doi":"10.1080/13814788.2024.2418299","DOIUrl":"10.1080/13814788.2024.2418299","url":null,"abstract":"<p><strong>Background: </strong>To better manage patients with a wide range of mental health problems, general practitioners would benefit from diagnostically accurate and time-efficient screening tools that comprehensively assess mental illness. Therefore, the aim of this systematic review was to identify screening tools that either take a multiple-mental disorder or a transdiagnostic approach. As primary and secondary outcomes, diagnostic accuracy and time efficiency were investigated.</p><p><strong>Methods: </strong>The data bases MEDLINE, Embase, Cochrane Library, Psyndex and PsycINFO were searched. Studies reporting on multiple-mental disorder or transdiagnostic screening tools used in primary care with adult patients were included. Sensitivity, specificity, positive and negative predictive value served as measures of diagnostic accuracy. Time efficiency was evaluated by the number of items of a screening tool and the time required for its completion and evaluation.</p><p><strong>Results: </strong>Eleven studies met the inclusion criteria. The majority of screening tools assessed multiple mental disorders separately. A sub-group of screening tools took a transdiagnostic approach by examining the spectrum of mood, anxiety and stress-related disorders. One screening tool used internalised, cognitive/somatic and externalised dysfunction as transdiagnostic domains of mental illness. Mostly, a sufficient sensitivity and specificity was reported. All screening tools were found to be time efficient.</p><p><strong>Conclusion: </strong>The eleven identified screening tools can support general practitioners to identify patients with mental health problems. However, there was great heterogeneity concerning their diagnostic scope of psychopathology. Further screening tools for primary care are needed that target broad constructs of mental illness, such as transdiagnostic factors or personality dysfunction.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2418299"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11500526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512998","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":"Relationship between patient-perceived quality of primary care and self-reported hospital utilisation in China: A cross-sectional study.","authors":"Chenwen Zhong, Junjie Huang, Lina Li, Zhuojun Luo, Cuiying Liang, Mengping Zhou, Nan Hu, Li Kuang","doi":"10.1080/13814788.2024.2308740","DOIUrl":"10.1080/13814788.2024.2308740","url":null,"abstract":"<p><strong>Background: </strong>Reducing avoidable hospital admissions is a global healthcare priority, with optimal primary care recognised as pivotal for achieving this objective. However, in developing systems like China, where primary care is evolving without compulsory gatekeeping, the relationship between patient-perceived primary care quality and hospital utilisation remains underexplored.</p><p><strong>Objectives: </strong>This study aimed to explore the association between patient-perceived primary care quality and self-reported hospital utilisation in China.</p><p><strong>Methods: </strong>Data were collected from 16 primary care settings. Patient-perceived quality of primary care was measured using the Assessment Survey of Primary Care scale across six domains (first-contact care, continuity, comprehensiveness, accessibility, coordination, and patient-centredness). Hospital utilisation included patient self-reported outpatient visits, hospital admissions, and emergency department (ED) visits in the last six months. Logistic regression analyses were examined associations between self-reported hospital utilisation and perceived primary care quality adjusted for potential confounders.</p><p><strong>Results: </strong>Of 1,185 patients recruited, 398 (33.6%) reported hospital utilisation. Logistic regression analyses showed that higher total scores for patient-perceived quality of primary care were associated with decreased odds of hospital utilisation (adjusted odds ratio(AOR): 0.417, 95% confidence interval (CI): 0.308-0.565), outpatient visits (AOR: 0.394, 95% CI: 0.275-0.566) and hospital admissions (AOR: 0.496, 95% CI: 0.276-0.891). However, continuity of care was positively associated with ED visits (AOR: 2.252, 95% CI: 1.051-4.825).</p><p><strong>Conclusion: </strong>Enhanced patient-perceived quality of primary care in China is associated with a reduction in self-reported overall hospital utilisation, including outpatient visits and hospital admissions. However, better continuity of care may be associated with increased ED visits. Further research is warranted for precise insights and validation of these findings.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2308740"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10898267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139974601","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":"Enhancing LGBT + primary healthcare in Slovenia: A national qualitative study of experiences and expectations of LGBT + people and family doctors.","authors":"Nina Jerala, Davorina Petek","doi":"10.1080/13814788.2024.2373121","DOIUrl":"10.1080/13814788.2024.2373121","url":null,"abstract":"<p><strong>Background: </strong>Despite growing acceptance of LGBT + individuals, an underlying stigma persists even in healthcare, resulting in substandard care and worse healthcare outcomes for LGBT + individuals.</p><p><strong>Objectives: </strong>To examine and compare the experiences and expectations regarding primary healthcare among LGBT + individuals and general practitioners (GPs) in Slovenia.</p><p><strong>Methods: </strong>We conducted an online national qualitative study using open-ended questions. To reach LGBT + population snowball method of recruitment was employed by sharing the questionnaire through LGBT + organisations, while GPs were invited by email of Association of family doctors in Slovenia. Anonymous data was collected from October to December 2021 and the questionnaires of 25 GPs and 90 LGBT + individuals of various ages, backgrounds, gender identities and sexual orientations were reviewed using thematic analysis.</p><p><strong>Results: </strong>Both LGBT + participants and GPs expressed a desire for equal treatment. However, while all GPs claimed to treat all patients equally, LGBT + participants reported more varied experiences. Specific knowledge, especially on LGBT + terminology and healthcare, was perceived as lacking among GPs, leading LGBT + individuals to seek advice from specialists or community counselling. Systemic barriers, including societal stigmatisation and limited formal education on LGBT + issues, were identified, highlighting the need for designated safe spaces and improved GP training. Safety emerged as a central theme, crucial for fostering trust and disclosure between patients and healthcare providers.</p><p><strong>Conclusion: </strong>The study underscores the significance of a sense of safety in the patient-doctor relationship and highlights the need for improved training and attitudes to provide inclusive and affirming healthcare for LGBT + individuals.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2373121"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11271072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560333","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":"Exploring the experiences of GPs in establishing and operating the chronic disease management programme in clinical practice in Ireland. A qualitative study.","authors":"Stephen Buckley, James O' Flynn, Tony Foley","doi":"10.1080/13814788.2024.2430521","DOIUrl":"10.1080/13814788.2024.2430521","url":null,"abstract":"<p><strong>Background: </strong>The management of chronic diseases, in the context of an ageing population and increasing life expectancy, is one of the major challenges facing the Irish health system. In 2020, a chronic disease management programme [CDM] was introduced in Irish general practice as part of a transformation in health policy to meet the changing needs of the population.</p><p><strong>Objectives: </strong>To explore GPs' experiences and perceptions of the impact of the introduction of CDM on general practice in Ireland.</p><p><strong>Methods: </strong>18 semi-structured interviews were conducted with GPs in clinical practice from across Ireland. GPs were purposefully recruited to capture the differing experiences faced by GPs in large and small practices in both urban and rural settings. Interviews were analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>GPs were enthusiastic about aspects of CDM, which they felt provided an improved framework for their approach to the management of chronic diseases. However, they described several challenges to implementation, especially around capacity constraints. CDM could have unintended consequences for aspects of routine GP care. GPs described how practice nurses had taken on a central role in both clinical and administrative aspects of the programme.</p><p><strong>Conclusions: </strong>GPs value the framework provided by CDM for their approach to the management of chronic disease. However, challenges around practice capacity and its impact both on the delivery of CDM and aspects of routine care highlight the importance for policy makers to provide continued support to strengthen the general practice infrastructure.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2430521"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752121","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":"'I just felt either I'm going to kill someone or I'm going to end up killing myself'. How does it feel to be burnt out as a practicing UK GP?","authors":"Ishbel Orla Whitehead, Suzanne Moffatt, Barbara Hanratty","doi":"10.1080/13814788.2024.2426981","DOIUrl":"10.1080/13814788.2024.2426981","url":null,"abstract":"<p><strong>Objective: </strong>To explore how it feels to be a burnt out GP in the NHS.</p><p><strong>Design: </strong>In depth qualitative interviews with 16 UK GPs with self-declared 'lived experience' of burnout.</p><p><strong>Setting: </strong>United Kingdom Primary Care.</p><p><strong>Results: </strong>Seven male and nine female GPs described their experiences of burnout to a peer researcher. Themes identified were exhaustion and depersonalisation, mental and physical illness, identity and existential crises, and finally tenacity and resilience. Participants were self-reflective and described distress, shame, stigma, and guilt, including times of suicidal behaviour and isolation due to their burnout.</p><p><strong>Conclusions: </strong>Burnout threatens a GP's sense of identity, purpose, and functioning in their lives, and ultimately can be life-threatening. Active listening to GP distress and a system wide approach to managing distress and burnout is urgently required.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2426981"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711886","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":"Effectiveness of the Assessment of Burden of Chronic Conditions (ABCC)-tool in patients with asthma, COPD, type 2 diabetes mellitus, and heart failure: A pragmatic clustered quasi-experimental study in the Netherlands.","authors":"Esther A Boudewijns, Danny Claessens, Onno C P van Schayck, Mascha Twellaar, Bjorn Winkens, Manuela A Joore, Lotte C E M Keijsers, Stijn Krol, Mathijs Urlings, Annerika H M Gidding-Slok","doi":"10.1080/13814788.2024.2343364","DOIUrl":"10.1080/13814788.2024.2343364","url":null,"abstract":"<p><strong>Background: </strong>The Assessment of Burden of Chronic Conditions (ABCC)-tool was developed to optimise chronic care.</p><p><strong>Objectives: </strong>This study aimed to assess the effectiveness of the ABCC-tool in patients with COPD, asthma, type 2 diabetes, and/or heart failure in primary care in the Netherlands.</p><p><strong>Methods: </strong>The study had a pragmatic, clustered, two-armed, quasi-experimental design. The intervention group (41 general practices; 176 patients) used the ABCC-tool during routine consultations and the control group (14 general practices; 61 patients) received usual care. The primary outcome was a change in perceived quality of care (PACIC; Patient Assessment of Chronic Illness Care) after 18 months. Secondary outcomes included change in the PACIC after 6 and 12 months, and in quality of life (EQ-5D-5L; EuroQol-5D-5L), capability well-being (ICECAP-A; ICEpop CAPability measure for Adults), and patients' activation (PAM; Patient Activation Measure) after 6, 12, and 18 months for the total group and conditions separately.</p><p><strong>Results: </strong>We observed a significant difference in the PACIC after 6, 12, and 18 months (18 months: 0.388 points; 95%CI: 0.089-0.687; <i>p</i> = 0.011) for the total group and after 6 and 12 months for type 2 diabetes. After 18 months, we observed a significant difference in the PAM for the total group but not at 6 and 12 months, and not for type 2 diabetes. All significant effects were in favour of the intervention group. No significant differences were found for the EQ-5D-5L and the ICECAP-A.</p><p><strong>Conclusion: </strong>Use of the ABCC-tool has a positive effect on perceived quality of care and patients' activation, which makes the tool ready for use in clinical practice. Healthcare providers (e.g. general practitioners and practice nurses) can use the tool to provide person-centred care.<b>Trial registration number:</b> ClinicalTrials.gov Registry (NCT04127383).</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2343364"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11104697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913155","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":"Person-centred care, a core concept of family medicine.","authors":"Igor Švab, Venija Cerovečki","doi":"10.1080/13814788.2024.2393860","DOIUrl":"10.1080/13814788.2024.2393860","url":null,"abstract":"","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2393860"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11351358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074589","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":"Early-career general practitioners' career intentions in Estonia: A qualitative study.","authors":"Marta Velgan, Anett Uibu, Elinor Õunap, Mari Katariina Kangasniemi, Nele R Michels, Ruth Kalda","doi":"10.1080/13814788.2024.2368557","DOIUrl":"10.1080/13814788.2024.2368557","url":null,"abstract":"<p><strong>Background: </strong>The shortage of general practitioners (GPs) is a worsening problem in many countries and poses a threat to the services provided by primary care and by extension for the entire healthcare system. Issues with GP workforce recruitment and retention can be reasons for this shortage.</p><p><strong>Objectives: </strong>To describe GP trainees and newly qualified GPs experiences and perceptions on how their training and early experiences of work influence their career intentions in primary care in Estonia.</p><p><strong>Methods: </strong>A qualitative study with GP trainees (<i>n</i> = 12) and newly qualified GPs (<i>n</i> = 13) using semi-structured group interviews (<i>n</i> = 6) was conducted. Interviews were conducted from October until November 2020. Data were analysed using thematic analysis with NVivo Software.</p><p><strong>Results: </strong>Although early-career GPs in Estonia envision their future roles as GP practice owners with patient list, this is often postponed due to various reasons. Early-career GPs expressed a sense of unpreparedness to fill all the roles of GPs' and found the process of establishing a GP practice and taking on a patient lists very complicated. They value work-life balance and prefer workplaces, which offer flexible working conditions.</p><p><strong>Conclusion: </strong>Potential strategies were identified to enhance the willingness of early-career GPs to continue their career as GP practice owners with patient list: improving the GP training program by placing more emphasis on managing skills and making the process of establishing GP practice and taking on a patient list less bureaucratic and more accessible.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2368557"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11225626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494288","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}