European Journal of General Practice最新文献

{"title":"Development and validation of a risk prediction model for hospital admission in COVID-19 patients presenting to primary care.","authors":"Laure Wynants, Natascha Jh Broers, Tamara N Platteel, Roderick P Venekamp, Dennis G Barten, Mathie Pg Leers, Theo Jm Verheij, Patricia M Stassen, Jochen Wl Cals, Eefje Gpm de Bont","doi":"10.1080/13814788.2024.2339488","DOIUrl":"https://doi.org/10.1080/13814788.2024.2339488","url":null,"abstract":"<p><strong>Background: </strong>There is a paucity of prognostic models for COVID-19 that are usable for in-office patient assessment in general practice (GP).</p><p><strong>Objectives: </strong>To develop and validate a risk prediction model for hospital admission with readily available predictors.</p><p><strong>Methods: </strong>A retrospective cohort study linking GP records from 8 COVID-19 centres and 55 general practices in the Netherlands to hospital admission records. The development cohort spanned March to June 2020, the validation cohort March to June 2021. The primary outcome was hospital admission within 14 days. We used geographic leave-region-out cross-validation in the development cohort and temporal validation in the validation cohort.</p><p><strong>Results: </strong>In the development cohort, 4,806 adult patients with COVID-19 consulted their GP (median age 56, 56% female); in the validation cohort 830 patients did (median age 56, 52% female). In the development and validation cohort respectively, 292 (6.1%) and 126 (15.2%) were admitted to the hospital within 14 days, respectively. A logistic regression model based on sex, smoking, symptoms, vital signs and comorbidities predicted hospital admission with a c-index of 0.84 (95% CI 0.83 to 0.86) at geographic cross-validation and 0.79 (95% CI 0.74 to 0.83) at temporal validation, and was reasonably well calibrated (intercept -0.08, 95% CI -0.98 to 0.52, slope 0.89, 95% CI 0.71 to 1.07 at geographic cross-validation and intercept 0.02, 95% CI -0.21 to 0.24, slope 0.82, 95% CI 0.64 to 1.00 at temporal validation).</p><p><strong>Conclusion: </strong>We derived a risk model using readily available variables at GP assessment to predict hospital admission for COVID-19. It performed accurately across regions and waves. Further validation on cohorts with acquired immunity and newer SARS-CoV-2 variants is recommended.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11060008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854432","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":"Moving forward after the COVID-19 pandemic: Lessons learned in primary care from the multi-country PRICOV-19 study.","authors":"Sara Willems, Pierre Vanden Bussche, Esther Van Poel, Claire Collins, Zalika Klemenc-Ketis","doi":"10.1080/13814788.2024.2328716","DOIUrl":"10.1080/13814788.2024.2328716","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has accentuated the indispensable role of primary care. <b>Objectives:</b> Recognising this, the PRICOV-19 study investigated how 5,489 GP practices across 38 countries (Austria, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Israel, Italy, Kosovo*, Latvia, Lithuania, Luxembourg, Malta, Republic of Moldova, Netherlands, North Macedonia, Norway, Poland, Portugal, Romania, Serbia, Slovenia, Spain, Sweden, Switzerland, Turkey, Ukraine, and United Kingdom) adapted their care delivery during the pandemic.</p><p><strong>Methods: </strong>Based on a series of discussions on the results of the PRICOV-19 study group, eight recommendations to enhance primary care's preparedness for future crises were formulated and endorsed by EQuiP and WONCA Europe.</p><p><strong>Results: </strong>The recommendations underscore the importance of recognising and sustaining the substantial strides made in patient safety within GP practices during the pandemic in current daily practices; acknowledging and supporting the pivotal role of GP practices in addressing health inequalities during crises; adopting interprofessional care models to enhance practices' resilience and adaptability to change; supporting training practices; creating healthy working environments; investing in infrastructure that supports adequate and safe care; and increasing funding for research on patient safety and primary care quality to inform evidence-based health policies and fostering international knowledge exchange among healthcare professionals and policymakers.</p><p><strong>Conclusion: </strong>Policymakers, primary care associations, and the broader healthcare system are urged to collaboratively take responsibility and increase support for GP practices to enhance their resilience, adaptability, and capacity to deliver safe and equitable healthcare during future crises.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10984223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177696","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":"Educational needs assessment for health advocate role in family medicine residency training in Turkey: A Delphi study.","authors":"Meral Demirören, Duygu Ayhan Başer","doi":"10.1080/13814788.2024.2386284","DOIUrl":"https://doi.org/10.1080/13814788.2024.2386284","url":null,"abstract":"<p><strong>Background: </strong>Health advocacy (HA) involves purposeful actions to inform, mobilise, and organise activities to address social determinants of health affecting individuals or communities. It is a fundamental component of medical practice, deemed mandatory by professional and educational bodies. Therefore, including health advocacy training in pre- and post-graduate medical education is crucial.</p><p><strong>Objectives: </strong>In this study, we aimed to determine the need for HA training for family physicians (FPs) based on expert opinions.</p><p><strong>Methods: </strong>We conducted a modified Delphi study with 105 academic experts and active FPs to explore HA training needs. Using a three-round technique, experts first answered five open-ended questions on HA competencies, teaching and assessment methods, learning environments, and integration in residency training. In the second round, statements from the responses were rated on a 5-point Likert scale, in the third round, statements below the 85% consensus level were revised and re-evaluated.</p><p><strong>Results: </strong>The panel consisted of 41 experts (33 academicians, 8 practitioners) who accepted the invitation and completed the study. At the end of the three rounds, consensus was reached on 38 statements for HA competencies, 15 for teaching methods, 8 for assessment methods, and 20 for integration for HA training.</p><p><strong>Conclusion: </strong>Competencies for the HA role are very broad in perspective and show commonalities with the FPs' 'professional', 'expert' and 'leader' roles. Longitudinally integration of the HA training into the national 'Family Medicine Residency Training Core Curriculum' through participatory processes and training of FM trainers in HA is strongly recommended.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114732","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":"How to overcome information and communication barriers in Human Papillomavirus vaccination? A SWOT analysis based on the opinions of European family doctors in contact with young people and their parents.","authors":"Hüsna Sarıca Çevik, A Gülsen Ceyhun Peker, Süleyman Görpelioğlu, Shlomo Vinker, Mehmet Ungan","doi":"10.1080/13814788.2024.2393858","DOIUrl":"10.1080/13814788.2024.2393858","url":null,"abstract":"<p><strong>Background: </strong>Family doctors (FDs)/General practitioners (GPs) are the key contact points for young people and their parents regarding Human Papillomavirus (HPV) vaccination. However, their recommendations are influenced by communication skills.</p><p><strong>Objectives: </strong>Under the EU4Health project, PROTECT-EUROPE, WONCA Europe led a task to identify and analyse strategies for clinicians' interpersonal communication skills when discussing HPV and its vaccination with young people and their parents.</p><p><strong>Methods: </strong>Strengths, Weaknesses, Opportunities, Threats (SWOT) analysis using qualitative data focused on HPV vaccine acceptance and communication with the target population. FDs/GPs, members of WONCA Europe, were recruited using convenience and snowball sampling through surveys at conferences and emails.</p><p><strong>Results: </strong>223 FDs/GPs from 36 countries participated. Strengths included face-to-face communication, extensively used to promote the HPV vaccine. Weaknesses involved financial constraints, limited knowledge about gender-neutral vaccination, safety concerns, and time pressure during the consultations. Opportunities included confidentiality, open dialogue, trusting relationship between FDs/GPs and the target population, continuing medical education, school training, and questions & answers sessions to increase vaccine communication. Threats included social norms and cultures, stigmas against HPV, and anti-vaccination movements hindering discussions on HPV vaccination.</p><p><strong>Conclusion: </strong>It is crucial to train FDs/GPs to address knowledge gaps, enhance communication skills, and maintain a trusting relationship with patients when discussing HPV vaccination. Overcoming financial barriers and ensuring gender-neutral vaccination programs are accessible across Europe are also essential. Providing accurate information through the web- and school-based channels and developing community-oriented approaches targeting sociocultural factors and different needs to eliminate HPV vaccine stigmas should be considered when recommending the vaccine.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114734","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":"Generic dispensing rates for substitutable drugs prescribed by general practitioners compared with other private ambulatory specialists: A study based on a French national reimbursement database.","authors":"Hugo Figoni, Sarah Robert, Kim Bonello, Gladys Ibanez, Julie Chastang, Candice Estellat","doi":"10.1080/13814788.2024.2407600","DOIUrl":"https://doi.org/10.1080/13814788.2024.2407600","url":null,"abstract":"<p><strong>Background: </strong>The use of generic drugs is a way for healthcare systems to reduce costs, particularly in ambulatory care. Several studies suggest that the prescriber's speciality is associated with the use of generic drugs, and that substitutable drugs prescribed by General Practitioners (GPs) are more often generic, but this association has never been studied in France. In the French legislative context, except in rare situations, all substitutable drugs prescribed should be dispensed in generic form.</p><p><strong>Objectives: </strong>Compare the generic drugs dispensing rate among substitutable drugs dispensed in community pharmacies prescribed by French private GPs with that of other private specialists, all other specialities combined (first objective) or each other speciality taken individually (second objective).</p><p><strong>Methods: </strong>We used a sample of an open available semi-aggregated database from the 2019 French health insurance system database. We compared with logistic regression models GPs to all other specialities combined, then GPs to the 19 other specialties taken individually, only on the substitutable drugs they prescribe in common.</p><p><strong>Results: </strong>In 2019, 53.4% of the drugs prescribed by French private ambulatory physicians were substitutable drugs, and 81.5% of them were dispensed in generic form. After adjustment, the generic dispensing rate for substitutable drugs was significantly higher for GPs than for other specialties (ORa 0.74 [IC95% 0.72-0.76]). Thirteen of the nineteen other specialities taken individually, such as endocrinologists (ORa 0.64 [IC95% 0.57-0.72]) and cardiologists (ORa 0.60 [0.56-0.63]) had significantly lower generic dispensing rates than GPs. No other speciality had a rate significantly higher than GPs.</p><p><strong>Conclusions: </strong>Substitutable drugs prescribed by French private GPs are more often dispensed in generic form than those from other private ambulatory specialties. To understand this result and optimise the use of generic drugs in outpatient settings, we need to study the different stages of drug use, from prescription by the physician to dispensing by the pharmacist and acceptance by the patient.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11486039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480999","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":"Development of the face-to-face component and recruitment strategy of a primary care digital social intervention for patients with asthma: Qualitative focus groups and interviews with stakeholders.","authors":"Georgios Dimitrios Karampatakis, Samuel Kimber, Helen E Wood, Chris J Griffiths, Stephanie J C Taylor, Xiancheng Li, Bill Day, Jonathan Mant, Clare Relton, Jane S Watson, Viv Marsh, Neil S Coulson, Anna De Simoni","doi":"10.1080/13814788.2024.2407594","DOIUrl":"10.1080/13814788.2024.2407594","url":null,"abstract":"<p><strong>Background: </strong>5.4 million people in the UK have asthma, with one third experiencing suboptimal control, leading to co-morbidities and increased healthcare use. A quarter of people with long-term conditions informally access peer support through online health communities (OHCs). However, integrating online peer support into primary care services to facilitate self-management is a new concept.</p><p><strong>Objectives: </strong>To develop together with stakeholders the content, delivery, and recruitment strategy of a digital social intervention to promote use of online peer support amongst asthma patients in primary care.</p><p><strong>Methods: </strong>Data was collected by qualitative, audio-recorded, one-to-one interviews with clinicians, and focus groups with patients with asthma from East London general practices. The topic guide was informed by patient and public involvement work. Data collected was iterative (i.e. new ideas were added to subsequent interviews and focus groups). Verbatim transcripts were uploaded to NVivo12 and thematically analysed.</p><p><strong>Results: </strong>Twenty patients from several ethnicities participated across five focus groups, and three general practitioners and three practice nurses were interviewed. The study's outputs included: the intervention's face-to-face content; content of clinician training; patient-facing leaflets/material; and a survey to recruit eligible patients. An intervention consisting of a structured consultation with a primary care clinician followed by OHC engagement, was developed based on three generated themes: 'introducing OHCs', describing how clinicians should introduce OHCs; 'OHC engagement', describing factors influencing OHC engagement; and 'clinician training'.</p><p><strong>Conclusion: </strong>Findings will assist clinicians in consultations about supporting self-management of patients through OHCs. Future research should evaluate feasibility, effectiveness, and cost-effectiveness of such support.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11441056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332449","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":"General Practitioners practice nurses and parents' perspectives on childhood overweight management - a qualitative study.","authors":"Maxime Adriana Maria van der Velden, Hevy Hassan, Dieuwke Schiphof, Madelon van Tilborg-den Boeft, Sylvia Buis, Wilma Jansen, Patrick Jan Eugène Bindels, Marienke van Middelkoop","doi":"10.1080/13814788.2024.2402259","DOIUrl":"10.1080/13814788.2024.2402259","url":null,"abstract":"<p><strong>Background: </strong>Overweight and obesity in children is a major health problem. General practice might be a promising setting for identifying and for the first steps in the management of overweight and obesity in children.</p><p><strong>Objective: </strong>To explore opinions, needs and preferences about the role of general practice in the management of overweight and obesity in children from the perspectives of Dutch general practitioners (GPs), practice nurses (PNs) and parents of children with and without overweight.</p><p><strong>Methods: </strong>A qualitative study using semi-structured focus group interviews. GPs and PNs were recruited from general practices from the region South-Western. Parents were mainly recruited via social media and primary schools. Twenty-five GPs, seven PNs and 18 parents were interviewed. All interviews were audio recorded, transcribed and thematically analysed.</p><p><strong>Results: </strong>GPs, PNs and parents agreed that it is the task of the GP to identify, address and refer children with overweight and obesity. However, GPs find it difficult to start this conversation due to time constraints; fear for the reaction of parents and children; lack of clarity about treatment and referral options. Parents indicated they are open to a conversation if the GP is non-judgmental, honest and respectful. PNs saw no role in managing overweight and obesity in children.</p><p><strong>Conclusion: </strong>Although GPs experience several barriers, GPs, PNs and parents all agreed that GPs should play a role in identifying, addressing and referring children with overweight and obesity. Supportive tools are required for GPs in order to play this role.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11441054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332450","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":"Comment on: Climate change is a health issue. The general practitioner and planetary health by Stoffers & Muris 2023.","authors":"Oisín Brady Bates, Natasha Freeman","doi":"10.1080/13814788.2023.2298332","DOIUrl":"10.1080/13814788.2023.2298332","url":null,"abstract":"","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10810653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139542437","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 'Consensus Reporting Items for Studies in Primary Care' (CRISP) statement in the European Journal of General Practice.","authors":"Jelle Stoffers,Jako Burgers","doi":"10.1080/13814788.2024.2370117","DOIUrl":"https://doi.org/10.1080/13814788.2024.2370117","url":null,"abstract":"","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142195996","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":"Evidence-based general practice: Selected abstracts from the 98th EGPRN Meeting, Porto, Portugal, 9–12 May 2024","authors":"Mine Kaya Bezgin","doi":"10.1080/13814788.2024.2390444","DOIUrl":"https://doi.org/10.1080/13814788.2024.2390444","url":null,"abstract":"With its strong commitment to Primary Care, Portugal’s healthcare landscape has witnessed significant strides in recent years. The 98th EGPRN meeting in Porto was a testament to the dedication and ...","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142195997","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}