European Journal of General Practice最新文献

{"title":"Diagnostic flow for all patients referred with non-specific symptoms of cancer to a diagnostic centre in Denmark: A descriptive study.","authors":"Christina Sadolin Damhus, John Brandt Brodersen, Gunnar Lauge Nielsen","doi":"10.1080/13814788.2023.2296108","DOIUrl":"10.1080/13814788.2023.2296108","url":null,"abstract":"<p><strong>Background: </strong>Since 2012, Cancer Patient Pathways for Non-specific Symptoms and Signs of Cancer (NSSC-CPP) have been implemented in Scandinavia and UK.</p><p><strong>Objectives: </strong>This study aimed to describe the diagnostic flow for all patients referred from 1 January to 30 June 2020 to the NSSC-CPP in the Diagnostic Centre in Farsø (DC-F), Denmark.</p><p><strong>Methods: </strong>During the study period, we prospectively recorded information on the diagnostic flow, including: pathway trajectory, symptoms and findings leading to referral, diagnostic procedures and diagnoses at the end of DC Farsø work-up and within 6-months for all patients referred to the NSSC-CPP in DC Farsø using electronic patient files and the Danish National Patient Registry (DNPR).</p><p><strong>Results: </strong>Of the 314 referrals to DC Farsø, 227 had diagnostic work-up in DC Farsø, the remaining were redirected to other CPPs (<i>n</i> = 11), outpatient clinics (<i>n</i> = 45) or redirected to general practice (<i>n</i> = 25). Of total referrals, 25 (8%) received a malignant diagnosis, 20 (6%) a non-malignant but clinically relevant diagnosis with initiation of treatment, 16 (5%) a non-malignant diagnosis but no treatment needed and in 253 (81%) referrals no severe new condition was diagnosed. Two (1%) additional malignancies were diagnosed within a 6-month follow-up period.</p><p><strong>Conclusion: </strong>By tracking all patients referred to the NSSC-CPP in DC Farsø, including those redirected, this is the first study to describe the diagnostic flow for all patients referred to a diagnostic centre in Denmark. This knowledge is important for further organisation and planning of the NSSC-CPP.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2296108"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10773629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139099235","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 impact of COVID-19 pandemic on Primary Health Care through 'health providers' eyes': Α qualitative study of focus groups and individual interviews in Greece.","authors":"Foteini Michalaki, Korina Marina Triantafillopoulou, Ilias Pagkozidis, Ilias Tirodimos, Theodoros Dardavesis, Zoi Tsimtsiou","doi":"10.1080/13814788.2024.2382218","DOIUrl":"10.1080/13814788.2024.2382218","url":null,"abstract":"<p><strong>Background: </strong>Primary Health Care (PHC) was the cornerstone of the pandemic response.</p><p><strong>Objectives: </strong>We aimed to explore the positive and negative impact of the pandemic, during its final wave, through 'PHC providers' eyes', as well as their recommendations towards restructuring and enhancing PHC services.</p><p><strong>Methods: </strong>A two-phase qualitative study was conducted, pursuing data triangulation from Focus Groups (FGs) and individual, semi-structured interviews for the purposes of data completeness and confirmation (summer 2022 and spring 2023, respectively). A purposive sample of settings was employed, including in total five PHC units according to location with different population distribution; one in Athens (FGs) and four in Northern Greece (interviews). Inductive content analysis was used.</p><p><strong>Results: </strong>In total, 24 PHC professionals participated in FGs, whereas 17 were individually interviewed. Our findings reflect a general understanding of the pandemic's positive imprint, namely acceleration of digitalisation, establishment of health protection measures, recognition of PHC's role, raise in public awareness of primary prevention, team-cooperation, increase in providers' self-efficacy, appointment of health professionals and re-organisation of accessibility. The negative impact is summarised in fatigue/burnout in PHC providers, patient safety concerns and changes in patients' behaviour. To increase resilience, participants suggest restructuring PHC, recruiting PHC personnel and enhancing digital infrastructure, maintenance of sanitary protection measures, investment in quality, and empowering patients through health literacy.</p><p><strong>Conclusion: </strong>Based on the lessons learnt, building further on the pandemic-accelerated digitalisation, emphasising on quality improvement and patient safety, ensuring providers' well-being, and empowering citizens through health literacy could be key in promoting PHC resilience.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2382218"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11275516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762691","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 healthcare professionals' perceptions, attitudes and ideas regarding asthma management in Greece: A mixed-method study.","authors":"Izolde Bouloukaki, Christos Spanias, Despo Ierodiakonou, Nikolaos Tzanakis, Siân Williams, Ioanna Tsiligianni","doi":"10.1080/13814788.2024.2418301","DOIUrl":"10.1080/13814788.2024.2418301","url":null,"abstract":"<p><strong>Background: </strong>Implementing asthma guideline recommendations is challenging and there is variation between countries, and different healthcare professionals (HCPs). The International Primary Care Respiratory Group (IPCRG) has introduced the Asthma Right Care (ARC) programme implemented in 24 low, middle, and high countries, including Greece. It offers a promising approach drawn from social movements for health to improve asthma care by engaging HCPs in implementing guideline-based asthma care.</p><p><strong>Objectives: </strong>To explore HCPs' perspectives on current provision of asthma care and their willingness to improve implementation of recommended guidelines using ARC programme tools in Greece.</p><p><strong>Methods: </strong>A mixed methods study conducted from September 2020 to April 2021. A convenience sample of 30 pharmacists, and 10 General Practitioners (GPs), responded to a questionnaire investigating perceptions, and attitudes, towards implementation of asthma guidelines. Then, a qualitative survey followed with semi-structured interviews to evaluate the feedback obtained from HCPs to assess the content, and applicability of the ARC tools. Data were analysed using thematic analysis.</p><p><strong>Results: </strong>A range of practical challenges in implementing guideline-recommended interventions, improving asthma control and management were described by all HCPs, including lack of time and education, high workload, patients' perceptions, and poor communication contributing to poor management and inadequate follow-up of people with asthma. However, most HCPs were willing to use ARC interventions to improve guideline implementation.</p><p><strong>Conclusion: </strong>HCPs in Greece encounter challenges in implementing asthma guidelines; however, they can overcome these challenges by using ARC interventions and engagement tools to address barriers and implement efficient asthma management strategies.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2418301"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512997","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":"Monitoring COVID-19 in Belgian general practice: A tool for syndromic surveillance based on electronic health records.","authors":"Bénédicte Vos, Laura Debouverie, Kris Doggen, Nicolas Delvaux, Bert Aertgeerts, Robrecht De Schreye, Bert Vaes","doi":"10.1080/13814788.2023.2293699","DOIUrl":"10.1080/13814788.2023.2293699","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 may initially manifest as flu-like symptoms. As such, general practitioners (GPs) will likely to play an important role in monitoring the pandemic through syndromic surveillance.</p><p><strong>Objectives: </strong>To present a COVID-19 syndromic surveillance tool in Belgian general practices.</p><p><strong>Methods: </strong>We performed a nationwide observational prospective study in Belgian general practices. The surveillance tool extracted the daily entries of diagnostic codes for COVID-19 and associated conditions (suspected or confirmed COVID-19, acute respiratory infection and influenza-like illness) from electronic medical records. We calculated the 7-day rolling average for these diagnoses and compared them with data from two other Belgian population-based sources (laboratory-confirmed new COVID-19 cases and hospital admissions for COVID-19), using time series analysis. We also collected data from users and stakeholders about the syndromic surveillance tool and performed a thematic analysis.</p><p><strong>Results: </strong>4773 out of 11,935 practising GPs in Belgium participated in the study. The curve of contacts for suspected COVID-19 followed a similar trend compared with the curves of the official data sources: laboratory-confirmed COVID-19 cases and hospital admissions but with a 10-day delay for the latter. Data were quickly available and useful for decision making, but some technical and methodological components can be improved, such as a greater standardisation between EMR software developers.</p><p><strong>Conclusion: </strong>The syndromic surveillance tool for COVID-19 in primary care provides rapidly available data useful in all phases of the COVID-19 pandemic to support data-driven decision-making. Potential enhancements were identified for a prospective surveillance tool.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2293699"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10776082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378821","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":"Impact of COVID-19 pandemic on the accuracy of telephone triage of callers with shortness of breath and/or chest discomfort in Dutch out-of-hours primary care: A retrospective observational study.","authors":"Michelle Spek, Anna S M Dobbe, Dorien L Zwart, Daphne C A Erkelens, Geert-Jan Geersing, Esther de Groot, Mathé Delissen, Frans H Rutten, Roderick P Venekamp","doi":"10.1080/13814788.2024.2430508","DOIUrl":"10.1080/13814788.2024.2430508","url":null,"abstract":"<p><strong>Background: </strong>Anecdotal reports suggest that missed diagnosis in general practice during the first wave of the COVID-19 pandemic contributed to a drop in life-threatening events (LTEs) detected in hospitals.</p><p><strong>Objectives: </strong>To investigate the impact of the COVID-19 pandemic on the accuracy of urgency allocation by telephone triage of patients with shortness of breath and/or chest discomfort in out-of-hours primary care (OHS-PC). Accuracy is defined as the correct allocation of high urgency to patients with LTEs and low urgency to those without.</p><p><strong>Methods: </strong>Retrospective observational study with data from callers contacting OHS-PC for shortness of breath and/or chest discomfort, between 1 March and 1 June 2019 (pre-pandemic) and 1 March to 1 June 2020 (first wave COVID-19 pandemic). Sensitivity and specificity of telephone urgency allocation were compared during both periods with LTEs, including acute coronary syndrome, and pulmonary embolism, as the reference.</p><p><strong>Results: </strong>3,064 adults (1,840 COVID-19 pandemic and 1,224 pre-pandemic, <i>p</i> < 0.001) were included in the study. The sensitivity of urgency allocation was similar during and before the COVID-19 pandemic (0.68, 95% CI 0.59 to 0.75 vs. 0.68, 95% CI 0.60 to 0.75, <i>p</i> = 0.944). Specificity was slightly higher during the COVID-19 pandemic (0.52, 95% CI 0.50 to 0.55 vs. 0.45, 95% CI 0.42 to 0.48, <i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Despite a surge in calls from adults with shortness of breath and/or chest discomfort during the COVID-19 pandemic, the accuracy of telephone triage for LTEs in OHS-PC remained similar to the pre-pandemic era. Improvement of telephone triage seems necessary in both periods.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2430508"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752143","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":"Setting targets for antibiotic use in general practice in Europe: A scoping review.","authors":"Nathaly Garzón-Orjuela, Kevin Roche, Heike Vornhagen, Aoife Moran, Scott Walkin, Walter Cullen, Catherine Blake, Akke Vellinga","doi":"10.1080/13814788.2024.2430507","DOIUrl":"10.1080/13814788.2024.2430507","url":null,"abstract":"<p><strong>Background: </strong>National Action Plans (NAPs) aim to address antimicrobial resistance (AMR) understanding and awareness but struggle to translate targets into clinically relevant guidance for general practice.</p><p><strong>Objective: </strong>To identify and map antibiotic use targets in European general practice and explore if and how these targets are linked to NAPs.</p><p><strong>Methods: </strong>A systematic search was carried out in MEDLINE (OVID), EMBASE and SCOPUS, with additional manual searches. The research questions were: What are existing targets for antibiotic use in general practice in the 31 European countries? and How are these targets linked to the NAPs on AMR?. The results are presented narratively.</p><p><strong>Results: </strong>77 reports were included, of which 33 focused on national targets and general practice or linking national and local targets. Reports describe local strategies to achieve targets, such as prescriber feedback, benchmarking systems and financial incentives. However, these reports provide aggregated targets for general practice, such as a percentage reduction of antibiotics prescribed. These targets are set in general, for a specific type of antibiotic, for an amount per number of patients, in defined daily doses or items. None of the reports translate national targets into clinically relevant or practical targets for general practitioners.</p><p><strong>Conclusion: </strong>Most European countries have an NAP with established targets, but the type and implementation of these targets vary between nations. Translating national targets into daily clinical practice is challenging and often lacks the involvement of prescribers. Aligning national and local targets would enhance coherence and more effectively contribute to improvements in antibiotic use.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2430507"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11610282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752215","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":"30 1","pages":"2298332"},"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":"Why are our medicines so expensive? Spoiler: Not for the reasons you are being told….","authors":"Els Torreele","doi":"10.1080/13814788.2024.2308006","DOIUrl":"10.1080/13814788.2024.2308006","url":null,"abstract":"<p><p>Often described as a natural economic trend, the prices that pharmaceutical companies charge for new medicines have skyrocketed in recent years. Companies claim these prices are justified because of the 'value' new treatments represent or that they reflect the high costs and risks associated with the research and development process. They also claim that the revenues generated through these high prices are required to pay for continued innovation.This paper argues that high prices are not inevitable but the result of a societal and political choice to rely on a for-profit business model for medical innovation, selling medicines at the highest price possible. Instead of focusing on therapeutic advances, it prioritises profit maximisation to benefit shareholders and investors over improving people's health outcomes or equitable access.As a result, people and health systems worldwide struggle to pay for the increasingly expensive health products, with growing inequities in access to even life-saving medicines while the biopharmaceutical industry and its financiers are the most lucrative business sectors.As the extreme COVID-19 vaccine inequities once again highlighted, we urgently need to reform the social contract between governments, the biopharmaceutical industry, and the public and restore its original health purpose. Policymakers must redesign policies and financing of the pharmaceutical research and development ecosystem such that public and private sectors work together towards the shared objective of responding to public health and patients' needs, rather than maximising financial return because medicines should not be a luxury.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2308006"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10836477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652189","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 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":"30 1","pages":"2339488"},"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":"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":"30 1","pages":"2407594"},"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}