European Journal of General Practice最新文献

{"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":"30 1","pages":"2402259"},"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":"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":"30 1","pages":"2407600"},"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":"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":"30 1","pages":"2328716"},"PeriodicalIF":2.3,"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":"Periodontal diseases and cardiovascular diseases, diabetes, and respiratory diseases: Summary of the consensus report by the European Federation of Periodontology and WONCA Europe.","authors":"David Herrera, Mariano Sanz, Lior Shapira, Carlos Brotons, Iain Chapple, Thomas Frese, Filippo Graziani, F D Richard Hobbs, Olivier Huck, Eva Hummers, Søren Jepsen, Oleg Kravtchenko, Phoebus Madianos, Ana Molina, Mehmet Ungan, Josep Vilaseca, Adam Windak, Shlomo Vinker","doi":"10.1080/13814788.2024.2320120","DOIUrl":"10.1080/13814788.2024.2320120","url":null,"abstract":"<p><strong>Background: </strong>Periodontitis is a chronic inflammatory non-communicable disease (NCD) characterised by the destruction of the tooth-supporting apparatus (periodontium), including alveolar bone, the presence of periodontal pockets, and bleeding on probing.</p><p><strong>Objectives: </strong>To outline, for family doctors, the implications of the association between periodontal and systemic diseases; to explore the role of family doctors in managing periodontitis as an ubiquitous non-communicable disease (NCD).</p><p><strong>Methods: </strong>The consensus reports of previous focused collaborative workshops between WONCA Europe and the European Federation of Periodontology (using previously undertaken systematic reviews), and a specifically commissioned systematic review formed the technical papers to underpin discussions. Working groups prepared proposals independently, and the proposals were subsequently discussed and approved at plenary meetings.</p><p><strong>Results: </strong>Periodontitis is independently associated with cardiovascular diseases, diabetes, chronic obstructive pulmonary disease, obstructive sleep apnoea, and COVID-19 complications. Treatment of periodontitis has been associated with improvements in systemic health outcomes. The article also presents evidence gaps. Oral health care professionals (OHPs) and family doctors should collaborate in managing these conditions, including implementing strategies for early case detection of periodontitis in primary medical care centres and of systemic NCDs in oral/dental care settings. There is a need to raise awareness of periodontal diseases, their consequences, and the associated risk factors amongst family doctors.</p><p><strong>Conclusion: </strong>Closer collaboration between OHPs and family doctors is important in the early case detection and management of NCDs like cardiovascular diseases, diabetes mellitus, and respiratory diseases. Strategies for early case detection/prevention of NCDs, including periodontitis, should be developed for family doctors, other health professionals (OHPs), and healthcare funders. Evidence-based information on the reported associations between periodontitis and other NCDs should be made available to family doctors, OHPs, healthcare funders, patients, and the general population.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2320120"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10962307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177731","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 back at the EJGP in 2023: What a rich harvest of relevant publications for primary care medicine!","authors":"Jelle Stoffers","doi":"10.1080/13814788.2024.2353237","DOIUrl":"10.1080/13814788.2024.2353237","url":null,"abstract":"","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2353237"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11123451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088393","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":"Did aetiology matter in illness duration and complications in patients presenting in primary care with acute respiratory tract infections early in the COVID-19 pandemic: An observational study in nine countries.","authors":"Roderick P Venekamp, Marinus J C Eijkemans, Nicolaas P A Zuithoff, Femke Böhmer, Slawomir Chlabicz, Annelies Colliers, Ana García-Sangenís, Lile Malania, Jozsef Pauer, Angela Tomacinschii, Theo J Verheij, Herman Goossens, Akke Vellinga, Christopher C Butler, Alike W van der Velden","doi":"10.1080/13814788.2024.2376084","DOIUrl":"10.1080/13814788.2024.2376084","url":null,"abstract":"<p><strong>Background: </strong>Despite considerable research into COVID-19 sequelae, little is known about differences in illness duration and complications in patients presenting in primary care with symptoms of acute respiratory tract infections (RTI) that are and are not attributed to SARS-CoV-2 infection.</p><p><strong>Objective: </strong>To explore whether aetiology impacted course of illness and prediction of complications in patients presenting in primary care with symptoms of RTI early in the COVID-19 pandemic.</p><p><strong>Methods: </strong>Between April 2020-March 2021 general practitioners from nine European countries recruited consecutively contacting patients with RTI symptoms. At baseline, an oropharyngeal-nasal swab was obtained for aetiology determination using PCR after follow-up of 28 days. Time to self-reported recovery was analysed with Kaplan-Meier curves. Predictors (baseline variables of demographics, patient and disease characteristics) of a complicated course (composite of hospital admission and persisting signs/symptoms at 28 days follow-up) were explored with logistic regression modelling.</p><p><strong>Results: </strong>Of 855 patients with RTI symptoms, 237 (27.7%) tested SARS-CoV-2 positive. The proportion not feeling fully recovered (15.6% vs 18.1%, <i>p</i> = 0.39), reporting being extremely tired (9.7% vs 12.8%, <i>p</i> = 0.21), and not having returned to usual daily activities (18.1% vs 14.4%, <i>p</i> = 0.18) at day 28 were comparable between SARS-CoV-2 positive (<i>n</i> = 237) and negative (<i>n</i> = 618) groups. However, among those feeling fully recovered (SARS-CoV-2 positive: 200 patients, SARS-CoV-2 negative: 506 patients), time to full recovery was significantly longer in SARS-CoV-2 patients (10.6 vs 7.7 days, <i>p</i> < 0.001). We found no evidence that predictors of a complicated course differed between groups (<i>p</i> = 0.07).</p><p><strong>Conclusion: </strong>Early in the pandemic, the proportion of patients not feeling fully recovered by 28 days was similar between SARS-CoV-2 positive and negative patients presenting in primary care with RTI symptoms, but it took somewhat longer for SARS-CoV-2 patients to feel fully recovered. More research is needed on predictors of a complicated course in RTI.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"30 1","pages":"2376084"},"PeriodicalIF":2.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592143","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":"30 1","pages":"2386284"},"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":"30 1","pages":"2393858"},"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":"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":"66 1","pages":"2370117"},"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":"26 1","pages":""},"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}