European Journal of General Practice最新文献

{"title":"Impact of primary care physicians working part-time on patient care: A scoping review.","authors":"Sebastian Kegreiss, Christian Studer, Patrick E Beeler, Stefan Essig, Rebecca Tomaschek","doi":"10.1080/13814788.2023.2271167","DOIUrl":"10.1080/13814788.2023.2271167","url":null,"abstract":"<p><strong>Background: </strong>Increasing numbers of primary care physicians (PCPs) are reducing their working hours. This decline may affect the workforce and the care provided to patients.</p><p><strong>Objectives: </strong>This scoping review aims to determine the impact of PCPs working part-time on quality of patient care.</p><p><strong>Methods: </strong>A systematic search was conducted using the databases PubMed, CINAHL, Embase, and the Cochrane Library. Peer-reviewed, original articles with either quantitative, qualitative or mixed methods designs, published after 2000 and written in any language were considered. The search strings combined the two concepts: part-time work and primary care. Studies were included if they examined any effect of PCPs working part-time on quality of patient care.</p><p><strong>Results: </strong>The initial search resulted in 2,323 unique studies. Abstracts were screened, and information from full texts on the study design, part-time and quality of patient care was extracted. The final dataset included 14 studies utilising data from 1996 onward. The studies suggest that PCPs working part-time may negatively affect patient care, particularly the access and continuity of care domains. Clinical outcomes and patient satisfaction seem mostly unaffected or even improved.</p><p><strong>Conclusion: </strong>There is evidence of both negative and positive effects of PCPs working part-time on quality of patient care. Approaches that mitigate negative effects of part-time work while maintaining positive effects should be implemented.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10990256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71429223","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":"GPs' perceptions of pharmacists working in general practices: A mixed methods survey study.","authors":"Eoin Hurley, Tony Foley, Elaine Walsh, Stephen Byrne, Kieran Dalton","doi":"10.1080/13814788.2023.2273841","DOIUrl":"10.1080/13814788.2023.2273841","url":null,"abstract":"<p><strong>Background: </strong>Pharmacists are increasingly incorporated into general practice teams globally and have been shown to positively impact patient outcomes. However, little research to date has focused on determining general practitioners' (GPs') perceptions of practice-based pharmacist roles in countries yet to establish such roles.</p><p><strong>Objectives: </strong>To explore GPs' perceptions towards integrating pharmacists into practices and determine if any significant associations were present between GPs' perceptions and their demographic characteristics.</p><p><strong>Methods: </strong>In June 2022, a survey was disseminated to GPs in Ireland <i>via</i> post (<i>n</i> = 500 in Munster region), Twitter, WhatsApp, and an online GP support and education network. Quantitative data were captured through multiple option and Likert-scale questions and analysed using descriptive and inferential statistics. Qualitative data were captured <i>via</i> free-text boxes, with the open comments analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>A total of 152 valid responses were received (24.6% response to postal survey). Overall, GPs welcomed the role of practice-based pharmacists and perceived that they would increase patient safety. Most agreed with practice pharmacists providing medicine information (98%) <i>vs.</i> 23% agreeing with practice pharmacists prescribing independently. Most agreed they would partake in a practice pharmacist pilot (78.6%). The free-text comments described current pressures in general practice, existing relationships with pharmacists, funding and governance strategies, potential roles for pharmacists in general practice, and anticipated outcomes of such roles.</p><p><strong>Conclusion: </strong>This study provides a deeper understanding of GPs' perceptions of integrating pharmacists into practices and the demographic characteristics associated with different perceptions, which may help better inform future initiatives to integrate pharmacists into practices.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488960","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":"Validation of the Lithuanian multimorbidity treatment burden questionnaire (MTBQ) and its association with primary care patient characteristics.","authors":"Olga Vasiliauskienė, Dovydas Vasiliauskas, Polly Duncan, Ausrine Kontrimiene, Lina Jaruseviciene, Aiste Cesnuleviciene, Gediminas Urbonas, Ida Liseckiene","doi":"10.1080/13814788.2023.2284257","DOIUrl":"10.1080/13814788.2023.2284257","url":null,"abstract":"<p><strong>Background: </strong>The increasing prevalence of multimorbidity among older people in Lithuania and other Central-Eastern European countries leads to a greater patient treatment burden and puts additional pressure on healthcare services.</p><p><strong>Objectives: </strong>This study aimed to validate the Lithuanian version of the Multimorbidity Treatment Burden Questionnaire (MTBQ).</p><p><strong>Methods: </strong>The Lithuanian version of the MTBQ was tested (2021-2022) with 789 patients from seven Lithuanian primary care centres who had two or more long-term conditions. The questionnaire translation's reliability, validity and dimensionality of the were assessed with Spearman's rank correlation, Cronbach's alpha, and factor reduction analysis. Treatment burden and its associations with sociodemographic and other indicators were analysed.</p><p><strong>Results: </strong>Lithuanian version of MTBQ had good internal reliability (Cronbach's alpha 0.711), validity, factor reduction applicability, and interpretability. The MTBQ scores of the questionnaire had a negative association with the quality-of-life scale (r=-0.327, 95% CI [-0.389, -0.264]) and positive associations with the self-rated health scores (<i>r</i> = 0.230, 95% CI [0.163, 0.297]) and with the number of comorbidities (<i>r</i> = 0.164, 95% CI [0.097, 0.233]). Distribution of treatment burden was identified (none (19,4%), low (46,6%), medium (25%), high (9%)). High treatment burden was found to be associated with having five or more long-term diseases, taking five or more medications, having anxiety or depression and living in a rural area.</p><p><strong>Conclusion: </strong>The study's findings show that the MTBQ is applicable in assessing the treatment burden of multimorbid patients in Lithuania. Furthermore, the study demonstrates that Lithuanian patients with multimorbidity have average treatment burden scores similar to or higher than participants in previous MTBQ validation studies.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10990257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138447049","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":"Transitioning from face-to-face to distance education. Part 1: A cross-sectional study in the former Yugoslavia during COVID-19.","authors":"Irena Zakarija-Grković, Aleksandar Stepanović, Davorina Petek, Marion Tomičić, Zlata Ožvačić, Venija Cerovecki, Igor Švab, Vesna Homar","doi":"10.1080/13814788.2023.2283831","DOIUrl":"10.1080/13814788.2023.2283831","url":null,"abstract":"<p><strong>Background: </strong>The countries of the former Yugoslavia have health and education systems with the same tradition but these have changed over the years. Little is known about how family medicine teaching transitioned from face-to-face to distance education during the COVID-19 pandemic.</p><p><strong>Objectives: </strong>to investigate student/teacher experience in transitioning from face-to-face to distance education.</p><p><strong>Methods: </strong>A cross-sectional, online survey was conducted among 21 medical schools of the former Yugoslavia between December 2021 and March 2022. Under/postgraduate teachers and students who taught/studied family medicine during the academic year 2020/2021 were invited to participate. Of 31 questions for students and 35 for teachers, all but nine open questions were analysed using descriptive statistics.</p><p><strong>Results: </strong>Seventeen of 21 medical schools contributed data involving 117 participants representing all countries of the former Yugoslavia. At the beginning of the pandemic, 30%, 26% and 15% of teachers, students and trainees, respectively, received formal preparation in distance education. Of these, 92% of teachers and 58% of students/trainees felt they were not adequately prepared. Synchronous teaching was the main method used, with a third using hybrid methods. All participants were least confident about online assessment. More than 75% of respondents agreed that lectures could be kept online, not patient consultations or practical skills' classes.</p><p><strong>Conclusion: </strong>Teachers used various old and new methods to provide learning opportunities despite COVID-19 constraints. Effective technology-based strategies are essential to ensure assessment integrity and enhance the learning environment.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10990255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138447047","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":"Non-adherence to non-insulin glucose-lowering drugs: Prevalence, predictors and impact on glycemic control and insulin initiation. A longitudinal cohort study in a large primary care database in Spain.","authors":"Rocío Zamanillo-Campos, María Zaforteza Dezcallar, Maria Asunción Boronat Moreiro, Alfonso Leiva Rus, Joana Ripoll Amengual, Jadwiga Konieczna, Maria Antonia Fiol-deRoque, Ignacio Ricci-Cabello","doi":"10.1080/13814788.2023.2268838","DOIUrl":"10.1080/13814788.2023.2268838","url":null,"abstract":"<p><strong>Background: </strong>A better understanding of patient non-adherence to type 2 diabetes medication is needed to design effective interventions to address this issue.</p><p><strong>Objectives: </strong>(1) To estimate the prevalence of non-adherence to diabetes medication; (2) to examine its impact on glycemic control and insulin initiation; (3) to develop and validate a prediction model of non-adherence.</p><p><strong>Methods: </strong>We conducted a longitudinal cohort study based on data from electronic health records. We included adult patients registered within the Health Service of the Balearic Islands (Spain) starting a new prescription of a non-insulin glucose-lowering drug between January 2016 and December 2018. We calculated non-adherence at 12 months follow-up, defined as medication possession ratio (MPR) ≤ 80%. We fitted multivariable regression models to examine the association between non-adherence and glycemic control and insulin initiation and identified predictors of non-adherence.</p><p><strong>Results: </strong>Of 18,119 patients identified, after 12 months follow-up, 5,740 (31.68%) were non-adherent. Compared with non-adherent, adherent patients presented lower HbA1c levels (mean difference = -0.32%; 95%CI = -0.38%; -0.27%) and were less likely to initiate insulin (aOR = 0.77; 95%CI = 0.63; 0.94). A predictive model explained 22.3% of the variation and presented a satisfactory performance (AUC = 0.721; Brier score = 0.177). The most important predictors of non-adherence were: non-Spanish nationality, currently working, low adherence to previous drugs, taking biguanides, smoker and absence of hypertension.</p><p><strong>Conclusion: </strong>Around one-third of the patients do not adhere to their non-insulin glucose-lowering drugs. More research is needed to optimise the performance of the predicting model before considering its implementation in routine clinical practice.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10990259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49694016","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":"Series: Practical guidance to qualitative research. Part 7: Qualitative evidence synthesis for emerging themes in primary care research: Scoping review, meta-ethnography and rapid realist review.","authors":"Albine Moser, Irene Korstjens","doi":"10.1080/13814788.2023.2274467","DOIUrl":"10.1080/13814788.2023.2274467","url":null,"abstract":"<p><p>This article, the seventh in a series aiming to provide practical guidance for qualitative research in primary care, introduces qualitative synthesis research for addressing health themes in primary care research. Qualitative synthesis combines rigorous processes and authorial judgement to present the collective meaning of research outputs; the findings of qualitative studies - and sometimes mixed-methods and quantitative research - are pooled. We describe three exemplary designs: the scoping review, the meta-ethnography and the rapid realist review. Scoping reviews aim to provide an overview of the evidence/knowledge or to answer questions regarding the nature and diversity of the evidence/knowledge available. Meta-ethnographies intend to systematically compare data from primary qualitative studies to identify and develop new overarching concepts, theories, and models. Rapid realist reviews aim to provide a knowledge synthesis by looking at complex questions while responding to time-sensitive and emerging issues. It addresses the question, 'what works, for whom, in what circumstances, and how?'We discuss these three designs' context, what, why, when and how. We provide examples of published studies and sources for further reading, including manuals and guidelines for conducting and reporting these studies. Finally, we discuss attention points for the research team concerning the involvement of necessary experts and stakeholders and choices to be made during the research process.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10990260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71415287","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":"Adapting patients' oncological treatment through remote participation of general practitioners in multi-disciplinary consultation meetings: A feasibility study.","authors":"Vladimir Druel,&nbsp;Laetitia Gimenez,&nbsp;Paul Tachousin,&nbsp;Nathalie Boussier,&nbsp;Eric Bauvin,&nbsp;Grosclaude Pascale,&nbsp;Odile Beyne-Rauzy,&nbsp;Marie-Eve Rougé Bugat","doi":"10.1080/13814788.2021.2003775","DOIUrl":"https://doi.org/10.1080/13814788.2021.2003775","url":null,"abstract":"<p><strong>Background: </strong>The general practitioner (GP) is central to managing patients with cancer, whose numbers are increasing worldwide. The GP's involvement requires better coordination between involved partners, in particular oncologists and GPs.</p><p><strong>Objectives: </strong>To conduct a feasibility study of remote participation of GPs in multi-disciplinary consultation meetings (MCMs). We analysed participation, participants' satisfaction, and their impact on therapeutic decisions.</p><p><strong>Methods: </strong>We conducted a feasibility study in the regional cancer centre of Toulouse, France. All patient cases discussed in the MCMs for myelodysplasia from 1 January to 31 March 2016 were included. Cases of patients aged over 18 years, with a diagnosis of myelodysplasia and registered with a GP were included if patients gave informed consent. One investigator collected the data provided by GPs during three telephone or video calls: before, during, and after the MCM, respectively.</p><p><strong>Results: </strong>Of 86 patient cases discussed during three months of MCMs, 44 were eligible for GP participation; 27 GPs participated in discussions of 27 patient cases. The GP's participation in the MCM led to a change in management in five cases, with four times treatment intensifications and once de-intensification. Medical, social, family-related, and psychological domains were discussed with input from the GPs. Overall, all participants were satisfied with the MCMs.</p><p><strong>Conclusion: </strong>Remote participation of GPs in MCMs is feasible and may result in adapting oncological and haematological management for patients. This patient-centred approach requires a specific organisation that, when implemented, satisfies the needs of all participants.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a9/b5/IGEN_28_2003775.PMC8865098.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39810318","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":"Experiences of patients with fibromyalgia at a Finnish Health Centre: A qualitative study.","authors":"Aleksi Varinen,&nbsp;Tiina Vuorio,&nbsp;Elise Kosunen,&nbsp;Tuomas H Koskela","doi":"10.1080/13814788.2022.2085683","DOIUrl":"https://doi.org/10.1080/13814788.2022.2085683","url":null,"abstract":"<p><strong>Background: </strong>Fibromyalgia is a functional syndrome. Despite recent findings, there is still considerable uncertainty about its diagnostic process.</p><p><strong>Objectives: </strong>This study aimed to explore patients' experiences with fibromyalgia during the diagnostic process in primary health care. Moreover, we tried to determine how diagnostic consultation could be improved.</p><p><strong>Methods: </strong>This study is based on data from patients with fibromyalgia in a primary health care study conducted in Nokia, Finland. Patients with fibromyalgia were identified from electronic medical records. Focus-group participants with fibromyalgia diagnoses were selected using a purposive sampling method to gather a maximum variation sample. Qualitative thematic analysis was used for the coded data from four focus-group discussions in 2018. A description of the coding tree was provided and researchers organised the codes. Finally, all researchers identified themes from the data.</p><p><strong>Results: </strong>The main unifying entities were the uncertainty and contradictions fibromyalgia patients faced on several occasions. Physicians sometimes offered other diagnoses - like depression - as an explanation for the symptoms, or used repetitive tests to eliminate other possible diagnoses. Furthermore, patients expressed their wishes for a holistic, empathetic, and up-to-date approach to their symptoms.</p><p><strong>Conclusion: </strong>In our interviews, a good doctor-patient relationship and continuity of care were necessary, as were the physician's attitude and knowledge of fibromyalgia. Our findings also suggest avoiding repeated or unnecessary rule-out tests and the overdiagnosis of psychiatric disorders is necessary.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9225685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40121166","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":"Antibiotic deprescribing: Spanish general practitioners' views on a new strategy to reduce inappropriate use of antibiotics in primary care.","authors":"Carl Llor, Gloria Cordoba, Sandi Michele de Oliveira, Lars Bjerrum, Ana Moragas","doi":"10.1080/13814788.2022.2130887","DOIUrl":"10.1080/13814788.2022.2130887","url":null,"abstract":"<p><strong>Background: </strong>A doctor may recommend that a patient stop an antibiotic course before its scheduled completion time if further treatment may cause more harm than benefit.</p><p><strong>Objectives: </strong>This study explores general practitioners' (GP) opinions about the use of antibiotic deprescribing (AD) in general practice.</p><p><strong>Methods: </strong>A cross-sectional, questionnaire-based study answered from February to March 2022. GPs (<i>n</i> = 6,083) affiliated with the largest Spanish scientific society of primary care were invited to participate. The survey included two statements related to use and fourteen views about AD rated by GPs using a 5-item Likert scale.</p><p><strong>Results: </strong>Eleven hundred and seven doctors completed the surveys (18.2%), of whom 92.5% (95% confidence interval [CI] 90.8-94%) reported having used the AD strategy in their practice at least once. GPs felt very confident in using a deprescribing strategy in patients with common cold and influenza (97.6% and 93.5%, respectively) but less with acute bronchitis (45.5%); 12.1% (95% CI, 10.2-14.2%) considered this practice harmful to patients. Respondents reported using AD more frequently when they initiated the antibiotic course (96.8%; 95% CI, 95.5-97.7) than when the treatment was initiated by another doctor (52.3%; 95% CI, 49.3-55.3%). However, doctors aged >60 years were more prone to use AD compared with younger colleagues (64.5% vs. 50%; <i>p</i> < 0.005).</p><p><strong>Conclusion: </strong>The GPs in this study employ the strategy of AD. Nonetheless, essential differences lie in their views of the way the strategy is used. Further studies are warranted to explore the beliefs behind these perceptions and promote wider use of AD by GPs.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9629099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40657870","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":"Added value of CRP to clinical features when assessing appendicitis in children.","authors":"Guus C G H Blok, Eelke D Nikkels, Johan van der Lei, Marjolein Y Berger, Gea A Holtman","doi":"10.1080/13814788.2022.2067142","DOIUrl":"10.1080/13814788.2022.2067142","url":null,"abstract":"<p><strong>Background: </strong>The diagnostic value of C-reactive protein (CRP) for appendicitis in children has not been evaluated in primary care. As biochemical responses and differential diagnoses vary with age, separate evaluation in children and adults is needed.</p><p><strong>Objectives: </strong>To determine whether adding CRP to symptoms and signs improves the diagnosis of appendicitis in children with acute abdominal pain in primary care.</p><p><strong>Methods: </strong>A retrospective cohort study in Dutch general practice. Data was collected from the Integrated Primary Care Information database between 2010 and 2016. We included children aged 4-18 years, with no history of appendicitis, presenting with acute abdominal pain, and having a CRP test. Initial CRP levels were related to the specialist's diagnosis of appendicitis, and the test's characteristics were calculated for multiple cut-offs. The value of adding CRP to signs and symptoms was analysed by logistic regression.</p><p><strong>Results: </strong>We identified 1076 eligible children, among whom 203 were referred for specialist evaluation and 70 had appendicitis. The sensitivity and specificity of a CRP cut-off ≥10 mg/L were 0.87 (95%CI, 0.77-0.94) and 0.77 (95%CI, 0.74-0.79), respectively. When symptoms lasted > 48 h, this sensitivity increased to 1.00. Positive predictive values for CRP alone were low (0.18-0.38) for all cut-off values (6-100 mg/L). Adding CRP increased the area under the curve from 0.82 (95%CI, 0.78-0.87) to 0.88 (95%CI, 0.84-0.91), and decision curve analysis confirmed that its addition provided the highest net benefit.</p><p><strong>Conclusion: </strong>CRP adds value to history and physical examination when diagnosing appendicitis in children presenting acute abdominal pain in primary care. Appendicitis is least likely if the CRP value is < 10 mg/L and symptoms have been present for > 48 h.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9103685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10437111","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}