European Journal of General Practice最新文献

{"title":"Effectiveness of tailored talks between a cancer screening specialist and general practitioners to improve the uptake of colorectal cancer screening in Ancona (Italy) during the pandemic period","authors":"Cecilia Acuti Martellucci, Giusi Giacomini, Maria Elena Flacco, Lamberto Manzoli, Margherita Morettini, Mosè Martellucci, Sara Rosati, Silvia Bizzarri, Matthew Palmer, Lidia Pascucci, Marco Uncini, Francesca Pasqualini","doi":"10.1080/13814788.2024.2340672","DOIUrl":"https://doi.org/10.1080/13814788.2024.2340672","url":null,"abstract":"Colorectal cancer (CRC) screening uptake in many countries has been low and further impacted by the COVID-19 pandemic. General Practitioners (GPs) are key facilitators, however research on their im...","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"89 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140573551","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":"Innovative Technologies and Methods in General Practice: Selected Abstracts from the 97th EGPRN Meeting, Prague, Czech Republic, 12–15 October 2023","authors":"","doi":"10.1080/13814788.2024.2312410","DOIUrl":"https://doi.org/10.1080/13814788.2024.2312410","url":null,"abstract":"Published in European Journal of General Practice (Vol. 30, No. 1, 2024)","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"35 1","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139925120","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":"Advance care planning among older adults in Belgium with Turkish backgrounds and palliative care needs: A qualitative interview study.","authors":"Hakki Demirkapu, Lieve Van den Block, Stéphanie De Maesschalck, Aline De Vleminck, F Zehra Colak, Dirk Devroey","doi":"10.1080/13814788.2023.2271661","DOIUrl":"10.1080/13814788.2023.2271661","url":null,"abstract":"<p><strong>Background: </strong>Data on advance care planning (ACP) among migrants in Europe is lacking. Research has shown that few older migrants in the United States perform ACP due to healthcare system distrust, collectivistic values and spirituality/religion.</p><p><strong>Objectives: </strong>To explore the ACP knowledge and perspectives of older Turkish-origin adults in Belgium requiring palliative care.</p><p><strong>Method: </strong>General practitioners (GPs) in Brussels and Antwerp recruited Turkish-origin participants aged ≥ 65 years with palliative care eligibility for this qualitative study. A GP conducted semi-structured interviews in Turkish in respondents' homes between May 2019 and February 2022 using a topic guide. Two researchers performed combined inductive/deductive thematic data analysis.</p><p><strong>Results: </strong>All 15 interviewees (average age, 79 years) lacked ACP awareness and information. Some had discussed specific end-of-life preferences (e.g. care location, burial place) with family. Still, many did not feel the need to discuss future healthcare preferences, due mainly to trust in God and family for caretaking and decision-making. Some respondents viewed ACP discussions as applicable, relieving the burden on family and enabling proactive addressing of 'what if' questions. Self-identified ACP barriers were fear of making wrong decisions, 'living in the moment' and difficulty discussing death. Facilitators were obtaining sufficient ACP information and recent family illness or death.</p><p><strong>Conclusion: </strong>Our sample of Turkish-origin older adults in Belgium requiring palliative care lacked ACP knowledge. Our findings suggest that their lack of engagement in discussing end-of-life medical care planning was linked to their family dynamics and religion. The findings have implications for healthcare providers to ethnic-minority groups.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"29 1","pages":"2271661"},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10990253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49694014","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":"Climate change is a health issue. The general practitioner and planetary health.","authors":"Jelle Stoffers, Jean Muris","doi":"10.1080/13814788.2023.2277569","DOIUrl":"10.1080/13814788.2023.2277569","url":null,"abstract":"","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"29 1","pages":"2277569"},"PeriodicalIF":2.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10990252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138048804","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":"Patients' perceptions of climate-sensitive health counselling in primary care: Qualitative results from Germany.","authors":"Silvan Griesel, Patricia Nayna Schwerdtle, Claudia Quitmann, Ina Danquah, Alina Herrmann","doi":"10.1080/13814788.2023.2284261","DOIUrl":"10.1080/13814788.2023.2284261","url":null,"abstract":"<p><strong>Background: </strong>Climate change is the greatest threat to global health in the twenty first century, yet combating it entails substantial health co-benefits. Physicians and other health professionals have not yet fully embraced their responsibilities in the climate crisis, especially about their communication with patients. While medical associations are calling on physicians to integrate climate change into health counselling, there is little empirical evidence about corresponding perceptions of patients.</p><p><strong>Objectives: </strong>This study aimed to explore primary care patients' perceptions of climate-sensitive health counselling.</p><p><strong>Methods: </strong>From July to December 2021, 27 qualitative interviews with patients were conducted and analysed using thematic analysis. A purposive sampling technique was applied to identify patients who had already experienced climate-sensitive health counselling in Germany.</p><p><strong>Results: </strong>Patients' perceptions of climate-sensitive health counselling were characterised by a high level of acceptance, which was enhanced by stressing the link between climate change and health, being credible concerning physician's own climate-friendly lifestyle, building upon good therapeutic relationships, creating a sense of solidarity, and working in a patient centred manner. Challenges and risks for acceptance were patients' disinterest or surprise, time constraints, feared politicisation of consultations, and evoking feelings of guilt and shame.</p><p><strong>Conclusion: </strong>These findings suggest that primary care patients can accept climate-sensitive health counselling, if it follows certain principles of communication, including patient-centredness. Our findings can be useful for developing communication guidelines, respective policies as well as well-designed intervention studies, which are needed to test the health and environmental effects of climate-sensitive health counselling.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"29 1","pages":"2284261"},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10773651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138447046","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":"Clinical diagnosis of SARS-CoV-2 infection: An observational study of respiratory tract infection in primary care in the early phase of the pandemic.","authors":"Alike W van der Velden, Milensu Shanyinde, Emily Bongard, Femke Böhmer, Slawomir Chlabicz, Annelies Colliers, Ana García-Sangenís, Lile Malania, Jozsef Pauer, Angela Tomacinschii, Ly-Mee Yu, Katherine Loens, Margareta Ieven, Theo J Verheij, Herman Goossens, Akke Vellinga, Christopher C Butler","doi":"10.1080/13814788.2023.2270707","DOIUrl":"10.1080/13814788.2023.2270707","url":null,"abstract":"<p><strong>Background: </strong>Early in the COVID-19 pandemic, GPs had to distinguish SARS-CoV-2 from other aetiologies in patients presenting with respiratory tract infection (RTI) symptoms on clinical grounds and adapt management accordingly.</p><p><strong>Objectives: </strong>To test the diagnostic accuracy of GPs' clinical diagnosis of a SARS-CoV-2 infection in a period when COVID-19 was a new disease. To describe GPs' management of patients presenting with RTI for whom no confirmed diagnosis was available. To investigate associations between patient and clinical features with a SARS-CoV-2 infection.</p><p><strong>Methods: </strong>In April 2020-March 2021, 876 patients (9 countries) were recruited when they contacted their GP with symptoms of an RTI of unknown aetiology. A swab was taken at baseline for later analysis. Aetiology (PCR), diagnostic accuracy of GPs' clinical SARS-CoV-2 diagnosis, and patient management were explored. Factors related to SARS-CoV-2 infection were determined by logistic regression modelling.</p><p><strong>Results: </strong>GPs suspected SARS-CoV-2 in 53% of patients whereas 27% of patients tested positive for SARS-CoV-2. True-positive patients (23%) were more intensively managed for follow-up, antiviral prescribing and advice than true-negatives (42%). False negatives (5%) were under-advised, particularly for social distancing and isolation. Older age (OR: 1.02 (1.01-1.03)), male sex (OR: 1.68 (1.16-2.41)), loss of taste/smell (OR: 5.8 (3.7-9)), fever (OR: 1.9 (1.3-2.8)), muscle aches (OR: 2.1 (1.5-3)), and a known risk factor for COVID-19 (travel, health care worker, contact with proven case; OR: 2.7 (1.8-4)) were predictive of SARS-CoV-2 infection. Absence of loss of taste/smell, fever, muscle aches and a known risk factor for COVID-19 correctly excluded SARS-CoV-2 in 92.3% of patients, whereas presence of 3, or 4 of these variables correctly classified SARS-CoV-2 in 57.7% and 87.1%.</p><p><strong>Conclusion: </strong>Correct clinical diagnosis of SARS-CoV-2 infection, without POC-testing available, appeared to be complicated.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"29 1","pages":"2270707"},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10990254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49694015","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 2: A qualitative study in the former Yugoslavia during COVID-19.","authors":"Davorina Petek, Irena Zakarija-Grković, Aleksandar Stepanović, Marion Tomičić, Zlata Ožvačić Adžić, Venija Cerovečki, Igor Švab, Vesna Homar","doi":"10.1080/13814788.2023.2283834","DOIUrl":"10.1080/13814788.2023.2283834","url":null,"abstract":"<p><strong>Background: </strong>Similar to other countries, Departments of Family Medicine in the former Yugoslavia had to transition from face-to-face to distance education during COVID-19.</p><p><strong>Objectives: </strong>To elucidate obstacles and facilitators of the transition from face-to-face to distance education.</p><p><strong>Methods: </strong>A cross-sectional, multicentre, qualitative study design was used to analyse nine open-ended questions from an online survey using inductive thematic analysis. The questionnaire was distributed to 21 medical schools, inviting them to involve at least two teachers/students/trainees. Data were collected between December 2021 and March 2022.</p><p><strong>Results: </strong>In 17 medical schools, 23 students, 54 trainees and 40 teachers participated. The following themes were identified: facilitators and barriers of transition, innovations for enhancing distance education, convenience of distance education, classical teaching for better communication, the future of distance education, reaching learning outcomes and experience of online assessment. Innovations referred mainly to new online technologies for interactive education and communication. Distance education allowed for greater flexibility in scheduling and self-directed learning; however, participants felt that classical education allowed better communication and practical learning. Teachers believed knowledge-related learning outcomes could be achieved through distance education but not teaching clinical skills. Participants anticipated a future where a combination of teaching methods is used.</p><p><strong>Conclusion: </strong>The transition to distance education was made possible thanks to its flexible scheduling, innovative tools and possibility of self-directed learning. However, face-to-face education was considered preferable for fostering interpersonal relations and teaching clinical skills. Educators should strive to strike a balance between innovative approaches and the preservation of personal experiences.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"29 1","pages":"2283834"},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10990258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138447048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of the spirometry-based motivational intervention to quit smoking: RESET randomised trial.","authors":"Francisco Martín-Luján, Antoni Santigosa-Ayala, Meritxell Pallejà-Millán, Cristina Rey-Reñones, Felipe Villalobos, Rosa Solà","doi":"10.1080/13814788.2023.2276764","DOIUrl":"10.1080/13814788.2023.2276764","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness of providing feedback on spirometry results for smoking cessation remains inconclusive according to the current evidence.</p><p><strong>Objectives: </strong>To assess the effectiveness of a motivational intervention based on spirometry results in achieving prolonged smoking abstinence (12 months post-intervention).</p><p><strong>Design and setting: </strong>A randomised, controlled, observer-blinded, multicentre clinical trial was conducted (from January 2012 to December 2015) in 20 primary healthcare centres in the Tarragona province, Spain.</p><p><strong>Methods: </strong>Participants, active smokers aged 35-70 without known respiratory disease, were recruited from primary healthcare centres by family doctors and nurses. They were randomly assigned to either the intervention group (IG = 308) or the control group (CG = 306). Both groups received brief smoking cessation counselling. Additionally, the IG underwent spirometry and received detailed information about the results, including lung age. The primary outcome was prolonged abstinence, defined as lasting at least 12 months and validated through cotinine measurement in urine.</p><p><strong>Results: </strong>The prolonged abstinence rate was 7.8% in the IG, compared to 2.6% in the CG (<i>p</i> = 0.004). At 12 months, in the multivariate analysis, the intervention was identified as an independent factor for smoking cessation (<i>OR</i> 2.8; 95%<i>CI</i> 1.2 to 7.7), a trend maintained throughout the follow-up (<i>HR</i> 2.74; 95%<i>CI</i> 1.13 to 6.62). Moreover, according to the Prochaska and DiClemente model, the preparation or action phase to quit was also associated with smoking cessation (<i>HR</i> 2.55, 95%<i>CI</i> 1.07 to 6.09).</p><p><strong>Conclusion: </strong>A primary care-delivered intervention involving brief counselling and detailed spirometry information proves effective in increasing abstinence rates among active smokers without known respiratory disease. Additionally, smoking cessation is also influenced by the individual's stage of change.</p><p><strong>Trial registration: </strong>ClinicatTrials.gov NCT02153047.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"29 1","pages":"2276764"},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10631381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488959","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":"Direct-to-patient digital diagnostics in primary care: Opportunities, challenges, and conditions necessary for responsible digital diagnostics.","authors":"María Villalobos-Quesada, Kendall Ho, Niels H Chavannes, Esther Pwa Talboom-Kamp","doi":"10.1080/13814788.2023.2273615","DOIUrl":"10.1080/13814788.2023.2273615","url":null,"abstract":"<p><strong>Background: </strong>Diagnostics are increasingly shifting to patients' home environment, facilitated by new digital technologies. Digital diagnostics (diagnostic services enabled by digital technologies) can be a tool to better respond to the challenges faced by primary care systems while aligning with patients' and healthcare professionals' needs. However, it needs to be clarified how to determine the success of these interventions.</p><p><strong>Objectives: </strong>We aim to provide practical guidance to facilitate the adequate development and implementation of digital diagnostics.</p><p><strong>Strategy: </strong>Here, we propose the quadruple aim (better patient experiences, health outcomes and professional satisfaction at lower costs) as a framework to determine the contribution of digital diagnostics in primary care. Using this framework, we critically analyse the advantages and challenges of digital diagnostics in primary care using scientific literature and relevant casuistry.</p><p><strong>Results: </strong>Two use cases address the development process and implementation in the Netherlands: a patient portal for reporting laboratory results and digital diagnostics as part of hybrid care, respectively. The third use case addresses digital diagnostics for sexually transmitted diseases from an international perspective.</p><p><strong>Conclusions: </strong>We conclude that although evidence is gathering, the often-expected value of digital diagnostics needs adequate scientific evidence. We propose striving for evidence-based 'responsible digital diagnostics' (sustainable, ethically acceptable, and socially desirable digital diagnostics). Finally, we provide a set of conditions necessary to achieve it. The analysis and actionable guidance provided can improve the chance of success of digital diagnostics interventions and overall, the positive impact of this rapidly developing field.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"29 1","pages":"2273615"},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10653613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72016170","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":"Time to treat the climate and nature crisis as one indivisible global health emergency.","authors":"Kamran Abbasi, Parveen Ali, Virginia Barbour, Thomas Benfield, Kirsten Bibbins-Domingo, Gregory E Erhabor, Stephen Hancocks, Richard Horton, Laurie Laybourn-Langton, Robert Mash, Peush Sahni, Wadeia Mohammad Sharief, Paul Yonga, Chris Zielinski","doi":"10.1080/13814788.2023.2276514","DOIUrl":"10.1080/13814788.2023.2276514","url":null,"abstract":"","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"29 1","pages":"2276514"},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138048805","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}