European Journal of General Practice最新文献

{"title":"The linguistic validation of the gut feelings questionnaire in Turkish.","authors":"Huseyin Elbi, Makbule Neslişah Tan, Sidika Ece Yokus, Fatih Ozcan, Vildan Mevsim, Erik Stolper","doi":"10.1080/13814788.2023.2273846","DOIUrl":"10.1080/13814788.2023.2273846","url":null,"abstract":"<p><strong>Background: </strong>'Gut feelings' are frequently used by general practitioners in the clinical decision-making process, especially in situations of uncertainty. The Gut Feelings Questionnaire (GFQ) has been developed in the Netherlands and is now available in English, French, German, Polish, Spanish, and Catalan, enabling cross-border studies on the subject. However, a Turkish version of the GFQ is lacking.</p><p><strong>Objectives: </strong>A Turkish version of the GFQ.</p><p><strong>Methods: </strong>A linguistic validation procedure was conducted, which took place in six phases: forward translation (step 1), backward translation (step 2), first consensus (step 3), cultural validation (step 4), second consensus (step 5), and final version (step 6).</p><p><strong>Results: </strong>The absence of literal equivalent of the term 'gut feelings' in Turkish was determined. The word 'intuition' was chosen as the Turkish literal equivalent of 'gut feelings'. There were also some challenges in finding the exact meanings of words and expressions in Turkish literature. However, we succeeded in finding adequate and responsible solutions. A Turkish version of the GFQ is available now.</p><p><strong>Conclusion: </strong>With these validated GFQs, Turkish GPs can facilitate studies of the role of 'gut feelings' in clinical reasoning.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"29 1","pages":"2273846"},"PeriodicalIF":3.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488961","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":"29 1","pages":"2273841"},"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":"29 1","pages":"2284257"},"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":"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":"29 1","pages":"2268838"},"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":"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":"29 1","pages":"2283831"},"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":"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":"29 1","pages":"2274467"},"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":"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":"28 1","pages":"95-101"},"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}

{"title":"Correction.","authors":"","doi":"10.1080/13814788.2022.2155364","DOIUrl":"https://doi.org/10.1080/13814788.2022.2155364","url":null,"abstract":"","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"28 1","pages":"252"},"PeriodicalIF":3.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9754031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10711261","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 6: Longitudinal qualitative and mixed-methods approaches for longitudinal and complex health themes in primary care research.","authors":"Irene Korstjens,&nbsp;Albine Moser","doi":"10.1080/13814788.2022.2053106","DOIUrl":"https://doi.org/10.1080/13814788.2022.2053106","url":null,"abstract":"<p><p>This article, the sixth in a series aiming to provide practical guidance for qualitative research in primary care, introduces two approaches for addressing longitudinal and complex health themes in primary care research. The first approach - longitudinal qualitative research - supports the study of change during the life course. The second approach - mixed-methods research - integrates quantitative and qualitative research to gain new insights to address the complex and multifaceted themes in primary care.We discuss the context, what, why, when and how of these approaches and their main practical and methodological challenges. We provide examples of empirical studies using these approaches and sources for further reading.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"28 1","pages":"118-124"},"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/7e/be/IGEN_28_2053106.PMC9132407.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10757571","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":"Safety netting advice for respiratory tract infections in out-of-hours primary care: A qualitative analysis of consultation videos.","authors":"Annelies Colliers,&nbsp;Hilde Philips,&nbsp;Katrien Bombeke,&nbsp;Roy Remmen,&nbsp;Samuel Coenen,&nbsp;Sibyl Anthierens","doi":"10.1080/13814788.2022.2064448","DOIUrl":"https://doi.org/10.1080/13814788.2022.2064448","url":null,"abstract":"<p><strong>Background: </strong>General practitioners (GPs) use safety netting advice to communicate with patients when and how to seek further help when their condition fails to improve or deteriorate. Although many respiratory tract infections (RTI) during out-of-hours (OOH) care are self-limiting, often antibiotics are prescribed. Providing safety netting advice could enable GPs to safely withhold an antibiotic prescription by dealing both with their uncertainty and the patients' concerns.</p><p><strong>Objectives: </strong>To explore how GPs use safety netting advice during consultations on RTIs in OOH primary care and how this advice is documented in the electronic health record.</p><p><strong>Methods: </strong>We analysed video observations of 77 consultations on RTIs from 19 GPs during OOH care using qualitative framework analysis and reviewed the medical records. Videos were collected from August until November 2018 at the Antwerp city GP cooperative, Belgium.</p><p><strong>Results: </strong>Safety netting advice on alarm symptoms, expected duration of illness and/or how and when to seek help is often lacking or vague. Communication of safety netting elements is scattered throughout the end phase of the consultation. The advice is seldom recorded in the medical health record. GPs give more safety netting advice when prescribing an antibiotic than when they do not prescribe an antibiotic.</p><p><strong>Conclusion: </strong>We provided a better understanding of how safety netting is currently carried out in OOH primary care for RTIs. Safety netting advice during OOH primary care is limited, unspecific and not documented in the medical record.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"28 1","pages":"87-94"},"PeriodicalIF":3.4,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9103350/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10248517","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}