British Journal of General Practice最新文献

{"title":"Evidence-based tests to monitor adults with type 2 diabetes mellitus in primary care: rapid reviews and consensus process.","authors":"Martha Mc Elwenspoek, Rachel O'Donnell, Joni Jackson, Sarah Dawson, Katie Charlwood, Alastair D Hay, Jessica Watson, Penny Whiting","doi":"10.3399/BJGP.2024.0744","DOIUrl":"10.3399/BJGP.2024.0744","url":null,"abstract":"<p><strong>Background: </strong>When monitoring long-term conditions, both over- and undertesting can risk patient harm and increase healthcare costs.</p><p><strong>Aim: </strong>To evaluate the evidence base for type 2 diabetes mellitus (T2DM) monitoring tests and develop methods for creating evidence-based testing strategies.</p><p><strong>Design and setting: </strong>Rapid reviews were conducted and a consensus process then used to evaluate the evidence base within primary care settings.</p><p><strong>Method: </strong>The authors identified tests that are recommended or used commonly to monitor T2DM. Filtering questions were created to examine the rationale for use of each test, which were answered by stepwise rapid reviews of evidence cited by guidelines, systematic reviews, and individual studies. A consensus group of patient representatives and clinicians voted whether tests should be included or excluded based on the evidence or whether further evidence was needed.</p><p><strong>Results: </strong>Of 15 tests, only haemoglobin A1c, to monitor disease progression and treatment response, and estimated glomerular filtration rate, to detect chronic kidney disease, have a strong evidence base. Based on available evidence and consensus group feedback, routinely testing for fructosamine to monitor disease progression; thyroid function, vitamin B12, ferritin, folate, clotting, bone profile, C-reactive protein, erythrocyte sedimentation rate, and B-type natriuretic peptide; and liver function for adverse treatment effects of metformin was deemed unnecessary. The study found insufficient evidence for lipids and haemoglobin to screen for secondary conditions, and for vitamin B12 to screen for adverse effects in those taking metformin.</p><p><strong>Conclusion: </strong>The study found that the evidence base for most T2DM monitoring tests is weak or absent. Clinicians should avoid non-evidence-based tests unless there are additional clinical indications for testing. Standardised evidence-based testing panels for T2DM and other long-term conditions could reduce unnecessary testing.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General practice chlamydia testing: a qualitative study of staff approaches using behavioural change theory.","authors":"Amna Asad, Beattie Rh Sturrock, Jessica Carter, John M Saunders, Jackie A Cassell, Greta Rait, Lorraine K McDonagh","doi":"10.3399/BJGP.2024.0498","DOIUrl":"10.3399/BJGP.2024.0498","url":null,"abstract":"<p><strong>Background: </strong>Chlamydia is the most diagnosed bacterial sexually transmitted infection (STI) in England, but opportunistic testing remains low in general practice despite high prevalence among young people. Attempts to increase testing have been met with little success; therefore, there is a need to explore why rates remain low and how this may be improved.</p><p><strong>Aim: </strong>To explore general practice staff perceptions of opportunistic chlamydia testing, including barriers, facilitators, interventions, and policies, using the Behaviour Change Wheel (BCW).</p><p><strong>Design & setting: </strong>Qualitative interviews and focus groups were undertaken with general practice staff in England.</p><p><strong>Method: </strong>Twenty-three semi-structured individual interviews and seven focus groups with general practice staff were conducted. Data were analysed using inductive thematic analysis, followed by thematic categorisation onto the BCW.</p><p><strong>Results: </strong>Participants identified several barriers to chlamydia testing corresponding with BCW components, including low perceived knowledge (psychological capability), general practice context (physical opportunity), cultural norms (social opportunity), testing not prioritised (reflective motivation), and concerns about patient reactions (automatic motivation). Proposed intervention functions included education, persuasion (for example, posters), incentivisation (for example, financial incentives), and environmental restructuring (for example, computer reminders). Potential policy categories discussed were communication and marketing (for example, campaigns) and service provision (for example, GP drop-in sessions at other venues).</p><p><strong>Conclusion: </strong>This study identified barriers to chlamydia testing in English general practice and potential ways to address these issues, contributing new insights to existing literature. This research can be utilised to design multi-component, impactful interventions to increase testing in general practice and ultimately reduce harm posed by chlamydia infections.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e648-e658"},"PeriodicalIF":5.2,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GP consultations for respiratory tract infections in children aged <5 years: a retrospective cohort study 2016-2023.","authors":"Kimberley Foley, Dougal Hargreaves, Alex Bottle, Jennifer K Quint, Azeem Majeed, Sejal Saglani, Sonia Saxena","doi":"10.3399/BJGP.2024.0501","DOIUrl":"10.3399/BJGP.2024.0501","url":null,"abstract":"<p><strong>Background: </strong>Little is known about how GP consultation rates for children's respiratory tract infections (RTIs) have changed since the COVID-19 pandemic restrictions lifted.</p><p><strong>Aim: </strong>To describe changes in GP consultation rates for RTIs in children aged <5 years from 2016 to 2023.</p><p><strong>Design & setting: </strong>A population-based retrospective cohort study using electronic health records from primary care practices across England.</p><p><strong>Method: </strong>All children aged <5 years registered with a general practice in the Clinical Practice Research Datalink Aurum database from April 2016 to March 2023 were included. Monthly GP consultation rates for RTIs from April 2021 to March 2023 were compared with the corresponding months during pre-pandemic years (April 2016 to February 2020).</p><p><strong>Results: </strong>There were 3 226 285 GP consultations for RTIs among 2 894 539 children. Pre-pandemic, mean monthly consultation rates ranged from lows in August to highs in November (from 2368 to 8682 per 100 000 children, respectively). Following the pandemic lockdowns in 2020, monthly rates in 2021/2022 peaked in June and October at 5152 and 5942 per 100 000 children, respectively, but the winter peak was less marked than pre-pandemic and mean monthly rates were 16.8% lower (95% confidence interval [CI] = - 13.4 to - 19.6). In 2022/2023, after all restrictions were lifted, rates remained around 15% below pre-pandemic years, but the winter peak for children aged 3-4 years was 8615 per 100 000 children, exceeding mean pre-pandemic winter peaks of 6011 per 100 000 children. This was an increase of 43.3% and coincided with a streptococcal group A outbreak. Across all ages there was a sharp increase (from 1486 to 2370 per 100 000 children, around 60%) in tonsillitis, <i>Streptococcus</i> A, and bacterial ear infections.</p><p><strong>Conclusion: </strong>This study shows reductions in GP consultations for RTIs in children aged <5 years since the lifting of COVID- 19 pandemic restrictions. Of concern is a sharp rise in tonsillitis, <i>Streptococcus</i> A, and bacterial ear infections that should be monitored.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e577-e585"},"PeriodicalIF":5.2,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding access to sexual and reproductive health in general practice using an adapted Candidacy Framework: a systematic review and qualitative evidence synthesis.","authors":"Rebecca L Mawson, Victoria Hodges, Sarah Salway, Caroline Mitchell","doi":"10.3399/BJGP.2024.0522","DOIUrl":"10.3399/BJGP.2024.0522","url":null,"abstract":"<p><strong>Background: </strong>General practice has a key role in reducing inequity in access to care relating to sexual and reproductive health (SRH). Unplanned pregnancy, abortion, and sexually transmitted infections are increasing and disproportionately affect deprived communities and minoritised ethnic groups. The Candidacy Framework is a practical and theoretical framework for understanding the complex interactional processes of access to SRH care in general practice.</p><p><strong>Aim: </strong>To use the Candidacy Framework to explore access to SRH care in general practice. The seven interaction stages are: identification of need; navigation of services; permeability of services; appearing and asserting need; adjudication by healthcare professional (HCP); offers or resistance of offer; and the local operating conditions or local production of candidacy.</p><p><strong>Design & setting: </strong>Systematic review with qualitative evidence synthesis using a framework approach.</p><p><strong>Method: </strong>A systematic search of MEDLINE, Embase, PubMed, and the Web of Science was conducted to identify primary qualitative research exploring access to SRH care in general practice from practitioner, public, and patient perspectives in countries with universal health care. The Candidacy Framework was used to synthesise the findings.</p><p><strong>Results: </strong>Analysis of 42 studies revealed the impact of stigma, shame, and embarrassment among individuals, communities, and HCPs. Findings showed limited inclusion of demographics, such as ethnicity and socioeconomic status. Barriers to access were more evident for those from lower socioeconomic communities, minoritised ethnic groups, and the LGBTQ+ community. There are multiple barriers, which include the behaviours of HCPs, who have a crucial role in recognising an individual's SRH need.</p><p><strong>Conclusion: </strong>General practice offers a cradle-to-grave healthcare service that should have SRH as a priority area of provision. Further understanding is needed about the impact of historic harms by medicine and health care on racialised individuals and minoritised genders.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e637-e647"},"PeriodicalIF":5.2,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physicians' appraisal of parental concerns: a qualitative assessment.","authors":"Laura Cuypers, Cato Dessers, Birgitte Schoenmakers, Jaan Toelen","doi":"10.3399/BJGP.2024.0554","DOIUrl":"10.3399/BJGP.2024.0554","url":null,"abstract":"<p><strong>Background: </strong>In clinical encounters with children and their parents, physicians rely on both analytical and non-analytical factors to assess the clinical problem. Research on clinical gut feeling has recognised this as a significant diagnostic factor, yet little is known about how physicians evaluate parental concerns.</p><p><strong>Aim: </strong>To investigate which parent- and physician-related factors influence a physician's assessment of parental concerns.</p><p><strong>Design and setting: </strong>Nine qualitative semi-structured focus group interviews were conducted with 15 GPs and 15 paediatricians in Belgium between May and August 2022.</p><p><strong>Method: </strong>The interview transcripts were independently coded and analysed thematically using the constant comparative analysis method.</p><p><strong>Results: </strong>The factors that physicians use to assess parental concerns can be categorised into four groups: parent-related, physician-related, context-related, and child-related factors. Within each category, there are multiple determinants, with the most influential being having multiple children as a parent, the physician's work experience, and disease severity.</p><p><strong>Conclusion: </strong>This study confirms some determining factors that have already been described in the literature, but it also identifies new determinants (for example, having multiple children as a parent and physician fatigue). Quantitative research could assess the extent to which the identified factors are involved in the assessment of gut feeling.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e618-e626"},"PeriodicalIF":5.2,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143569018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying people at risk of rheumatoid arthritis in primary care: a qualitative study.","authors":"Anna M Anderson, Suzanne H Richards, Caroline Flurey, Heidi J Siddle","doi":"10.3399/BJGP.2024.0590","DOIUrl":"10.3399/BJGP.2024.0590","url":null,"abstract":"<p><strong>Background: </strong>Identification of rheumatoid arthritis (RA) in primary care is challenging and often delayed. Anticyclic citrullinated peptide (anti-CCP) antibody testing of people presenting to primary care with new-onset musculoskeletal symptoms without synovitis could help address this; those testing positive are at increased risk of developing RA.</p><p><strong>Aim: </strong>To explore how primary care clinicians currently identify and refer patients with suspected RA, and the behaviours required to implement a prediction model for guiding targeted anti-CCP testing for non-specific musculoskeletal symptoms in primary care.</p><p><strong>Design and setting: </strong>A qualitative descriptive study in primary care in England.</p><p><strong>Method: </strong>Eight GPs and eight musculoskeletal First Contact Practitioners (physiotherapists) participated in semi-structured interviews to explore their experiences of identifying and/or referring patients with suspected RA, and their views of a implementation package for the anti-CCP prediction model. Data were analysed using framework analysis.</p><p><strong>Results: </strong>Variations in practice were evident across the pathway for identifying and/or referring patients with suspected RA, including in access to and use of the anti-CCP test. Implementing the anti-CCP prediction model would require clinicians to believe its benefits outweigh its risks, engagement of primary and secondary care teams, and incorporation of the prediction model within an easily accessible and useable clinical-decision support system. Participants' views about implementing the anti-CCP prediction model varied but were mostly positive overall.</p><p><strong>Conclusion: </strong>Implementing a prediction model to guide targeted anti-CCP testing in primary care could be feasible. Further research is required to explore the potential benefits, risks, and costs of a pathway for identifying and/or managing people at risk of RA.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e627-e636"},"PeriodicalIF":5.2,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving healthcare information for young people with ADHD in general practice: a qualitative study.","authors":"Anna Price, Kieran Becker, Rebecca Gudka, John Headley Ward, Jane R Smith, Faraz Mughal, G J Melendez-Torres, Emma Pitchforth, Tamsin Newlove-Delgado","doi":"10.3399/BJGP.2024.0755","DOIUrl":"10.3399/BJGP.2024.0755","url":null,"abstract":"<p><strong>Background: </strong>Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that can have poor long-term outcomes when unmanaged. Young people aged 16-25 years with ADHD are often unable to access specialist health care as recommended by UK guidelines because of gaps in services, poor transitional support between child and adult services, and long waiting lists. Healthcare information, which is important for condition management, may help mitigate service gaps and support thriving in people with ADHD; however, little is known about provision via primary care.</p><p><strong>Aim: </strong>To investigate experiences of information provision supporting management of young people with ADHD in general practice and explore the potential of digital resources.</p><p><strong>Design and setting: </strong>This qualitative study comprised interviews with young people with ADHD, their supporters, and primary healthcare professionals from sites across England.</p><p><strong>Method: </strong>Participants were recruited from five purposively sampled general practices, varying by local area characteristics. Semi-structured interviews included questions about information provision, healthcare information needs, and digital resources. Themes were generated using reflexive thematic analysis, within a critical realist framework.</p><p><strong>Results: </strong>In total, 20 participants were recruited (11 healthcare professionals and nine people with lived experience). Four themes were generated: lack of ADHD-specific resources, supporting patients with condition management, dedicated resources for clinicians, and digital resources enhancing care<i>.</i> CONCLUSION: People with lived experience and healthcare professionals want better healthcare information about ADHD in general practice, including co-produced resources to support understanding and self-management. Digital resources represent a potentially cost-effective and accessible solution that is currently underutilised.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e586-e596"},"PeriodicalIF":5.2,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient characteristics and degrees of discontinuity of care in Danish general practice: a cohort study.","authors":"Ditte Elschner Rimestad, Peder Ahnfeldt-Mollerup, Troels Kristensen","doi":"10.3399/BJGP.2024.0570","DOIUrl":"10.3399/BJGP.2024.0570","url":null,"abstract":"<p><strong>Background: </strong>Continuity of care is crucial for effective health care, but patients often experience discontinuity of care. Understanding the patterns and associated patient characteristics can guide interventions to improve continuity of care.</p><p><strong>Aim: </strong>To investigate longitudinal provider discontinuity of care to identify disparities in patient characteristics across degrees of discontinuity of care in Danish general practice.</p><p><strong>Design & setting: </strong>Cohort study using data from all Danish general practice patients aged ≥12 years, who were alive between 2007 and 2018.</p><p><strong>Method: </strong>Logistic regression was employed to estimate discontinuity of care at level 0 versus: 1-2 shifts, 3-4 shifts, 5-6 shifts, 7-8 shifts, and ≥9 shifts. Five regression models were used to analyse the odds of different levels of discontinuity of care relative to demographic, regional, municipal, socioeconomic, and morbidity factors.</p><p><strong>Results: </strong>The majority of males were likely to have lower levels of discontinuity of care than females; however, males in the subgroup with the most shifts had a higher likelihood of experiencing the highest level of discontinuity. Younger adults aged 25-44 years had a higher likelihood of moderate-to-high discontinuity of care compared to those aged 12-24 years, whereas older adults had a lower probability. Discontinuity of care was higher among residents of the Capital and Zealand Regions, and varied by municipality type - being lowest in intermediate areas and highest in peripheral and rural municipalities at the most severe levels. Individuals who were unemployed, those in the lower income quartiles, and those classified as being of 'other ethnicities' and single status had increased probability of discontinuity of care. Patients with lower or moderate-to-high morbidity were also more likely to experience discontinuity of care than patients with no chronic diseases.</p><p><strong>Conclusion: </strong>This study revealed disparities in discontinuity of care linked to lower socioeconomic status and higher morbidity, with varying odds by region, municipality type, age, and gender.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e509-e517"},"PeriodicalIF":5.2,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing the inverse care law in Scottish general practice: systematic scoping review.","authors":"James Bogie, Meike van Dijk, Cara Bezzina, Carey Lunan, David Henderson, Stewart W Mercer, David N Blane","doi":"10.3399/BJGP.2024.0622","DOIUrl":"10.3399/BJGP.2024.0622","url":null,"abstract":"<p><strong>Background: </strong>Recent evidence demonstrates persistence of the inverse care law (ICL) in general practice in England. Although the ICL was well-described in Scotland 20 years ago, progress in interventions since then is unclear.</p><p><strong>Aim: </strong>To review national and local interventions that aimed to specifically address the ICL in Scottish general practice since 2000.</p><p><strong>Design and setting: </strong>This was a systematic scoping review set in Scotland.</p><p><strong>Method: </strong>Embase, Web of Science, PubMed, CINAHL, Cochrane and BASE from 2000 to February 2024 were searched. A systematic grey literature search of government, NHS and third-sector websites was also performed. All papers were double screened for inclusion. Both quantitative and qualitative studies were included and quality was assessed using the Joanna Briggs Institute tools.</p><p><strong>Results: </strong>Out of 13 089 results, 67 papers reporting on 20 interventions were included. Interventions to improve general practice in deprived areas were categorised as: (a) enhancing patients' financial or social support, (b) targeting specific health conditions, (c) targeting specific groups, and (d) enhancing generalist health care. Six interventions accounted for 66% (44/67) of all included papers. Only two interventions have been rolled out nationally - community link workers and welfare advice and health partnerships - with both facing uncertain long-term funding.</p><p><strong>Conclusion: </strong>There remains a major implementation gap between Scottish Government's policy ambitions to address health inequalities and sustainable delivery on the ground. To address the ICL, greater overall investment in general practice is needed, together with additional resources for more deprived areas according to local population need (a 'proportionate universalism' approach).</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e549-e558"},"PeriodicalIF":5.2,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personal GP continuity improves healthcare outcomes in primary care populations: a systematic review.","authors":"Sven Göran Engström, Malin André, Eva Arvidsson, Carl Johan Östgren, Margareta Troein, Lars Borgquist","doi":"10.3399/BJGP.2024.0568","DOIUrl":"10.3399/BJGP.2024.0568","url":null,"abstract":"<p><strong>Background: </strong>Personal continuity is a hallmark for GPs but there is insufficient evidence to support its benefits in ordinary primary care populations.</p><p><strong>Aim: </strong>To investigate the effects of GP personal continuity on the healthcare outcomes of primary care populations.</p><p><strong>Design and setting: </strong>Systematic review of quantitative studies investigating associations between personal continuity of care and outcomes such as mortality and healthcare utilisation.</p><p><strong>Method: </strong>Embase, PubMed, Scopus, and Web of Science were searched for studies published between 1 January 2000 and 31 October 2023. Owing to study heterogeneity the synthesis was conducted narratively; study results were summarised and expressed as having higher (compared with lower) continuity of care. Certainty of each summarised result was assessed using the GRADE framework.</p><p><strong>Results: </strong>Out of 5792 unique references, 18 studies were included in the final analyses. The outcomes were grouped into three categories of summarised outcomes. Higher (when compared with lower) personal continuity with a GP/family physician probably prevents premature mortality (moderate certainty: four studies, 5 638 305 participants), probably reduces the risk of admission to hospital (moderate certainty: 11 studies, 13 642 684 participants), and probably lowers risk of emergency department visits (moderate certainty: seven studies, 3 855 487 participants).</p><p><strong>Conclusion: </strong>Higher, compared with lower, continuity in the relationship between GP and patients in primary care populations is associated with reduced mortality, admissions to hospital, and emergency department visits. Relatively small improvements in personal continuity, which may be achieved in most practices, significantly reduce healthcare consumption, and thus may have an impact on access to care, which has implications for healthcare policy.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e518-e525"},"PeriodicalIF":5.2,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}