British Journal of General Practice最新文献

{"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 and 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":""},"PeriodicalIF":5.3,"publicationDate":"2025-06-16","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 and 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 studies 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":""},"PeriodicalIF":5.3,"publicationDate":"2025-06-16","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":"Primary care transformation in Scotland: a comparison of two cross-sectional national surveys of GPs' views in 2018 and 2023.","authors":"Eddie Donaghy, Kieran D Sweeney, Lauren Ng, Holly Haines, Alexandra Thompson, David Henderson, Harry Hx Wang, Andrew Thompson, Bruce Guthrie, Stewart W Mercer","doi":"10.3399/BJGP.2024.0500","DOIUrl":"10.3399/BJGP.2024.0500","url":null,"abstract":"<p><strong>Background: </strong>The 2018 Scottish GP contract established GP clusters and multidisciplinary team (MDT) expansion. Qualitative studies have suggested suboptimal progress with these initiatives.</p><p><strong>Aim: </strong>To quantify progress since the introduction of the new contract.</p><p><strong>Design and setting: </strong>A cross-sectional postal survey of all qualified GPs was undertaken in Scotland in 2023.</p><p><strong>Method: </strong>GPs' working lives, career intentions, and views on the new contract were compared with a similar survey conducted in 2018.</p><p><strong>Results: </strong>In total, 1385/4529 (31%) GPs responded to the 2023 survey compared with 2465/4371 (56%) in 2018. Job satisfaction and negative job attributes were similar in both surveys. Both positive job attributes (<i>P</i> = 0.011) and job pressures (<i>P</i> = 0.004) increased but the changes were small (effect sizes <0.2). Significantly more GPs were planning to reduce hours (<i>P</i><0.001) and leave direct patient care (<i>P</i> = 0.008) in 2023 than in 2018. Quality leads' views on cluster working were unchanged, with 70%-80% reporting insufficient support. Cluster knowledge and engagement was unchanged but there were small increases in knowledge of quality improvement. More than half of the GPs reported that access to MDT staff was insufficient to reduce their workload in all staff categories except vaccinations. Significantly more practices were trying to recruit GPs (<i>P</i><0.01), and GPs reported worsening NHS services, higher workload, and lower practice sustainability in 2023 (<i>P</i><0.001). Only 5% of GPs in the 2023 survey thought that the new contract had improved the care of patients with complex needs.</p><p><strong>Conclusion: </strong>GPs report few improvements in working life 5 years after the new contract was introduced, and are responding by planning to reduce their hours or leave direct patient care.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959011","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":"Continuity of care in general practice and secondary care: retrospective cohort study.","authors":"Thomas Beaney, Thomas Woodcock, Paul Aylin, Azeem Majeed, Jonathan Clarke","doi":"10.3399/BJGP.2024.0579","DOIUrl":"10.3399/BJGP.2024.0579","url":null,"abstract":"<p><strong>Background: </strong>Better continuity in primary and secondary care is linked to improved health outcomes, but it is unclear whether the sociodemographic determinants of continuity are the same in both settings and whether continuity measures in each setting are associated.</p><p><strong>Aim: </strong>To examine the determinants of relational continuity in general practice and fragmented outpatient specialty care in people with clusters of multiple long-term conditions (LTCs) and the association between continuity in each setting.</p><p><strong>Design and setting: </strong>A cohort of patients aged ≥18 years registered to general practices in England throughout 2019 and who had linked hospital outpatient records. Patients with ≥2 of 212 LTCs and with ≥3 general practice and ≥3 outpatient appointments were included.</p><p><strong>Method: </strong>The Continuity of Care Index (COCI) was calculated separately for visits to the same a) GP and b) outpatient specialty, and associations calculated for sociodemographic factors and number of LTCs with COCI scores. The association was also assessed between indices in each setting using univariable and multivariable fractional logit regression.</p><p><strong>Results: </strong>Of 1 135 903 patients, 56.3% (<i>n</i> = 639 489) were aged ≥60 years. Age was the strongest determinant of continuity in general practice, whereas number of LTCs was the strongest determinant in secondary care. Although statistically significant (<i>P</i><0.001), the relationship between the COCI in general practice and outpatients was clinically insignificant in both univariable and multivariable models.</p><p><strong>Conclusion: </strong>A lack of strong association between continuity of care in general practice and outpatient settings was found. This suggests that fragmented hospital care is not mitigated by increased continuity in general practice.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820118","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":"Social determinants of distress in South Asian men with long-term conditions: a qualitative study in primary care.","authors":"Hassan Awan, Nadia Corp, Tom Kingstone, Carolyn A Chew-Graham","doi":"10.3399/BJGP.2024.0386","DOIUrl":"10.3399/BJGP.2024.0386","url":null,"abstract":"<p><strong>Background: </strong>People with long-term physical conditions are more likely to experience distress, depression, or anxiety. Physical-mental comorbidity is associated with lower quality of life, poorer clinical outcomes, and increased mortality than physical conditions alone. People of South Asian origin are the largest minority group in the UK, and more likely to have long-term conditions (LTCs) such as diabetes and heart disease.</p><p><strong>Aim: </strong>To explore how men of South Asian origin with LTCs understand and experience emotional distress as well as the experiences of GPs supporting them.</p><p><strong>Design and setting: </strong>A UK qualitative study interviewing South Asian men with diabetes or coronary heart disease, and GPs working at practices with higher proportions than average in the UK of people of South Asian origin.</p><p><strong>Method: </strong>Online semi-structured interviews with South Asian men and GPs were undertaken. Data were analysed via reflexive thematic analysis. Topic guides were modified iteratively as data collection and analysis progressed. An ethnically appropriate patient advisory group of South Asian men was involved in all stages of the research.</p><p><strong>Results: </strong>Seventeen South Asian men with LTCs and 18 GPs were interviewed. Participants described contextualising distress, including LTCs influencing distress and the intersections of social determinants of distress including ethnicity, poverty, and perceptions of prejudice. Participants understood distress as different from depression with the need to negotiate multiple identities as well as integrative paradigms of health.</p><p><strong>Conclusion: </strong>This study highlights the influence of social determinants of distress in South Asian men with LTCs. It provides an insight into how primary care has the potential to address health inequalities by considering the intersection of these factors.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e397-e405"},"PeriodicalIF":5.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142633295","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":"Patient experiences with person-centred and integrated chronic care, focusing on patients with low socioeconomic status: a qualitative study.","authors":"Hester E van Bommel, Lena Ha Raaijmakers, Maria Etc van den Muijsenbergh, Tjard R Schermer, Jako S Burgers, Tessa van Loenen, Erik Wma Bischoff","doi":"10.3399/BJGP.2024.0400","DOIUrl":"10.3399/BJGP.2024.0400","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness of single disease management programmes in general practice may be limited for patients with low socioeconomic status (SES), as these programmes insufficiently take into account the specific problems and needs of this population. A person-centred integrated care (PC-IC) approach focusing on individual patient's needs and concerns could address these problems.</p><p><strong>Aim: </strong>To explore experiences of patients with (multiple) chronic diseases with regard to the acceptability of a general practice-based PC-IC approach, with a focus on patients with low SES, and to establish which modifications are needed to tailor the approach to this group.</p><p><strong>Design and setting: </strong>In 2021, a feasibility study in seven general practices in the Netherlands was carried out. The healthcare professionals provided care based on a PC-IC approach for patients with diabetes, chronic respiratory diseases and/or cardiovascular disorders. Patients were followed for 6 months.</p><p><strong>Method: </strong>This was a qualitative study using focus group discussions, in-depth interviews, and semi-structured telephone interviews in a total of 46 patients with chronic diseases and multimorbidity, including 31 patients with low SES.</p><p><strong>Results: </strong>An overall positive experience of participants with the PC-IC approach was observed. Discussing their health made patients feel they were being taken more seriously and seen as a unique individual, and it provided the opportunity to discuss their life and health concerns. Recommended adaptations of the PC-IC approach for patients with low SES include creating materials that are clear and easy to understand and offering communication training for healthcare professionals.</p><p><strong>Conclusion: </strong>The PC-IC approach seems helpful for patients with chronic diseases, provided that it is tailored to their skills and abilities. Several modifications for patients with low SES were suggested.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e423-e430"},"PeriodicalIF":5.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807647","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":"Low-dose amitriptyline for irritable bowel syndrome: a qualitative study of patients' and GPs' views and experiences.","authors":"Emma J Teasdale, Hazel A Everitt, Sarah L Alderson, Alexander C Ford, James Hanney, Matthew Chaddock, Emmajane Williamson, Heather Cook, Amanda J Farrin, Catherine Fernandez, Elspeth A Guthrie, Suzanne Hartley, Amy Herbert, Daniel Howdon, Delia Muir, Sonia Newman, Pei Loo Ow, Matthew J Ridd, Christopher M Taylor, Ruth Thornton, Alexandra Wright-Hughes, Felicity L Bishop","doi":"10.3399/BJGP.2024.0303","DOIUrl":"10.3399/BJGP.2024.0303","url":null,"abstract":"<p><strong>Background: </strong>Irritable bowel syndrome (IBS) can cause troublesome symptoms, which impact patients' quality of life and incur considerable health service resource use. Guidelines suggest low-dose amitriptyline for IBS as second-line treatment, but this is rarely prescribed in primary care.</p><p><strong>Aim: </strong>To explore patients' and GPs' views and experiences of using low-dose amitriptyline for IBS.</p><p><strong>Design and setting: </strong>Qualitative interview study with patients and GPs in England, nested within the ATLANTIS trial of low-dose amitriptyline versus placebo (ISRCTN48075063).</p><p><strong>Method: </strong>Semi-structured telephone interviews were conducted with 42 patients at 6 months post-randomisation, with 19 patients again at 12 months post-randomisation, and with 16 GPs between April 2020 and March 2022. Reflexive thematic analysis was used to analyse patient and GP data separately, then together, to identify unique and cross-cutting themes.</p><p><strong>Results: </strong>We found concerns about amitriptyline being an antidepressant, medicalising IBS, and side effects. Perceived benefits included the low and flexible dose, ease of treatment, and familiarity of amitriptyline and its potential to offer benefits beyond IBS symptom relief. These concerns and perceived benefits were expressed in the context of desire for a novel approach to IBS: GPs were keen to offer more options for IBS and patients sought a cure for their symptoms.</p><p><strong>Conclusion: </strong>Patients and GPs felt that the potential benefits of trying low-dose amitriptyline for IBS outweighed their concerns. When offering low-dose amitriptyline for IBS, GPs could address patient concerns about taking an antidepressant for IBS, highlighting the low and flexible dosage, and other potential benefits of amitriptyline such as improved sleep.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e431-e439"},"PeriodicalIF":5.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082670","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":"Safety issues in post-discharge care of older patients in general practice: an ethnographic study.","authors":"Rachel Ann Spencer, Zakia Shariff, Jeremy Dale, Graeme Currie","doi":"10.3399/BJGP.2024.0284","DOIUrl":"10.3399/BJGP.2024.0284","url":null,"abstract":"<p><strong>Background: </strong>Post-inpatient discharge is a risky time for older patients, especially those with polypharmacy and multimorbidity. General practice care at this time, including the processes for managing hospital discharge summaries, lacks standardisation and is of variable quality. Understanding these processes will support the design of interventions and guidance to improve general practice management of the post-discharge period.</p><p><strong>Aim: </strong>To understand and visualise how ongoing care for older people after discharge from hospital is organised in general practice, including the processes for managing discharge summaries.</p><p><strong>Design and setting: </strong>Rapid ethnography study in 10 general practices in the West Midlands, England.</p><p><strong>Method: </strong>We mapped the practices' systems of post-discharge care. Data sources included informal conversations with staff, practice policies, and direct observations of discharge summary handling. Fieldnotes and quotes were subject to an interpretivist framework analysis. A systems modelling technique (the Functional Resonance Analysis Method) was used to present visual representations of the professional roles working in these complex systems.</p><p><strong>Results: </strong>Three basic typographies of system emerged based on professional roles: GP-led, pharmacist-led, and administrative-led. We report on three themes that weave around the Functional Resonance Analysis Method process maps: comfort with demands of administrative role; general practice team dynamics; and interaction with patients.</p><p><strong>Conclusion: </strong>General practice systems for inpatient discharge summary processing are complex and varied. New roles in general practices are being used extensively, often requiring significant input in supervision by GPs. Our findings highlight safety features of different systems and should help practices understand the advantages and limitations of models they work within.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e412-e422"},"PeriodicalIF":5.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016760","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":"How changes in GPs' ways of working have affected community nurses: a qualitative study.","authors":"Louisa Polak, Kristian Pollock, Stephen Barclay, Ben Bowers","doi":"10.3399/BJGP.2024.0534","DOIUrl":"10.3399/BJGP.2024.0534","url":null,"abstract":"<p><strong>Background: </strong>A growing literature examines the way two changes in primary care - the shift towards remote working and the diversification of practice teams to incorporate, for instance, physician associates and paramedics - affect patient care within the practice. However, little is known about the effect of these changes on community nurses.</p><p><strong>Aim: </strong>To explore community nurses' experiences of delivering palliative care in the context of GPs' new ways of working.</p><p><strong>Design and setting: </strong>Qualitative study using focus groups in the UK.</p><p><strong>Method: </strong>Focus groups were conducted on Zoom with community nurses. Data were analysed thematically using constant comparison.</p><p><strong>Results: </strong>Community nurses described extending their roles in palliative care. Alongside pride and satisfaction about this, participants raised several areas of concern and dissatisfaction, some of which they associated with changes in GPs' ways of working. Two reasons for dissatisfaction concerned remote working. First, remote communication with colleagues was seen as creating obstacles to nurses' everyday collaboration with GPs, damaging important working relationships. Second, nurses increased their workload by taking the lead in person-centred care where they saw remote provision by GPs as unsatisfactory. Where workforce diversification led to delegating home visits to paramedics or nurse practitioners, community nurses described feeling a lack of the 'GP back-up' that many identified as essential for community palliative care.</p><p><strong>Conclusion: </strong>When considering and evaluating interventions that change the way GPs work, policymakers and commissioners should look not only at consequences that affect primary care teams, but also at the effects across the complex ecosystem within which these teams operate.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e406-e411"},"PeriodicalIF":5.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069615","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":"Supporting patients to use online services in general practice: focused ethnographic case study.","authors":"Jennifer Newbould, Carol Bryce, Stephanie Stockwell, Bethan Treadgold, John Campbell, Christine Marriott, Emma Pitchforth, Laura Sheard, Rachel Winder, Helen Atherton","doi":"10.3399/BJGP.2024.0137","DOIUrl":"10.3399/BJGP.2024.0137","url":null,"abstract":"<p><strong>Background: </strong>In England online services in general practice encompass a range of provision from ordering repeat medication to having a consultation. Some groups of individuals may find accessing and/or using such services difficult and may require 'digital facilitation', that is the range of processes, procedures, and personnel which seeks to support NHS patients in their uptake and use of online services.</p><p><strong>Aim: </strong>To gain insight, from the perspective of general practice staff and patients/carers, into how and why digital facilitation might lead to benefits, and the key processes involved in supporting patients to use online services.</p><p><strong>Design and setting: </strong>Eight general practices across England with varied geographical and sociodemographic characteristics were included in the study.</p><p><strong>Method: </strong>This was a focused ethnographic case study of observations and interviews (<i>N</i> = 69).</p><p><strong>Results: </strong>Typically, digital facilitation was delivered in an <i>ad hoc</i> fashion to individual patients. Online services were delivered via multiple systems each working differently and creating a need for support so that patients could access them. Younger practice staff were expected to deliver support on account of their age, despite there being no evidence of age-related training and experience. It was understood by practice staff that patients with challenging personal circumstances may require specific support to access online services.</p><p><strong>Conclusion: </strong>At present patient use of online services is supported by digital facilitation that is primarily delivered by reception staff. Supporting patients to use online services requires review of how many services are provided and what for, and consideration for the time and effort needed to support patients to use them.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e382-e389"},"PeriodicalIF":5.3,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11920896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689779","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}