British Journal of General Practice最新文献

{"title":"The art of noticing: a lesson from general practice.","authors":"Janani Lambotharan","doi":"10.3399/bjgp25X740889","DOIUrl":"10.3399/bjgp25X740889","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"75 752","pages":"124"},"PeriodicalIF":5.3,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525383","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":"What is this life if, full of care, we have no time to stand and stare?","authors":"Andrew Papanikitas","doi":"10.3399/bjgp25X740865","DOIUrl":"10.3399/bjgp25X740865","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"75 752","pages":"122"},"PeriodicalIF":5.3,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525384","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":"Chronic kidney disease management in primary care: challenges and possible developments.","authors":"Heather Walker, Michael K Sullivan, Bhautesh Dinesh Jani, Katie Gallacher","doi":"10.3399/bjgp25X740829","DOIUrl":"10.3399/bjgp25X740829","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"75 752","pages":"104-106"},"PeriodicalIF":5.3,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525371","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":"Assisted dying - we can't be neutral.","authors":"Rachel Fisher","doi":"10.3399/bjgp25X740853","DOIUrl":"10.3399/bjgp25X740853","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"75 752","pages":"108-109"},"PeriodicalIF":5.3,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525368","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":"Crossing the Rubicon: assisted dying in general practice.","authors":"David R Grube","doi":"10.3399/bjgp25X740841","DOIUrl":"10.3399/bjgp25X740841","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"75 752","pages":"108"},"PeriodicalIF":5.3,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525373","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 and locum use for acute consultations: observational study of subsequent workload.","authors":"Harshita Kajaria-Montag, Stefan Scholtes, Denis Pereira Gray, Kate Sidaway-Lee, Michael Freeman, Philip Evans","doi":"10.3399/BJGP.2024.0312","DOIUrl":"10.3399/BJGP.2024.0312","url":null,"abstract":"<p><strong>Background: </strong>Workload is probably the biggest challenge facing general practice and little is known about any modifiable factors. For GPs, both continuity and locum status are associated with differences in outcomes.</p><p><strong>Aim: </strong>To determine whether practice and hospital workload after an index acute consultation depend on the type of GP consulted (locums and practice GPs with [regular] and without [non-regular] continuity, and locums).</p><p><strong>Design and setting: </strong>An observational, cross-sectional analysis of consultation-level data from English general practices from the Clinical Practice Research Datalink from 2015 to 2017.</p><p><strong>Method: </strong>Antibiotic prescription was used as a marker for acute consultations with regression models to calculate adjusted relative risks for emergency department consultations and admissions, outpatient referrals, and test ordering, as well as the patients' GP reconsultation interval following consultations with the three types of GP.</p><p><strong>Results: </strong>After adjustment, consultations with antibiotic prescriptions with regular GPs with continuity were associated with fewer subsequent hospital admissions and lower emergency department use but higher outpatient referrals relative to locums and non-regular GPs. Locums ordered tests less often (relative risk [RR] -24.3%, 95% confidence interval [CI] = -27.3 to -21.2) than regular GPs whereas non-regular GPs ordered tests more often (RR 19.1%, 95% CI = = 16.4 to 21.8). Patients seeing their regular GP had on average a 9% longer (95% CI = 8 to 10) reconsultation interval than if they saw any other GP.</p><p><strong>Conclusion: </strong>The differences in outcomes were associated more with having continuity than with GP locum status. Seeing a GP with whom the patient had continuity of care was associated with reduced workload within the practice and in hospital.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e181-e186"},"PeriodicalIF":5.3,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054317","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":"Books: <i>The Art of Uncertainty: How to Navigate Chance, Ignorance, Risk and Luck</i>: Our closest companion.","authors":"Richard Lehman","doi":"10.3399/bjgp25X740937","DOIUrl":"https://doi.org/10.3399/bjgp25X740937","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"75 752","pages":"128"},"PeriodicalIF":5.3,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525369","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":"Adoption of clinical pharmacist roles in primary care: longitudinal evidence from English general practice.","authors":"Michael Anderson, Igor Francetic","doi":"10.3399/BJGP.2024.0320","DOIUrl":"10.3399/BJGP.2024.0320","url":null,"abstract":"<p><strong>Background: </strong>Over the past decade, the number of clinical pharmacists working within multidisciplinary teams in English general practices has expanded.</p><p><strong>Aim: </strong>To examine changes in quality of prescribing after the adoption of clinical pharmacist roles in English general practices.</p><p><strong>Design and setting: </strong>Longitudinal cohort study in English general practice.</p><p><strong>Method: </strong>Two-way fixed-effects regression was used to compare differences in prescribing indicators in general practices with and without pharmacists between September 2015 and December 2019.</p><p><strong>Results: </strong>Between September 2015 and December 2019, the proportion of practices employing a clinical pharmacist increased from 236/7623 (3.1%) to 1402/6836 (20.5%). Clinical pharmacist implementation resulted in statistically significant reductions in total costs of medicines per 1000 patients (-0.85%, 95% confidence interval [CI] = -1.50% to -0.21%), the total number of opioid prescriptions per 1000 patients (-1.06%, 95% CI = -1.82% to -0.29%), and the average daily quantity of anxiolytics per 1000 patients (-1.26%, 95% CI = -2.40% to -0.12%). Clinical pharmacist implementation also resulted in reductions in the total number of prescriptions per 1000 patients (-0.58%, 95% CI = -1.30% to 0.13%) and the total number of antibiotic prescriptions per 1000 patients (-0.51%, 95% CI = -1.30% to 0.27%) that trended towards statistical significance. There were no statistically significant differences in the share of broad-spectrum versus narrow-spectrum antibiotics (0.02%, 95% CI = -0.07% to 0.11%) and the oral morphine equivalence of high-dose opioids (>120 mg per 24 h) per 1000 patients (1.19%, 95% CI = -0.46% to 2.85%).</p><p><strong>Conclusion: </strong>This analysis is limited by practice-level data but supports the hypothesis that clinical pharmacist implementation results in improvements in prescribing quality.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e173-e180"},"PeriodicalIF":5.3,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332816","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":"Yonder: Impact of workload, sleep apnoea and dementia, ethics of lateness, and registrar professional identity.","authors":"Alex Burrell","doi":"10.3399/bjgp25X740961","DOIUrl":"10.3399/bjgp25X740961","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"75 752","pages":"130"},"PeriodicalIF":5.3,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525387","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":"Experiences of social prescribing in the UK: a qualitative systematic review.","authors":"Nur Hidayati Handayani, Marta Wanat, Stephanie Tierney","doi":"10.3399/BJGP.2025.0179","DOIUrl":"10.3399/BJGP.2025.0179","url":null,"abstract":"<p><strong>Background: </strong>Social prescribing connects patients to resources or activities to meet their non-medical needs. In the UK, it is often implemented in primary care. In the social prescribing pathway, patients are directed to link workers to identify suitable solutions for their needs such as art workshops or welfare benefit guidance. Social prescribing marks a notable transition from traditional medical treatments to more comprehensive strategies focusing on holistic health and wellbeing. Insights from patient experiences can improve the development of social prescribing to better meet their needs. This understanding can aid in improving the delivery and outcomes of social prescribing.</p><p><strong>Aim: </strong>To synthesise qualitative research on the experiences of social prescribing among patients in the UK.</p><p><strong>Design and setting: </strong>Qualitative systematic review using thematic synthesis for peer-reviewed studies that focused on experiences of users of social prescribing in the UK.</p><p><strong>Method: </strong>An exhaustive search was performed in six databases: ASSIA, CINAHL, Embase, MEDLINE, PsycINFO, and Social Sciences Citation Index via Web of Science. The Critical Appraisal Skills Programme tool for qualitative research was used for quality assessment and the PRISMA 2020 checklist was used to ensure the report transparency.</p><p><strong>Results: </strong>Titles and abstracts of 1269 studies were screened. In total, 85 studies were full-text screened, and 19 studies were included in the review. Five analytical themes were developed from these studies: a) searching for hope in times of adversity; b) variability in temporal responsiveness; c) sustained change from a positive response; d) feeling supported and empowered by the social prescribing pathway; and e) misalignment producing no response.</p><p><strong>Conclusion: </strong>Patients might experience lasting advantages from social prescribing if it aligns with their needs and expectations. Results highlighted the importance of matching social prescribing referral with patients' readiness to engage. Therefore, it is recommended that healthcare professionals evaluate patient suitability before beginning a social prescribing referral.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e203-e210"},"PeriodicalIF":5.3,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392066","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}