British Journal of General Practice最新文献

{"title":"Prevalence and patterns of testing for anaemia in primary care in England.","authors":"Margaret Smith, Cynthia Wright-Drakesmith, Sarah Haynes, Suzanne Maynard, Akshay Shah, Noemi Ba Roy, Joseph Lee, Katja Maurer, Simon J Stanworth, Clare Bankhead","doi":"10.3399/BJGP.2024.0336","DOIUrl":"https://doi.org/10.3399/BJGP.2024.0336","url":null,"abstract":"<p><p><b>Background</b> Despite epidemiological data on anaemia being available on a global scale, its prevalence in the United Kingdom is not well described. <b>Aim</b> To investigate anaemia prevalence and testing patterns for haemoglobin and other blood parameters. <b>Design and Setting</b> A population-based cohort study using data drawn from the Clinical Practice Research Datalink Aurum database in 2019. <b>Method</b> We extracted demographic data for each person who was registered at their current practice during 2019, including linked data on Index of Multiple Deprivation. We calculated anaemia prevalence in 2019 based on World Health Organization specified age and gender thresholds for haemoglobin. We classified anaemia based on mean corpuscular volume and ferritin. We followed up people with anaemia for up to one year to investigate longitudinal testing patterns for haemoglobin. <b>Results</b> The cohort contained 14 million people. Anaemia prevalence in 2019 was 4.1% (5.1 % females and 3.1% males). Prevalence was higher in people aged >65 years, Black and Asian ethnicities, and people living in areas with higher social deprivation. Only half of people with anaemia and a mean corpuscular volume of ≤100 fL had an accompanying ferritin value recorded. About half of people with anaemia had a follow-up haemoglobin test within one-year, most of which still indicated anaemia. <b>Conclusion</b> Anaemia is prevalent in the UK with large disparities between levels of demographic variables. Investigation and follow-up of anaemia is suboptimal in many patients. Health interventions aimed at improving anaemia investigation and treatment are needed, particularly in these at-risk groups.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808189","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":"Books: <i>Beast in the Shadows</i>: <i>'A delicious mixture of noir, gothic, humour, and perversity'</i>.","authors":"John Launer","doi":"10.3399/bjgp24X740193","DOIUrl":"10.3399/bjgp24X740193","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"74 749","pages":"566"},"PeriodicalIF":5.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752261","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":"Confusion between avoidant restrictive food intake disorder, restricted intake self-harm, and anorexia nervosa: developing a primary care decision tree.","authors":"Clare Ellison, Ursula Philpot","doi":"10.3399/bjgp24X740109","DOIUrl":"10.3399/bjgp24X740109","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"74 749","pages":"559"},"PeriodicalIF":5.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752280","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":"'Tis the season of the primary care miscellany.","authors":"Andrew Papanikitas","doi":"10.3399/bjgp24X740025","DOIUrl":"10.3399/bjgp24X740025","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"74 749","pages":"549"},"PeriodicalIF":5.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752366","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":"Multimorbidity and person-centred care in a socioeconomically deprived community: a qualitative study.","authors":"Marianne McCallum, Sara Macdonald, Frances S Mair","doi":"10.3399/BJGP.2024.0286","DOIUrl":"10.3399/BJGP.2024.0286","url":null,"abstract":"<p><strong>Background: </strong>People with multimorbidity (>2 long-term conditions) have poorer outcomes in areas of high socioeconomic deprivation (SED). High-quality person-centred care (PCC) is important in those with multimorbidity, but socially vulnerable populations have not, to our knowledge, informed current PCC models.</p><p><strong>Aim: </strong>To explore how wider community factors influence management of multimorbidity in the context of high SED, how high-quality PCC is defined by patients, and whether this influences healthcare management.</p><p><strong>Design and setting: </strong>Ethnographically informed case study in a community experiencing high SED in Scotland.</p><p><strong>Method: </strong>Participant observation (138 h) was undertaken within four community groups who also took part in two participatory workshops. There were 25 in-depth interviews with people with multimorbidity, recruited from local general practices; emerging findings were discussed with interviewees in one focus group. Field notes/transcripts were analysed using inductive thematic analysis.</p><p><strong>Results: </strong>Key aspects of PCC were 'patient as person', 'strong therapeutic relationship', 'coordination of care', and 'power sharing'; power sharing was particularly enabling but rarely happened (barriers often unseen by practitioners). Shared community experiences of 'being known', 'stigma', and 'none of the systems working' influenced how people approached health services and healthcare decisions. High-quality PCC may have been particularly effective in this setting because of its influence on ameliorating wider shared negative community experiences.</p><p><strong>Conclusion: </strong>In a high SED setting PCC is important and can enhance engagement. Wider community factors have a critical influence on engagement with health care in areas of high SED and PCC may be particularly important in this context because of its influence ameliorating these. Policymakers should prioritise and resource PCC.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e805-e813"},"PeriodicalIF":5.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513384","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":"Severe mental illness as a risk factor for recorded diagnosis of osteoporosis and fragility fractures in people aged ≥50 years: retrospective cohort study using UK primary care data.","authors":"Christina Avgerinou, Kate Walters, Juan Carlos Bazo-Alvarez, David Osborn, Robert Michael West, Andrew Clegg, Irene Petersen","doi":"10.3399/BJGP.2024.0055","DOIUrl":"10.3399/BJGP.2024.0055","url":null,"abstract":"<p><strong>Background: </strong>Severe mental illness (SMI) has been associated with reduced bone density and increased risk of fractures, although some studies have shown inconsistent results.</p><p><strong>Aim: </strong>To examine the association between SMI and recorded diagnosis of osteoporosis and fragility fracture in people aged ≥50 years.</p><p><strong>Design and setting: </strong>Population-based cohort study set in UK primary care.</p><p><strong>Method: </strong>Anonymised primary care data (IQVIA Medical Research Database) were used. Patients with a diagnosis of SMI aged 50-99 years (2000-2018) were matched to individuals without SMI. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Analyses were stratified by sex and age, accounting for social deprivation, year, smoking, alcohol, and body mass index.</p><p><strong>Results: </strong>In total, 444 480 people were included (SMI <i>n</i> = 50 006; unexposed <i>n</i> = 394 474). In men, diagnosis of SMI increased the likelihood of an osteoporosis diagnosis, with differences mainly observed among the youngest (aged 50-54 years: HR 2.12, 95% CI = 1.61 to 2.79) and the oldest (aged 85-99 years: HR 2.15, 95% CI = 1.05 to 4.37), and SMI increased the risk of fragility fractures across all ages. In women, SMI increased the risk of an osteoporosis diagnosis only in those aged 50-54 years (HR 1.16, 95% CI = 1.01 to 1.34), but increased the risk of fragility fractures across all ages. There were more than twice as many men with SMI with fragility fracture records than with an osteoporosis diagnosis: fragility fracture:osteoporosis = 2.10, compared with fragility fracture:osteoporosis = 1.89 in men without SMI. The fragility fracture:osteoporosis ratio was 1.56 in women with SMI versus 1.11 in women without SMI.</p><p><strong>Conclusion: </strong>SMI is associated with an increased likelihood of fragility fractures and osteoporosis underdiagnosis. Interventions should be considered to mitigate the increased risk of fractures in people with SMI.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e861-e869"},"PeriodicalIF":5.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11497150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581588","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":"People from ethnic minorities seeking help for long COVID: a qualitative study.","authors":"Nina Smyth, Damien Ridge, Tom Kingstone, Dipesh P Gopal, Nisreen A Alwan, Alexa Wright, Ashish Chaudhry, Sophie Clark, Rebecca Band, Carolyn A Chew-Graham","doi":"10.3399/BJGP.2023.0631","DOIUrl":"10.3399/BJGP.2023.0631","url":null,"abstract":"<p><strong>Background: </strong>People from ethnic minority groups are disproportionately affected by COVID-19, less likely to access primary health care, and have reported dissatisfaction with health care. Although the prevalence of long COVID in ethnic minority groups is unclear, such populations are underrepresented in long-COVID specialist clinics and long-COVID lived-experience research, which informed the original long-COVID healthcare guidelines.</p><p><strong>Aim: </strong>To understand the lived experiences of long COVID in people from ethnic minority groups.</p><p><strong>Design and setting: </strong>Qualitative study of people living with long COVID in the UK.</p><p><strong>Method: </strong>Semi-structured interviews with people who self-disclosed long COVID were conducted between June 2022 and June 2023 via telephone or video call. Thematic analysis of the data was conducted. People who were living with long COVID, or caring for someone with long COVID, advised on all stages of the research.</p><p><strong>Results: </strong>Interviews were conducted with 31 participants representing diverse socioeconomic demographics. Help-seeking barriers included little awareness of long COVID or available support, and not feeling worthy of receiving care. Negative healthcare encounters were reported in primary health care; however, these services were crucial for accessing secondary or specialist care. There were further access difficulties and dissatisfaction with specialist care. Experiences of stigma and discrimination contributed to delays in seeking care and unsatisfactory experiences, resulting in feelings of mistrust in health care.</p><p><strong>Conclusion: </strong>Empathy, validation of experiences, and fairness in recognition and support of healthcare needs are required to restore trust in health care and improve the experiences of people with long COVID.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e814-e822"},"PeriodicalIF":5.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11497153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141163096","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 for survivors of trafficking.","authors":"Jill O'Leary","doi":"10.3399/bjgp24X739929","DOIUrl":"10.3399/bjgp24X739929","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"74 749","pages":"532-533"},"PeriodicalIF":5.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752333","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":"Exploring the lived experience for the most vulnerable.","authors":"Euan Lawson","doi":"10.3399/bjgp24X739917","DOIUrl":"10.3399/bjgp24X739917","url":null,"abstract":"","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":"74 749","pages":"531"},"PeriodicalIF":5.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752286","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":"Digitalised primary care in the UK: a qualitative study of the experiences of minoritised ethnic communities.","authors":"Farjana Islam, Sara Bailey, Gina Netto","doi":"10.3399/BJGP.2024.0308","DOIUrl":"10.3399/BJGP.2024.0308","url":null,"abstract":"<p><strong>Background: </strong>Barriers to accessing and using primary care services among minoritised ethnic communities have been extensively evidenced in the UK. However, the impact of the rapid digitalisation of these services on these communities remains under-researched.</p><p><strong>Aim: </strong>To explore the impact of digitalisation on access to and use of primary care services among minoritised ethnic communities.</p><p><strong>Design and setting: </strong>Underpinned by a critical realist intersectional approach, and employing qualitative research methods, this study explores minoritised ethnic individuals' experiences of digital primary care in the UK.</p><p><strong>Method: </strong>In total, 100 minoritised ethnic adults who identify as Black African, Black Caribbean, Bangladeshi, Indian, Pakistani, Chinese, and of mixed or multiple ethnic heritage in four sites in the UK were purposively recruited and interviewed. Interviews were thematically analysed to increase understanding of how individuals' ethnicity intersects with other characteristics (for example, language, age, gender, socioeconomic status) to identify constraints and enablements to accessing health care.</p><p><strong>Results: </strong>Minoritised ethnic individuals' access to digital primary care is impeded by factors such as digital precarity (for example, inadequate devices, internet connectivity, and digital literacy skills), a lack of language support, and staff shortcomings in responding to ethnically diverse populations. Intergenerational support and bespoke offerings by general practices in some areas enable some individuals to overcome some of the constraints.</p><p><strong>Conclusion: </strong>The rapid digitalisation of primary care services is replicating and potentially exacerbating barriers to using these services among minoritised ethnic communities, a finding that merits urgent attention by practitioners and policymakers.</p>","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e823-e831"},"PeriodicalIF":5.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141767","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}