British Journal of General Practice最新文献_第9页

Collaboration across the primary and specialist care interface in Early Intervention in Psychosis services: a qualitative study. 精神病早期干预服务中基层/专科医生之间的合作：一项定性研究。

IF 5.3 2区医学

British Journal of General Practice Pub Date : 2024-09-26 Print Date: 2024-10-01 DOI: 10.3399/BJGP.2023.0558

Michelle Rickett, Tom Kingstone, Veenu Gupta, David Shiers, Paul French, Belinda Lennox, Mike Crawford, Ed Penington, Anna Hedges, Jo Ward, Ryan Williams, Paul A Bateman, Carolyn A Chew-Graham

{"title":"Collaboration across the primary and specialist care interface in Early Intervention in Psychosis services: a qualitative study.","authors":"Michelle Rickett, Tom Kingstone, Veenu Gupta, David Shiers, Paul French, Belinda Lennox, Mike Crawford, Ed Penington, Anna Hedges, Jo Ward, Ryan Williams, Paul A Bateman, Carolyn A Chew-Graham","doi":"10.3399/BJGP.2023.0558","DOIUrl":"10.3399/BJGP.2023.0558","url":null,"abstract":"Background: People with new psychotic symptoms may be managed in an Early Intervention in Psychosis (EIP) service. They may be discharged back to primary care at the end of their time in an EIP service.Aim: To explore the role of primary care in supporting people with psychosis in an EIP service.Design and setting: Qualitative study, within a programme of work to explore the optimum duration of management in an EIP service in England.Method: Semi-structured interviews were carried out with people in EIP services, carers, GPs, and EIP practitioners between September 2022 and September 2023. Data collection continued until information power was achieved. Data were thematically analysed using principles of constant comparison.Results: While most service users and carers described their experiences of EIP services as positive, there are issues around access to and discharge from the services. GPs reported difficulties in referring people into EIP services, having little contact with people who are supported by EIP services, and not being included in planning discharge from EIP services to primary care. Service users and carers described challenges at the point of discharge from EIP services to primary care, associated with feelings of abandonment.Conclusion: This study suggests that GPs should have a role in the support of people in EIP services (in particular, monitoring and managing physical health) and their carers. Inclusion of GPs in managing discharge from EIP services is vital. We suggest that a joint consultation with the service user, their carer (if they wish), along with the EIP care coordinator and GP would make this transition smoother.","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":"e709-e716"},"PeriodicalIF":5.3,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11350604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140159613","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}

引用次数: 0

A bitter pill to swallow: the rising use of street valium in Scotland. 难以下咽的苦药：苏格兰街头安定片使用率的上升。

IF 5.3 2区医学

British Journal of General Practice Pub Date : 2024-09-26 Print Date: 2024-10-01 DOI: 10.3399/bjgp24X739557

Paul McNamara, Yoosuf Ibrahim

引用次数: 0

Managing chronic cough in adults in primary care. 在初级保健中处理成人慢性咳嗽。

IF 5.3 2区医学

British Journal of General Practice Pub Date : 2024-09-26 Print Date: 2024-10-01 DOI: 10.3399/bjgp24X739653

Kevin Gruffydd-Jones, Sean Parker

引用次数: 0

Books: Fighting for the Soul of General Practice: the Algorithm Will See You Now: A strong manifesto. 书籍为全科医学的灵魂而战：算法现在就能看到你：一份强有力的宣言。

IF 5.3 2区医学

British Journal of General Practice Pub Date : 2024-09-26 Print Date: 2024-10-01 DOI: 10.3399/bjgp24X739605

Andrew Papanikitas

引用次数: 0

General practice in interesting times. 有趣时代的综合实践

IF 5.3 2区医学

British Journal of General Practice Pub Date : 2024-09-26 Print Date: 2024-10-01 DOI: 10.3399/bjgp24X739521

Andrew Papanikitas

引用次数: 0

The case for Integrated Training Posts. 综合培训岗位的理由。

IF 5.3 2区医学

British Journal of General Practice Pub Date : 2024-09-26 Print Date: 2024-10-01 DOI: 10.3399/bjgp24X739497

Nur Gasmelsid, Jonathan Mok, Noreen Ryan

引用次数: 0

What is a full-time GP? 什么是全职全科医生？

IF 5.3 2区医学

British Journal of General Practice Pub Date : 2024-09-26 Print Date: 2024-10-01 DOI: 10.3399/bjgp24X739425

Thomas Round

引用次数: 0

Experiences of integrating social prescribing link workers into primary care in England: Bolting on, fitting in or belonging. 英格兰将社会处方联系工作者纳入初级保健的经验：勉强、融入还是归属。

IF 5.3 2区医学

British Journal of General Practice Pub Date : 2024-09-24 DOI: 10.3399/BJGP.2024.0279

Stephanie Tierney, Debra Westlake, Geoff Wong, Amadea Turk, Steven Markham, Jordan Gorenberg, Joanne Reeve, Caroline Mitchell, Kerryn Husk, Sabi Redwood, Catherine Pope, Beccy Baird, Kamal R Mahtani

{"title":"Experiences of integrating social prescribing link workers into primary care in England: Bolting on, fitting in or belonging.","authors":"Stephanie Tierney, Debra Westlake, Geoff Wong, Amadea Turk, Steven Markham, Jordan Gorenberg, Joanne Reeve, Caroline Mitchell, Kerryn Husk, Sabi Redwood, Catherine Pope, Beccy Baird, Kamal R Mahtani","doi":"10.3399/BJGP.2024.0279","DOIUrl":"https://doi.org/10.3399/BJGP.2024.0279","url":null,"abstract":"Background: Following the 2019 NHS Long-Term Plan, link workers (LWs) have been employed across primary care in England to deliver social prescribing (SP).Aim: To understand and explain how the LW role is being implemented in primary care in England.Design and setting: Realist evaluation undertaken in England.Method: Focused ethnographies around seven LWs from different parts of England. As part of this, we interviewed 61 patients and 93 professionals from healthcare and the voluntary, community and social enterprise (VCSE) sector. We reinterviewed 41 patients, seven LWs and a LW manager 9-12 months after their first interview.Results: We developed four concepts around how LWs are integrated (or not) within primary care: Centralising or diffusing power; Forging an identity in general practice; Demonstrating effect; Building a facilitative infrastructure. These concepts informed the development of a programme theory around a continuum of integration of LWs into primary care - from being 'bolted on' to existing provision, without much consideration, to 'fitting in', shaping what is delivered to be accommodating, through to 'belonging', whereby they are accepted as a legitimate source of support, making a valued contribution to patients' broader well-being.Conclusion: SP was introduced into primary care to promote greater attention to the full range of factors affecting patients' health and well-being, beyond biomedicine. For that to happen, our analysis highlights the need for a whole system approach to defining, delivering and maintaining this new part of practice.","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332817","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}

引用次数: 0

Adoption of clinical pharmacist roles in primary care: Longitudinal evidence from English general practice. 在初级保健中采用临床药剂师角色：来自英国全科实践的纵向证据。

IF 5.3 2区医学

British Journal of General Practice Pub Date : 2024-09-24 DOI: 10.3399/BJGP.2024.0320

Michael Anderson, Igor Francetic

{"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":"https://doi.org/10.3399/BJGP.2024.0320","url":null,"abstract":"Background: Over the last decade, the number of clinical pharmacists working within multidisciplinary teams in English general practice has expanded Aim: This study examines changes in quality of prescribing after the adoption of clinical pharmacists in English general practices.Methods: Two-way fixed effects regression was used to compare differences in prescribing indicators in general practices in England with and without pharmacists following implementation between September 2015 and December 2019 Results: Between September 2015 and December 2019, the proportion of practices employing a clinical pharmacist increased from 236/ 7,623 (3.10%) to 1,402/ 6,836 (20.51%). Clinical pharmacist implementation resulted in statistically significant reductions in total costs of medicines per 1,000 patients (-0.85% ,95% CI -1.50%, -0.21%), the total number of opioid prescriptions per 1,000 patients (- 1.06%, 95% CI -1.82%, -0.29%), and the average daily quantity (ADQs) of anxiolytics per 1,000 patients (-1.26%, 95% CI -2.40%, -0.12%). Clinical pharmacist implementation also resulted in reductions in the total number of prescriptions per 1,000 patients (-0.58%, 95% CI -1.30%, 0.13%), and the total number of antibiotic prescriptions per 1,000 patients (-0.51%, 95% CI -1.30%, 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%, 0.11%) and the oral morphine equivalence of high-dose opioids (>120mg per 24 hours) per 1,000 patients (1.19%, 95% CI -0.46%, 2.85%).Conclusion: Our analysis is limited by aggregate data at the practice-level but supports the hypothesis that clinical pharmacist implementation results in improvements in prescribing quality.","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The role of primary care in depression relapse: a qualitative study. 初级保健在抑郁症复发中的作用：一项定性研究。

IF 5.3 2区医学

British Journal of General Practice Pub Date : 2024-09-20 DOI: 10.3399/BJGP.2024.0384

Andrew Stephen Moriarty, Emma Williams, Dean McMillan, Simon Gilbody, Carolyn A Chew-Graham

{"title":"The role of primary care in depression relapse: a qualitative study.","authors":"Andrew Stephen Moriarty, Emma Williams, Dean McMillan, Simon Gilbody, Carolyn A Chew-Graham","doi":"10.3399/BJGP.2024.0384","DOIUrl":"https://doi.org/10.3399/BJGP.2024.0384","url":null,"abstract":"Background Relapse contributes to the clinical and societal burden associated with depression. It is not well understood how relapse risk and prevention are managed and discussed between patients and general practitioners in primary care. Aim To understand the extent to which relapse risk and prevention are discussed and managed in general practice. Design and Setting Qualitative study in general practice. Method Participants were recruited through UK general practices. Data were generated using semi-structured interviews and analysed using thematic analysis. Patient and public involvement informed all aspects of the study. Results Twenty-three people with lived experience of depression and twenty-two GPs were interviewed. Three themes are presented in this paper: perceived determinants of depression course (participants viewed environmental, social and personal factors as being most significant); relapse risk and prevention (relapse was considered important but not consistently or routinely discussed in general practice consultations); and the key role of the GP-patient relationship and communication. Conceptually, relapse was perceived as having limited meaning and usefulness in primary care, due to the implication of an episodic, discrete course not recognised by many patients and an over-reliance on biomedical diagnosis. Longer-term follow-up and monitoring of depression could be improved in primary care. Conclusion We provide an evidence-informed framework to improve practice systems and GP consultations to improve longer-term care and support for people with depression. Going forwards, brief scalable relapse prevention interventions are needed to improve the ongoing care of people with depression in primary care; implementing these would require additional primary care resources.","PeriodicalId":55320,"journal":{"name":"British Journal of General Practice","volume":" ","pages":""},"PeriodicalIF":5.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301480","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}

引用次数: 0