BMC primary care最新文献

{"title":"Accuracy of point-of-care ultrasound examination of the lung in primary care performed by general practitioners: a cross-sectional study.","authors":"David Halata, Dusan Zhor, Roman Skulec, Bohumil Seifert","doi":"10.1186/s12875-025-02802-4","DOIUrl":"https://doi.org/10.1186/s12875-025-02802-4","url":null,"abstract":"<p><strong>Background: </strong>Lung ultrasonography (LUS) is a point-of-care imaging modality with growing potential in primary care.</p><p><strong>Objectives: </strong>While its use is well established in hospital settings, data on its accuracy when performed by general practitioners (GPs) remain limited. This study aimed to assess the diagnostic accuracy of LUS conducted by GPs following structured training.</p><p><strong>Methods: </strong>We recruited 17 GPs from various regions of the Czech Republic. They completed a two-day educational course focused on LUS. Patients with current dyspnoea (NYHA II-IV) or a history of dyspnoea within the last four weeks were included and underwent LUS to assess the presence of pleural effusion and interstitial syndrome. An independent expert sonographer, blinded to clinical data, evaluated recorded LUS video loops as the reference standard. LUS findings were categorized into A profile (presence of A lines and intact lung sliding, indicating normal aeration), B profile (three or more B lines per intercostal space in at least two intercostal spaces per hemithorax, suggesting interstitial syndrome), pulmonary consolidation and pleural effusion.</p><p><strong>Results: </strong>A total of 128 patients were enrolled in the study. A total of 768 thoracic segments were examined. A profile was identified in 642 (83.6%) segments, B profile in 108 (14.1%), pulmonary consolidation in 8 (1.0%), and pleural effusion in 12 (1.6%). For the identification of A profile, the sensitivity was 97.51% (95% CI 95.98-98.57), and the specificity was 88.10% (95% CI 81,13-93,18); for B profile, the sensitivity was 87.04% (95% CI 79,21-92,73), and the specificity was 97.73% (95% CI96,28-98,72); for pulmonary consolidation, the sensitivity was 100.0% (95% CI 63,06-100,00), and the specificity was 100.0% (95% CI 99,52-100,0); for pleural effusion, the sensitivity was 83.33% (95% CI 51,59-97,91), and the specificity was 99.87% (95% CI 99,27-100,00).</p><p><strong>Conclusion: </strong>Our findings provide important preliminary data, demonstrating that GPs can perform LUS accurately after a structured training program. THE TRIAL REGISTRATION IDENTIFIER: is NCT04905719.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"99"},"PeriodicalIF":2.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Doctor-patient communication in obesity disease - the perspective of Polish primary care physicians.","authors":"Iwona Drozdowska, Antonina Doroszewska, Tomasz Pasierski","doi":"10.1186/s12875-025-02797-y","DOIUrl":"https://doi.org/10.1186/s12875-025-02797-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Obesity is a chronic disease that is affecting an increasing number of patients. The prevalence of obesity, the age of patients affected, and the range of associated comorbidities suggest that general practitioners will engage with this patient group extensively throughout their professional careers. It is regrettable that numerous obstacles impede the efficacious treatment of obesity by primary care physicians. These include inadequate training in obesity management and communication with patients, as well as a pervasive and problematic bias in the approach to the treatment of patients with obesity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The objective of the study was to examine the knowledge, self-assessment, experiences and perceptions of primary care doctors in Poland with regard to the communication and management of obesity. The data were collected via computer-assisted telephone interviewing (CATI). The sample was deliberately random selected from the available database of numbers. The inclusion criteria were aged 24 or over and active working as a primary care doctor in Poland. The research sample comprised 150 primary care doctors with various medical specialties, including the following: family medicine, internal medicine, pediatrics, endocrinology, diabetology, and others. An even distribution of participants was not ensured with respect to the parameters considered.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The findings of our study indicate that primary care physicians mostly disagreed with the view that patients living with obesity are less hardworking or more demanding but just over half disagreed that these patients are lazier than others. Doctors reported rarely using fear-based language or blaming excessive food consumption for obesity. Instead, many emphasized that obesity is a disease and considered the patient's perspective. Doctors who rated their communication skills and medical knowledge needed for conversations with patients living with obesity more highly were more likely to address this topic during a visit for an unrelated medical condition. Those who avoided the topic often felt they lacked the skills or knowledge to engage patients effectively. Almost half of the surveyed physicians had not received any training in communicating with patients living with obesity and only 11% had the issue addressed in a course for specialization.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and implications: &lt;/strong&gt;The study indicates a necessity for changes in the curricula of both pre- and postgraduate education, including an enhancement of the knowledge and abilities of primary care providers in the domain of communication during visits with patients with obesity, the encouragement of lifestyle modifications and the implementation of efficacious treatments for obesity, as well as activities designed to modify the negative attitudes of primary care physicians towards patients living with obesity which should not appear in healthcare ","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"101"},"PeriodicalIF":2.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthier together. How arts on prescription can promote psychosocial wellbeing: a qualitative study.","authors":"Anita Jensen, Annika Brorsson","doi":"10.1186/s12875-025-02800-6","DOIUrl":"https://doi.org/10.1186/s12875-025-02800-6","url":null,"abstract":"<p><strong>Background: </strong>Mental health problems are an increasing challenge for primary healthcare. It puts strain on the healthcare professionals with limited time and resources. In several countries, healthcare professionals can refer patients with mental health issues to structured arts programmes, namely Arts on Prescription (AoP). This study explores the qualitative findings from a 3-year study on Arts on Prescription.</p><p><strong>Methods: </strong>Primary healthcare patients were recruited to participated in a 10-week group-based arts programme, twice a week for 2 h (22 sessions over 10 weeks, comprising a mixture of arts and cultural activities facilitated by arts professionals) referred from 18 different primary healthcare centres. Twenty-eight participants volunteered to be interviewed using a semi-structured one-to-one approach. The transcribed interviews were analysed using a thematic analysis.</p><p><strong>Results: </strong>Three themes were identified as Social community & Connectedness, Self-efficacy and Routine & Structure. Through the identified themes positive effects of psychosocial wellbeing is described as reported by the participants connecting to their experiences of participating in the Arts on Prescription programme including finding common grounds, feeling healthier and more human, connecting with inner resources, and establishing new routines.</p><p><strong>Conclusions: </strong>The findings highlight the potential of Arts on Prescription programmes to promote holistic psychosocial wellbeing, and to facilitate personal growth through community engagement and structured arts activities with salutogenic approaches.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"100"},"PeriodicalIF":2.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health information management of older, multimorbid patients in German primary care: feasibility and first results of the outcome measures of a cluster-randomised controlled pilot trial - HYPERION-TransCare.","authors":"Astrid-Alexandra Klein, Maria Hanf, Truc Sophia Dinh, Franziska Brosse, Jenny Petermann, Steve Piller, Sylvia Schulz-Rothe, Lena Schäfer, Karola Mergenthal, Hanna M Seidling, Sophia Klasing, Nina Timmesfeld, Bahareh Yousefi, Marjan van den Akker, Karen Voigt","doi":"10.1186/s12875-025-02774-5","DOIUrl":"10.1186/s12875-025-02774-5","url":null,"abstract":"<p><strong>Background: </strong>Availability of information at the interface of outpatient and inpatient care remains an important and inadequately resolved issue in Germany and beyond. As a vulnerable group with complex care needs, older patients, mostly multimorbid, are especially affected by the consequences. This trial tested the feasibility and implementability of a complex intervention which aimed at improving the availability of health information among patients and different healthcare providers.</p><p><strong>Methods: </strong>The prospective two-arm blinded pilot cRCT was accompanied by an explorative mixed-methods process evaluation. Over a period of six months in 2022, general practitioner (GP) practices in Germany with patients (≥ 65, multimorbid, polypharmacy) participated in testing the implementation of the intervention and the trial design (intervention (IG) vs control group (CG)). Here, the focus is on the feasibility and exploratory results of the primary (combined endpoint of hospitalisation, falls and mortality) and secondary outcome measures (improving GP practices' and patients' knowledge of health-related resource use (FIMA), as well as improving patients' Health Literacy (HLQ-G) and Satisfaction with Medication Information (SIMS-D)). Data were analysed according to the intention to treat principle.</p><p><strong>Results: </strong>Twelve GP practices were randomised (6 per IG/CG). Of 159 patients invited, 93 were included in the analyses (52 IG/41 CG). At t0 and t1, only few self-reported data from patients (5 resp. 10) or from the GP questionnaire (resp. 0) were missing. At least one survey perspective was available for each patient at both survey times. Overall, there were few missing items in the questionnaires, so the scores could not be calculated in 4-18% of cases (primary combined endpoint 9%), and there were no single items with increased missing values (n = 0 to 7). The concordance of the hospitalisation data from patients and GP practices was about 80%. Exploratory analyses showed no effects of the intervention on primary or secondary outcome measures.</p><p><strong>Conclusions: </strong>The primary combined endpoint was feasible. The secondary outcomes and survey methods used also proved feasible for GP practices and older multimorbid patients, with low missing rates. However, there was no hint of the influence of the intervention in the study groups in the explorative analyses.</p><p><strong>Trial registration: </strong>The trial was registered in the DRKS German Clinical Trials Register: registration number DRKS00027649 (date: 19.01.2022); http://www.drks.de/DRKS00027649 .</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"98"},"PeriodicalIF":2.0,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-Think the Strip: de-implementing a low value practice in primary care.","authors":"Katrina E Donahue, Marcella H Boynton, Jennifer Leeman, Jennifer Rees, Erica Richman, Kathleen Mottus, Lisa P Spees, Maihan B Vu, April B Reese, Hazel Tapp, Adam Lee, Asia Johnson, Rebecca J Cleveland, Laura A Young","doi":"10.1186/s12875-025-02781-6","DOIUrl":"10.1186/s12875-025-02781-6","url":null,"abstract":"<p><strong>Background: </strong>Self-monitoring of blood glucose (SMBG) is a low value health care practice that does not benefit most patients with non-insulin treated type 2 diabetes (T2DM). This paper evaluates Re-Think the Strip (RTS), a multi-component study aimed at de-implementing SMBG among non-insulin treated T2DM patients in primary care.</p><p><strong>Methods: </strong>This study used a pre-post design to evaluate the effectiveness and implementation of Re-Think the Strip in 20 primary care clinics with a comparison group of 34 clinics within one health system. De-implementation strategies were implemented over 12 months and practices were followed for 18 months.</p><p><strong>Results: </strong>There was an overall decrease in the odds of receiving a prescription for diabetes testing supplies (i.e., test strips and/or lancets) between the baseline and 12-month intervention follow-up for intervention and comparison clinics (OR 0.96, 95% CI 0.94, 0.98). However, there was no statistically significant difference in prescribing between the intervention and comparison clinics. In sensitivity analyses, a small intervention effect was observed for those patients newly diagnosed with T2DM or newly assigned to a study clinic (OR = 0.97, 95% CI 0.95, 1.00).</p><p><strong>Conclusions: </strong>De-implementation strategies are feasible in primary care practices. Although prescriptions for SMBG decreased in intervention practices, they also decreased in the comparison practices. Newly diagnosed patients or new patients may be more receptive to de-implementation. Other factors, including the COVID-19 pandemic and baseline prescribing rates may have limited the effectiveness of the RTS de-implementation strategy.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"96"},"PeriodicalIF":2.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a domestic violence training and support intervention in Palestinian primary care clinics in the west bank: a mixed method study.","authors":"Nagham Joudeh, Amira Shaheen, Loraine J Bacchus, Manuela Colombini, Abdulsalam Alkaiyat, Helen Lambert, Rasha Hashlamoon, Gene Feder","doi":"10.1186/s12875-025-02751-y","DOIUrl":"10.1186/s12875-025-02751-y","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Domestic violence (DV) is a violation of human rights and a major public health problem that damages the health of women and their families. In the occupied Palestinian territories, 29% of women have a lifetime exposure to intimate partner violence, the most prevalent form of DV. Despite the existence of national policies to prevent and respond to DV, implementation within the Palestinian primary health care system has been weak. We developed, piloted, and evaluated a system-level intervention, including training for health care providers and care pathways for women patients. The aim of our evaluation was to determine the feasibility and acceptability of the HEalthcare Responding to violence and Abuse (HERA) intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Formative phase: adaptation of a previous (HERA) intervention implemented in primary health care settings in Palestine, informed by stakeholder meetings, interviews with clinic managers and health care providers (HCP), facility-level readiness data, and findings of a previous pilot study. The training component of the intervention, delivered by the Palestinian Counseling Centre, included a train-the-trainer session, two clinic-based training sessions, and reinforcement sessions for front-line healthcare providers in four clinics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Intervention: &lt;/strong&gt;Healthcare providers were trained to ask about DV, give immediate support, and offer a referral to a nurse case manager. The care pathway beyond the case manager was either referral to a primary-care based psychologist or social worker or to a gender-based violence focal point external to the clinic that coordinated referrals to appropriate external services (e.g. police, safe house, psychologist, social worker). Evaluation phase: Thematic analysis of post-intervention semi-structured interviews with (HCP) and trainers; observations of training sessions and field notes. Provider Intervention Measure (PIM) data on changes in HCP attitudes and practice were analysed with descriptive statistics. Identification and referral rates for women disclosing DV 12 months before and 12 months after the intervention were obtained from clinic registries. We developed a theory of change to triangulate our qualitative and quantitative data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The training proved acceptable to HCPs and there was evidence of positive change in attitudes and readiness to engage with women patients experiencing DV. Compared to the year before the intervention, there was a reduction in the number of patients disclosing DV during the intervention and of referrals in three of the four clinics. This reduction may be explained by the impact of the Covid 19 pandemic on clinic priorities, lack of time, persisting HCP fear about engaging with DV, and HCP rotation between clinics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The delivery of the training component of the HERA intervention within the Palestinian primary healthcare s","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"97"},"PeriodicalIF":2.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights into the morbidity profiles of epidemiologically excluded COVID-19 patients in primary care settings during the third wave of the pandemic in the Anuradhapura District, Sri Lanka.","authors":"Parami Abeyrathna, Suneth Buddhika Agampodi, Shyamalee Samaranayake, Pahala Hangidi Gedara Janaka Pushpakumara","doi":"10.1186/s12875-025-02792-3","DOIUrl":"10.1186/s12875-025-02792-3","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has dramatically impacted healthcare systems worldwide, leading to changes in the delivery of healthcare services. A profound effect on the well-being of non-COVID-19 patients has been reported, but limited evidence is available from developing countries. This study aimed to describe the morbidity profiles of epidemiologically excluded COVID-19 patients during the pandemic in the primary care setting of the Anuradhapura District of Sri Lanka.</p><p><strong>Methods: </strong>This cross-sectional healthcare institution-based study collected morbidity profiles from six state-owned and five private primary care facilities (PCFs) in the Anuradhapura District during the third wave of the COVID-19 pandemic. Reasons for Encounters (RFEs) were recorded from physically available and epidemiologically excluded COVID-19 patients in a paper-based data format and coded using the International Classification of Primary Care.</p><p><strong>Results: </strong>Out of 1630 primary care encounters, 187 RFEs were identified. Most patients were females (n = 899, 55%) and in the adult age category (n = 1297, 79%). The median age of the patients was 39 years (interquartile range: 21-55). Older patients were likelier to seek primary care in the state sector (p < .001). Most children presented to the private sector compared to state PCFs (p < 0.001). The majority of females significantly utilised state sector PCFs (p = 0.043). Upper respiratory tract infections (n = 154, 9.00%) were the most common RFE. The highest burden of systemic RFEs was associated with dermatological (n = 294, 18%) and respiratory conditions (n = 274, 16%). More than one-third of adults (n = 487, 37.5%) suffered from a self-reported non-communicable disease (NCD). Hypertension (n = 235, 48%), diabetes mellitus (n = 184, 38%), and dyslipidemia (n = 134, 28%) were the most observed NCDs. Multimorbidity was reported in 195 (40%) adult patients with an NCD.</p><p><strong>Conclusion: </strong>The pandemic has led to a shift in primary care morbidity profiles, with a higher incidence of dermatological and respiratory diseases and NCDs among healthcare seekers. Patients sought care from the state and private sector differently depending on age, sex, and nature of illness. Primary care services must prepare to adapt to changes in healthcare-seeking patterns and morbidity profiles during pandemics to ensure comprehensive care is available on demand.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"95"},"PeriodicalIF":2.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lingering symptoms in non-hospitalized patients with COVID-19 - a prospective survey study of symptom expression and effects on mental health in Germany.","authors":"Jörn Rohde, René Bundschuh, Yvonne Kaußner, Anne Simmenroth","doi":"10.1186/s12875-025-02784-3","DOIUrl":"10.1186/s12875-025-02784-3","url":null,"abstract":"<p><strong>Background: </strong>The infection rates with SARS-CoV 2 virus, known since 2019, are currently significantly weakened in their dynamics. Nevertheless, COVID 19 is still a common disease, which in most cases is overcome quite well and can be treated by the general practitioner. Despite an initially uncomplicated disease progression, the long-term consequences can be considerable. Symptoms persisting over a period of more than 12 weeks after infection are summarized as Post-COVID (PC) syndrome. The aim of this study is to document the symptom expression in PC patients in the outpatient setting, with a major focus on limitations in daily life and consequences for mental health.</p><p><strong>Methods: </strong>This survey is part of a prospective European collaborative study with the German cohort having been slightly extended and evaluated separately. Data collection was performed by telephone interviews of adult SARS CoV 2 positive patients using standardized questionnaires (38 open and 6 closed questions). After an inclusion interview, follow-up interviews were conducted every 4 weeks over a period of 6 months. Participants were recruited in collaboration with the local health department (Wuerzburg, Germany).</p><p><strong>Results: </strong>Sixty participants were recruited in April and May 2021. After 12 weeks (PC cutoff), 48.3% still reported symptoms related to SARS-CoV-2 infection. The most commonly reported symptoms were fatigue/tiredness (33.3%), reduced concentration (26.7%), and shortness of breath (23.3%). One-quarter of respondents reported impaired functioning, with the most common daily limitations being sports (28.3%), work (25.0%), and social life (15.0%). At 6 months, 21.6% of respondents experienced anxiety and 11.6% reported depressive symptoms. Overall, 40.0% of respondents were concerned that their health would deteriorate again or not fully normalize because of COVID-19. Over two-thirds (70.0%) visited a physician during the course of the study because of COVID-19, 73.8% of whom visited their general practitioner.</p><p><strong>Conclusion: </strong>PC in outpatient care appears to be a complex and multifaceted condition that not only presents with physical symptoms, but also has a significant impact on mental health and daily life. Although the complexity of the condition is not yet fully understood, our findings suggest that it presents long-term challenges, particularly in outpatient care. Further research, particularly in larger and more diverse cohorts, is needed to confirm these observations. Routine screening for psychosocial comorbidities could be a valuable approach to identify supportive interventions that may help to reduce the risk of chronification and/or somatization.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"94"},"PeriodicalIF":2.0,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11963417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of family health climate in physical activity and sedentary behaviour in primary care patients with diabetes - a cross-sectional study.","authors":"Amelia Ahmad Hatib, Hui Li Koh, Sai Zhen Sim","doi":"10.1186/s12875-025-02789-y","DOIUrl":"10.1186/s12875-025-02789-y","url":null,"abstract":"<p><strong>Background: </strong>The shared perceptions and cognitions of a family toward health such as exercise are termed the family health climate (FHC), and they may influence individual physical activity levels. This study aimed to examine the associations between the FHC and physical activity and sedentary behaviour in adult patients with diabetes while accounting for sociodemographic factors and self-determined motivation.</p><p><strong>Methods: </strong>This cross-sectional study was conducted at a polyclinic in Singapore. The participants completed anonymized, self-administered questionnaires that collected data on sociodemographic variables, family health climate for physical activity (FHC-PA), self-reported physical activity and sedentary behaviour (Global Physical Activity Questionnaire), and self-determined motivation (Behavioural Regulation in Exercise Questionnaire‑2). The data were analysed descriptively, and logistic regression was performed to examine the sociodemographic, FHC and motivational covariates of physical activity and sedentary behaviour.</p><p><strong>Results: </strong>A total of 345 participants were included in the analysis. The majority were male (60.3%), Chinese (67.5%), and working (72.8%). The mean age was 61.56 (SD 10.71) years. A minority of the participants had sufficient physical activity (41.2%), and most were sedentary (62%). After we adjusted for sociodemographic factors and self-determined motivation, the FHC-PA score and its subdomains were not associated with physical activity levels (p > 0.05) or sedentary behaviour (p > 0.05). Those with higher identified regulation scores had higher odds of being sufficiently active, whereas those with higher external regulation scores, from larger households and who were employed had lower odds of sufficient physical activity. Higher degrees of autonomous motivation were associated with reduced sedentary behaviour, whereas being employed was associated with increased sedentary behaviour.</p><p><strong>Conclusion: </strong>The FHC-PA, in the presence of self-determined motivation and sociodemographic factors, was not associated with the individual physical activity levels of adults with diabetes. Further studies can be conducted to determine whether it plays a mediating role. As identified regulation was associated with both physical activity and sedentary behaviour, interventions can be mapped to target this motivational domain.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"93"},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11959952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives of patients on the role of general practice pharmacists: a systematic review and meta-synthesis of qualitative studies.","authors":"Abrar H F Hassan, Heather E Barry, Carmel M Hughes","doi":"10.1186/s12875-025-02787-0","DOIUrl":"10.1186/s12875-025-02787-0","url":null,"abstract":"<p><strong>Background: </strong>There is a scarcity of research about patients' perspectives on the role of general practice pharmacists (GPPs). In this review, we aimed to compile qualitative evidence of patients' perspectives regarding the role of GPPs.</p><p><strong>Methods: </strong>A systematic, qualitative meta-synthesis was undertaken. A comprehensive search was conducted on six databases. Additionally, the reference lists of included studies were searched. Findings and verbatim quotes were extracted from the included studies and were analysed using thematic synthesis. The Critical Appraisal Skills Programme (CASP) checklist was employed to evaluate the quality of the included studies. The GRADE-CERQual approach was utilised to evaluate confidence in the findings.</p><p><strong>Results: </strong>Ten qualitative studies were included. Four main themes were identified: awareness of the GPP (patients were unaware of the GPP's role), accessibility to the GPP (some patients had difficulties arranging appointments with GPPs), benefits and challenges (medication review conducted by GPPs reaffirmed patients' trust in taking their medicines, although some were dissatisfied with the medication review process), and GPP integration into general practice (successful integration of GPPs was attributed to their skills and teamwork). The included studies satisfied all or at least seven out of the ten criteria of the CASP checklist. GRADE-CERQual indicated high confidence for one theme, and moderate confidence for three themes.</p><p><strong>Conclusions: </strong>This systematic review and meta-synthesis of qualitative studies provides valuable insights into patients' perspectives on the role of GPPs. The findings highlight both positive aspects and challenges associated with GPP integration into primary care, including concerns about role awareness and accessibility. These findings suggest that while GPPs can add value to general practice teams, there is a need for improved patient education about the GPP role and enhanced accessibility to maximise the potential benefits of the GPPs.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"90"},"PeriodicalIF":2.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11956316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}