BMC primary care最新文献

{"title":"Association between prescription patterns and primary care clinic closures in South Korea: A longitudinal retrospective cohort study.","authors":"Ha Jin Kim, BeLong Cho, Jae Moon Yun","doi":"10.1186/s12875-025-02986-9","DOIUrl":"10.1186/s12875-025-02986-9","url":null,"abstract":"<p><strong>Background: </strong>Primary care clinic sustainability affects healthcare service delivery. However, the impact of prescription patterns on primary care clinic sustainability remains unclear. We analyzed the association between prescription patterns of frequently used medications and primary care clinic closures in South Korea.</p><p><strong>Methods: </strong>We used Korean National Health Insurance Service data on office-based primary care clinics established between 2003 and 2012, and their claims data from January 1, 2002 to December 31, 2015. We assessed the effects of prescription patterns on primary care clinic closures in Korea. Prescription patterns included prescription rates of benzodiazepines and injectable medications for all visits, antibiotics for upper respiratory tract infections, and steroids for musculoskeletal diseases. We calculated these rates for the first year after the establishment of each clinic. We adjusted the association for patient-group- and clinic-related factors over 12 years. We used multivariate Cox proportional hazards regression for analyses.</p><p><strong>Results: </strong>Among 14,525 clinics, 4,681 were closed during the observation period. The average follow-up period was 5.3 years. An increase in the benzodiazepine prescription rate was associated with a lower risk of closure (hazard ratio [HR]: 0.87; 95% confidence interval [CI]: 0.82-0.92, per 10% point increase; p < 0.001). Steroid prescriptions for musculoskeletal diseases influenced clinic closure (HR: 0.96; 95% CI: 0.94-0.99, per 10% point increase; p = 0.002). Prescription rates of antibiotics for upper respiratory tract infections (HR: 1.00; 95% CI: 0.98-1.01; p = 0.496) and any injectable medications (HR: 0.99; 95% CI: 0.97-1.01; p = 0.247) did not affect primary care clinic closure.</p><p><strong>Conclusions: </strong>Steroid and benzodiazepine prescriptions were linked to lower clinic closure risk, while antibiotic and injectable prescriptions were not. These findings suggest that evidence-based prescribing may not compromise clinic viability and that appropriate care and sustainability can be achieved together through informed policy.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"293"},"PeriodicalIF":2.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194064","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":"Barriers and limitations for undergoing mammography screenings among Kuwaiti women (aged 40-69) attending primary health care centers.","authors":"Omar Alfailakawi, Hussain Alostath, Asmaa Aldubian, Al-Ghala Alsaleh, Ghadeer Alsughayer, Alaa Alshamran, Ali Ashkanani, Hussein Kamal, Haneen Mohammad, Mohammad Murad, Duaa Hasan, Mohamed Hany Shehata","doi":"10.1186/s12875-025-02971-2","DOIUrl":"10.1186/s12875-025-02971-2","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is the leading cancer among women in Kuwait, yet mammography screening (MS) uptake remains suboptimal despite the Kuwait National Mammography Screening Program (KNMSP). This study identifies barriers to MS adherence among Kuwaiti women aged 40-69, focusing on sociocultural, knowledge-related, and systemic factors.</p><p><strong>Methods: </strong>A cross-sectional study was conducted across five primary healthcare centers in Kuwait (June-August 2023) using semi-structured interviews with 201 women. Data were analyzed via SPSS to assess awareness, attitudes, and screening uptake.</p><p><strong>Results: </strong>Only 25.4% of participants underwent MS within the past two years, with 52.2% never screened. Despite 91.5% being aware of screening programs, 84.6% exhibited poor overall awareness. Key barriers included fear of pain (77.6%) and physical discomfort (76.1%). Younger women (40-49 years) and employed individuals had significantly lower uptake (p = 0.001 and p = 0.004, respectively). Women invited to screen were 61.4% more likely to participate (p < 0.001). Trust in screening programs strongly correlated with adherence (p < 0.001), while conflicting medical advice reduced uptake (p = 0.03).</p><p><strong>Conclusion: </strong>Low MS uptake persists due to fear, discomfort, and gaps in targeted education, despite program awareness. Younger and employed women require tailored interventions. Recommendations include culturally resonant campaigns addressing modesty concerns, pre-screening counseling to alleviate pain-related anxiety, and proactive invitation systems via employer partnerships or automated reminders. Future studies should employ population-based sampling and qualitative.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"295"},"PeriodicalIF":2.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194003","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":"Importance, facilitators and barriers for finnish general practitioner involvement in clinical practice guideline panels: a survey.","authors":"Ilona Mikkola, Jorma Komulainen, Maria Hagnäs, Raija Sipilä","doi":"10.1186/s12875-025-03017-3","DOIUrl":"10.1186/s12875-025-03017-3","url":null,"abstract":"<p><strong>Background: </strong>Difficulties in recruiting general practitioners (GPs) to clinical practice guideline panels (CPGPs) have been noted. However, little is known about the specific nature of these challenges. Our objective was to investigate (1) GPs' insights on the importance of their involvement in clinical practice guideline development and (2) the most essential facilitators and barriers related to GPs' involvement in CPGPs.</p><p><strong>Methods: </strong>For this survey, we invited GPs who had been CPGP members in Current Care Guidelines of Finnish Medical Society Duodecim during the years 2017-2022 (n = 78) to an e-mail survey, which collected information on respondents' backgrounds and aspects of their GP involvement prior to, during, and after the clinical practice guideline process. GPs were identified from the registry of Duodecim. In this article, we report the qualitative analysis of the data. We analysed open-ended questions both deductively (using WONCA core competencies) and inductively regarding the question of important reasons for GP involvement. Facilitators and barriers to involvement were analysed inductively.</p><p><strong>Results: </strong>Overall, 39 GPs (50.0%) responded. The three most important elements reflecting importance of GPs' involvement in CPGPs were GPs' understanding of primary care management, GPs' role as a major target group of clinical practice guidelines, and GP-specific problem-solving skills. The most important facilitators were information and education related to guideline work, a supportive employer attitude, and financial support. Conversely, lack of time and knowledge regarding the critical appraisal of research evidence were the most important barriers.</p><p><strong>Conclusion: </strong>GPs' involvement in CPGPs should be supported by strengthening the promotive factors and reducing barriers to participation.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"300"},"PeriodicalIF":2.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194043","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":"Profiles of home-based medical care service demand among older patients with different characteristics: a cluster analysis.","authors":"Hang Li, Qiying He, Suzhen Liu","doi":"10.1186/s12875-025-03014-6","DOIUrl":"10.1186/s12875-025-03014-6","url":null,"abstract":"<p><strong>Background: </strong>There is a large demand gap for home-based medical services. Understanding the characteristics of people in need of services can help provide relevant services more effectively and accurately.</p><p><strong>Objective: </strong>To understand the health status categories and characteristics of home-based medical services for older patients with chronic diseases.</p><p><strong>Methods: </strong>A cross-sectional research method was used to investigate the self-reported service needs and health status of 371 older patients with chronic diseases from four areas: environment, psychosocial, physical, and health-related behaviors. K-means cluster analysis was used to classify the population, and variance analysis was used to examine the basic characteristics of different categories of patients.</p><p><strong>Results: </strong>Only 191 patients self-reported needing home-based medical care and were divided into three clusters: outstanding demand for psychological services, comprehensive health services in demand, and continuous optimization of health levels. There were statistically significant differences in the education level, economic status, health status, living conditions, and cohabitation status of the three clusters of patients (P < 0.05).</p><p><strong>Conclusion: </strong>The home-based medical service needs of community-dwelling older adults with chronic diseases may vary based on education level, economic status, and health status. How to provide appropriate services according to educational background, economic status and health status is a service topic that needs to be studied in the future.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"294"},"PeriodicalIF":2.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194069","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":"Facilitators and barriers to health professionals' competence in delivering quality primary health care in the digital era in Amhara region, Ethiopia: an exploratory qualitative study.","authors":"Gebeyehu Tsega, Mirkuzie Woldie, Gizachew Yismaw, Getu Degu","doi":"10.1186/s12875-025-03003-9","DOIUrl":"10.1186/s12875-025-03003-9","url":null,"abstract":"<p><strong>Background: </strong>Despite the critical role of professional competence in providing quality primary health care, evidence on the facilitators and barriers to health professionals' competence is limited. Therefore, we explored factors influencing health professionals' competence in delivering quality primary health care in Amhara region, Ethiopia.</p><p><strong>Methods: </strong>A qualitative case study was conducted in Amhara region from November 1 to December 30/2023. We conducted key informant interviews with five faculty members from training institutions, five health service or facility managers, and five study participants from non-governmental organizations. Additionally, we conducted in-depth interviews with twelve health professionals. The number of participants was determined based on information saturation, and purposive heterogeneous sampling was used. A thematic analysis was conducted to analyze the data. The Standards for Reporting Qualitative Research (SRQR) were used to report findings.</p><p><strong>Results: </strong>Factors influencing the competence of health professionals in providing quality primary health care were divided into two main categories: facilitators and barriers. The presence of educational technologies, advanced instructional methods, educational design, the education-for-life model, universities, colleges, CPD centers, and NGOs working on health workforce capacity development in the region were facilitators of health professionals' competence to provide quality primary health care. On the other hand, identified barriers include poorly prepared and demotivated students, the rapid expansion of universities and colleges with inadequate infrastructure, weak external quality assurance systems, poor collaboration between education and health systems, and the impacts of conflict and COVID-19.</p><p><strong>Conclusion: </strong>Although facilitators exist to enhance health professionals' competence in the region, higher education institutions have not effectively produced the competent professionals necessary for quality primary health care. Factors such as poor-quality pre-service education, inconsistent and poorly implemented CPD initiatives, and limited NGO-funded training have all contributed to the subpar competence of health professionals. There is an urgent need for collaboration between the Ministry of Health and the Ministry of Education to plan, revise, and implement health professional training, improve the quality of pre-service education, and optimize in-service training and CPD efforts.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"296"},"PeriodicalIF":2.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194045","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":"Development and evaluation of a behaviour change intervention to increase general practitioner REferral of people with hip and knee osteoarthritis to community-based First-linE caRe (REFER): a mixed methods study.","authors":"A M Ezzat, A Gibbs, D De Oliveira Silva, M Ferraz Pazzinatto, J L Kemp, J Manski-Nankervis, C J Barton","doi":"10.1186/s12875-025-02968-x","DOIUrl":"10.1186/s12875-025-02968-x","url":null,"abstract":"","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"291"},"PeriodicalIF":2.6,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180604","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":"Perceived barriers and facilitators to implementing a weight management programme in a primary care setting in Singapore: a qualitative study.","authors":"Rachel Li Cui Lim, Swetha S Kumar, Chirk Jenn Ng","doi":"10.1186/s12875-025-02940-9","DOIUrl":"10.1186/s12875-025-02940-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Obesity, a growing problem worldwide and locally, is a risk factor for many chronic conditions. Weight loss has been shown to improve health outcomes and weight management programmes are effective in achieving weight loss. However, the effectiveness and sustainability of weight management programmes are variable. The six-month, seven-touch-point Weight Management Programme (WeightWise) is a locally developed multidisciplinary programme based on the latest evidence and expert opinion. This study aimed to explore the perceived barriers and facilitators to delivering WeightWise prior to its implementation in the Singapore public primary care setting (polyclinics).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Between September 2023 and January 2024, a qualitative study was conducted across two polyclinics designated to pilot WeightWise. Twenty-six healthcare practitioners, including clinic directors, doctors, nurses, dietitians and physiotherapists, who would be involved in running WeightWise or referring patients to WeightWise, were interviewed by the researchers using an interview guide, in either a focus group or individually. Interviews were audio-recorded, transcribed verbatim, checked and analysed thematically using the NVivo software.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The participants in this study expressed a gap in weight management in primary care and found WeightWise relevant and timely. However, they highlighted potential barriers to implementing WeightWise in terms of patient enrolment and programme delivery. For enrolment to WeightWise, the participants were concerned about a lack of prioritisation by the practitioners on weight management, time constraint, complex referral criteria and pricing. However, they highlighted potential facilitators to enrolment including targeting young and motivated patients, as well as identifying eligible patients at pre-consult vitals measurement stations. For WeightWise delivery, the perceived barriers were: increased workload for nurses, difficulty in accessing information on community exercise programmes, lack of weight management knowledge amongst practitioners, inconvenient programme timings and uncertainty in long-term benefits of WeightWise. The perceived facilitators to delivering WeightWise were: the use of remote care modalities, preventive care awareness through Healthier SG (a national health initiative), training programmes for practitioners and continuous peer support for patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study identified the need to focus on both enrolment and delivery when implementing WeightWise. It also identified low prioritisation of weight management, lack of practitioner knowledge, lack of resources and costs as key barriers when implementing a weight management programme. Tailored healthcare professionals training, additional resources and cost analysis is recommended before its implementation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical trial number: &lt;/strong&gt;Not appli","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"290"},"PeriodicalIF":2.6,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180639","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 Edmonton frail scale: a feasibility study on assessing frailty among older adults with multimorbidity in Norwegian primary health care.","authors":"Turid Rimereit Aarønes, Kristin Taraldsen, Are Hugo Pripp, Linda Aimée Hartford Kvæl","doi":"10.1186/s12875-025-02996-7","DOIUrl":"10.1186/s12875-025-02996-7","url":null,"abstract":"<p><strong>Background: </strong>The growing prevalence of multimorbidity and frailty, driven by an ageing population and changing health trends, is placing significant pressure on healthcare systems. Frailty assessments provide valuable insights into patient vulnerability, allowing for early interventions to prevent functional decline and reduce hospitalisations. Despite their importance, standardised frailty assessment instruments are not widely used in primary care. This study investigated the feasibility of using one such instrument, the multidimensional Edmonton Frail Scale (EFS), in Norwegian primary healthcare.</p><p><strong>Methods: </strong>This feasibility study involved 14 healthcare professionals (10 physiotherapists and four nurses) from primary healthcare in three Norwegian municipalities. Participants were trained to use the EFS to assess and generate frailty scores. Four focus group interviews explored these professionals' experiences of using the EFS with home-dwelling older adults with multimorbidity. The EFS scores were analysed with descriptive statistics, and the interview data underwent reflexive thematic analysis.</p><p><strong>Results: </strong>Through interview analysis, we identified three main themes: (i) enabling collaborative planning, (ii) facilitating comprehensive assessments, and (iii) integrating and understanding EFS competently. The assessment of frailty using the EFS among home-dwelling older adults with multimorbidity (n = 86) revealed scores ranging from 2 to 14, with 2% of these adults categorised as fit, 18% as pre-frail and 80% as frail. Most participants failed the clock test, and many had been hospitalised in the past year. Despite these challenges, 83% reported very good or fair self-perceived health, though the EFS scores indicated significant dependency in daily activities. Polypharmacy was common, with three-quarters of patients taking five or more medications. Additionally, recent weight loss, mobility issues and sadness or depression were frequently reported.</p><p><strong>Conclusions: </strong>The EFS supported collaborative care planning by identifying frailty domains, facilitating tailored interventions to address challenges such as polypharmacy, mobility issues, emotional well-being, and dependency in daily activities. The themes of collaborative care, comprehensive assessments, and competent integration highlight the EFS's potential as a multidimensional instrument for routine use in primary care. With proper healthcare professional training, the EFS can promote person-centred care, improve overall care quality and support the early detection and prevention of complications, addressing the complex needs of older adults with multimorbidity.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"289"},"PeriodicalIF":2.6,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180627","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":"Enabling general practice research in singapore: A qualitative exploration of barriers, facilitators and solutions.","authors":"Xin Hui Sam, Glenys Shu Wei Quak, Aik Chen Edwin Chng, Eng Sing Lee, Jo-Anne Manski-Nankervis","doi":"10.1186/s12875-025-02964-1","DOIUrl":"10.1186/s12875-025-02964-1","url":null,"abstract":"<p><strong>Background: </strong>The importance of primary care research in informing clinical practice and policy is well demonstrated. In the Singapore setting, the majority of research occurs in public institutions called polyclinics as opposed to the private general practice setting where approximately 80% of primary care clinical service provision takes place. There is a need to increase research in the private general practice setting to ensure that findings are relevant to this setting. This study aimed to explore the barriers, facilitators and motivations impacting on Singaporean GP's involvement in research with a view to optimising the structure and supports offered by SPARK, a practice-based research network (PBRN).</p><p><strong>Methods: </strong>GPs were recruited from SPARK network, research collaborators and networks of the researchers. Semi-structured interviews were conducted face to face or via zoom and audio recorded. Interviews were transcribed and then thematic analysis was conducted using a deductive and inductive approach.</p><p><strong>Results: </strong>Fifteen GPs participated in the study. Four major themes (motivators, barriers, facilitators, PBRN) and 14 subthemes were identified from the interviews. Whilst there were barriers at the GP, practice, system and individual research project levels, there were strong intrinsic (altruism, alignment with personal interest) and extrinsic (better patient care, job enrichment, enhancing primary care) motivators. Important facilitators included practice support, funding, streamlining of research practices, collaboration and acknowledgement of the contribution of GPs. PBRNs could support this through providing research infrastructure underpinned by communication and relationships and the sharing of research outcomes.</p><p><strong>Conclusions: </strong>There is acknowledgement that research conducted in the Singapore general practice environment is important, but barriers such as time, financial support and lack of systemic structures exist which limit participation. PBRNs, such as SPARK, can play a role in bridging the existing gap between clinical experience and academic expertise. The findings of this study will inform future SPARK activities to build a dynamic general practice research environment in Singapore.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"292"},"PeriodicalIF":2.6,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12465257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180624","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":"Shift in therapeutic approaches in patients with hypercholesterolemia - a secondary data analysis.","authors":"Elena Zink, Jost Steinhäuser, Paul-Georg Blickle, Wolfgang C G von Meißner, Christoph Strumann","doi":"10.1186/s12875-025-02982-z","DOIUrl":"10.1186/s12875-025-02982-z","url":null,"abstract":"<p><strong>Background: </strong>Atherosclerotic cardiovascular disease is a leading cause of death and hypercholesterolemia is one relevant risk factor. There are two established guidelines for the management of high cholesterol in general practice in Germany, one of these is from the European Society of Cardiology (ESC). This analysis examines whether treatment modalities and clinical outcomes in German primary care have changed after the publication of the 2019 ESC (European Society of Cardiology)/EAS (European Atherosclerosis Society) guidelines on dyslipidaemia.</p><p><strong>Methods: </strong>A retrospective cohort study (2001-2023) with data extracted from electronic health record systems of 17 primary care practices. The Data was used to compare drug treatment and outcomes before and after 2019, the year of the ESC guideline publication. Multilevel regression analysis was used to assess the effects of the new guidelines, accounting for time trends and patient- and practice-level factors.</p><p><strong>Results: </strong>Statin prescriptions for 23,322 patients with hypercholesterolemia increased from 6% in 2001 to 27% in 2023, with an increase in treatment intensity after 2012. Despite general reductions in total and LDL cholesterol, cardiovascular events remained unchanged, while reported complaints associated with side effects increased. Multilevel regression showed more prescriptions after the new ESC/EAS guidelines, with no effect on treatment intensity or outcomes.</p><p><strong>Conclusion: </strong>Following the publication of the new ESC/EAS guideline, a modest rise in statin prescriptions has been documented. However, despite improved lipid profiles, clinically relevant events did not decrease yet, and side effects increased, questioning the benefit of tailoring statin therapy to lower lipid thresholds in real world data so far.</p><p><strong>Trial registration: </strong>German Clinical Trials Register: DRKS00032936. Registration Date: October 30, 2023.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"287"},"PeriodicalIF":2.6,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12462300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152017","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}