BMC primary carePub Date : 2025-09-03DOI: 10.1186/s12875-025-02941-8
I G Arslan, M Vervloet, E W de Bekker-Grob, K Hek, B J Knottnerus, C Wagner, L van Eikenhorst
{"title":"The role of environmental impact in healthcare providers' choices of inhalers for treatment of asthma and COPD: a discrete choice experiment.","authors":"I G Arslan, M Vervloet, E W de Bekker-Grob, K Hek, B J Knottnerus, C Wagner, L van Eikenhorst","doi":"10.1186/s12875-025-02941-8","DOIUrl":"10.1186/s12875-025-02941-8","url":null,"abstract":"<p><strong>Background: </strong>Pressurised metered-dose inhalers (pMDIs), often prescribed for the treatment of COPD and asthma have a high global warming potential (GWP) compared to dry powder inhalers (DPIs) and soft-mist inhalers. Despite calls to switch from high to DPIs or soft-mist inhalers, prescriptions of pMDIs have increased in recent years. Understanding healthcare providers' preferences can help develop strategies to promote prescribing low GWP inhalers. This study aimed to determine healthcare providers' preferences when prescribing inhalers for asthma and COPD, including its GWP (i.e. environmental impact).</p><p><strong>Methods: </strong>A survey containing a discrete choice experiment was conducted. Primary care providers were repetitively asked to choose between scenarios of inhalers that differed in five attributes: multidose or unidose system (i.e. ease of use), reduction in number of exacerbations, side effects, out of pocket costs and GWP. A multinomial logit model was used to determine the relative importance of the attributes.</p><p><strong>Results: </strong>A total of 76 healthcare providers (general practitioners (GPs), nurse specialists and nurse practitioners) completed the survey. On average, the attribute 'reduction in number of exacerbations' was most important in their choice for inhalers, followed by, 'side effects', 'GWP', 'out of pocket costs', and 'multidose or unidose system'. Healthcare providers were willing to accept a high GWP inhaler instead of a low GWP inhaler when the inhaler reduced the number of exacerbations and were willing to opt for low GWP inhaler with higher out of pocket costs instead of a high GWP inhaler with lower out of pocket costs.</p><p><strong>Conclusions: </strong>Healthcare providers valued clinical factors (i.e. reduction in number of exacerbations and low side effects) as most important when choosing inhalers for their patients with COPD or asthma, however GWP was also an important driver of choice. Understanding these preferences can support strategies to support sustainable inhalers for COPD and asthma, contributing to climate change mitigation. For example by enhancing the provision of information regarding inhaler GWP, while ensuring that clinical effectiveness remains the primary focus.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"278"},"PeriodicalIF":2.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994637","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":"Challenges faced by healthcare providers in implementing preconception care for women with diabetes in public health clinics in Malaysia - A qualitative study.","authors":"Irmi Zarina Ismail, Chirk Jenn Ng, Ping Yein Lee, Norita Hussein","doi":"10.1186/s12875-025-02991-y","DOIUrl":"10.1186/s12875-025-02991-y","url":null,"abstract":"<p><strong>Background: </strong>In Malaysia, diabetes in pregnancy poses a significant challenge. If uncontrolled, it leads to unfavourable maternal and foetal outcomes. Preconception care offers healthcare providers and women with diabetes an opportunity to minimise risk factors before pregnancy. However, the utilisation of this service in the public health clinics remains limited. This study aimed to explore the challenges experienced by healthcare providers in implementing preconception care for women with diabetes.</p><p><strong>Methods: </strong>This was a qualitative study that employed a single case study approach. Participants were purposely recruited for focus group discussions and in-depth interviews. An interview guide, developed based on the Theoretical Domain Framework, was used. All interviews were conducted at four public health clinics in a state with a high prevalence of diabetes in Malaysia. Interviews were audio-recorded and transcribed verbatim. The transcripts were then analysed through thematic analysis, using a reflexive approach with an inductive strategy. Ethical approval was obtained from the Medical Research Ethics Committee, Ministry of Health Malaysia.</p><p><strong>Results: </strong>Fifty-three healthcare providers involved in preconception care were interviewed. Three major themes affecting the provision and delivery of preconception care for women with diabetes were identified: (1) Systemic and organisational barriers which create foundational barriers, (2) Healthcare provider factors which affect frontline implementation, and (3) Patient-related factors which influence the engagement of women with diabetes in utilising preconception care. This study identifies gaps within healthcare systems and providers, as well as factors influencing women with diabetes that need to be addressed for effective implementation of preconception care.</p><p><strong>Conclusion: </strong>This study offers insights into the challenges of implementing preconception care effectively. Within the healthcare system, instead of segregating management within similar healthcare facilities, consolidating resources could address manpower and infrastructure challenges. Providing comprehensive training for healthcare providers is crucial to improve care quality and health literacy among women with diabetes. Successful implementation relies on effective engagement between healthcare providers and the women. In this way, preconception care can be recognised as an essential component of the diabetes management pathway within the healthcare system in the country.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"277"},"PeriodicalIF":2.6,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12406450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980735","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":"Integration of newborn screening for sickle cell disease into primary health care in Bukavu, Democratic Republic of the Congo: a pilot study.","authors":"Nash Mwanza Nangunia, Olivier Mukuku, Viviane Bianga Feza, Yves Mulindilwa Kyembwa, Théophile Barhwamire Kabesha, Zacharie Kibendelwa Tsongo, André Kabamba Mutombo, Stanislas Okitotsho Wembonyama","doi":"10.1186/s12875-025-02976-x","DOIUrl":"https://doi.org/10.1186/s12875-025-02976-x","url":null,"abstract":"<p><strong>Introduction: </strong>Sickle cell disease (SCD) is an inherited genetic disorder that represents a major public health challenge in sub-Saharan Africa, particularly in the Democratic Republic of the Congo (DRC). This disease, characterized by an amino acid substitution in the beta-globin chain, requires early management to reduce serious complications and improve patients' quality of life. This study aimed to test the feasibility of integrating newborn screening for SCD into primary health care in Bukavu, in the DRC, to improve health outcomes for affected infants and reduce serious complications associated with the disease.</p><p><strong>Methods: </strong>A prospective cohort pilot study was conducted from November 2022 to December 2023 in 15 primary healthcare facilities in Bukavu. Mothers were screened for SCD at antenatal clinics and maternities. Blood samples from mothers and newborns were collected and tested using the HemoTypeSC™ point-of-care testing. Results were confirmed by Gazelle® electrophoresis in case of a positive result.</p><p><strong>Results: </strong>Out of the 6,353 sensitized mothers, 4,496 consented to undergo screening, resulting in an acceptance rate of 70.77%. Among them, 91.61% were HbAA, 8.16% were HbAS, and 0.22% were HbSS. Among the mothers with HbS, only 77 received follow-up until delivery, demonstrating the feasibility of the follow-up process. The findings revealed that out of the 77 newborns, 66.23% were HbAA, 29.87% were HbAS, and 3.90% were HbSS.</p><p><strong>Conclusions: </strong>The integration of newborn screening for SCD into primary health care in Bukavu, in the DRC, has demonstrated feasibility and effectiveness in the early identification of affected infants. This initiative has the potential to mitigate the serious complications linked to the disease and enhance health outcomes for patients. These findings set the stage for broader adoption of this approach to address the implications of SCD on maternal and child health in the DRC.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"275"},"PeriodicalIF":2.6,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980747","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}
BMC primary carePub Date : 2025-08-30DOI: 10.1186/s12875-025-02980-1
Romans Eshtaya, Ahmad Ayed, Malakeh Z Malak, Anas Shehadeh
{"title":"The association between diabetes management self-efficacy and quality of life among Palestinian patients with type 2 diabetes.","authors":"Romans Eshtaya, Ahmad Ayed, Malakeh Z Malak, Anas Shehadeh","doi":"10.1186/s12875-025-02980-1","DOIUrl":"https://doi.org/10.1186/s12875-025-02980-1","url":null,"abstract":"<p><strong>Background: </strong>Self-efficacy emerges as a crucial element that impacts engagement in self-care behaviors among patients with type 2 diabetes. There is a lack of studies examining management self-efficacy and quality of life among patients with type 2 diabetes in Palestine. Thus, this study examined these variables among this cohort.</p><p><strong>Methods: </strong>A cross-sectional study and a convenience sample of 397 patients with type 2 diabetes who attended diabetic clinics in the North West Bank, Palestine, were recruited. Data were collected using a paper self-reported questionnaire composed of the RVDQOL-13 scale to assess the quality of life and the diabetes management self-efficacy scale. The participants received the questionnaire in person during their scheduled clinic visits and completed it independently. The researchers were responsible for distributing the questionnaires to participants and collecting them on the same day during the period from June to September 2023.</p><p><strong>Results: </strong>The participants reported a high diabetes management self-efficacy, with a mean score of 73.6 (± 14.5), while their quality of life was generally poor, with a mean score of 47.6 (± 13.1). Quality of life showed significant positive associations with employment (p.b.r = 0.143, p < 0.01), monthly income (p.b.r = 0.137, p < 0.01), educational level (p.b.r = 0.137, p < 0.01), male gender (p.b.r = 0.120, p < 0.05), diabetes management self-efficacy (r = 0.545, p < 0.01), and duration of diabetes (r = 0.157, p < 0.01). In contrast, quality of life was negatively associated with body mass index (BMI) (p.b.r = -0.100, p < 0.05) and HbA1c levels (r = -0.265, p < 0.01). Multiple regression analysis identified diabetes management self-efficacy (b = 0.474, p < 0.001) and longer duration of diabetes (b = 0.204, p < 0.015) as significant positive predictors of quality of life. Conversely, higher HbA1c levels were found to be a significant negative predictor of quality of life (b= -1.278, p < 0.001).</p><p><strong>Conclusions: </strong>This study emphasizes the need for multi-dimensional, person-centered care for patients with type 2 diabetes. Effective diabetes interventions should address the social, psychological, and educational needs that shape quality of life.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"274"},"PeriodicalIF":2.6,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12398177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980490","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}
BMC primary carePub Date : 2025-08-29DOI: 10.1186/s12875-025-02994-9
Hadisossadat Hosseini, Maryam Rassouli, Hadi Hayati, Heshmatolah Heydari
{"title":"Correction: The effect of community-based palliative supportive care integrated with primary health care (PHC) on the outcomes of terminally ill cancer patients.","authors":"Hadisossadat Hosseini, Maryam Rassouli, Hadi Hayati, Heshmatolah Heydari","doi":"10.1186/s12875-025-02994-9","DOIUrl":"https://doi.org/10.1186/s12875-025-02994-9","url":null,"abstract":"","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"272"},"PeriodicalIF":2.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980838","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}
BMC primary carePub Date : 2025-08-29DOI: 10.1186/s12875-025-02973-0
Alicia Prinz, Sabrina Hoppe, Rik Crutzen, Stefan Wilm, Sabrina Kastaun
{"title":"General practitioners' educational and training needs and requirements for advising patients with coronary heart disease on physical activity: findings from a qualitative study in Germany.","authors":"Alicia Prinz, Sabrina Hoppe, Rik Crutzen, Stefan Wilm, Sabrina Kastaun","doi":"10.1186/s12875-025-02973-0","DOIUrl":"https://doi.org/10.1186/s12875-025-02973-0","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization and German treatment guidelines emphasise integrating physical activity (PA) advice into primary care of patients with coronary heart disease (CHD). However, this is often inadequately implemented in German general practice. A key barrier may be healthcare professionals' limited knowledge and skills in providing effective and efficient PA guidance - both in general as well as for patients with CHD. International guidelines recommend targeted training for general practitioners (GPs). Understanding GPs' specific educational and training needs is crucial to developing tailored training programmes for improving implementation of advising CHD patients on PA.</p><p><strong>Methods: </strong>Between March and June 2023, 12 problem-centred one-on-one interviews and six moderated focus groups (n = 37 participants) with GPs were conducted in-person (total N = 49 GPs, 37% female, mean age 56 years (36-78 years)). Interview and focus group topic guides were developed and pilot-tested by the multi-professional study team. Transcripts from audio-recorded data were analysed using both deductive and inductive content structuring, within a multi-professional team, with active involvement of GPs. This analysis extends a previous study using the same dataset. RESULTS: GPs recognise the benefits of PA for CHD patients. Their conceptualisations of PA (e.g., definitions of sport and PA, general statements on PA) vary and the incorporation of PA in everyday activities (e.g., using stairs) to encourage behaviour change is sometimes recommended. GPs identify the following key training needs for providing PA advice to CHD patients: peer exchange and self-reflection, evidence-based knowledge on PA and CHD, practical tools and support materials to facilitate the integration of PA advice into routine practice. These include low-barrier, time-efficient communication techniques, and role-play simulations. CONCLUSION: This qualitative study provides insights into GPs' needs and preferences regarding the content, didactics, and organisation of training on PA advice. To enhance competence and foster deeper learning, training should combine evidence-based knowledge with practical elements such as simulations and reflective peer exchange. Building on previous findings about GPs' attitudes and experiences, the identified educational needs offer a foundation for developing tailored training to support PA counselling in routine primary CHD care. This training will be implemented and evaluated in a subsequent study.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"273"},"PeriodicalIF":2.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980758","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}
BMC primary carePub Date : 2025-08-28DOI: 10.1186/s12875-025-02977-w
Jared R Brosch, Diana Summanwar, Nicole R Fowler, Dustin B Hammers, Anthony J Perkins, Anna Higbie, Kristen Swartzell, Deanna R Willis
{"title":"An innovative health systems approach to support early detection of cognitive impairment in primary care - the brain health navigator.","authors":"Jared R Brosch, Diana Summanwar, Nicole R Fowler, Dustin B Hammers, Anthony J Perkins, Anna Higbie, Kristen Swartzell, Deanna R Willis","doi":"10.1186/s12875-025-02977-w","DOIUrl":"https://doi.org/10.1186/s12875-025-02977-w","url":null,"abstract":"<p><strong>Background: </strong>Patients and providers experience barriers to early detection of mild cognitive impairment (MCI) and dementia. We developed a new primary care-based role, the Brain Health Navigator (BHN), who is trained to assess patients for cognitive impairment, identify addressable causes, suggest appropriate diagnostic testing, connect patients to resources, and assist patients in accessing disease-modifying treatments and dementia care management. This study describes the BHN role, the feasibility of implementing the BHN in Primary Care (PC) clinics, and the initial patients' outcomes for those who saw the BHN.</p><p><strong>Methods: </strong>Patients ≥65 years were screened with a Digital Cognitive Assessment (DCA) in seven PC clinics from June 1, 2022, to May 31, 2023. Patients who scored likely cognitively impaired or borderline for impairment were eligible for referral to the BHN. Clinics and providers could determine if referrals were automatic or on a patient-by-patient basis. The BHN encounter included a comprehensive assessment of standardized tools and suggested laboratory and imaging studies to facilitate the diagnostic process and connect patients to resources, care and treatment, and research opportunities.</p><p><strong>Results: </strong>466 of 861 patients with likely impaired or borderline impaired DCA results were referred to the BHN.More patients with likely impaired scores (62.7%) were referred to the BHN compared to those with borderline scores (47.6%). Of the 466 referred patients, 28.9% with likely impaired scores and 23.5% with borderline scores completed a BHN visit. Patients who were seen by the BHN had a significantly higher likelihood of receiving a new diagnosis of MCI than patients who did not see the BHN and were more likely to have orders for diagnostic tests, such as vitamin B12 thyroid function and Magnetic Resonance Imaging of the head and neck. Referrals to both neurology and neuropsychology were significantly more common among patients who completed the BHN visit.</p><p><strong>Conclusions: </strong>A BHN enhances follow-up care and monitoring for patients with abnormal cognitive screening tests. A BHN visit increases the rate of evidence-based diagnostic evaluation for MCI and dementia in PC.</p><p><strong>Trial registration: </strong>This study was designated as exempt by the Indiana University Institutional Review Board (#15281).</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"271"},"PeriodicalIF":2.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980718","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}
BMC primary carePub Date : 2025-08-28DOI: 10.1186/s12875-025-02924-9
Amélie Richard, Céline Lambert, Pierre Bernard, Hélène Vaillant-Roussel, Catherine Laporte
{"title":"Capillary CRP in primary care in France: an observational study.","authors":"Amélie Richard, Céline Lambert, Pierre Bernard, Hélène Vaillant-Roussel, Catherine Laporte","doi":"10.1186/s12875-025-02924-9","DOIUrl":"https://doi.org/10.1186/s12875-025-02924-9","url":null,"abstract":"","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"269"},"PeriodicalIF":2.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980741","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}
BMC primary carePub Date : 2025-08-28DOI: 10.1186/s12875-025-02967-y
Conglei You, Jingyi Zhao, Tengyang Fan, Lingling Wang, Lijuan Zhang, Guohao Zhao, Huan Tang, Na Wang, Xu Yang, Mi Yao
{"title":"Navigating fragmented care: a qualitative study on multimorbidity management challenges in Beijing's tiered healthcare system.","authors":"Conglei You, Jingyi Zhao, Tengyang Fan, Lingling Wang, Lijuan Zhang, Guohao Zhao, Huan Tang, Na Wang, Xu Yang, Mi Yao","doi":"10.1186/s12875-025-02967-y","DOIUrl":"https://doi.org/10.1186/s12875-025-02967-y","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity is a growing public health concern, especially in countries with aging populations. Although a tiered healthcare system has been implemented to improve primary care, managing patients with multimorbidity has been challenging.</p><p><strong>Methods: </strong>This study conducted focus group discussions involving 21 patients with multimorbidity in Beijing via a flexible topic guide to explore their experiences. Participants were sampled from urban and rural areas, ensuring a diverse representation of demographics and health conditions. The data were analyzed using the framework method. The themes and subthemes were identified through iterative coding and discussion.</p><p><strong>Results: </strong>Four main themes emerged: (1) Living with multimorbidity, where patients view chronic conditions as an inevitable part of aging but struggle with self-management, particularly medication adherence and lifestyle modifications; (2) healthcare system challenges, driven by ineffective tiered policies and digital exclusion, especially among elderly patients; (3) financial burdens, with rural patients facing greater out-of-pocket costs due to insurance inequities and policy-induced strains; and (4) doctor-patient relationships, where communication gaps and a lack of continuity hinder patient-centered care. Patients emphasized the need for better care coordination, financial support, and empathetic communication.</p><p><strong>Conclusion: </strong>This study underscores systemic gaps in China's healthcare system for multimorbidity care. To address these issues, policymakers should prioritize (1) strengthening primary care coordination through multidisciplinary teams, (2) expanding financial protection for chronic disease management to reduce urban-rural disparities, and (3) training providers in patient-centered communication and shared decision-making. These actionable steps can serve as a blueprint for LMICs aiming to build integrated, patient-centered systems for multimorbidity management.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"270"},"PeriodicalIF":2.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980835","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}