BMC primary care最新文献

{"title":"Coronary computed tomography angiography in primary care patients with chest pain or dyspnea - a cross-sectional study.","authors":"Erik Stertman, Fade Gabro, Mårten Sandstedt, Oleg Sysoev, Jörg Lauermann, Carl Johan Östgren, Sofia Sederholm Lawesson, Jan Engvall, Staffan Nilsson, Fredrik Iredahl","doi":"10.1186/s12875-025-02877-z","DOIUrl":"10.1186/s12875-025-02877-z","url":null,"abstract":"<p><strong>Aims: </strong>Coronary Computed Tomography Angiography (CCTA) is recommended as a first-line investigation to exclude significant coronary artery stenosis in case of low to intermediate pre-test probability (PTP). The aim was to investigate CCTA findings in relation to the PTP of patients referred directly from primary health care centres.</p><p><strong>Methods/results: </strong>In this retrospective cohort study consecutive primary care CCTA referrals in a Swedish county 1st of June 2021 until 30th Nov. 2022 were included. CCTA reports were obtained for 483 patients ≥ 30 years old, without known CAD and stratified as no CAD, with atheromatosis or with suspected significant stenosis. For the 381 patients with eligible PTP data, the mean age was 60 years and 70% were women. While the median PTP was 11%, significant stenosis was suspected on CCTA in 18%. Among patients with PTP ≤ 15%, CCTA exposed no significant stenosis in 88%. No significant stenosis was found in patients with PTP < 5% true to patient age and gender in a sensitivity analysis (n = 25).</p><p><strong>Conclusions: </strong>CCTA ruled out coronary stenosis as the cause of chest pain and dyspnea in 88% of patients referred from primary care with PTP 5-15%. PTP estimations by primary care physicians in CCTA referrals agreed with the occurrence of suspected significant stenosis among patients with PTP 5-15%, but underestimated it in PTP > 15%. The validity of PTP estimates < 5% was low.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"178"},"PeriodicalIF":2.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112864","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":"What motivates general practitioners of the future: qualitative study of Irish trainees.","authors":"Aisling Egan, Peter Hayes, Andrew O'Regan","doi":"10.1186/s12875-025-02883-1","DOIUrl":"10.1186/s12875-025-02883-1","url":null,"abstract":"<p><strong>Background: </strong>There is a worldwide shortage of general practitioners (GPs). The aim of this study is to explore the perspectives of GP trainees and to understand their motivators and career priorities to inform future GP workforce planning.</p><p><strong>Methods: </strong>A qualitative study, consisting of one-to-one, semi-structured interviews was conducted with GP trainee participants and data were analysed thematically. Every GP trainee currently enrolled in vocational training nationally was invited to participate. 'Social Cognitive Career Theory' and 'Sociocultural Theory' were used as theoretical frameworks to inform the interview guide and its analysis.</p><p><strong>Results: </strong>Seventeen GP trainees were interviewed. One meta-theme was identified from interviews: 'Sustainable work as part of a fulfilling life'. This meta-theme of sustainability threads through each of the five related subthemes: Family, stability and support, burnout aversion, role-modelling, and well supported portfolio careers in practice.</p><p><strong>Conclusion: </strong>Understanding priorities and motivators of GP trainees will inform future healthcare planning, in particular, the type of role to which trainees aspire and the type of health service they in which they will work.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"176"},"PeriodicalIF":2.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112894","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":"Team climate, job satisfaction, burnout and practice performance: results of a national survey of staff in general practices in England.","authors":"Peter Williams, Heather Gage, Bridget Jones, Carole Aspden, Jessica Smylie, Thomas Bird, Morro M L Touray, Phelim Brady, John Campbell, Rupa Chilvers, Catherine Marchand, Stephen Peckham, Suzanne H Richards, Karen Spilsbury, Mark Joy, Simon de Lusignan","doi":"10.1186/s12875-025-02780-7","DOIUrl":"10.1186/s12875-025-02780-7","url":null,"abstract":"<p><strong>Background: </strong>Measures are needed to address recruitment and retention problems in general practice in England. A good team climate, the relational processes of team working, can mitigate pressured work environments, but little is known about it.</p><p><strong>Objectives: </strong>To explore factors associated with more favourable team climates in general practices and investigate associations between team climate and outcomes for staff and practice performance.</p><p><strong>Methods: </strong>All 6475 general practices in England were eligible to take part in an online cross-sectional survey. Clinical and non-clinical staff in practices were invited to participate. Data were gathered using the 14 item version of the Team Climate Inventory; analysis was conducted on 10 items because piloting indicated many participants could not answer four items about practice objectives. Secondary outcomes included single item measures of job satisfaction, intention to remain working in the practice and burnout. Practice performance measures were: attainment in the Quality and Outcomes pay-for-performance system (for clinical effectiveness) and patient experience ratings from the national General Practice Patient Survey. Staff outcomes were analysed, principally by role. Practices in which over 50% of staff participated were included in modelling of practice level outcomes.</p><p><strong>Results: </strong>A total of 9835 individual members of staff from 809 practices participated. Most indicated a favourable team climate in their practice, (mean 3.77, on scale 1-5 best, SD 0.84); 61.3% stated they were mostly or extremely satisfied in their jobs; 26.1% met the criteria for high burnout. General Practitioners, compared to other clinical and non-clinical staff, perceived team climate to be better, and reported less likelihood of leaving, yet lower job satisfaction and higher burnout. In practice-level modelling, team climate improved as practice size decreased. Staff outcomes (job satisfaction, likelihood of remaining in post, less burnout) were associated with a better practice team climate, as were patient experience ratings. Higher GP to patient ratios were associated with improved job satisfaction, less burnout and more favourable patient experience ratings.</p><p><strong>Conclusions: </strong>Policies focussed on improving team climate could improve staff outcomes and contribute to mitigating the workforce crisis in general practice in England. Guidance on fostering good team climates is needed for practices.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"173"},"PeriodicalIF":2.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095982","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":"How do patients, medical assistants and physicians accept and experience tablet-based cognitive testing by medical assistants in general practice? - A qualitative study.","authors":"Kristin Rolke, Carolin Rosendahl, Klaus Weckbecker, Alexander Hanke, Michael Wagner, Leon Nissen, Lara Marie Reimer, Stephan Jonas, Philipp Schaper, Jochen René Thyrian, Florian Schweizer, Judith Tillmann","doi":"10.1186/s12875-025-02823-z","DOIUrl":"10.1186/s12875-025-02823-z","url":null,"abstract":"<p><strong>Background: </strong>Approximately 1.8 million people with dementia live in Germany and the number is expected to increase in the coming years. Between 360,000 and 440,000 new cases are diagnosed each year. General practitioners (GPs) are often the first point of contact for people with concerns about their memory performance or already noticed symptoms of dementia. However, structural barriers can hinder timely diagnosis by GPs, resulting in diagnoses frequently being made later in the disease's progression. Tablet-based cognitive testing, carried out by medical assistants (MAs) in GP practices, is being tested in the iCreate feasibility study, and could facilitate detection of dementia, allowing those affected to receive timely treatment and support. However, the acceptance, user experience and perceived benefits and consequences of routine implementation of such a not established procedure remain unclear until now.</p><p><strong>Methods: </strong>In this qualitative study, seven GPs, six MAs and eight patients were qualitatively interviewed regarding the acceptance, user experience of the tablet-based procedure and its implications for GP care. Semi-structured interviews were conducted using newly developed guidelines, recorded, transcribed and analysed according to Kuckartz and Rädiker using MAXQDA.</p><p><strong>Results: </strong>All respondent groups had a positive perception of the digital testing in GP practices. Interviewed MAs welcomed the new responsibilities, and patients gladly accepted the opportunity of cognitive assessment in response to their memory concerns. GPs supported delegating additional tasks to MAs. Patients found the digital testing tasks feasible to complete on the tablet and MAs also had positive experiences using the tablet as test administrators. All groups can generally envision a long-term implementation of the tests in practice, but also noted possible barriers, like the need for additional communication with specialists, limited time resources, and currently insufficient remuneration of cognitive testing.</p><p><strong>Conclusions: </strong>The positive user experience and high acceptance of participants indicate that tablet-based cognitive testing in GP settings can be highly feasible and can thus lead to indicated specialist referrals. Consequently, the management of patients exhibiting dementia symptoms should increasingly commence in GP practices, receive adequate funding, and occur in close collaboration with other specialized disciplines.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"174"},"PeriodicalIF":2.0,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12085061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095981","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":"Impact of a continuing medical education program on primary care providers - an analysis of a child psychiatry education program in Saskatchewan.","authors":"Malin Clark, Madhav Sarda, Mariam Alaverdashvili, Thuy Le, Adrian Teare, James Barton, Peter S Jensen, Anna Felstrom","doi":"10.1186/s12875-025-02872-4","DOIUrl":"10.1186/s12875-025-02872-4","url":null,"abstract":"<p><strong>Background: </strong>Treating children and youth with mental health problems in the primary care setting is challenging for many reasons. One barrier to care is a lack of physician knowledge of child psychiatry. Saskatchewan has implemented a 6-month course developed by the non-profit REACH Institute and adapted to Canada (CanREACH), focused on teaching and implementing evidence-based child psychiatric diagnostic and treatment methods into primary care. Our study focused on determining this program's impact on primary care providers (PCPs) and patients.</p><p><strong>Methods: </strong>To determine the impact of CanREACH, we assessed the knowledge and skills gained by PCPs and determined whether these were retained over time. To evaluate systemic impact, we examined if the pre-training and post-training referrals to an outpatient child psychiatry clinic were impacted for PCPs who had taken the course.</p><p><strong>Results: </strong>PCPs developed significant skills and comfort in assessing, diagnosing and treating various mental illnesses and retained this knowledge over time. PCPs who had taken the course had a significant reduction in referrals (0.9 per PCP) made to child psychiatry, as compared to those who had not taken the course (1.3 per PCP) (p < 0.05). This long-term retention of skills provides reassurance about the effectiveness of the CanREACH program.</p><p><strong>Conclusions: </strong>Education improved the capacity of primary care providers to manage child and adolescent psychiatry cases, reducing the need to refer children to psychiatry subspecialists. This ultimately improved access to outpatient child psychiatry care for Saskatchewan residents.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"172"},"PeriodicalIF":2.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087035","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":"Can self-rated health be useful to primary care physicians as a diagnostic indicator of metabolic dysregulations amongst patients with type 2 diabetes? A population-based study.","authors":"K Umeh, S Adaji","doi":"10.1186/s12875-024-02671-3","DOIUrl":"10.1186/s12875-024-02671-3","url":null,"abstract":"<p><strong>Background: </strong>Although most of the management of type 2 diabetes (T2DM) occurs in primary care, and physicians are tasked with using a 'whole person' approach, there is currently a lack of research on psychosocial diagnostic indicators for detecting metabolic abnormalities in T2DM patients. This study examined relations between SRH and metabolic abnormalities in patients with type 2 diabetes, adjusting for metabolic comorbidity.</p><p><strong>Method: </strong>A total of 583 adults with type 2 diabetes were identified from the 2019 HSE (Health Survey for England). Data on metabolic syndrome (MetS) was extracted, including lipids (high density lipoprotein cholesterol (HDL-C)), glycated haemoglobin (HbA1c), blood pressure (systolic/diastolic), and anthropometric measures (BMI, waist/hip ratio). Bootstrapped hierarchical regression and structural equation modelling (SEM) were used to analyse the data.</p><p><strong>Results: </strong>Adjusting for metabolic covariates attenuated significant associations between SRH and metabolic abnormalities (HDL-C, HbA1c), regardless of MetS status. Analysis by gender uncovered covariate-adjusted associations between SRH and both HDL-C (in men) and HbA1c (in women) (p's = 0.01), albeit these associations were no longer significant when evaluated against a Bonferroni-adjusted alpha value (p > 0.004). Sensitivity analysis indicated most findings were unaffected by the type of algorithm used to manage missing data. SEM revealed no indirect associations between SRH, metabolic abnormalities, and lifestyle factors.</p><p><strong>Conclusions: </strong>While poor SRH can help primary care physicians identify T2DM patients with metabolic dysfunction, it may not offer added diagnostic usefulness over clinical biomarkers.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"171"},"PeriodicalIF":2.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087030","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":"Assessing the implementation and impact of a social prescribing protocol in primary care.","authors":"Marina Pola-Garcia, Natalia Enríquez Martín, Alberto Turón Lanuza, Fátima Méndez-López, Ángel Gasch-Gallén, María Luz Lou Alcaine, Carmén Belén Benedé Azagra","doi":"10.1186/s12875-025-02862-6","DOIUrl":"10.1186/s12875-025-02862-6","url":null,"abstract":"<p><strong>Background: </strong>Social prescribing allows clinicians to refer people to resources or activities in their community to improve their abilities and health. Implementation of social prescribing is growing. However, there is not enough evidence on several related issues. The aim of study was to analyse the implementation of the asset-based model in the primary care teams in Aragón and to describe the profile of people who benefit most and are most satisfied with social prescribing.</p><p><strong>Methods: </strong>It is an analytical observational study in the 123 primary healthcare teams of Aragon from September2018 to December2022. The data were obtained from Electronical Health Record, checked and cleaned. A descriptive analysis was performed for qualitative and mean and standard deviation for quantitative variables. To analyse the associations between attendance, satisfaction, and improvement with all variables, several analyses were conducted using different methods. Finally, a cluster analysis was developed with the most benefited and satisfied people.</p><p><strong>Results: </strong>During the study period, 2,735 asset recommendations were made to 2,578 different people and 1,050 follow-ups to 552. There was an increase in the use of the protocol over time, except during the COVID pandemic. Most recommendations were made to women (73.3%-2,006). The average age was 65. There were more referrals in the smallest places (3.11 referrals/1000inhabitants). The most frequent linked health issues were psychological problems (572 - 20.9%). Physical skills were the abilities that professionals most tried to promote (28.4-1,709). In the follow-ups, the 81.4%(373) reported attending to the asset regularly. There were differences according to age and health problems. The average of improvement was 3.87/5 with differences by age, municipality size and health problems. For satisfaction, the average was 4.57/5 with differences by age and health problems. The lowest level of improvement and satisfaction was found for social problems. The cluster analysis highlighted several groups. Three profiles were distinguished in terms of high improvement and four of high satisfaction. In both cases, the variables related to areas for enhancement primarily defined the profiles.</p><p><strong>Conclusions: </strong>It is necessary to continue research with strong methodological and complementary approaches. This manuscript is optimistic about the use and impact of the social prescription in primary health care.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"169"},"PeriodicalIF":2.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12083031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087027","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 influence of professional identification and organizational incentives on turnover intentions: a hierarchical linear model in Beijing's family doctors.","authors":"Ziyan Zhai, Chengsen Cui, Kai Meng","doi":"10.1186/s12875-025-02859-1","DOIUrl":"10.1186/s12875-025-02859-1","url":null,"abstract":"<p><strong>Background: </strong>The high turnover intentions among family doctos (FDs) in China have impacted the stability of teams and the quality of healthcare services in community health centers (CHCs). The factors influencing FDs' turnover intentions include not only individual characteristics but also organizational environmental factors within CHCs. This study aims to explore the mechanism of the impact of FDs' professional identification and organizational incentives on their turnover intentions.</p><p><strong>Methods: </strong>This study selected 3 397 FDs from 102 CHCs in six districts of Beijing as the research subjects. Multiple scales were used to quantify FDs' professional identity, turnover intention, and organizational incentives. A Hierarchical Linear Model (HLM) was employed to investigate the effects of organizational-level and individual-level factors on turnover intentions and to analyze the interaction between individuals and organizations.</p><p><strong>Results: </strong>The study found that FDs' professional identification has a significant negative impact on turnover intentions (Beta=-0.242, P < 0.001). The level of organizational incentives in CHCs had a significant negative impact on turnover intentions (Beta=-0.173, P < 0.001), and the level of organizational incentives played a significant negative moderating role in the process of individual professional identification influencing turnover intentions (Beta = 0.004, P < 0.05).</p><p><strong>Conclusions: </strong>Enhancing FDs' professional identity can lower their turnover intention, and the impact of personal identity on turnover intention diminishes in institutions with strong organizational incentives. During the training stage of FDs, it is essential to foster a strong personal professional identity value the role of organizational incentives, and optimize the overall organizational environment.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"170"},"PeriodicalIF":2.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087039","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":"Dementia care management in primary care practices: a descriptive study among nurse practitioners.","authors":"Lusine Poghosyan, Maura Dougherty, Grant R Martsolf, Kyle Featherston, Josh Porat-Dahlerbruch, Soo Borson, Tatiana Sadak, Siqing Wang, Monica O'Reilly-Jacob","doi":"10.1186/s12875-025-02855-5","DOIUrl":"https://doi.org/10.1186/s12875-025-02855-5","url":null,"abstract":"<p><strong>Background: </strong>More than 55 million people worldwide have dementia, and every year, 10 million new cases are diagnosed. In the United States (U.S.) alone, 6.9 million Americans ages 65 and older have dementia. Health systems are searching for innovative solutions to expand the primary care system's capacity to care for these patients. Advanced practice nurses such as nurse practitioners (NPs) are vital to increasing primary care capacity to meet the need, yet primary care NPs often face structural, organizational, and workforce challenges. More specifically, little is known about NPs who care for dementia patients in primary care settings. This study explored the practice structural capabilities, organizational context, and job outcomes (i.e., burnout, job dissatisfaction, and intent to leave the practice) among NPs providing care for patients with dementia in U.S. primary care practices.</p><p><strong>Methods: </strong>We conducted a national cross-sectional survey of NPs using modified Dillman methods. Between 2021 and 2023, NPs working in primary care practices who cared for patients with dementia received a mail and online survey. Additional survey mailings, emails, postcard reminders, and phone calls encouraged non-respondents to participate. In total, 968 NPs responded across 847 practices. We estimated a response rate of 16.4-36.4%.</p><p><strong>Results: </strong>NPs reported that the quality of dementia care in their practices is poorer than the overall care provided. About 45% of NPs indicated that dementia care in their practices is less than \"very good,\" while only 17% reported that the overall care delivered falls below that standard. Additionally, NPs reported significant deficits in practice structural capabilities for dementia care and challenges with administration within their organization. The findings show that over a third of NPs report burnout.</p><p><strong>Conclusions: </strong>Given the projected growth in the number of patients with dementia and the growing workforce of NPs worldwide, policy and practice efforts should be directed toward strengthening primary care practices to provide quality care for dementia patients. Bolstering NP workforce capacity and supporting NP roles in dementia care could improve organizational capacity to provide dementia care. However, widespread burnout among NPs found in our study could undermine their contribution to the dementia care workforce.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"164"},"PeriodicalIF":2.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082501","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":"How to improve support for people with (complex) multiple-problems through social prescribing in a vulnerable neighborhood; professionals', experts-by-experience' and clients' perspectives.","authors":"C Bos, S Vader, N van Vooren, K Jerković-Ćosić, B Keij","doi":"10.1186/s12875-025-02867-1","DOIUrl":"10.1186/s12875-025-02867-1","url":null,"abstract":"<p><strong>Background: </strong>Comparative analysis of literature on social prescribing implementation suggests that strategies for implementing social prescribing for people with (complex) multiple-problems may differ significantly from those for people with mild-psychosocial issues. Similar findings have been observed in the Netherlands, where a SP program has been developed in 2018. This study examines the perspectives of health and care professionals, experts-by-experience, and clients regarding the design and implementation of social prescribing in vulnerable neighborhoods in order to better support people with (complex) multiple-problems.</p><p><strong>Methods: </strong>This study includes the first steps of the participatory action research methodology. During the research, 26 semi-structured interviews and observations were applied to gain insight among professionals, experts-by-experience and clients.</p><p><strong>Results: </strong>The findings indicate that support for people with (complex) multiple-problems requires more than a referral to already existing activities and services. Experts-by-experience and clients highlighted the necessity for a tailored based approach that considers clients' unique circumstances, e.g. the clients' living environment, particularly for those with (complex) multiple-problems and having a multicultural backgrounds. While all participants recognized the importance of addressing wider health needs, they also identified several challenges in doing so. Key themes for improving the support for individuals with (complex)multiple-problems are related to fragmentation due to insufficient collaboration, and to how wider health needs can best be addressed and by whom.</p><p><strong>Conclusion: </strong>While there is a clear willingness to enhance support for people with multiple-problems, findings reveal significant challenges faced by all parties involved. A key issue identified is the mismatch between what clients need and what professionals are able to provide. Ultimately, a tailored approach is essential for effectively addressing the complex and wider health needs of both individuals and populations, in order to improve their overall health and well-being outcomes. This approach may be feasible by providing clients with (complex) multiple-problem with a single case manager as first point of entry.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"165"},"PeriodicalIF":2.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082505","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}