BMC primary care最新文献

{"title":"Perspectives of primary care nurses on the organization of the COVID-19 vaccine rollout: a qualitative study.","authors":"Rhiannon Lyons, Maria Mathews, Lindsay Hedden, Julia Lukewich, Emily Gard Marshall, Jennifer E Isenor, Jamie Wickett, Emilie Dufour, Leslie Meredith, Dana Ryan, Sarah Spencer, Crystal Vaughan, Cheryl Cusack","doi":"10.1186/s12875-025-02747-8","DOIUrl":"10.1186/s12875-025-02747-8","url":null,"abstract":"<p><strong>Background: </strong>Primary care nurses, including nurse practitioners (NPs), registered nurses (RNs), and licensed practical nurses/registered practical nurses (LPNs/RPNs), play a pivotal role in pandemic management and outbreak planning. There is extensive literature surrounding COVID-19 vaccination efforts in Canada; however, limited research addresses the involvement of primary care nurses, as well as the organization and integration of these efforts into primary care settings. This study aimed to describe the organizational challenges, barriers, and facilitators to primary care nurses' roles in COVID-19 vaccination.</p><p><strong>Methods: </strong>As part of a mixed methods case study, we conducted semi-structured qualitative interviews with primary care nurses employed in regions across four Canadian provinces: British Columbia, Ontario, Nova Scotia, and Newfoundland and Labrador. During the interviews, nurses described their activities throughout different phases of the COVID-19 pandemic, factors that facilitated or impeded their efforts, and potential contributions nurses could have made. We applied a thematic analysis approach and analyzed codes related to the organization of the COVID-19 vaccination rollout.</p><p><strong>Results: </strong>We interviewed 76 nurses (24 NPs, 37 RNs, and 15 LPNs/RPNs) between May 2022 and January 2023. We identified five overarching components of the COVID-19 vaccination rollout that influenced primary care nurses' perceptions and experiences: (1) information, (2) training, (3) coordination, (4) integration, and (5) compensation. Participants reported both positive and negative experiences with the vaccine rollout. Rapidly evolving information made it difficult for nurses to stay informed and training for vaccine delivery posed barriers due to time requirements and redundancy. Support was often lacking for new electronic systems, and regional coordination varied, sometimes resulting in miscommunication. Delays in integrating vaccination into primary care, logistical challenges, and disparities in compensation between nurses and physicians also presented challenges.</p><p><strong>Conclusions: </strong>Findings highlight the critical roles of primary care nurses in mass vaccination campaigns, underscoring the need for targeted information, effective training, streamlined coordination, better integration into primary care, and more equitable compensation. Integrating these services into primary care can enhance future vaccination efforts by leveraging nurses' expertise to improve vaccine access and delivery.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"53"},"PeriodicalIF":2.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506518","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":"An evaluation of Scottish green health prescriptions using the APEASE criteria.","authors":"Neil Howlett, Imogen Freethy, Sian Harding, Adam P Wagner, Lisa Miners, Honey Anne-Greco, Laura Lamming, Nigel Lloyd, Katherine E Brown","doi":"10.1186/s12875-025-02746-9","DOIUrl":"10.1186/s12875-025-02746-9","url":null,"abstract":"<p><strong>Background: </strong>Time spent in green space such as parks and forests can have positive effects on physical and mental health. Green Health Partnerships were set up in Scotland to promote use of green space for health improvement. One of the main mechanisms to achieve this was the setup of Green Health Prescriptions (GHPr). This study evaluates three GHPrs in different localities across a range of feasibility elements, and the funding and resourcing associated with implementation.</p><p><strong>Methods: </strong>Interviews were conducted across service user, referrer, link worker, and activity provider groups across Dundee, Highland, and North Ayrshire. Interviews were deductively analysed using the APEASE (Acceptability, Practicability, Effectiveness, Affordability, Spillover effects, Equity) criteria. Data within each APEASE domain was then inductively coded producing more reflexive sub-themes. Data on funding and resources associated with delivering each programme was also collected to provide further context to the APEASE criteria.</p><p><strong>Results: </strong>All stakeholder groups generally found the concept of using green spaces and the GHPr acceptable, and, although service users perceived that staff were often good communicators, there were times where awareness of and knowledge about the GHPr were lacking. There were reported improvements across a wide range of physical and mental health, and social outcomes for service users. The GHPr was also considered affordable in terms of the green health activity sessions. A key issue for staff across practicability, acceptability, and with monitoring equity, was the lack of underpinning IT infrastructure for referrals, communication with link workers, and data capture to reflect on service user progress. As implemented in Dundee, progression through the GHPr, after initial referral, took on average 195 min, at a cost of £64 per service user.</p><p><strong>Conclusions: </strong>This evaluation highlighted the potential benefits for service users that can be realised through a GHPr. However, a lack of supportive systems to capture referral information, communicate between professionals, and document service user progress limits a more robust and extensive evaluation of the current GHPr model.</p><p><strong>Evaluation registration: </strong>Research Registry identifier: researchregistry9069, registration date: 25/04/23.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"50"},"PeriodicalIF":2.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477209","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":"Exploring the impact of three-dimensional patient satisfaction structure on adherence to medication and non-pharmaceutical treatment: a cross-sectional study among patients with hypertension in rural China.","authors":"Meng Zhang, Wenqin Chen, Yanyun Xu, Jiyuan Fang, Yinzi Liu, Xiang Liu, Liyuan Song","doi":"10.1186/s12875-025-02739-8","DOIUrl":"10.1186/s12875-025-02739-8","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a chronic disease that requires strict adherence to therapeutic recommendations. While some studies have shown an association between hypertensive patient satisfaction and treatment adherence, research on the relationship between multi-dimensional satisfaction and patient adherence to medication as well as non-pharmaceutical treatment remains limited. This study aimed to examine the association among multiple dimensions of patient satisfaction and adherence among patients with hypertension in rural China.</p><p><strong>Methods: </strong>The research has a cross-sectional study design. A multi-stage, stratified random sampling approach was employed to survey a cohort of 2350 patients with hypertension in rural China. Patient satisfaction and adherence were measured using the instrument of European Task Force on Patient Evaluation of General Practice (EUROPEP) and the Treatment Adherence Scale for Hypertension Patients (TASHP). Multiple linear regression analysis was performed to identify factors influencing patient adherence, while structural equation modeling (SEM) was conducted to elucidate the relationships among various dimensions of patient satisfaction and adherence.</p><p><strong>Results: </strong>Our findings indicate that patient satisfaction with clinical behavior was positively associated with medication adherence (β = 0.088, p < 0.05) and non-pharmaceutical treatment adherence (β = 0.152, p < 0.01). Patient satisfaction with continuity and cooperation also had a positive influence on medication adherence (β = 0.177, p < 0.01) and non-pharmaceutical treatment adherence (β = 0.134, p < 0.01). However, although patient satisfaction with the organization of care had a negative impact on medication adherence (β=-0.259, p < 0.01), it did not affect non-pharmaceutical treatment adherence. Further, patient adherence was associated by region, age, level of education, course of the disease, and self-reported health status.</p><p><strong>Conclusions: </strong>Our study highlights the importance of understanding the differential effects of patient satisfaction on adherence in rural China. To improve the management of patients with hypertension in rural areas, primary care institutions should focus on enhancing their capacity, improving the level and capabilities of their chronic disease management team members, promoting effective doctor-patient communication, and providing personalized health education.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"51"},"PeriodicalIF":2.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477265","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 of a patient assessment to meet the needs of patients suffering from advanced non-oncological diseases - the KOPAL trial.","authors":"Gabriella Marx, Tina Mallon, Henrikje Stanze, Manuel Zimansky, Nils Schneider, Friedemann Nauck, Martin Scherer, Nadine Pohontsch","doi":"10.1186/s12875-025-02750-z","DOIUrl":"10.1186/s12875-025-02750-z","url":null,"abstract":"<p><strong>Background: </strong>Patients suffering from progressive non-oncologic chronic diseases are primarily treated in primary care. Early integration of palliative care (PC) can improve patients' quality of life and reduce burdensome physical symptoms. To guide interprofessional counselling between GPs and specialist palliative home care teams, we developed an aide memoire for patients diagnosed with advanced non-oncological chronic diseases, the KOPAL conversation guide, as part of the KOPAL trial. The aim of this study was to ensure the conversation guide covers all relevant care aspects in order to reveal individual gaps and needs in healthcare.</p><p><strong>Methods: </strong>We conducted three focus groups including four patients, seven health care providers, and five stakeholders. During each group, a draft of the conversation guide was discussed, revised, and consented from the respective perspectives.</p><p><strong>Results: </strong>The final KOPAL conversation guide contains eight key topics: living with the illness, physical, emotional, personal, and social situation, information and communication, control and autonomy, emergency management. Each topic refers to a number of related subtopics listed in each respective thematic section. The conversation should start with the introductory question referring to the patient's current well-being. At the end, patients are asked to state their primary concern based on the conversation.</p><p><strong>Conclusions: </strong>The KOPAL conversation guide is a broad evaluation and communication tool. It covers potential PC needs of non-oncological patients and provides a basis for interprofessional case planning, and counselling. Applying the guide may help to bridge gaps in communication between general and specialist PC professionals as well as between professionals and patients.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"52"},"PeriodicalIF":2.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477258","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":"Correction: Patient experiences in primary care do not differ according to rurality: a cross-sectional study.","authors":"Makoto Kaneko, Hironori Yamada, Tadao Okada","doi":"10.1186/s12875-025-02752-x","DOIUrl":"10.1186/s12875-025-02752-x","url":null,"abstract":"","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"49"},"PeriodicalIF":2.0,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477252","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":"Identifying the needs of natural caregivers caring for a person with dementia: a mixed method study.","authors":"Clarisse Dibao-Dina, Nasri Lydia, Dagot Céline, Fouquet Jean-Philippe, Rideau Sophie, Dumas Vincent, Neff Guillaume, Payen Véronique, Rube-Millon Delphine, Lemaile Marie, Nkodo Jacques-Alexis, Camus Vincent, Fougère Bertrand, Giraudeau Bruno, Beauchamp Dominique, Foucault Fruchard Laura, Renoux Cécile, Robert Jean","doi":"10.1186/s12875-025-02724-1","DOIUrl":"10.1186/s12875-025-02724-1","url":null,"abstract":"<p><strong>Background: </strong>Many available interventions to reduce challenges of natural caregivers of people living with dementia have limited efficacy since they do not meet the caregiver's individual needs. This study aims to evaluate caregivers' needs with the future goal of developing a tailored, multicomponent intervention to ease caregiver challenges through appropriate caregiver-centred interventions.</p><p><strong>Methods: </strong>Mixed method study using a convergent design with quantitative and qualitative data collection and analysis performed at similar times. For the cross-sectional quantitative study, questionnaires were sent to natural adult caregivers of a person with dementia identified by local healthcare professionals and general practitioners exercising in a rural and an urban department. For the qualitative descriptive study, individual caregiver interviews and healthcare professional focus groups were conducted in two primary healthcare territories in both departments. Data about screening for caregiver challenges and any help provided to the caregiver were collected. Quantitative data were analysed using descriptive statistics and qualitative data underwent thematic analysis using the grounded theory approach. Quantitative and qualitative results were described using a narrative discussion approach, then results were combined on a theme-by-theme basis using the weaving approach enabling integrated analysis.</p><p><strong>Results: </strong>A total of 199 general practitioners and 67 caregivers participated in the quantitative study. In the qualitative study, 10 caregivers from the urban area and 12 caregivers from the rural area participated in the individual interviews, and 9 healthcare professionals participated in the focus groups. Our broad categories of caregiver needs were identified: awareness and early diagnosis, information and training, practical, coordinated support, and psychological support. The integrated analysis highlighted areas for improvement in meeting these needs, especially a better identification of the caregiver role, caregiver distress, better information about what the caregiver has to expect in terms of the disease's progression and daily management, ways to improve awareness in general population, acceptation of practical support and its coordination and adaptation.</p><p><strong>Conclusions: </strong>Identified needs were concordant with those in the literature. The mixed method used enabled expectations to be explored by analysing together the points of view of both patients and healthcare professionals in order to identify ways of improving their care.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"48"},"PeriodicalIF":2.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473371","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":"Why patients fail to seek information on OTC product interactions with a direct-acting oral anticoagulant: perspectives on information-seeking.","authors":"Marley P D Magee, Janice B Schwartz, Amanda McArthur, Ruey-Ying Liu, Derjung M Tarn","doi":"10.1186/s12875-025-02740-1","DOIUrl":"10.1186/s12875-025-02740-1","url":null,"abstract":"<p><strong>Background: </strong>Many patients taking direct-acting oral anticoagulants (DOACs) also consume over-the-counter (OTC) products (dietary supplements and OTC medications), yet many lack knowledge of potential interactions that may increase or decrease DOAC efficacy and may not seek information about OTC products. The objective of this study was to describe patient attitudes and beliefs that inhibited information seeking about potential apixaban-OTC product interactions.</p><p><strong>Methods: </strong>Participants included English-, Spanish-, Mandarin-, and Cantonese-speaking adults from two large academic medical centers who reported taking apixaban (a frequently prescribed DOAC) in the past month. Thematic analysis was performed on semi-structured interviews.</p><p><strong>Results: </strong>Sixty patients aged 24-93 years (mean = 65.3; SD = 15.6) were interviewed; 55% were women. Participants took a total of 236 OTC products. Those with potential interactions with apixaban warranting consideration for therapy modification included: ibuprofen (n = 14; 5.9%), aspirin (n = 8; 3.4%), and naproxen (n = 3; 1.3%). Interviews revealed 5 major themes related to a lack of information-seeking about OTC products: (1) patients lack awareness of the potential for interactions; (2) patients believe that OTC products are safe and/or regulated (largely because they were familiar with the products, had previously taken them, or assumed that dietary supplements were regulated by the Food and Drug Administration); (3) patients believe that providers are responsible for alerting patients about potential interactions (as patients assumed that providers were aware of their OTC product use); (4) patients had prior knowledge of and/or used OTC products infrequently; and (5) obtaining information can be inconvenient. Inquiries regarding preferred information sources revealed 59 (98.3%) patients most frequently sought or would seek information from physicians and 34 (56.7%) from the internet.</p><p><strong>Conclusions: </strong>Patients taking apixaban raised reasons for not seeking information about potential OTC product interactions that included poor awareness, perceptions regarding the safety of OTC products, and beliefs in provider responsibility for informing them about interactions. Greater patient education is needed regarding the potential for OTC product-DOAC interactions and the regulation of OTC products, particularly dietary supplements.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"47"},"PeriodicalIF":2.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473372","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":"Knowledge, Attitudes, and Practices of General Physicians towards Mild Cognitive Impairment amidst an evolving era of Interprofessional Collaboration: Insights from a small-scale survey in India.","authors":"Aarushi Soni, Prajith Carthik, Manoj Kumar Devara, Aysha Rooha, Gagan Bajaj, Sheetal Raj Moolambally, Arun Shirali, Archith Boloor","doi":"10.1186/s12875-025-02748-7","DOIUrl":"10.1186/s12875-025-02748-7","url":null,"abstract":"<p><strong>Background: </strong>Early identification and intervention of Mild Cognitive Impairment (MCI), led by General Physicians (GPs), can delay dementia onset and enhance patient outcomes. GPs recognize MCI risk factors, conduct assessments, and manage associated conditions, playing a crucial role in cognitive pathology intervention, especially in the era of Interprofessional Collaboration (IPC). In India, where cognitive impairment rates are projected to rise sharply, understanding GPs' knowledge, attitudes, and practices (KAP) is vital. This study aimed to investigate the KAP of GPs regarding the diagnosis and treatment of MCI using a customized, predesigned questionnaire.</p><p><strong>Method: </strong>The study employed a cross-sectional design using a convenience sample of 180 invited participants between July and October 2023. A customized questionnaire, based on Lu et al., 2022, evaluated GPs' KAP regarding MCI and IPC in the Indian context towards its assessment and management. The tool including 9 knowledge items, 15 attitude items, and 12 practice items, was made available through Google Forms and disseminated via WhatsApp. Responses were scored to indicate KAP levels, with maximum scores being 50 for knowledge, 75 for attitudes, and 60 for practices.</p><p><strong>Results: </strong>103 GPs completed the survey, showing varied practice experience. The average knowledge score was 28.1 ± 7.98, indicating uncertainty about MCI-related factors and diagnostic criteria. Attitude scores averaged 53.5 ± 4.73, with most GPs endorsing early detection and non-pharmacological interventions. Practice scores averaged 41.8 ± 8.32, showing mixed adherence to screening and referral practices. Most participants found IPC highly effective for MCI diagnosis and management, with many referring patients to specialists for confirmation, while over half used an IPC approach for both. Education level and previous experience significantly influenced knowledge and practice scores.</p><p><strong>Conclusion: </strong>This study sheds light on the evolving landscape of Indian GPs' KAP related to MCI assessment and management. It identifies areas where understanding could be strengthened and highlight opportunities for growth through education and training. Notably, there is a need for increased involvement in IPC. These findings emphasize the importance of holistic approaches, advocating for enhanced education and the fostering of collaborative relationships across disciplines to tackle the rising prevalence of MCI in India effectively.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"46"},"PeriodicalIF":2.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460961","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":"Adherence to pharmacological therapy for hypertension in Portugal: a health professionals focus groups study.","authors":"Beatriz Rosendo-Silva, João Gonçalves, Filipe Prazeres, Luiz Miguel Santiago, Inês Rosendo","doi":"10.1186/s12875-025-02705-4","DOIUrl":"10.1186/s12875-025-02705-4","url":null,"abstract":"<p><strong>Introduction: </strong>The perspectives of local healthcare professionals for developing effective strategies to enhance medication adherence in arterial Hypertension as well as its barriers have not yet been explored through qualitative research in Portugal.</p><p><strong>Objectives: </strong>This study aimed to assess the views of healthcare professionals including general practitioners/family physicians, nurses, and community pharmacists, from Portugal on effective strategies to improve medication adherence in Hypertension, and to identify factors hindering pharmacological adherence.</p><p><strong>Methods and analyses: </strong>This was a qualitative study with synchronous online focus groups, in which, the participants were general practitioners/family physicians, family nurses, or community pharmacists in Portugal with experience managing patients with Hypertension. They were selected based on age, sex, and geographical region with the number of focus groups determined by theoretical saturation. Recruitment was facilitated through specific mailing lists. Purposive and snowball sampling techniques were employed. Focus group discussions were recorded and transcribed. Two researchers conducted content analyses via MAXQDA^®2023, applying comparative analysis and reaching consensus. The results are described narratively.</p><p><strong>Results: </strong>Three focus group discussions revealed a multifaceted approach to improving medication adherence for Hypertension. Key strategies to enhance coordination and communication among healthcare professionals, patients, and caregivers were identified. These included shared informatics software among healthcare professionals; using mobile applications and wearables; health literacy initiatives and patient empowerment; preprepared medication in pillboxes; involving family and the concept of a \"family pharmacist\". Participants highlighted barriers to medication adherence such as the lack of communication with patients concerning issues like medication adherence.</p><p><strong>Conclusions: </strong>This qualitative study outlines strategies to improve medication adherence among patients with Hypertension in Portugal. These involve improving healthcare coordination and communication, patient empowerment, and involving family and \"family pharmacists\" in supporting adherence. These strategies are based on the insights of healthcare professionals and could be implemented following robust intervention studies.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"44"},"PeriodicalIF":2.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450967","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 involvement of specialists in primary healthcare teams for managing diabetes: a systematic review and meta-analysis.","authors":"Jia Li, Zhihan Xu, Huilan Zhou, Zhansheng Li, Beibei Yuan","doi":"10.1186/s12875-025-02743-y","DOIUrl":"10.1186/s12875-025-02743-y","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus requires ongoing management and care coordination. The majority of patients with diabetes were managed in primary healthcare settings. Several quality improvement programs have introduced specialist involvement in primary healthcare teams. However, synthesized evidence is needed to support policy improvements regarding the impact of specialist-primary healthcare coordination on glycemic control in diabetes care.</p><p><strong>Objective: </strong>This systematic review and meta-analysis aimed to assess the effectiveness of specialist involvement in primary healthcare teams on glycemic control of patients with diabetes.</p><p><strong>Methods: </strong>A search of five electronic databases (PubMed, Embase, Web of Science Core Collection, CNKI, and Wanfang Database) was conducted to identify relevant studies published until October 21st, 2023. We assessed the methodological quality of the included studies using the suggested risk of bias criteria for EPOC (Cochrane Effective Practice and Organization of Care). We conducted the certainty assessment using the GRADE guideline. The outcome measured was the HbA1c level. Meta-analyses were performed using random-effects models.</p><p><strong>Results: </strong>A total of 12 studies (7 randomized controlled trials and 5 controlled before-after studies) were included in the meta-analysis. The involvement of specialists in primary healthcare teams was associated with a statistically significant reduction in HbA1c level compared to usual or standard care (mean difference - 0.57, 95% CI: -0.86 to -0.27, I² = 88.17%).</p><p><strong>Conclusion: </strong>The findings revealed that the interventions might improve the care delivered and patients' health outcomes. However, due to the very low certainty of evidence on the effectiveness on glycemic control, the interventions implemented in the included studies should be employed with caution in future policy-making to achieve improved HbA1c levels. Further research with a more rigorous design is needed to provide evidence of higher certainty and quality.</p><p><strong>Registration: </strong>The systematic review and meta-analysis was registered in the PROSPERO International Prospective Register of Systematic Reviews (registration No. CRD42022384589 available at https://www.crd.york.ac.uk/prospero/#searchadvanced ).</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"45"},"PeriodicalIF":2.0,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450973","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}