BMC primary care最新文献

{"title":"Closing the hypertension gap with ABPM: a primary care quality-improvement study.","authors":"S Bhat, W Cullen, T Heffernan, D Molony","doi":"10.1186/s12875-026-03427-x","DOIUrl":"10.1186/s12875-026-03427-x","url":null,"abstract":"<p><strong>Background: </strong>Hypertension remains substantially underdiagnosed and undertreated globally, with ambulatory blood pressure monitoring (ABPM) - the gold standard for hypertension diagnosis - significantly underutilised in primary care. Nurse-led protocols offer a scalable approach to closing these gaps, yet evidence from rural Irish general practice is limited.</p><p><strong>Methods: </strong>This retrospective paired clinical audit reviewed electronic health records of 706 adults aged ≥ 25 years with clinic systolic blood pressure ≥ 150 mmHg or a coded ICPC-2 diagnosis of hypertension at a single rural Irish general practice. In November 2019, a nurse-led clinical practice pathway based on ESH and NICE guidelines was implemented in the practice, empowering practice nurses to independently initiate ABPM referrals, deliver lifestyle counselling, and coordinate follow-up. Data were then collected pre-protocol (November 2017 to 2019) and post-protocol (November 2019 to 2022) to assess changes in HTN diagnosis and management. Paired categorical outcomes were compared using McNemar's test with Bonferroni correction; continuous outcomes were compared using the Wilcoxon signed-rank test.</p><p><strong>Results: </strong>ABPM utilisation rose by more than 10% (57.1% to 69.0%), enabling more accurate diagnosis and treatment decisions. Coded hypertension diagnoses rose from 78.9% to 83.9%, and the proportion achieving guideline-recommended BP targets improved from 37.7% to 44.1%. Antihypertensive therapy was meaningfully intensified: ACEi/ARB and calcium channel blocker prescribing increased significantly, and the mean number of medication classes rose from 1.88 to 2.18. Post-protocol analysis identified a sequence of associations linking ABPM uptake to new hypertension diagnosis (OR 6.60) and new diagnosis to antihypertensive prescribing (OR 5.45).</p><p><strong>Conclusions: </strong>A nurse-led protocol centred on ABPM as the diagnostic cornerstone was associated with significant improvements in hypertension diagnosis and treatment in a rural Irish primary care setting, sustained throughout the COVID-19 pandemic. These findings support wider evaluation of nurse-led, ABPM-integrated models as a practical approach to closing the hypertension treatment gap in primary care.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450909","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":"Resilience and adaptation of public healthcare centers to climate change in Northern Jordan.","authors":"Rami Saadeh, Mays Alghizzawi, Mohammed Z Allouh","doi":"10.1186/s12875-026-03471-7","DOIUrl":"10.1186/s12875-026-03471-7","url":null,"abstract":"<p><strong>Background: </strong>Climate change (CC) is a global phenomenon significantly influenced by human activities. As CC-related hazards are increasing rapidly, effective adaptation and resilience measures are urgently needed to manage these hazards. The purpose of this study is to assess the resilience and adaptation of healthcare centers (HCs) in Northern Jordan to CC-related hazards.</p><p><strong>Methods: </strong>An explanatory mixed-method design was employed in this study, using a structured closed-ended questionnaire and an interview guide. The questionnaire consisted of seven sections: baseline characteristics of centers; risk recognition; service delivery; workforce; water, sanitation, and healthcare waste management; infrastructure; and energy. A convenience sampling approach was used to collect quantitative data from 67 HCs in 4 governorates. Further, a purposive sample of 15 HCs' directors were interviewed to collect qualitative data.</p><p><strong>Results: </strong>Climate resilience of HCs in Northern Jordan was significantly low. The percentage of HCs with high resilience levels was only 16.4% (n = 11), including eight comprehensive HCs and three primary HCs. The percentages of HCs with high resilience levels for (1) risk recognition, (2) service delivery, (3) workforce, (4) water, sanitation, and healthcare waste management, (5) infrastructure, and (6) energy were 13.4%, 50.7%, 31.3%, 37.3%, 14.9%, and 9%, respectively. Three main themes were identified from the interviews: (1) perceptions of climate change and its health impacts, (2) the role of HCs in addressing climate change, and (3) challenges and constraints in enhancing climate change resilience.</p><p><strong>Conclusion: </strong>This study identified significant gaps in HCs' resilience to climate-related risks. Key weaknesses were observed in energy supply, risk recognition, and infrastructure. Some strengths were identified, particularly in service delivery. There is a pressing need for multisectoral cooperation, climate-related legislation, and training initiatives to improve adaptiveness and build a resilient healthcare system.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148439163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of health literacy and attitudes toward artificial intelligence in the acceptance of telemedicine services among adults in Turkey: a cross-sectional study.","authors":"Furkan Şakiroğlu, Ertuğrul Çoruh, Muhammet Doğan, İdeal Beraa Yılmaz Kartal, Mehmet Akif Nas","doi":"10.1186/s12875-026-03470-8","DOIUrl":"10.1186/s12875-026-03470-8","url":null,"abstract":"<p><strong>Background: </strong>The digital transformation in healthcare has led to an increase in the use of telemedicine and artificial intelligence (AI)based applications. This study aims to examine the associations between e-health literacy, attitudes toward AI, and acceptance of telemedicine, and to test whether attitudes toward AI statistically mediate the association between e-health literacy and acceptance of telemedicine.</p><p><strong>Methods: </strong>Our study was conducted between January 1 and March 1, 2026. This cross-sectional study included 277 participants who visited a family health center. Data were collected using a sociodemographic information form, the General Attitude Scale toward Artificial Intelligence in Health Services, the Attitude Scale toward Telemedicine, and the e-Health Literacy Scale. Hierarchical regression analysis and mediation analysis using the bootstrap method (5,000 resamples) were performed.</p><p><strong>Results: </strong>The mean age of the participants was 30.52 ± 9.95, and 57.4% were female. In the hierarchical regression analysis, e-health literacy (β = 0.28, p < .001) and a positive attitude toward AI (β = 0.23, p = .010) were found to positively predict telemedicine acceptance, while a negative attitude toward AI (β = -0.28, p = .002) was found to negatively predict it. In the mediation analysis, it was determined that e-health literacy has a strong direct effect on telemedicine acceptance (β = 0.545, p < .001), but AI attitudes do not play a mediating role in this relationship (p > .05).</p><p><strong>Conclusion: </strong>E- health literacy is a strong and direct determinant of telemedicine acceptance, independent of attitudes toward AI. Negative attitudes toward AI were associated with lower acceptance of telemedicine services. The results of our study suggest that strategies aimed at improving e- health literacy and addressing AI related concerns may be effective in promoting the widespread adoption of telemedicine, particularly in primary care settings.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431613","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":"Comparing the quality of video and phone consultations in primary care telemedicine: a cross-sectional study of over 180,000 appointments.","authors":"Daniel Beirão, Filipe Freitas Pinto, João Magalhães, Carlos Franclim Silva, Bernardo Sousa-Pinto, Ana Luísa Neves, Paulo Santos","doi":"10.1186/s12875-026-03454-8","DOIUrl":"10.1186/s12875-026-03454-8","url":null,"abstract":"<p><strong>Background: </strong>Telemedicine has gained prominence in primary care, but evidence comparing its modalities is scarce.</p><p><strong>Methods: </strong>We conducted a cross-sectional study of 184,308 video and phone consultations from a telemedicine platform in Portugal, comparing quality indicators based on the Institute of Medicine (IOM) domains.</p><p><strong>Results: </strong>Video consultations were associated with lower recurrence rates, higher patient-reported helpfulness (95.4% vs. 92.3%), and greater satisfaction. Time to appointment was shorter for phone consultations, but video had a longer duration.</p><p><strong>Conclusions: </strong>In this cross-sectional analysis, video consultations were associated with higher patient-reported helpfulness and lower short-term recurrence than telephone consultations, while telephone offered faster access. Because telephone users were substantially older and the dataset lacked measures of comorbidity, illness severity, and socioeconomic status, these associations are likely confounded by indication and should not be read as causal evidence of superior quality. The findings nonetheless point to differences between modalities and to the importance of equitable access to information-richer consultations.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13651062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148439143","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":"Prevalence and factors associated with controlled blood pressure among hypertensive patients in a Malaysian primary health clinic-a cross-sectional study.","authors":"A'qilah Baharudin, Faiz Baharudin, Aneesa Abdul Rashid","doi":"10.1186/s12875-026-03447-7","DOIUrl":"10.1186/s12875-026-03447-7","url":null,"abstract":"<p><strong>Background: </strong>Controlled Blood pressure (BP) in hypertensive patients is essential in reducing the risk of cardiovascular diseases. Even a slight reduction in BP control may significantly improve cardiovascular outcomes. Several factors have been associated with controlled BP. We aimed to determine the prevalence of controlled BP among hypertensive patients and its associated factors in a Malaysian primary health clinic.</p><p><strong>Method: </strong>A cross-sectional study was conducted among Malaysian adults aged 18 years and above with underlying hypertension who attended a public healthcare clinic located in a suburban area of Melaka, Malaysia, from December 2024 to February 2025. Participants were selected via systematic random sampling. Data were collected through self-administered questionnaires, medical records, and clinical blood pressure measurement. Blood pressure control status was determined based on clinic blood pressure readings measured during visits. Documented home blood pressure monitoring (HBPM) records, when available in the medical records, were reviewed as supplementary clinical information. A multiple logistic regression was conducted to determine the factors associated with controlled blood pressure.</p><p><strong>Results: </strong>A total of 460 hypertensive patients were included in this study, with a response rate of 96.8%. Only 41.5% of the participants (n = 191) had controlled BP. The median age was 64 (IQR:17) and the majority were female (57.4%, n = 264). The significant factors associated with controlled blood pressure among the study population were increasing age (aOR = 1.037, 95% CI [1.018,1.057], p < 0.001), female gender (aOR = 2.092, 95% CI [1.388,3.151], p < 0.001), participants who took one or two anti-hypertensive (aOR = 1.921, 95% CI [1.145,3.224],p = 0.013) and (aOR = 2.830, 95% CI [1.637,4.895], p < 0.001) respectively, participants without diabetes (aOR = 1.689, 95% CI [1.112,2.566], p = 0.014), and participant who had documented HBPM (aOR = 4.489, 95% CI [2.337,8.623], p < 0.001).</p><p><strong>Conclusions: </strong>The findings suggest that the prevalence of controlled blood pressure, 41.5% is still low among the study population. Controlled blood pressure was associated with increasing age, female gender, patients on fewer than three antihypertensive medications, hypertensive patients without diabetes mellitus, and those who have documented home blood pressure monitoring.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426933","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, attitude and practice towards oral anticoagulants: a cross-sectional study among healthcare professionals in Nigeria.","authors":"Edidiong Orok, Segun Johnson Showande","doi":"10.1186/s12875-026-03474-4","DOIUrl":"10.1186/s12875-026-03474-4","url":null,"abstract":"<p><strong>Background: </strong>Oral anticoagulants (OACs) are essential for managing thromboembolic disorders. Good knowledge, attitude, and practice of healthcare professionals (HCPs) can ensure the safe and effective use of these medicines in patients. This study assessed the knowledge, attitude, and practice of OACs use by HCPs in Nigeria and identified the predictors associated with these factors.</p><p><strong>Methods: </strong>The study was a nationwide cross-sectional study conducted via a structured questionnaire disseminated via online and physical methods. Knowledge (18 items) was assessed through multiple-choice questions, while attitude (7 items) and practice (8 items) were measured using Likert scale items. Knowledge and practice scores were categorised as good (≥ 70%), fair (> 40 - <70%), or poor (< 40%), while attitude was grouped as positive (≥ 70%), neutral (> 40 - <70%), or negative (< 40%). Multiple linear regression was carried out to determine the predictors of knowledge, attitude, and practice of the HCPs.</p><p><strong>Results: </strong>A total of 687 HCPs [nurses (280, 40.8%), pharmacists (273, 39.7%), and physicians (134, 19.5%)] participated. Most of the HCPs showed fair knowledge (physicians 67 (50.0%), pharmacists 143 (52.4%), nurses 172 (61.4%)), positive attitude (physicians 113 (84.3%), pharmacists 254 (93.1%), nurses 216 (77.1%)) and good practice (physicians 97 (72.4%), pharmacists 191 (70.0%), nurses 190 (67.9%)) regarding OAC usage. Nurses had significantly lower knowledge (B = - 0.783, p = 0.035) and attitude scores (B = - 1.059, p = 0.004) than pharmacists, whereas physicians had comparable knowledge (B = 0.267, p = 0.475) and attitude scores (B = 0.354, p = 0.304). Prior training was associated with higher knowledge (B = 1.228, p < 0.001) and practice (B = 1.339, p = 0.002) scores of OAC use among HCPs.</p><p><strong>Conclusion: </strong>Most healthcare professionals reported fair knowledge, positive attitude, and good practice toward oral anticoagulant use. Prior training and profession type were significant predictors. Targeted training programs are essential to improve competency and ensure optimal patient care in the use of OACs.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426992","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 of good consultations in primary health care clinics in Botswana: a qualitative study of patients' and doctors' views.","authors":"V Setlhare, S Madiba","doi":"10.1186/s12875-026-03473-5","DOIUrl":"10.1186/s12875-026-03473-5","url":null,"abstract":"<p><strong>Background: </strong>The behaviours and attributes of doctors affect the quality of consultations. Although good consultations improve the quality of care, there is a dearth of evidence on factors that facilitate good consultations.</p><p><strong>Aim: </strong>The aim of the study was to explore factors that facilitate good consultations in Botswana public primary healthcare (PHC) clinics from the perspective of doctors and patients.</p><p><strong>Setting: </strong>We conducted the study in public (PHC) clinics in four health districts of Botswana. Patients with a wide range of acute and chronic diseases sought health care from these clinics. Nurses, pharmacists, and non-specialist doctors were some of the healthcare (HCWs) who gave services to these patients.</p><p><strong>Methods: </strong>This was a qualitative study in which consenting adult participants (doctors and patients) with consultation experience were purposively selected to ensure variety in age, gender, work experience, place of residence, education and employment status. Participants were recruited from public PHC clinics in several health districts in Botswana. Audiotaped semi-structured interviews were used to collect data, until saturation. Data were analysed for themes.</p><p><strong>Results: </strong>Seventeen doctors and 32 patients participated in this study. Thematic analysis of the data showed that participants thought the facilitators of good consultations were, creating a conducive environment for the consultation, providing enough time for the consultation, continuity of care, effective communication, and creating an environment to maintain confidentiality.</p><p><strong>Conclusion: </strong>The facilitators of good consultations included creating rapport between doctors and patients, improving the ambience of the consultation rooms, ensuring continuity of care, maintaining effective and mutually acceptable communication, and satisfying patients' desire for the confidentiality of consultations. On deep reflection, we can see that these facilitators are subject to central government, local government, clinic, and individual level factors. These factors interact with each other and are subsumed in a complex interactive health system.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13647736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426927","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":"Even the COVID-19 pandemic didn´t change anything: insights from a trend study on the cooperation of general practitioners and occupational health physicians in Germany.","authors":"Monika A Rieger, Anke Wagner, Martina Michaelis, Stefanie Joos, Stefan Wilm","doi":"10.1186/s12875-026-03463-7","DOIUrl":"10.1186/s12875-026-03463-7","url":null,"abstract":"<p><strong>Background: </strong>The working fields of general practitioners (GPs) and occupational health physicians (OHPs) overlap manifoldly. Yet, cooperation between both groups is often scarce as has been revealed by studies from several countries. During the COVID-19 pandemic, GPs dealt with many work-related counselling topics. We conducted a trend study surveying German GPs and OHPs in 2014/2015 (GPOP-0 study) and 2023/2024 (GPOP-Trend) to analyse trends regarding a potential change of attitudes towards interdisciplinary cooperation over time, before and after the COVID-19 pandemic.</p><p><strong>Methods: </strong>The trend study used repeated cross-sectional surveys and an identical questionnaire for GPs and OHPs, which was sent by postal mail to both groups. The questionnaire covered topics regarding cooperation and attitudes towards both professional groups, as well as questions to assess the perceived quality of cooperation with regard to counselling purposes specific for the COVID-19 pandemic (only in GPOP-Trend). The statistical analysis followed a prior published analysis plan, and comprised an exploratory factor analysis, Mann-Whitney U tests, and regression analyses.</p><p><strong>Results: </strong>More than 1,000 physicians took part in both surveys (GPOP-0: 585 GPs and 473 OHPs, response rate 35%; GPOP-Trend: 482 GPs and 532 OHPs, response rate: 30%). We identified hardly any cooperation between these two groups during the COVID-19 pandemic. In cases where cooperation took place, it was rated more positively by OHPs than by GPs in retrospect. Comparing the total survey data of both time points revealed that attitudes among GPs and OHPs changed only little over time. The strongest predictor for the attitudes surveyed was the variable \"professional group\" in all regression models. This predictor was also the most relevant, when investigating the influence of different variables during the COVID-19 pandemic on attitudes towards cooperation of GPs and OHPs.</p><p><strong>Conclusions: </strong>Socialization within a professional group seems to be the determining factor, and therefore attitudes remain stable as described by Social Identity Theory. We assume that interventions that focus solely on strengthening cooperation between GPs and OHPs therefore have only a very limited effect. We therefore suggest another approach with interventions targeting primarily on patient outcomes and the design of clear interfaces or clinical pathways.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13374197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414178","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":"Triglyceride-glucose index normalized by waist circumference and life's simple 7 to identify high-risk hypertensive patients in primary care.","authors":"Ana María Armas-Padrón, Miriam Sicilia-Sosvilla, Ana Perdomo-Ramírez, Pedro Ruiz-Esteban, Armando Torres, Domingo Hernández","doi":"10.1186/s12875-026-03457-5","DOIUrl":"10.1186/s12875-026-03457-5","url":null,"abstract":"<p><strong>Background: </strong>Hypertension affects over one billion adults and remains the leading contributor to global cardiovascular mortality. The triglyceride-glucose index normalized by waist circumference (TyG-WC) is emerging as a surrogate measure of insulin resistance and visceral adiposity, both associated with metabolic disorders and higher cardiovascular risk. Ideal cardiovascular health metrics (CVHM) from the American Heart Association's Life's Simple 7 (LS7) are strongly associated with reduced cardiovascular risk. Previous analyses from this cohort also demonstrated significant associations between LS7-derived CVHM and adverse clinical outcomes. However, it remains unclear whether TyG-WC provides additional and complementary prognostic information beyond LS7 in hypertensive patients. Therefore, the prognostic value of assessing the TyG-WC index together with the LS7 score to identify high-risk hypertensive patients in primary care remains largely unexplored.</p><p><strong>Methods: </strong>We conducted a longitudinal cohort study of 243 hypertensive adults from a primary-care center in Tenerife, Spain. Baseline TyG-WC index, LS7 metrics, anthropometric variables, biochemical parameters, and comorbidities were recorded. Outcomes included hypertension-mediated organ damage (HMOD) and related comorbidities (HRC), all-cause hospitalization, and mortality. Participants were followed for a minimum of two years, with HMOD-HRC, all-cause hospitalization, and all-cause mortality data updated through September 2025. Logistic regression analyses evaluated the independent associations of TyG-WC and CVHM with the adverse composite outcome (HMOD-HRC, hospitalization, and death).</p><p><strong>Results: </strong>Higher TyG-WC quartiles were associated with the composite outcome: OR 2.23 (Q2), 2.96 (Q3), and 5.12 (Q4) versus Q1. Associations between CVHM scores and clinical outcomes were consistent with previous findings from this cohort. Only 10.7% of participants achieved 4-5 ideal LS7 metrics, whereas 41.2% had 0-1. Higher CVHM scores were also associated with lower body mass index, waist-to-height ratio, fasting glucose, triglycerides, hs-CRP, and with a lower prevalence of diabetes and cardiovascular disease. TyG-WC increased progressively across poorer CVHM categories.</p><p><strong>Conclusions: </strong>Elevated TyG-WC independently predicted HMOD-HRC, hospitalization, and all-cause mortality. The associations observed for LS7-derived cardiovascular health metrics were consistent with previous reports from this cohort. Assessing both TyG-WC and LS7 may strengthen cardiometabolic risk stratification in hypertensive primary-care populations.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426997","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":"Caregiver's burden and their relationship to physical activity, exercise self-efficacy, perceived exercise benefits and barriers in caregivers of children with autism spectrum disorder.","authors":"Güllü Aydın Yağcıoğlu, Ayşe Kübra Söyler, Kübra Ersoy Temiz, Turan Emre Özdemir, Berkan Torpil","doi":"10.1186/s12875-026-03468-2","DOIUrl":"10.1186/s12875-026-03468-2","url":null,"abstract":"<p><strong>Background: </strong>Caregivers of children with autism spectrum disorder (CwASD) often face high levels of stress, emotional exhaustion and physical strain due to the complex and demanding nature of caring for a child with special needs. As caregivers' well-being may contribute positively to caregiving and thus reduce caregiver burden, there is a need for studies that elucidate the factors associated with caregiver burden. Therefore, this study aims to examine the relationship between caregiving burden and physical activity, exercise self-efficacy, and perceived exercise benefits and barriers in caregivers of CwASD.</p><p><strong>Methods: </strong>The study population consisted of primary caregivers of a CwASD for at least 1 year. Caregiving burden was assessed using the Zarit Caregiver Burden Scale, physical activity using the International Physical Activity Questionnaire-Short form (IPAQ-SF), exercise self-efficacy using the Exercise Self-Efficacy Scale, and perceived exercise benefit using the Exercise Benefits/Barriers Scale. The relationship between caregiver burden and other parameters was analysed.</p><p><strong>Results: </strong>The study included 55 participants. There was no relationship between caregiver burden and IPAQ-SF, exercise self-efficacy scale, and exercise benefit/barriers scale in caregivers of CwASD (p>0.05). In addition, the caregiving burden was associated with the number of children in the family and duration of care (r: 0.35; p<0.05). According to linear regression, the overall model was not statistically significant (p>0.05) and explained 16.7% of the variance in caregiver burden.</p><p><strong>Conclusions: </strong>The current findings suggest that the burden experienced by caregivers of CwASD may be influenced by factors beyond those related to physical activity. Further research is needed to identify additional determinants of caregiver burden and develop more targeted support approaches.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148426983","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}