BMC primary care最新文献

{"title":"A screening question to assess risk of using antibiotics without a prescription: a diagnostic study.","authors":"Ashley Collazo, Eva Amenta, Kiara Olmeda, Marissa Valentine-King, Lindsey Laytner, Azalia Mancera, Roger Zoorob, Michael K Paasche-Orlow, Richard L Street, Barbara W Trautner, Larissa Grigoryan","doi":"10.1186/s12875-025-02811-3","DOIUrl":"https://doi.org/10.1186/s12875-025-02811-3","url":null,"abstract":"<p><strong>Objectives: </strong>Non-prescription antibiotic use (using antibiotics without medical advice) is potentially unsafe and promotes antimicrobial resistance. We studied predictors of prior non-prescription use and whether screening for prior non-prescription antibiotic use predicted intention of future non-prescription antibiotic use.</p><p><strong>Methods: </strong>The survey was performed from January 2020 - June 2021 in six public primary care clinics and two private emergency departments. Prior non-prescription users were respondents who reported taking oral antibiotics for symptoms without contacting a clinician. Intended use was defined by answering yes to the question, \"would you use antibiotics without contacting a doctor/nurse/dentist/clinic.\" We examined predictors for prior non-prescription use. We also calculated the sensitivity, specificity, and positive and negative predictive value (PPV, NPV) of (a) any prior non-prescription antibiotic use and (b) prior use in the past 12 months - for future intended non-prescription use.</p><p><strong>Results: </strong>Of 564 survey respondents, 246 (43.6%) reported non-prescription use; 91 (37.0%) of these respondents, 16.1% overall, reported doing so in the past 12 months. Approximately 63% of non-prescription antibiotic use was in those with a previous prescription of the same antibiotic for similar symptoms/illnesses. The screening characteristics of non-prescription use in the past 12 months to identify intention to use of antibiotics without a prescription in the future were: sensitivity 75.9% (95% CI: 65.3-84.6), specificity 91.4% (95% CI: 87.8-94.2), Bayes' PPV 74.5% (95% CI: 66.7-80.9), and Bayes' NPV 93.7% (95% CI: 90.5-96.1).</p><p><strong>Conclusions: </strong>This study proposed a method to screen for future use of non-prescription antibiotics, which may have implications on antimicrobial stewardship efforts in primary care settings.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"111"},"PeriodicalIF":2.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030014","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":"Informant accuracy of IQCODE, AD8 and GPCOGi for diagnosis of dementia: does your friend know best?","authors":"Jasmine Chingono, Samuel Thomas Creavin, Mark Fish, Sarah Cullum, Antony Bayer, Sarah Purdy, Yoav Ben-Shlomo","doi":"10.1186/s12875-025-02745-w","DOIUrl":"https://doi.org/10.1186/s12875-025-02745-w","url":null,"abstract":"<p><strong>Background: </strong>Increasing numbers of people require evaluation for possible dementia. However, research on the accuracy of informant questionnaires in primary care remains limited.</p><p><strong>Methods: </strong>This study assessed the diagnostic accuracy of IQCODE, AD8, and GPCOGi based on the informant's relationship to the patient. We recruited 240 participants from 21 general practices in South West England. The reference standard for a diagnosis of dementia was made by a specialist clinician using ICD-10 criteria. A threshold of greater than 3.3 on IQCODE, greater or equal to 2 on AD8 and less than 5 on the informant component of GPCOG was used to indicate an abnormal test.</p><p><strong>Results: </strong>Of 238 participants with informant data, 131 had dementia, 60 had CIND, and 47 had normal cognition. Median informant age was 70 years (IQR 60 years to 78 years). 71% of informants were female and 56% were spouses. On all three questionnaires, compared to spouses, adult descendants tended to score participants more cognitively impaired, whereas friends scored participants less cognitively impaired. However, there was little evidence of difference by informant type once fully adjusted. Sensitivity by informant type ranged from 91 to 100% for IQCODE, 94-100% for AD8 and 99% to100% for GPCOGi. There was no significant difference in sensitivity by informant type. Specificity by informant type ranged from 25 to 79% for IQCODE, 13-75% for AD8 and 17-38% for GPCOGi. Adult descendants tended to have the lowest specificity at 25% (95% CI 10-47%) for IQCODE, 13% (95% CI 3-32%) for AD8 and 17% (95% CI 5-37%) for GPCOGi. Friends tended to have the highest specificity at 79% (95% CI 49-95%) for IQCODE, 75% (95% CI 48-93%) for AD8 and 38% (95% CI 15-64%) for GPCOGi.</p><p><strong>Conclusions: </strong>An informant of any relationship type, using IQCODE, AD8 or GPCOGi may be useful for ruling out dementia but not for ruling it in. We found no evidence of difference between spouse or adult descendants but friends performed significantly better overall on IQCODE and AD8.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"112"},"PeriodicalIF":2.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060607","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":"Effects of multidisciplinary teamwork in non-hospital settings on healthcare and patients with chronic conditions: a systematic review and meta-analysis.","authors":"Yanli Shi, Hongmin Li, Beibei Yuan, Xin Wang","doi":"10.1186/s12875-025-02814-0","DOIUrl":"https://doi.org/10.1186/s12875-025-02814-0","url":null,"abstract":"<p><strong>Background: </strong>There is evidence that multidisciplinary teams can improve health outcomes for patients with chronic conditions, enhance the quality and coordination of care, and promote teamwork among staff in hospital settings. However, their effectiveness in non-hospital settings remains unclear. Therefore, we conducted a systematic review and meta-analysis to assess the effects of multidisciplinary teams on patients with chronic conditions, health professionals, and healthcare in non-hospital settings.</p><p><strong>Methods: </strong>We searched PubMed, Web of Science, Embase, EconLit, OpenGrey, China National Knowledge Infrastructure (CNKI), and WanFang for randomised controlled trials published before March 2025. Narrative syntheses were used to synthesise the characteristics of multidisciplinary teams, interventions, and effects. Data were statistically pooled using both random-effects and fixed-effects meta-analyses to synthesize the outcomes. The methodological quality of the included studies was assessed using Cochrane's risk of bias tool.</p><p><strong>Results: </strong>Thirty-nine studies were analyzed, with a total of 8186 participants. Nurses, general practitioners, and specialists were the most common members of the multidisciplinary teams. Staffing models, shared care and role expansion or task shifting are the most common multidisciplinary teamwork interventions. Narrative syntheses revealed improvements in self-management, self-efficiency, satisfaction, health behaviours, and knowledge. A meta-analysis found a significant reduction in hospitalisation days for patients with chronic obstructive pulmonary disease (MD=-0.66, 95% CI -1.05 to -0.26, I² = 0%) and significant improvement in quality of life for patients with chronic heart failure (MD=-4.63, 95% CI: -8.67 to -0.60, I² = 0%). There is no consistent evidence of other indicators of this effect.</p><p><strong>Conclusions: </strong>Multidisciplinary teamwork can improve patient-reported outcomes for patients with chronic conditions in non-hospital settings, but the effects on clinical outcomes, health utilisation, and costs are not evident.</p><p><strong>Trial registration: </strong>The study protocol was registered with PROSPERO on January 21, 2019, with the registration number CRD42019121109.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"110"},"PeriodicalIF":2.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035634","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":"Diagnosing acute coronary syndrome in telephone triage: does it matter who initially calls? A cross-sectional study.","authors":"Mathé Delissen, Anique Sm Dobbe, Daphne Ca Erkelens, Loes Tc Wouters, Hester M den Ruijter, Joy Sa Corsel, Alja Sluiter, Frans H Rutten, Dorien Lm Zwart","doi":"10.1186/s12875-025-02801-5","DOIUrl":"https://doi.org/10.1186/s12875-025-02801-5","url":null,"abstract":"<p><strong>Background: </strong>Adequate triage of patients with symptoms suggestive of ACS is crucial. Considering who calls might be useful to improve telephone triage of these patients. In this article, we aim to assess whether a call made by a surrogate is related to urgency allocation or higher odds of an acute coronary syndrome (ACS) than patient-initiated calls, and to assess possible gender differences.</p><p><strong>Methods: </strong>Cross-sectional study of patients with symptoms suggestive of ACS who called the out-of-hours service in primary care (OHS-PC). Calls were classified into \"patient-initiated call\" or \"surrogate call\". Call and patient characteristics were collected. Odds ratios (OR) were calculated for the relationship between the type of call and (i) urgency allocation, (ii) ACS, and (iii) ACS or other life-threatening event, stratified for gender.</p><p><strong>Results: </strong>In total 2,428 recordings were included for analysis. Around half of the recordings were surrogate calls, and these more often received a high urgency (80.0%) than patient-initiated calls (57.8%), OR 2.92 (95%CI 2.44-3.50); in women OR 3.46, (95%CI 2.70-4.45), in men OR 2.42 (95%CI 1.86-3.16). Of all participants, 11.0% were diagnosed with an ACS; in women 8.0%, in men 14.7%. In the surrogate call group this was 14.4%, in the patient-initiated call group 7.6%; OR 2.04 (95%CI 1.57-2.67). In women, the OR was 2.46 (95%CI 1.63-3.77), in men 1.69 (95%CI 1.20-2.41).</p><p><strong>Conclusions: </strong>Compared to patients who call themselves, surrogate calls on behalf of a patient with symptoms suggestive of ACS receive more often a high urgency, and these patients have a risk twice as high of an ACS, an effect similar in women and men. It is useful for triage at the OHS-PC to consider who calls if it concerns a patient with symptoms suggestive of ACS.</p><p><strong>Clinical trial number: </strong>NTR7331. Registration Date 26-06-2018.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"109"},"PeriodicalIF":2.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059210","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":"Physical activity prescription in general practice in France: where do we stand? A cross-sectional study.","authors":"Dragos-Paul Hagiu, Laurine Entemeyer, Aurélien Falcon","doi":"10.1186/s12875-025-02815-z","DOIUrl":"https://doi.org/10.1186/s12875-025-02815-z","url":null,"abstract":"<p><strong>Background: </strong>Physical activity on prescription (PAP) is recognized as an effective preventive and therapeutic tool for various diseases, yet its application by general practitioners (GPs) varies widely. This study aims to analyse PAP usage practices among GPs in France, focusing on prescription frequency, targeted pathologies, and influencing factors. It also explores GPs' perceptions of facilitators and barriers to PAP.</p><p><strong>Methods: </strong>A cross-sectional study was conducted between October 23, 2023, and April 23, 2024, collecting data from a sample of GPs across France. A structured questionnaire was used to assess the frequency of PAP usage, target populations, as well as GPs' knowledge and perceived barriers to prescribing PA. Descriptive and analytical methods were employed to analyse the data, and logistic regression was used to examine associations between physician characteristics, PAP practices, and key barriers to prescribing.</p><p><strong>Results: </strong>Among respondents, 39.1% reported prescribing PAP, with a median prescription rate of approximately twice per month. Reduced sedentary behaviour (< 4 h) was significantly associated with a higher frequency of PAP (pOR 3.6, p = 0.044). Knowledge of a nearby sport-health facility strongly predicted prescription (pOR 3.7 p < 0.001). Prescription support tools positively influenced prescribing rates (pOR 1.6 p = 0.041). In contrast, GPs unaware of any tools prescribed significantly less.</p><p><strong>Conclusion: </strong>These findings suggest that improving access to sport-health facilities and providing GPs with effective support tools could significantly enhance PAP practices.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"107"},"PeriodicalIF":2.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029027","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":"Sick leave prescriptions in general medicine: results from the ECOGEN study.","authors":"Cyril Bègue, Matthieu Peurois, Charlotte Orvain, Yves Roquelaure, Audrey Petit, Aline Ramond-Roquin","doi":"10.1186/s12875-025-02712-5","DOIUrl":"https://doi.org/10.1186/s12875-025-02712-5","url":null,"abstract":"<p><strong>Background: </strong>Sick leave is a significant social and economic concern, with substantial costs and potential adverse consequences for patients. Understanding the factors influencing sick leave prescriptions is essential to improve their relevance and impact. The principal objective of this study was to describe general medicine consultations that led to sick leave prescriptions.</p><p><strong>Methods: </strong>The ECOGEN study, conducted from November 2011 to April 2012 in France, systematically analysed thousands of general medicine consultations. Data collected from 10,271 consultations, involving non-retired patients aged 18 to 65, provided insights into the determinants of sick leave prescriptions. Various patient and General Practitioners (GP) characteristics, consultation details, and health issues were considered.</p><p><strong>Results: </strong>16.5% of the consultations analysed, resulted in sick leave prescriptions. Several determinants were identified. Older patients received fewer sick leave prescriptions. Laborers had higher prescription rates, reflecting their poorer health and harsh working conditions. Longer consultations were associated with lower prescription rates. Sick leave prescriptions varied by health issue, with higher rates for musculoskeletal, digestive, respiratory, social, and psychiatric problems.</p><p><strong>Conclusion: </strong>Understanding the determinants of sick leave prescriptions is essential for their appropriate use. This study reveals the intricate interplay of patient characteristics, health issues, and GP factors in these decisions. Despite the fact that the study was not specifically designed to study the prescription of sick leave and that the data relate to a relatively short period, the winter of 2011-2012, it provides important insights into the prescription of sick leave. Improved comprehension can enhance the relevance and effectiveness of sick leave prescriptions, benefiting both individuals and society. Further qualitative research is necessary to explore the underlying factors driving these decisions in greater detail.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"108"},"PeriodicalIF":2.0,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035899","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 hypertension knowledge on adherence to antihypertensive therapy: a cross-sectional study in primary health care centers during the 2024 Sudan conflict.","authors":"Maha Rhamttallah, Abubakr Mahmoud, Eltoum Mohamedelnour, Hamid Magzoub, Lina S Altayib","doi":"10.1186/s12875-025-02812-2","DOIUrl":"https://doi.org/10.1186/s12875-025-02812-2","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a global health issue, particularly in low- and middle-income countries. Effective management requires medication adherence, which is often compromised in conflict zones such as Sudan. This study examines the relationship between patients' knowledge of hypertension and their adherence to antihypertensive therapy in Sudan amidst ongoing conflict.</p><p><strong>Methods: </strong>A cross-sectional study conducted across six primary healthcare centers in Al-Dammer, Sudan, included 389 hypertensive patients selected through convenience sampling. Data were collected using face-to-face questionnaire that assessed sociodemographics, medication adherence (GMAS), and hypertension knowledge (HKT). Analyses were conducted in SPSS, with percentages for categorical data, means ± SD for continuous data, and nonparametric tests (Shapiro-Wilk, Kruskal-Wallis) for non-normal distributions.</p><p><strong>Results: </strong>Most participants were female (63%), and 43.7% were over 60 years old. Knowledge levels were categorized as average (57.8%), high (25.2%), and low (17%). Adherence rates were as follows: 1% poor, 2.8% low, 22.6% partial, 26.5% good, and 47% high. A positive correlation was found between knowledge and adherence (r = 0.47, p < 0.001). Major barriers to adherence included affordability (43.4%) and unavailability of medications (36.2%). While 82.3% of participants had a history of controlled hypertension, only 58.4% remained controlled at their most recent measurement, with 41.6% presenting uncontrolled blood pressure, highlighting challenges in sustained hypertension management. Improved adherence was associated with higher income, better education, and controlled blood pressure.</p><p><strong>Conclusion: </strong>Higher hypertension knowledge was significantly associated with better adherence and improved blood pressure control. However, sustained control remains a challenge, as 41.6% of participants had uncontrolled hypertension at their last measurement. Addressing economic barriers and medication shortages through targeted interventions is essential for improving long-term hypertension management in conflict settings.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"104"},"PeriodicalIF":2.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042147","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":"Referral reasons of type 2 diabetes patients from general practitioners to diabetes specialists: a cross-sectional observational study.","authors":"Antonin Ludinard, Jan Chrusciel, Stephane Sanchez","doi":"10.1186/s12875-025-02809-x","DOIUrl":"https://doi.org/10.1186/s12875-025-02809-x","url":null,"abstract":"<p><strong>Background: </strong>Diabetes is a global public health concern. The follow-up of patients with diabetes is often undertaken by general practitioners (GPs), but referral rates to specialists show variations. The primary objective of this study was to describe the factors associated with the referral of type 2 diabetes patients from GPs to diabetes specialists.</p><p><strong>Methods: </strong>An observational survey-based cross-sectional study was conducted with GPs practicing in France between 17 May 2023 and 13 July 2023. Physician characteristics, referral rate and attitudes towards referral were collected. Characteristics associated with frequent referrals were evaluated using a multivariable logistic regression model.</p><p><strong>Results: </strong>A total of 325 GPs located in 52 departments (mean age 43 years) responded to the questionnaire. Most responding GPs were women (63%). Most GPs (76%) stated that they rarely or never referred their patients with type 2 diabetes to a diabetes specialist. The most frequent barrier to referral was delays in accessing a specialist (57%), and it was often cited both in the infrequent referral group (56%) and the frequent referral group (58%). In multivariable analysis, higher referral rates were associated with physician age (Odds Ratio OR per year 1.04, 95% Confidence Interval CI 1.01 to 1.07), diabetes care network membership (OR 2.81, 95% CI 1.15 to 6.88), referrals motivated by the introduction of insulin therapy (OR 2.73, 95%CI 1.44 to 5.34) or to consolidate communication about therapeutics and compliance (OR 2.34, 95%CI 1.18 to 4.67), expecting advice regarding new medication such as SGLT-2 inhibitors (OR 2.08, 95% CI 1.11 to 3.98), and the mention of patient refusal as one of the main barriers to referral (OR 1.85, 95% CI 1.03 to 3.38) were associated with higher referral rates. Conversely, doubts about the added value of the diabetes specialist was associated with infrequent referrals (OR 0.25, 95% CI 0.08 to 0.66).</p><p><strong>Conclusions: </strong>These factors indicate a possible role for lasting professional relationships, where trust built over shared network memberships and years of practice can facilitate referrals. Newly established GPs may find it beneficial to contact specialists in their region to discuss referral procedures. This could facilitate the referral of patients and improve access to specialist care.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"105"},"PeriodicalIF":2.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993656","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":"Psychometric properties of the rapid neurodevelopmental assessment in detecting social-emotional problems during routine child developmental monitoring in primary healthcare.","authors":"Tia Campbell, Dianne C Shanley, Marjad Page, Theresa McDonald, Melanie Zimmer-Gembeck, Megan Hess, Jodie Watney, Erinn Hawkins","doi":"10.1186/s12875-025-02807-z","DOIUrl":"https://doi.org/10.1186/s12875-025-02807-z","url":null,"abstract":"<p><strong>Background: </strong>The global prevalence of social-emotional problems in children and adolescents is nearly double in First Nations populations compared to non-First Nations populations, highlighting health inequities due to the impact of colonisation. Addressing this requires culturally responsive social-emotional screening in primary healthcare, enhanced by a simple, psychometrically sound tool. The Rapid Neurodevelopmental Assessment (RNDA) is user-friendly, incorporates child observations and parental input, and can be used by primary healthcare providers. This study evaluated the RNDA's performance in screening social-emotional problems during routine health checks with First Nations children.</p><p><strong>Methods: </strong>Working with an Aboriginal Community Controlled Health Organisation in Australia, children (60% male, 92% identifying as First Nations) aged 3 to 16 years (M = 8.40, SD = 3.33) and a caregiver participated in this study as part of a health check. The convergence with, and accuracy of, children's scores derived from single-item measures of seven social-emotional problems on the RNDA was compared to their corresponding multi-item scores from the parent-report Behavior Assessment System for Children 3rd Edition (BASC-3).</p><p><strong>Results: </strong>Each of the single-item measures on the RNDA were significantly correlated with the corresponding multi-item construct on the BASC-3, except for anxiety. The total accuracy of the RNDA relative to the BASC-3 was 58 to 81%, with high sensitivity for four of the seven items: hyperactivity (90%), attention problems (87%), externalising problems (82%) and behaviour symptoms index (88%). Sensitivity of the remaining items ranged from 14 to 71% and specificity ranged from 29 to 88%. The measure showed an average positive predictive value of 50% and negative predictive value of 75%.</p><p><strong>Conclusions: </strong>The single-item measures within the RNDA's behaviour domain showed good convergent validity relative to the BASC-3. Most items had acceptable accuracy, comparable with similar screening measures. These findings further support the RNDA's integration into First Nations child health checks, allowing for a rapid, holistic assessment of child development to improve health equity.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"106"},"PeriodicalIF":2.0,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031494","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":"Patient preferences for key organizational features of primary cardiovascular care in Quebec: a discrete choice experiment.","authors":"Claudio Del Grande, Janusz Kaczorowski, Marie-Pascale Pomey","doi":"10.1186/s12875-025-02810-4","DOIUrl":"https://doi.org/10.1186/s12875-025-02810-4","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular diseases and their risk factors are leading causes of morbidity and mortality worldwide, and are among the top reasons for primary care visits. Little is known about patient preferences for primary care in the context of chronic conditions. This study aimed to investigate the effect of key organizational features identified by patients and providers on patients' choice of a preferred primary care practice to receive cardiovascular care.</p><p><strong>Methods: </strong>A discrete choice experiment survey was completed by a weighted online sample of 501 Quebec residents having or being at risk of cardiovascular disease. Respondents completed one of two blocks of nine choice sets by indicating, among three hypothetical primary care practice alternatives in each choice set, their preferred and second-most preferred options. Alternatives were differentiated on the basis of five key attributes identified as priorities in an earlier Delphi study: listening to and respecting care preferences; providing personalized information; 24-to- 48-h accessibility in the event of a problem; continuity of care; and up-to-date clinical skills. Each attribute could be assigned a best, moderate, or worst level. Choices were analyzed using generalized multinomial logit modeling. Marginal effects and choice probabilities for policy-relevant scenarios were estimated.</p><p><strong>Results: </strong>All five attributes significantly influenced choices of primary care practice. The marginal effects of worst attribute levels were of much greater magnitude than those of best levels for all attributes. Improving short-term accessibility from worst to moderate level had the largest average incremental effect on the probability of patients choosing a practice. Best continuity of care was more valued by older patients and those in poorer general health, but had nonsignificant impact unless it was coupled with enhanced short-term accessibility.</p><p><strong>Conclusions: </strong>A balanced approach across the key organizational features covered seems more advantageous for primary care practices than focusing solely on achieving excellence in any single attribute. The interactions between patient preferences for short-term accessibility and continuity of care should be taken into account when planning and implementing organizational change in primary care. Whether these preferences are generalizable to other jurisdictions and subsets of primary care patients deserves further exploration.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"103"},"PeriodicalIF":2.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051301","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}