BMC primary care最新文献

{"title":"The development of electronic health record-extractable quality indicators for osteoporosis in primary care: A rand-modified Delphi method.","authors":"Elize Heymans, Elisabeth Segaert, Bert Vaes, Steve Van den Bulck","doi":"10.1186/s12875-025-02841-x","DOIUrl":"https://doi.org/10.1186/s12875-025-02841-x","url":null,"abstract":"<p><strong>Background: </strong>Osteoporosis is a common chronic condition and a cause of morbidity and mortality worldwide. Currently, osteoporosis is under-diagnosed and under-treated. There is an important role for the general practitioner (GP) in the prevention and management of this condition. The electronic health record (EHR) can be used to effectively pinpoint at-risk patients and enhance the quality of care provided to those suffering from osteoporosis. This study aims to develop evidence-based and EHR-extractable quality indicators (QIs).</p><p><strong>Methods: </strong>The RAND/UCLA- modified Delphi method was used. After an extensive literature search, recommendations were retrieved from the selected evidence-based guidelines and included in a questionnaire if they met the 'SMART'-criteria (specific, measurable, acceptable, realistic and time-related). Next, an expert panel (8 general practitioners, 2 patients, a geriatrician, a rheumatologist and an EHR specialist) was formed and asked to grade the selected recommendations individually. A consensus meeting was hosted to discuss the results. After their final appraisal, a set of quality indicators was developed out of the included recommendations.</p><p><strong>Results: </strong>Out of 11 evidence-based guidelines 478 recommendations were retrieved. After applying the 'SMART' criteria, 38 recommendations were presented to the panel of experts. After the written questionnaire round and the consensus meeting 25 recommendations were included. Twenty recommendations remained after final appraisal and were converted into 34 quality indicators of which 13 are currently extractable out of the electronic health record in Belgium.</p><p><strong>Conclusion: </strong>This study generated 34 evidence-based quality indicators for osteoporosis in primary care. This set enables general practitioners to measure and enhance the quality of care for osteoporosis patients through automated audit and feedback.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"145"},"PeriodicalIF":2.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029029","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":"A case scenario study on adherence to GINA recommendations by primary care physicians in an area of Southern Italy: the \"Progetto Padre 2.0\".","authors":"Mauro Maniscalco, Claudio Candia, Marta Coppola, Silvestro Ennio D'Anna, Carmen Lombardi, Claudia Merola, Antonio Iovine, Pasquale Ambrosino, Antonio Molino, Salvatore Fuschillo","doi":"10.1186/s12875-025-02846-6","DOIUrl":"10.1186/s12875-025-02846-6","url":null,"abstract":"<p><strong>Background: </strong>Accurate diagnosis and management of bronchial asthma are complex processes guided by national and international asthma guidelines, particularly the Global Initiative for Asthma (GINA). However, adherence to these guidelines is often suboptimal, varying across healthcare professionals and countries, which can lead to poor asthma control and increased healthcare costs.</p><p><strong>Aim: </strong>In this observational study, we assessed the alignment to GINA recommendations in the diagnosis and management of asthma among 15 primary care physicians in two metropolitan areas of the Campania region, Southern Italy.</p><p><strong>Methods: </strong>120 patients were randomly selected from the electronic medical records of 15 primary care physicians. Afterwards, the alignment of diagnostic pathways and treatments with current GINA recommendations was assessed by an experienced chest physician. Three main outcomes were defined: diagnostic congruence, diagnostic workup congruence, and therapeutic congruence.</p><p><strong>Results: </strong>Overall, 26.7% of our sample presented with an incongruous asthma diagnosis, while only 46.7% patients had therapeutic prescriptions in line with the latest GINA document recommendations. Patients treated in accordance with GINA recommendations exhibited significantly higher ACT scores, averaging 20.5 ± 4.0, compared to those receiving non-guideline-directed therapy, who averaged 15.7 ± 6.1 (p < 0.001). Diagnostic congruence showed a direct correlation with atopy (r = 0.277, p = 0.002) and an inverse correlation with ACT score (r = -0.335, p < 0.001).</p><p><strong>Conclusions: </strong>The results of this study indicate that adherence to asthma guidelines in the metropolitan areas of Naples and Benevento remains insufficient. Further research focused on developing individualized interventions to manage non-adherence is warranted.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"144"},"PeriodicalIF":2.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014071","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":"Barriers in prescribing antidiabetic medications with cardiovascular benefits: practice, experience, and attitudes of GPs in Croatia.","authors":"Tomislav Kurevija, Dunja Šojat, Ines Bilić-Ćurčić, Silvija Canecki-Varžić, Ljiljana Trtica-Majnarić","doi":"10.1186/s12875-025-02837-7","DOIUrl":"https://doi.org/10.1186/s12875-025-02837-7","url":null,"abstract":"<p><strong>Background: </strong>The treatment approaches of type 2 diabetes (T2D) are being transformed, due to the availability of novel antidiabetic medications, sodium-glucose co-transporter 2 inhibitors (SGLT2ins), and glucagon-like peptide-1 receptor agonists (GLP-1 RAs). Despite their proven beneficial effects, recent research points to their insufficient prescription. This study aimed to reveal the prescription rates of SGLT2ins and GLP-1 RAs among general practitioners (GPs) in Croatia and to examine factors associated with their low self-confidence in prescribing them.</p><p><strong>Methods: </strong>A self-designed survey questionnaire was used and delivered to the GPs' e-mail addresses in digital format. The data on the number of individuals diagnosed with T2D and prescribed new antidiabetic medications were checked by the respondents in their electronic database. Factors associated with lower GPs` self-confidence in prescribing SGLT2ins and GLP-1 RAs were assessed by bivariate and multivariate logistic regression analyses.</p><p><strong>Results: </strong>The study included 168 GPs (66.1% women; 49.4% specialists in family medicine) and a cohort of 23,036 individuals with T2D. The prescription rates of SGLT2ins and GLP-1 RAs were 21.0% and 14.4%, respectively. Specialists stated a higher level of self-confidence in prescribing these medications, compared to other respondents. In the multivariate models, a factor that was shown to reduce the likelihood of low GPs` self-confidence in prescribing SGLT2ins was \"familiarity with the side effects of these medications\" (OR = 0.03), while factors that increased this likelihood were: \"being familiar with GLP-1 RAs` side effects\" (OR = 4.8), \"an insufficient knowledge and experience of GPs in adjusting two target outcome measures to the same patient\" (OR = 2.2), and \"the GPs` assumption that the new guidelines` protocol which separates two target outcome measures is useful only in some cases but not in all\" (OR = 5.4). Regarding GLP-1 RAs, only one factor - \"familiarity of GPs with GLP-1 RAs side effects\", was shown to reduce the probability of GPs` low self-confidence in prescribing this group of medications (OR = 0.27).</p><p><strong>Conclusion: </strong>It is of the utmost importance to identify barriers the GPs face when prescribing these medications, as well as to suggest potential strategies to optimize their prescription.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"143"},"PeriodicalIF":2.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065421","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 effect of community-based palliative supportive care integrated with primary health care (PHC) on the outcomes of terminally ill cancer patients.","authors":"Hadisossadat Hosseini, Maryam Rassouli, Hadi Hayati, Heshmatolah Heydari","doi":"10.1186/s12875-025-02831-z","DOIUrl":"https://doi.org/10.1186/s12875-025-02831-z","url":null,"abstract":"<p><strong>Background: </strong>Cancer is increasing worldwide. Palliative care can help reduce the suffering of patients with cancer. Providing palliative care with a primary health care (PHC) approach can lead to greater patient access to palliative services. Given the lack of studies in this area, the present study aimed to determine the impact of community-based palliative care integrated with PHC on outcomes of terminally ill cancer patients.</p><p><strong>Methods: </strong>This was a randomized controlled trial. Research population included 120 cancer patients in Khorramabad in 2023. A convenience sampling method was conducted, and then subjects were allocated to the intervention and control groups through randomization blocks with size of four. Subjects in the intervention group received PHC-integrated community-based palliative support for two months, while their control peers received their routine health care programs during the same period. The data were gathered using the Palliative Care Outcome Scale before and two months after the intervention and then were analyzed using SPSS 22 software and descriptive and inferential statistics.</p><p><strong>Results: </strong>The mean scores of all dimensions of palliative outcomes, including physical, psychological, emotional, and social, as well as the overall palliative care outcome, improved after the intervention in the experimental group, and these changes were statistically significant (p < 0.001). Before the intervention, the mean score of overall palliative care outcome was 22.21 ± 2.89 in the intervention group and 21.88 ± 2.55 in the control group (P = 0.51), While after the intervention, the mean scores in the experimental and control groups changed to 17.98 ± 2.88 and 21.83 ± 2.69, respectively, and this difference was statistically significant (p < 0.001). The mean changes in the overall palliative outcome score before and after the intervention in the experimental and control groups were 4.23 ± 2.83 and 0.5 ± 0.72, respectively, and this difference was statistically significant (p < 0.001).</p><p><strong>Conclusion: </strong>The community-based palliative care integrated into the PHC structure could positively affect all aspects of palliative care. It is recommended that policymakers create conditions where cancer patients can receive care through the PHC structure. More studies are required to designate the strengths and weaknesses of this care approach.</p><p><strong>Trial registration number: </strong>IRCT20180721040540N5, 2023-06-07, Registered on June 7,2023. https://irct.behdasht.gov.ir/user/trial/68288/view .</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"139"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036574","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-centered care and satisfaction of patients with diabetes: insights from a survey among patients at primary healthcare centers in Saudi Arabia.","authors":"Nizar Alsubahi, Wim Groot, Ahmed Ali Alzahrani, Ala'eddin Ahmad, Milena Pavlova","doi":"10.1186/s12875-025-02778-1","DOIUrl":"https://doi.org/10.1186/s12875-025-02778-1","url":null,"abstract":"<p><strong>Background and objective: </strong>Patient-centered care (PCC) and patient satisfaction are pivotal in healthcare provision for patients with diabetes. This study investigates the link between perceived PCC and satisfaction with care among patients with diabetes in Saudi Arabia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at 47 primary healthcare centers affiliated with general hospitals, including King Abdullah Medical Complex, King Abdulaziz Hospital, East Jeddah Hospital, King Fahd General Hospital, and Al Thagr General Hospital, operated by the Ministry of Health in Jeddah City, Saudi Arabia, between July and August 2023. Over 800 patients with diabetes were approached through a random sampling technique at the reception areas of these centers. These patients were directed to designated private rooms for further engagement, where they completed a face-to-face questionnaire administered by an interviewer. Data analysis was conducted using the software package SPSS version 28 and AMOS version 28.</p><p><strong>Results: </strong>Of the 594 patients who participated in the study (response rate 73.4%), the results indicated that the perceived level of PCC, including physical comfort (β = 0.200, p = 0.000), continuity in care transition (β = 0.114, p = 0.031), access to care (β = 0.203, p = 0.000), information and education (β = 0.169, p = 0.001), and family and friends involvement (β = 0.082, p = 0.023), were significantly related to patient satisfaction. However, other perceived PCC components, like patient preferences (β = 0.052, p = 0.233), care coordination (β = 0.078, p = 0.123), and emotional support (β=-0.080, p = 0.066), did not appear to have a significant relationship with patient satisfaction. Income and level of education substantially impacted the perception of PCC and satisfaction with care. One notable finding was that the perceived level of PCC had a strong positive relationship with patient satisfaction (β = 0.762, p = 0.002).</p><p><strong>Conclusion: </strong>This study highlights the significant positive relationship between PCC and patient satisfaction in diabetes care in Saudi Arabia. It emphasizes the need for healthcare tailored to individual needs and demographic factors. This provide advocates the broader integration of PCC principles in health systems, particularly in Saudi Arabia, to improve patient experience and satisfaction. Policymakers should integrate patient-centered care into healthcare policies to improve service quality and health outcomes.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"140"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057935","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":"Implementation and acceptability of the Caregiver Care Model in general practice: a mixed-method feasibility study.","authors":"Mette Kjaergaard Nielsen, Marie Cecilie Vinther, Mai-Britt Guldin, Kaj Sparle Christensen, Anna Mygind","doi":"10.1186/s12875-025-02833-x","DOIUrl":"https://doi.org/10.1186/s12875-025-02833-x","url":null,"abstract":"<p><strong>Background: </strong>Being a caregiver can be demanding. Therefore, we developed the Caregiver Care Model for general practice. The model consists of a mandatory dialogue questionnaire, which is used to identify support needs in caregivers, grief-facilitating questions, and an overview of community-based caregiver initiatives for caregivers in need of support. We aimed to test the implementation and acceptability of the model in general practice.</p><p><strong>Methods: </strong>We used a fixed, convergent, mixed-methods approach to test the model in five general practices in the Central Denmark Region among 40 caregivers. Quantitative data included monitoring data collected by health professionals in an online database at inclusion and after each consultation. Qualitative data were derived from five introductory meetings and semi-structured interviews with ten health professionals. The analysis focused on the implementation (delivery and process) and the health professionals' acceptability of the model.</p><p><strong>Results: </strong>All 40 caregivers participated in the first consultation, and 29 (73%) had two or more consultations. Eight caregivers (20%) were referred to community-based initiatives or a private-practice psychologist. The mandatory dialogue questionnaire was completed by 30 (75%) caregivers prior to the first consultation, and it was rated useful by general practitioners (GPs) and staff in 26 (74%) of encounters. GPs and staff perceived the dialogue questionnaire to be useful to direct the first consultations towards the most relevant issues, whereas the usefulness of the facilitating questions was unclear due to the brief introduction to them. The list of community-based initiatives was considered useful in urban areas, but not in rural areas with long distance to initiatives. Here, support from general practice was needed to promote mental health in caregivers and avoid sick leave.</p><p><strong>Conclusion: </strong>The Caregiver Care Model was in line with core values of general practice and the dialogue questionnaire targeted the consultations on relevant issues for the caregiver. Health professionals provided targeted support, including follow-up consultations and referred a group for community-based initiatives, especially caregivers in urban settings. The findings call for increased focus on caregivers and education of general practitioners and staff to facilitate caregiver reactions in connection with loss and grief.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"142"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059866","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":"Investigating the association between recorded smoking cessation interventions and smoking cessation in people living with cardiovascular disease using UK general practice data.","authors":"Angela Difeng Wu, Nicola Lindson, Rafael Perera, Min Gao, Paul Aveyard, Rachna Begh, Jamie Hartmann-Boyce","doi":"10.1186/s12875-025-02843-9","DOIUrl":"10.1186/s12875-025-02843-9","url":null,"abstract":"<p><strong>Background: </strong>Smoking significantly increases the risk of cardiovascular diseases (CVD), yet quitting smoking after diagnosis of CVD can mitigate further negative impacts. However, encouraging smoking cessation remains a challenge for General Practitioners (GPs) with concerns regarding mental health. Since 2004, the UK's Quality and Outcomes Framework (QOF) incentivises GP smoking cessation support. Despite this, a significant proportion of individuals diagnosed with CVD continue to smoke after diagnosis. This study aims to investigate the frequencies and types of smoking cessation interventions offered to people with CVD (defined as coronary heart disease (CHD) and stroke), with and without mental illness, and assess their association with successful cessation.</p><p><strong>Methods: </strong>This retrospective cohort study examined adults diagnosed with CHD or stroke using the QResearch general practice records database (1996-2019). We evaluated the frequency and types of smoking cessation interventions documented in patients' records, including education, brief interventions, pharmacological support, referrals, and counselling. Logistic regression assessed the relationship between recorded interventions and smoking abstinence rates within the one-year post-index event, considering QOF incentives and mental illness presence.</p><p><strong>Results: </strong>While smoking cessation education was common in general practice settings, prescriptions for nicotine replacement therapy or other evidence-based interventions were comparatively low. CHD and stroke populations showed a significant association between any intervention and smoking cessation within one year (CHD: OR 1.41, 95% CI 1.36-1.45; stroke: OR 1.49, 95% CI 1.43-1.55). Education consistently correlated with higher cessation likelihoods, while other interventions were linked to lower rates. Individuals with common and serious mental illness were less likely to quit, irrespective of intervention. QOF implementation led to increased documentation of advice but not intensive support or treatment, with pre-QOF interventions associated with significantly increased abstinence likelihoods (CHD: OR 5.09, 95% CI 4.84-5.35; stroke: OR 4.44, 95% CI 4.07-4.86).</p><p><strong>Conclusions: </strong>Financial incentives for GP smoking cessation support outlined in QOF may not suffice to enhance methods that are more efficacious or improve cessation rates, especially among people with mental illness. Practical strategies that provide tangible support and treatment are needed for CVD patients, including those with mental illness, to facilitate successful cessation.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"141"},"PeriodicalIF":2.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060274","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":"Professional training to implement the dietary guidelines for the Brazilian population in primary health care: development and content validity of a massive open online course.","authors":"Vanessa Del Castillo Silva Couto, Rafael Marques Soares, Patrícia Constante Jaime","doi":"10.1186/s12875-025-02806-0","DOIUrl":"https://doi.org/10.1186/s12875-025-02806-0","url":null,"abstract":"<p><strong>Background: </strong>The Dietary Guidelines for the Brazilian Population provide recommendations for healthy diets to prevent noncommunicable chronic diseases, emphasizing the golden rule: always prefer natural or minimally processed foods and freshly prepared dishes and meals to ultra-processed foods. While widely recognized, the integration of dietary advice based on the Dietary Guidelines recommendations has not yet been sufficiently incorporated into Primary Health Care. Protocols based on the Brazilian Dietary Guidelines for Individual Dietary Advice were developed to support healthcare professionals in providing individualized dietary advice based on the Brazilian Dietary Guidelines tailored to different stages of lifetime. Training healthcare professionals to use the Protocols might increase their confidence and is a strategic step toward implementing the Guidelines in routine care. This study aimed to develop and validate a Massive Open Online Course (MOOC) on the Protocols based on the Brazilian Dietary Guidelines for individual dietary advice.</p><p><strong>Methods: </strong>This methodological study investigated the development and content validity of a Massive Open Online Course designed to qualify Primary Health Care professionals in dietary advice based on the Protocols. Development and validation involved defining objectives, theoretical frameworks and learning skills; creating content and structure; conducting content validity assessments through a panel of experts; analyzing the results via content validity index scores and thematic content analysis with a comprehensive approach; and refining pedagogical tools in the virtual learning environment.</p><p><strong>Results: </strong>A Massive Open Online Couse, titled QualiGuia, was developed. All the content sessions achieved content validity index scores above the cutoff grade (0.8). Experts' perceptions were categorized to assess content adequacy, clarity, relevance, and alignment with the theoretical framework. Suggestions for improvement and potential implementation challenges were also addressed. The course included case studies reflecting typical Primary Health Care situations with appropriate complexity and depth, effectively meeting learning objectives.</p><p><strong>Conclusions: </strong>The Massive Open Online Course QualiGuia was validated as an effective tool for training Primary Health Care professionals to use the Protocols based on the Brazilian Dietary Guidelines. Its content and structure align with the goals of the Guidelines, supporting healthcare providers in integrating dietary advice into Primary Health Care practices.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"138"},"PeriodicalIF":2.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047350","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":"Motivations, delivery, perceived benefits, and barriers to delivery of the parkrun practice initiative in general practices across the UK: a national cross-sectional online survey of healthcare professionals and event organisers.","authors":"Callum J Leese, Ross Clarke, Robert H Mann, Rosina Cross, Hussain Al-Zubaidi, Blair H Smith, Emma J Cockcroft","doi":"10.1186/s12875-025-02827-9","DOIUrl":"https://doi.org/10.1186/s12875-025-02827-9","url":null,"abstract":"<p><strong>Background: </strong>Physical activity offers significant health benefits, yet many people in the United Kingdom do not meet recommended guidelines. Primary care plays a crucial role in physical activity promotion, but barriers can hinder implementation. The parkrun practice initiative, launched in 2018, aims to address these barriers by linking general practices with local parkrun events.</p><p><strong>Aim: </strong>This study aimed to evaluate the parkrun practice initiative from the perspective of staff at general practices and parkrun event organisers, exploring the motivations for joining, the variety of ways in which the initiative was delivered, perceived benefits on patients and staff, and barriers to implementation.</p><p><strong>Methods: </strong>A cross-sectional online survey was distributed via email to 1,852 registered parkrun practices and 800 'linked' parkrun event organisers. Descriptive statistics were used to present quantitative data. Content analysis was used to analyse qualitative data.</p><p><strong>Results: </strong>Responses from 416 staff at parkrun practices (22% of registered practices) and 439 event organisers (55% of all events organisers) were included in the analysis. Attendance of staff at the local parkrun and sharing of information with patients were the main means of initiative implementation. Our findings highlight the perceived benefits of the initiative on staff and patient health and wellbeing, parkrun practice staff morale, and community engagement. A discrepancy is noted between what is being done by practices and what is being perceived by event organisers. Major barriers to implementation included: a lack of time; a lack of engagement of practice staff; the COVID-19 pandemic; and access to the nearest parkrun.</p><p><strong>Conclusion: </strong>To address the barriers in implementing the parkrun practice initiative in primary care, our findings indicate that future initiatives should look to include: (1) clear and ongoing communication to ensure widespread engagement of patients, staff and event organisers; (2) ease of implementation (minimising time demands); and (3) adequate resource allocation to facilitate implementation (e.g., financial, educational, personnel). Further research is required to increase understanding of the impact on patient outcomes, staff morale, and the behavioural mechanisms influencing initiative implementation.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"137"},"PeriodicalIF":2.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12038959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030017","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 psychiatric mental health nurse practitioner in the general practice: a realist evaluation multiple case study.","authors":"Ans Tordoir, Veerle van Laarhoven, Noortje van Duijnhoven, Peter Coolen, Enzio Boeijen, Maud van Vlerken, Carla Jutte, Miranda Laurant, Anneke van Vught","doi":"10.1186/s12875-025-02844-8","DOIUrl":"https://doi.org/10.1186/s12875-025-02844-8","url":null,"abstract":"<p><strong>Background: </strong>Mental health problems are highly prevalent worldwide and the mental health system faces significant gaps in treatment coverage due to stigma, professional shortages and accessibility issues. In the Netherlands, patients first visit their general practitioner (GP) for mental health problems, with an increasing number of people seeking mental health counselling and treatment in general practice. Dutch general practices have been experimenting with deploying psychiatric mental health nurse practitioners (PMHNP) to enhance mental healthcare accessibility. How to best deploy this profession in the general practice team and everyday care, is yet unknown.</p><p><strong>Objective: </strong>This study aims to understand how deployment of the PMHNP in the general practice works and how it contributes to the accessibility and quality of mental primary healthcare and job satisfaction of professionals in the general practice.</p><p><strong>Methods: </strong>This multiple case study used principles of realist evaluation methodology for data collection and analysis focusing on context, mechanism and outcome (CMO). Seven general practices employing a PMHNP, were included. Data was collected through observations, interviews and group discussions with professionals working in the general practice and patients treated by the PMHNP. Cross-case analysis involved work sessions with professionals of these seven cases.</p><p><strong>Results: </strong>This study identified three mechanisms that provide insight into how deploying PMHNP contributes to improved experienced accessibility and quality of mental health care, enhances job satisfaction and reduces workload especially for the GP: (1) motivation and investment; (2) familiarity and trust; and (3) equivalence and autonomy. These mechanisms were triggered in a context with the presence of (1) a vision on mental health care in general practice, (2) physical attendance of the PMHNP, (3) a patient population suited to the expertise of the PMHNP, and (4) financial possibilities.</p><p><strong>Conclusion: </strong>Participants in this study believe a transition in general practices is necessary to provide sustainable, lowtreshold mental healthcare in primary care setting. They see the PMHNP as the professional to fill this gap. To optimally deploy the PMHNP and ensure accessible, high-quality mental healthcare, the mechanisms of (1) motivation and investment, (2) familiarity and trust, and (3) equivalence and autonomy should be activated.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"136"},"PeriodicalIF":2.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045305","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}