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Perceptions of the usefulness of Choosing Wisely among general practitioners in Norway: a nationwide survey. 挪威全科医生对明智选择有用性的看法:一项全国性调查。
IF 2.6
BMC primary care Pub Date : 2025-08-02 DOI: 10.1186/s12875-025-02928-5
Jørgen Breivold, Karin Isaksson Rø, Stein Nilsen, Stefán Hjörleifsson
{"title":"Perceptions of the usefulness of Choosing Wisely among general practitioners in Norway: a nationwide survey.","authors":"Jørgen Breivold, Karin Isaksson Rø, Stein Nilsen, Stefán Hjörleifsson","doi":"10.1186/s12875-025-02928-5","DOIUrl":"10.1186/s12875-025-02928-5","url":null,"abstract":"<p><strong>Background: </strong>Choosing Wisely is an international initiative to curb medical overuse. The Norwegian College of General Practice has published recommendations to avoid commonly used services for safer healthcare. This study investigated Norwegian GPs' perceptions of Choosing Wisely.</p><p><strong>Methods: </strong>Cross-sectional online survey of Norwegian GPs in 2021. We report GPs' perceptions of Choosing Wisely recommendations as proportions, using multiple ordinal regression to assess factors influencing the campaign's perceived usefulness.</p><p><strong>Results: </strong>Responses from 900 GPs, with a response rate of 18% were included. 81% were aware of Choosing Wisely, and of these 82% found the campaign somewhat or very useful in reducing overdiagnosis or overtreatment. This correlated with lower levels of work-related stress (adjusted odds ratio (AOR) 0.61, 95% confidence interval (CI) 0.45-0.83) and more frequently reaching an agreement with patients to avoid unnecessary medical activities (AOR 1.93, 95% CI 1.26-2.95). More frequently reaching agreement with patients was also associated with finding the campaign very useful (AOR 2.21, 95% CI 1.51-3.24). Among those who did not find the campaign useful, 74% stated that this could partly be due to the campaign's inability to influence patients' opinions. 90% of the GPs who were aware of the campaign had implemented one or more recommendations.</p><p><strong>Conclusions: </strong>Choosing Wisely appears to be considered useful by a substantial proportion of Norwegian GPs. Since the effectiveness of the campaign seems to be linked to the ability to manage gatekeeping, it may be beneficial to bolster the gatekeeping role of GPs and raise public awareness of medical overuse.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"240"},"PeriodicalIF":2.6,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769409","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}
引用次数: 0
The most common diagnoses in primary care, and changes over time, in the total population of Stockholm, Sweden. 在瑞典斯德哥尔摩的总人口中,初级保健中最常见的诊断,并随着时间的推移而变化。
IF 2.6
BMC primary care Pub Date : 2025-08-01 DOI: 10.1186/s12875-025-02938-3
Per Wändell, Gunnar Ljunggren, Axel C Carlsson
{"title":"The most common diagnoses in primary care, and changes over time, in the total population of Stockholm, Sweden.","authors":"Per Wändell, Gunnar Ljunggren, Axel C Carlsson","doi":"10.1186/s12875-025-02938-3","DOIUrl":"10.1186/s12875-025-02938-3","url":null,"abstract":"<p><strong>Objective: </strong>Primary care is the base in many health care systems, and to identify the most registered diagnoses in primary care is a way to identify the overall health care use and needs in society. We estimated the rates of the 30 most common diagnoses in primary health care and their male to female ratio.</p><p><strong>Research design and methods: </strong>This was a study including inhabitants 18 years and older out of all 2.3 million inhabitants living in Region Stockholm, Sweden. Data on all healthcare appointments from primary care during 2019-2021 were extracted from the Stockholm County Council data warehouse known as VAL. Primary care data were analyzed by underlying population and age. In 2019, only physical visits were available, but during 2021 digital visits were included. For the specific diagnoses, physical and digital visits were merged.</p><p><strong>Results: </strong>The five most common diagnoses in primary care were: essential hypertension (I10), myalgia (M79), type 2 diabetes (E11), dorsalgia (M54), and pain in joint (M25). The female-to-male ratios were higher for 27 of the 30 most common diagnoses, for example stress reaction (F43), malaise and fatigue (R53), and headache (R51). Chronic ischaemic heart disease (I25), Type 2 diabetes (E11), and Atrial fibrillation (I48) were more common in men.</p><p><strong>Conclusions: </strong>Most of the common diagnoses in primary care are more often registered in women than in men. The higher presence of diagnoses of pain and mental illness seems to mirror the higher sick leave among women in recent years.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"235"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12315263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765856","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}
引用次数: 0
Antimicrobial prescribing patterns among pediatric outpatient encounters in primary healthcare centers in Bujumbura Mairie, Burundi. 布隆迪布琼布拉马里初级卫生保健中心儿科门诊抗菌素处方模式
IF 2.6
BMC primary care Pub Date : 2025-08-01 DOI: 10.1186/s12875-025-02944-5
Audace Manirakiza, Shital Mahindra Maru, David Gitonga Nyamu, Thomas Bizimana, Manassé Nimpagaritse
{"title":"Antimicrobial prescribing patterns among pediatric outpatient encounters in primary healthcare centers in Bujumbura Mairie, Burundi.","authors":"Audace Manirakiza, Shital Mahindra Maru, David Gitonga Nyamu, Thomas Bizimana, Manassé Nimpagaritse","doi":"10.1186/s12875-025-02944-5","DOIUrl":"10.1186/s12875-025-02944-5","url":null,"abstract":"<p><strong>Background: </strong>Understanding prescribing patterns is essential for developing targeted interventions to promote rational antimicrobial use. This study evaluated antimicrobial prescribing patterns among pediatric outpatients at primary healthcare centers (PHCs) in Bujumbura Mairie, republic of Burundi.</p><p><strong>Methods: </strong>We conducted a cross-sectional study at 20 PHCs in Bujumbura Mairie, Republic of Burundi, to evaluate antimicrobial prescribing patterns. We collected retrospectively 2022-year data from medical records using the World Health Organization/International Network of Rational Use of Drugs (WHO/INRUD) core drug indicators. According to these WHO guidelines, a minimum sample size of 600 prescriptions is recommended to assess drug use indicators. To meet this requirement, a total of 800 paediatric outpatient prescriptions were sampled. Prescriptions for inpatients were excluded.</p><p><strong>Results: </strong>A total of 497 (62.1%) out of 800 prescriptions contained antimicrobials, far exceeding WHO recommendations (20-26.8%). Younger patients, particularly children under five, received the highest proportion of antimicrobial prescriptions (15.6%). Although generic prescribing (95.0%) and adherence to the National Essential Medicine Lists (NEML) (95.8%) were high, they fell short of WHO benchmarks (100%). Most prescriptions followed monotherapy (92.8%) with a low average of 1.1 antimicrobials per prescription (WHO guidelines 1.6-1.8). Although Access-group dominated (71.3%), Watch-group usage (25.3%) surpassed the recommended threshold (< 20%), and WHO non-recommended fixed-dose combinations were also prescribed (3.4%). In addition, 26.2% of prescriptions lacked documented indications.</p><p><strong>Conclusion: </strong>The present study highlights strong adherence to essential medicine lists and generic antimicrobial use. However, findings also reveal areas for improvement, including the need for documentation of indication and reduction of utilization of Watch group antibiotic use. To optimize antimicrobial use and prevent AMR in Burundi's paediatric population, further national research, healthcare worker training, diagnostics, and antimicrobial stewardship implementation are necessary.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"236"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765855","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}
引用次数: 0
27 Years of retention outcomes for a nine-university primary health care nurse practitioner program in Ontario, Canada. 加拿大安大略省九所大学初级卫生保健护士执业方案27年的保留结果
IF 2.6
BMC primary care Pub Date : 2025-07-31 DOI: 10.1186/s12875-025-02874-2
Alice Ormiston, Guillaume Semblat, Robyn Gorham, Sandra Carroll, Maher El-Masri, Jean Daniel Jacob, Kristen Jones-Bonofiglio, Claire Mallette, Christina McMillan Boyles, Debbie Sheppard-LeMoine, Victoria Smye, Erna Snelgrove-Clarke
{"title":"27 Years of retention outcomes for a nine-university primary health care nurse practitioner program in Ontario, Canada.","authors":"Alice Ormiston, Guillaume Semblat, Robyn Gorham, Sandra Carroll, Maher El-Masri, Jean Daniel Jacob, Kristen Jones-Bonofiglio, Claire Mallette, Christina McMillan Boyles, Debbie Sheppard-LeMoine, Victoria Smye, Erna Snelgrove-Clarke","doi":"10.1186/s12875-025-02874-2","DOIUrl":"10.1186/s12875-025-02874-2","url":null,"abstract":"<p><strong>Background: </strong>In this article we present 27 years of graduate retention outcomes for a nine-university consortium education program for Primary Health Care Nurse Practitioners (NPs) in Ontario, Canada. We assessed graduate retention in terms of whether graduates are or were practicing: 1) as an NP in Ontario; and 2) as an NP in the geographic region of Ontario where they graduated. It also looks at the geographic distribution of graduates retained as NPs in the province and measures the percentage of graduate NPs who were working in rural and remote areas.</p><p><strong>Methods: </strong>The authors mined the Ontario nursing public registry to identify how many graduates were, or had been, registered as an NP in Ontario at any time between 1996 and December 2022. The authors used registry data to identify the agency where these NP graduates were practising in the province, and then used a google map interface to identify what percentage were still practising in the university region where they graduated. The Rurality Index of Ontario (RIO), a tool used to measure the level of rurality of Ontario communities in terms of health care access, was used to assess the percentage of NPs grads practising in rural and remote areas.</p><p><strong>Results: </strong>86.7% of NP graduates were registered as practising NPs in Ontario at the time of the study, or had been registered as practising at some time in the past, with a range of 84% to 91% across the universities. 48% to 79% of graduates registered as currently practising NPs in Ontario remained in the region where they had graduated. Geographic maps show a broad distribution of graduates both within university regions and across the province. 8.6% to 38.9% of graduates were working in rural or remote areas. Graduates from universities in northern Ontario had the highest percentage practising in rural and remote areas. Graduate NP rural practice rates in both northern and southern regions reflected the rural demographics of their regions.</p><p><strong>Conclusions: </strong>The findings show that the university consortium model supports NP recruitment and retention across the province, including in rural and remote areas.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"234"},"PeriodicalIF":2.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12312426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762528","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}
引用次数: 0
Exercise prescription and patient outcomes. 运动处方和患者结果。
IF 2.6
BMC primary care Pub Date : 2025-07-29 DOI: 10.1186/s12875-025-02953-4
Lianne Wood, Garrett Ash
{"title":"Exercise prescription and patient outcomes.","authors":"Lianne Wood, Garrett Ash","doi":"10.1186/s12875-025-02953-4","DOIUrl":"10.1186/s12875-025-02953-4","url":null,"abstract":"<p><p>Exercise is frequently prescribed yet our understanding of how to best optimize exercise prescription is limited, and we do not know which patient outcomes are most important. In this editorial, we outline challenges, innovations and future directions, and invite contributions to BMC Primary Care's \"Exercise Prescription and Patient Outcomes\" Collection.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"233"},"PeriodicalIF":2.6,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746316","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}
引用次数: 0
Baseline cohort data from HARMONY, a cluster randomised controlled trial of culturally safe domestic violence management in general practice. 来自HARMONY的基线队列数据,HARMONY是一项一般实践中文化安全家庭暴力管理的随机对照试验。
IF 2.6
BMC primary care Pub Date : 2025-07-28 DOI: 10.1186/s12875-025-02890-2
Angela J Taft, Felicity Young, Kelsey L Hegarty, Jane Yelland, Danielle Mazza, Douglas Boyle, Richard Norman, Claudia García-Moreno, Cattram Nguyen, Xia Li, Bijaya Pokharel, Molly Allen Leap, Gene Feder
{"title":"Baseline cohort data from HARMONY, a cluster randomised controlled trial of culturally safe domestic violence management in general practice.","authors":"Angela J Taft, Felicity Young, Kelsey L Hegarty, Jane Yelland, Danielle Mazza, Douglas Boyle, Richard Norman, Claudia García-Moreno, Cattram Nguyen, Xia Li, Bijaya Pokharel, Molly Allen Leap, Gene Feder","doi":"10.1186/s12875-025-02890-2","DOIUrl":"10.1186/s12875-025-02890-2","url":null,"abstract":"<p><strong>Background: </strong>Domestic violence and abuse (DVA) is a globally prevalent, health damaging problem. In high income countries, migrant /refugee populations from low/middle income countries often consist of young families. DVA is more prevalent, and barriers to disclosure greater among migrant/refugee than native-born families. Consequently, general practice (GP) patient populations are increasingly diverse, but evidence for culturally safe and effective GP management is minimal. The HARMONY study tested a culturally safe DVA intervention to improve GP identification and referral among South Asian families.</p><p><strong>Methods: </strong>HARMONY was a pragmatic cluster RCT in 19 GP clinics in two regions of Melbourne, Australia. Eligible practices required ≥ 1 South Asian GP; used one of two common software programs; and agreed to have GrHanite™ software on practice computers. This analysis investigated baseline DVA and ethnicity identification in routine electronic GP data. Deidentified aggregated data for female patients aged ≥ 18 with DVA identification, referral, and South Asian ethnicity data were extracted from medical records. Chi Square for comparison of proportions.</p><p><strong>Results: </strong>Twenty-four clinics were recruited and randomised, but five dropped out due to Covid. Fifty-two percent (50/96) of 19 clinics' staff were South Asian. While 46.7% of female patients (21,220/45,438) were aged 26-45 years, 17.6% (7,874/45,438) were South Asian. There were more South Asian patients in Comparison 20.6% (4,193/20,312) than Intervention 14.7% (3,681/25,126) clinics. South Asian women had less access to Medicare (83% vs 97%) and pensions (13% vs 22%). At baseline, clinicians recorded 0.58% (265/45,438) DVA-affected women. Notably, they identified fewer South Asian (0.38%) (28/7,874) than non-South Asian women experiencing DVA (0.63%) (237/37,564),-0.28% (0.12%-0.43%), p = 0.004. No referrals were identified.</p><p><strong>Conclusion: </strong>DVA was notably under-identified in these patient populations, but worse among South-Asian female patients. While almost one in six of HARMONY's female population were South Asian, fewer than four in 1000 South Asian women were identified as experiencing DVA. Greater effort to regularly train and to support GP clinics to better identify DVA is vital but even more important in diverse communities to provide culturally safe DVA identification, care and documentation.</p><p><strong>Trial registration: </strong>ACTRN12618001845224 on 13/11/2018.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"232"},"PeriodicalIF":2.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735800","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}
引用次数: 0
Data collection in pediatric outpatient settings during the SARS-CoV-2 pandemic: motivators and barriers to establishing a research network of primary care providers. SARS-CoV-2大流行期间儿科门诊数据收集:建立初级保健提供者研究网络的动力和障碍
IF 2.6
BMC primary care Pub Date : 2025-07-28 DOI: 10.1186/s12875-025-02934-7
Ann-Cathrin Lütten, Michelle Seiler, Christoph Berger, Ralf von der Heiden, Anna Bewer Silvestri, Marc Sidler, Johannes Trück, Michael von Rhein
{"title":"Data collection in pediatric outpatient settings during the SARS-CoV-2 pandemic: motivators and barriers to establishing a research network of primary care providers.","authors":"Ann-Cathrin Lütten, Michelle Seiler, Christoph Berger, Ralf von der Heiden, Anna Bewer Silvestri, Marc Sidler, Johannes Trück, Michael von Rhein","doi":"10.1186/s12875-025-02934-7","DOIUrl":"10.1186/s12875-025-02934-7","url":null,"abstract":"<p><strong>Background: </strong>Data collection in the pediatric primary care settings, conducted by general practitioners and pediatricians, is inherently challenging. However, during the COVID-19 pandemic caused by the SARS-CoV-2 virus, the urgent need for real-time, localized information on the pandemic's impact on children motivated a network of pediatric practices in the canton of Zurich to undertake systematic data collection and analysis. This initiative aimed to complement established public health networks by providing focused insights from the local pediatric primary care perspective.</p><p><strong>Aims of the study: </strong>The aim of this study was to establish a research network of pediatric primary care providers (PCP) for data collection in the canton of Zurich, using the pandemic as an opportunity to test the feasibility of such a collaborative system. Secondary aims were to monitor respiratory infections, SARS-CoV-2 test results, and workload impacts among pediatric practices in ther Canton of Zurich during the pandemic.</p><p><strong>Methods: </strong>Pediatric practices in the canton of Zurich were invited to enter data on respiratory infections, the indications for and results of SARS-CoV-2 tests, and transmission routes into an online database, as well as staff workload and distress per week. Also, initial structural data including the number of staff, hours worked per staff member, and patient volume per week were documented. Structural data were available for all 44 practices, with 28 practices contributing data on respiratory infections and SARS-CoV-2 testing. Following data collection, an online survey was distributed to both participants and non-participants to gather feedback on the study process.</p><p><strong>Results: </strong>Throughout the data collection period, the weekly number of tests performed varied from 77 to 1066, with positive tests ranging from zero to 65 per week and positivity rates between zero and 0.4. A strong correlation was observed between respiratory infections and the number of tests performed (r = 0.95, p < 0.01) and between the number of tests and the proportion of positive test results in late 2020 and early 2021 (r = 0.492-0.805, p < 0.01). Most infections were attributed to transmission from parents or unknown sources. Structural data indicated wide variations in clinical working hours per week (physicians: median 24 h, range: 8.8-50 h; assistants: median 22.5 h, range: 2.9-63.3) and patient numbers per week (physicians: median 50, range: 3.3-135; assistants: 38.3, range: 7.1-90). No significant correlation was found between the number of SARS-CoV-2 tests and staff stress levels. Feedback on the data collection indicated that participants found data entry manageable, highly valued the regular interim feedbacks on results, and expressed strong interest in participating in similar future studies.</p><p><strong>Conclusion: </strong>The study demonstrated the feasibility of regional data colle","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"231"},"PeriodicalIF":2.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144735801","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}
引用次数: 0
Stakeholder understanding of social prescribing in England: a qualitative study in primary care. 利益相关者对英国社会处方的理解:一项初级保健的定性研究。
IF 2.6
BMC primary care Pub Date : 2025-07-23 DOI: 10.1186/s12875-025-02908-9
I Fattorini, D Westlake, A Turk, K R Mahtani, S Tierney
{"title":"Stakeholder understanding of social prescribing in England: a qualitative study in primary care.","authors":"I Fattorini, D Westlake, A Turk, K R Mahtani, S Tierney","doi":"10.1186/s12875-025-02908-9","DOIUrl":"10.1186/s12875-025-02908-9","url":null,"abstract":"<p><strong>Background: </strong>Social prescribing (SP) seeks to support patients' wider needs by connecting them to non-medical community resources. Link workers (LWs) facilitate SP's delivery across the National Health Service (NHS) in England. As a concept, SP may be perceived in different ways by various stakeholders. This study set out to explore how SP is understood among healthcare professionals (HCPs), voluntary and community sector (VCS) representatives, LWs, and patients (Ps) in England.</p><p><strong>Methods: </strong>A secondary qualitative analysis was conducted using interview data from a realist evaluation on the implementation of LWs in primary care. Interview data from 106 participants (HCPs, VCS representatives, LWs, Ps), across seven sites in England, were analysed using reflexive thematic analysis.</p><p><strong>Results: </strong>Analysis resulted in 127 codes. These were clustered into the following themes: (1) the need for system optimisation, (2) SP as a tool for personal empowerment, (3) SP's broad and inclusive nature, (4) community engagement through LWs, and (5) a holistic approach to well-being. These themes highlight SP's potential as an integrated and empowering ecosystem; requiring effective collaboration and clearer communication among stakeholders to enhance understanding of its purpose, streamline referral processes, and align expectations for greater impact. Understanding of SP could be related to five broad questions around how, who, what, where, and why; the themes produced from the analysis aligned with these questions, each exploring different dimensions of SP. Through this, we developed the 5Ws Framework, which is outlined in the paper.</p><p><strong>Conclusions: </strong>SP is not a standalone intervention; it is a complex system that requires optimisation and balance across its elements. Its effectiveness as an integrated empowerment ecosystem depends on addressing all facets of the 5Ws-how, who, what, where, and why it operates-engaging the right stakeholders, clearly defining its scope, and implementing it appropriately. Policymakers and commissioners could use the 5Ws Framework to guide decision-making, align health system priorities, and ensure the effective integration of SP within primary care.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"230"},"PeriodicalIF":2.6,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285178/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700473","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}
引用次数: 0
A pharmacist-led educational and audit & feedback strategy to reduce antibiotic prescription in primary care: the AFA study. 药剂师主导的教育和审计和反馈策略,以减少抗生素处方在初级保健:AFA研究。
IF 2
BMC primary care Pub Date : 2025-07-19 DOI: 10.1186/s12875-025-02933-8
A Soler, A Huguet, A Leiva, C Vicens, F Bejarano-Romero, E Sempere, T Izquierdo, M M Parera, R Seco, M Fages, A Medina, L Castillo-Palomares, E López-Guerrero, B A Ferrer, L Ugarriza, M Llarena, L Gallardo-Alfaro
{"title":"A pharmacist-led educational and audit & feedback strategy to reduce antibiotic prescription in primary care: the AFA study.","authors":"A Soler, A Huguet, A Leiva, C Vicens, F Bejarano-Romero, E Sempere, T Izquierdo, M M Parera, R Seco, M Fages, A Medina, L Castillo-Palomares, E López-Guerrero, B A Ferrer, L Ugarriza, M Llarena, L Gallardo-Alfaro","doi":"10.1186/s12875-025-02933-8","DOIUrl":"10.1186/s12875-025-02933-8","url":null,"abstract":"<p><strong>Introduction: </strong>The increasing emergence of bacteria resistant to antibiotic treatments has become a global public health concern and one of the leading causes of death worldwide. This growing threat demands urgent and coordinated action from health systems across the globe. A key driver of antimicrobial resistance is the inappropriate and excessive use of antibiotics, which accelerates the development of resistant strains. At the same time, the lack of new antibiotics in development exacerbates the crisis. In this context, promoting the appropriate and prudent use of antibiotics is essential to limit the emergence and spread of resistance.</p><p><strong>Methods: </strong>A randomized, multicentre, parallel-group clinical trial with a hybrid type I (effectiveness-implementation) design to reduce antibiotic prescriptions in primary care. General practitioners from three regional health systems in Spain will be randomly assigned (1:1) to an intervention or active control group. The intervention includes a monthly Audit & Feedback report, pharmacist-led consultations, clinical messages, patient information sheets, and an online training module. The primary outcome is the rate of antibiotic prescriptions per 100 patient visits at 12-month follow-up. Implementation outcomes will be assessed using the RE-AIM framework. All analyses will follow the intention-to-treat principle.</p><p><strong>Ethics and dissemination: </strong>The study was approved by the Balearic island, Valencia and IDIAP Jordi Gol Ethical Committee, follows the Declaration of Helsinki, Good Clinical Practice guidelines, and applicable national and European regulations concerning clinical trials and data protection.</p><p><strong>Trial registration: </strong>ISRCTN11175879, registration date: 11/12/2024.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"228"},"PeriodicalIF":2.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669101","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}
引用次数: 0
Stratifying the population based on health risk: identification of patient key health risk factors through consensus techniques. 根据健康风险对人群进行分层:通过共识技术确定患者的关键健康风险因素。
IF 2
BMC primary care Pub Date : 2025-07-19 DOI: 10.1186/s12875-025-02923-w
Carolina Castagna, Andrew Huff, Aaron Douglas, Matteo Garofano, Massimo Fabi, Richard Hass, Vittorio Maio
{"title":"Stratifying the population based on health risk: identification of patient key health risk factors through consensus techniques.","authors":"Carolina Castagna, Andrew Huff, Aaron Douglas, Matteo Garofano, Massimo Fabi, Richard Hass, Vittorio Maio","doi":"10.1186/s12875-025-02923-w","DOIUrl":"10.1186/s12875-025-02923-w","url":null,"abstract":"<p><strong>Background: </strong>Risk stratification is a population health management approach that classifies patients according to their health risks and projected care needs. This strategy is especially valuable in primary care, where timely interventions for high-risk individuals can lead to better health outcomes, reduced healthcare expenditures, and a more sustainable healthcare system. The goal of this study was to establish expert consensus on the clinical and sociodemographic patient factors that should be incorporated into a primary care risk stratification tool.</p><p><strong>Methods: </strong>A multidisciplinary expert panel of 24 healthcare professionals, including primary care providers (PCPs), specialists, and allied health professionals, was convened in June 2024 by Local Health Authority of Parma, Italy. Using the Nominal Group Technique, the panel was asked to define 'health risk' and identify contributing factors based on clinical and social relevance and data availability in patients' PCP electronic medical records. A modified Delphi process, following ACCORD guidelines for consensus-based methods, was conducted in three rounds (July-October 2024) to derive numerical weights for the factors. Survey questions rated the perceived importance of factors using a Likert scale (1 = no importance to 9 = critical importance). Consensus, defined as ≥ 75% agreement among panelists, set each factor's weight to the median importance rating.</p><p><strong>Results: </strong>Health risk was defined as \"the likelihood of a progressive deterioration of an individual's health status due to medical and/or psychosocial-welfare conditions that could lead to hospitalization or death within a year.\" A total of 31 clinical and social factors were identified, and consensus about importance was achieved for all factors. Higher-weighted factors included advanced age, excessive polypharmacy, cancer, cognitive impairment, and social-psychological distress, followed by clinical conditions such as renal failure, stroke, and heart failure, and previous hospitalizations and emergency room visits.</p><p><strong>Conclusions: </strong>The tool provides a robust framework for population health risk stratification in primary care, aligning with Italy's healthcare reform goals. Future phases will validate the tool's predictive performance using patient-level PCP data and assess its implications for policy and practice.</p>","PeriodicalId":72428,"journal":{"name":"BMC primary care","volume":"26 1","pages":"229"},"PeriodicalIF":2.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144669102","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}
引用次数: 0
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