Primary health care research & development最新文献

{"title":"The impact of primary care funding on health inequalities: an umbrella review.","authors":"Ian Holdroyd, Lucy McCann, Maya Berger, Rebecca Fisher, John Ford","doi":"10.1017/S146342362500012X","DOIUrl":"10.1017/S146342362500012X","url":null,"abstract":"<p><strong>Background: </strong>The funding of primary care is subject to intense debate internationally. Three main funding models predominate: capitation, pay-for-performance, and fee-for-service. A number of systematic reviews regarding the effect of primary care funding structures have been published, but not synthesized through an equity lens. Given the urgent need for evaluating funding models and addressing inequalities, a reliable, synthesized evidence base concerning the effects of funding on inequalities is imperative.</p><p><strong>Aims: </strong>This umbrella review aims to systematically evaluate all systematic reviews available on the effect of different primary care funding models in high-income countries on inequalities in funding, access, outcomes, or experience from inception until 2024.</p><p><strong>Methods: </strong>Three databases (MEDLINE, EMBASE, Cochrane) and a machine learning living evidence map were searched. Abstracts and titles were double screened, before two authors independently screened full texts, extracted data, and performed quality assessments utilizing the AMSTAR2 tool.</p><p><strong>Findings: </strong>The search identified 2480 unique articles, of which 14 were included in the final review. Only one review compared reimbursement systems; capitation systems were more equitable between ethnic groups compared to pay-for-performance in terms of primary care access, continuity, and quality. Twelve reviews reviewed the impact of the introduction of pay-for-performance models, predominantly focusing on the Quality and Outcomes Framework (QOF) in the UK. Synthesized findings suggest that QOF's introduction coincided with reduced socioeconomic health inequalities in the UK overall, but not in Scotland. Overall, inequalities in age narrowed, but inequalities measured by sex widened. One review found evidence that targeting funding for minority groups, with poorer health, was effective. A further review found that introducing privately provided general practices in Sweden and allowing patients to choose these over public-owned options generally benefitted those with higher income and lower health needs. We identify a range of gaps in the literature, which should inform future research.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e24"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525476","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":"Considering family trees as a useful tool in family medicine: a systematic review.","authors":"Ksenija Tušek-Bunc, Alem Maksuti, Danica Rotar-Pavlič","doi":"10.1017/S1463423625000131","DOIUrl":"10.1017/S1463423625000131","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to perform a systematic literature review of the purpose, design, and use of family trees by family physicians (FPs).</p><p><strong>Background: </strong>Family trees offer a valuable contribution to understanding the relevance of the patient's family history in comprehensive primary healthcare provision. There is little research on the role of family trees in the everyday practice of FPs. Studies often focus on specific diseases and their context: however, a comprehensive exploration of the usefulness of family trees is crucial for FPs.</p><p><strong>Methods: </strong>A systematic literature review was conducted through a keyword search in the PubMed and Cochrane databases. Based on the inclusion and exclusion criteria selected, 24 studies were identified and a qualitative analysis was performed.</p><p><strong>Findings: </strong>A total of 369 publications were identified across 32 fields. Twenty-four studies were included in the final analysis according to the QUOROM statement. The results underscore the role of family trees and highlight the value of this tool's multidimensionality. The use of this tool directs FPs to consider a genetic cause and a possible referral to a geneticist. The value of a family tree lies in the personalized patient-oriented treatment in connection with hereditary risks for chronic diseases. For FPs, the greatest challenge in treating patients is determining their risk of developing a chronic disease or cancer. Using a family tree can improve the quality of their healthcare.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e21"},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An innovative nurse practitioner-led service for children from families living in housing instability.","authors":"Alicia Bell, Yvonne K Parry, Matthew Ankers, Nina Sivertsen, Eileen Willis, Sally Kendall, Huahua Yin","doi":"10.1017/S1463423625000118","DOIUrl":"10.1017/S1463423625000118","url":null,"abstract":"<p><strong>Aim: </strong>To report on the design and results of an innovative nurse practitioner (NP)-led specialist primary care service for children facing housing instability.</p><p><strong>Background: </strong>During 2017-2018, children aged 0-14 years represented 23% of the total population receiving support from specialist homeless services in Australia. The impact of housing instability on Australian children is considerable, resulting in disengagement from social institutions including health and education, and poorer physical and mental health outcomes across the lifespan. Current services fail to adequately address health and educational needs of children facing housing insecurity. Research identifies similar circumstances for children in other high-income countries. This paper outlines the design, and reports on results of, an innovative NP-led primary care service for children facing housing instability introduced into three not-for-profit faith-based services in one Australian state.</p><p><strong>Methods: </strong>Between 2019 and 2021, 66 children of parents experiencing housing instability received standardized health assessment and referral where appropriate by a NP. Data from the standardized tool, such as condition and severity, were recorded to determine common conditions. In addition, comprehensive case notes recorded by the NP were used to understand potential causes of conditions, and referral needs, including potential barriers.</p><p><strong>Findings: </strong>The 66 children assessed were aged between 7 weeks to 16 years. Developmental delay, low immunization rates, and dental caries were the most common conditions identified. Access to appropriate services was inhibited by cost, disengagement, and COVID-19.</p><p><strong>Conclusion: </strong>Given their advanced skills and knowledge, embedding NPs in specialist homeless services is advantageous to help vulnerable children.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e22"},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517475","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":"Digital health technology use in Australian general practice (GP) consultations: a cross-sectional analysis of the medicine in Australia: balancing employment and life study.","authors":"Michael Tran, Joel Rhee, Katrina Blazek, Chinthaka Balasooriya, Kylie Vuong","doi":"10.1017/S1463423625000143","DOIUrl":"10.1017/S1463423625000143","url":null,"abstract":"<p><strong>Background and objective: </strong>The use of technology including digital decision support tools has become more ubiquitous in general practice. Australian GPs' use of digital decision support tools, the sentiments, and associations with practitioner and practice characteristics. Positive and negative sentiments were considered facilitators and barriers to the uptake of digital decision support tools.</p><p><strong>Methods: </strong>Secondary analysis of a cross-sectional study was undertaken with data from the Medicine in Australia: Balancing Employment and Life (MABEL) survey was analysed. 3,126 GPs responded from a total of 27,829 participants representing all types of physicians, surveyed in September 2018. Descriptive statistics was used to examine facilitators and barriers to GP uptake of digital decision support tools, and multivariable logistic regression was used to examine its associations with practitioner and practice characteristics.</p><p><strong>Results: </strong>2240 GPs in this study (83.8%) reported using digital decision support tools with largely positive sentiments regarding technology use in consultations. Reservations include privacy concerns, system incompatibility, and lack of support. Those using digital decision support tools were more likely to be female, younger and bulk-billing.</p><p><strong>Discussion: </strong>Perceived facilitators of digital decision support tools in Australian general practice include improvements in patient outcomes, satisfaction, care processes, and saving time. Barriers include concerns about data privacy, lack of support, incompatibility, and being time-consuming. There was higher uptake amongst bulk-billing and female practitioners. Further research on the clinical usefulness of digital decision support tools and its impact on decision-making in general practice would be of value.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e19"},"PeriodicalIF":0.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517391","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":"Validation of the Finnish Diabetes Risk Score and development of a country-specific diabetes prediction model for Turkey.","authors":"Neslisah Ture, Ahmet Naci Emecen, Belgin Unal","doi":"10.1017/S1463423625000180","DOIUrl":"10.1017/S1463423625000180","url":null,"abstract":"<p><strong>Aims: </strong>Diabetes is a global health concern, and early identification of high-risk individuals is crucial for preventive interventions. Finnish Diabetes Risk Score (FINDRISC) is a widely accepted non-invasive tool that estimates the 10-year diabetes risk. This study aims to validate the FINDRISC in the Turkish population and develop a specific model using data from a nationwide cohort.</p><p><strong>Method: </strong>The study used data of 12249 participants from the Türkiye Chronic Diseases and Risk Factors Survey. Data included sociodemographic variables, lifestyle factors, and anthropometric measurements. Multivariable logistic regression was employed using FINDRISC variables to predict incident type 2 diabetes mellitus (T2DM). Two country-specific models, one incorporating the waist-to-hip ratio (WHR model) and the other waist circumference (WC model), were developed. The least absolute shrinkage and selection operator (LASSO) algorithm was used for variable selection in the final models, and model discrimination indexes were compared.</p><p><strong>Results: </strong>The optimal FINDRISC cut-off was 8.5, with an area under the curve (AUC) of 0.76, demonstrating good predictive performance in identifying T2DM cases in the Turkish population. Both WHR and WC models showed similar predictive accuracy (AUC: 0.77). Marital status and education were associated with increased diabetes risk in both country-specific models.</p><p><strong>Conclusion: </strong>The study found that the FINDRISC tool is effective in predicting the risk of type 2 diabetes in the Turkish population. Models using WHR and WC showed similar predictive performance to FINDRISC. Sociodemographic factors may play a role in diabetes risk. These findings highlight the need to consider population-specific characteristics when evaluating diabetes risk.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e18"},"PeriodicalIF":0.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506551","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":"Person-centred integrated primary care for refugees: a mixed-methods, stepped wedge design study to assess the impact.","authors":"Rabia Çinar, Mieke de Klein, José Renkens, Reinier Akkermans, Mursal Latify, Bart Walewijn, Maria van den Muijsenbergh, Tessa van Loenen","doi":"10.1017/S1463423625000167","DOIUrl":"10.1017/S1463423625000167","url":null,"abstract":"<p><strong>Aim: </strong>To assess the impact of a person-centred culturally sensitive approach in primary care on the recognition and discussion of mental distress in refugee youth.</p><p><strong>Background: </strong>Refugee minors are at risk for mental health problems. Timely recognition and treatment prevent deterioration. Primary care is the first point of contact where these problems could be discussed. However, primary care staff struggle to discuss mental health with refugees.Guided by the needs of refugees and professionals we developed and implemented the Empowerment intervention, consisting of a training, guidance and interprofessional collaboration in four general practices in the Netherlands.</p><p><strong>Methods: </strong>This mixed-method study consisted of a quantitative cohort study and semi-structured interviews. The intervention was implemented in a stepped wedge design. Patient records of refugee youth and controls were analysed descriptively regarding number of contacts, mental health conversations, and diagnosis, before and after the start of the intervention.Semi-structured interviews on experiences were held with refugee parents, general practitioners, primary care mental health nurses, and other participants in the local collaboration groups.<b>Findings:</b>A total of 152 refugees were included. Discussions about mental health were significantly less often held with refugees than with controls (16 versus 38 discussions/1000 patient-years) but increased substantially, and relatively more than in the control group, to 47 discussions/1000 patient-years (compared to 71 in the controls) after the implementation of the programme.The intervention was much appreciated by all involved, and professionals in GP felt more able to provide person-centred culturally sensitive care.</p><p><strong>Conclusion: </strong>Person-centred culturally sensitive care in general practice, including an introductory meeting with refugees, in combination with interprofessional collaboration, indeed results in more discussions of mental health problems with refugee minors in general practice. Such an approach is assessed positively by all involved and is therefore recommended for broader implementation and assessment.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e17"},"PeriodicalIF":0.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506549","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":"Feasibility of utilizing the Modified Centor Criteria in adult virtual care.","authors":"Ahmed Allabban, Samay Shah, Neal Sikka, Colton Hood","doi":"10.1017/S1463423625000052","DOIUrl":"10.1017/S1463423625000052","url":null,"abstract":"<p><p>The Modified Centor criteria (MCC) is a validated clinical decision tool determining the need for testing in suspected <i>Streptococcal pharyngitis</i>. This study aims to understand the use of this tool to guide testing during remote evaluation. Patients with sore throats and no more than 3 days of symptoms were recruited from the emergency department and urgent care at an urban academic centre in 2019-2022. All patients enrolled were 18 years or older. Each participant had three MCC recorded, once in person and again by two different blinded telemedicine providers (TP). A total of 172 patients were screened and 40 were enrolled, they had a mean age 32 and were 43% male. We calculated inter-rater reliability between in-person and telemedicine providers, using a threshold score of strep testing (≥2) and non-testing scores (<2). Cohen's kappa between in-person and telemedicine providers was 0.68 while the TP were in complete agreement.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e15"},"PeriodicalIF":0.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143506547","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":"Health professionals' use of smartphone apps for clients with low back pain: an observational study.","authors":"Claudia Didyk, Lucy Kate Lewis, Belinda Lange","doi":"10.1017/S1463423625000209","DOIUrl":"10.1017/S1463423625000209","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to explore health professionals' use, barriers, confidence, and preferences for technology and smartphone apps to assist clients with self-managing low back pain (LBP).</p><p><strong>Methods: </strong>Prospective observational cross-sectional survey of registered Australian health professionals that managed clients with LBP.</p><p><strong>Results: </strong>In total, 52 survey responses were included (mean age 43 ±13.8 years). Most did not personally use healthy lifestyle apps (60%) and did not recommend apps due to a lack of knowledge of app effectiveness (93%). The largest barrier to recommending apps was the potential for apps to be misused as a substitute to health professional diagnosis. Fifteen recommended smartphone apps (mean age 36 ±10.6 years) and were at least moderately confident in choosing/recommending apps (94%) and assessing app quality (80%). Those more likely to recommend apps personally used apps for healthy lifestyle behaviours (odds ratio (OR) 5.1 (p = 0.009)) were physiotherapists (OR 0.13 (p = 0.035) c/f chiropractors in their profession for <10 years (OR 8.6 (p = 0.015)) c/f >30 years. Increasing age decreased the odds (OR 0.94 (p = 0.013)) of recommending apps.</p><p><strong>Conclusions: </strong>Health professionals do not recommend LBP self-management apps due to a lack of knowledge of their effectiveness. Those that do recommend apps are confident with app choice, recommendation, and app quality assessment. Physiotherapists with <10 years' experience were most likely to recommend apps.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e14"},"PeriodicalIF":0.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484966","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":"Food hygiene practice and associated factors among food handlers working in food establishments in sub-Saharan Africa: a systematic review and meta-analysis.","authors":"Yibeltal Assefa Atalay, Natnael Atnafu Gebeyehu, Kelemu Abebe Gelaw","doi":"10.1017/S146342362500009X","DOIUrl":"10.1017/S146342362500009X","url":null,"abstract":"<p><strong>Introduction: </strong>Food hygiene practices are crucial to avoid foodborne illness and improve human well-being. Millions of people get sick, and many of them pass away due to eating unhealthy food. Foodborne diseases are still a public health problem in developing countries.</p><p><strong>Objective: </strong>This study aimed to determine the prevalence and factors associated with food hygiene practices among food handlers in sub-Saharan Africa.</p><p><strong>Methods: </strong>An extensive search was conducted using various databases including PubMed, Science Direct, African Journal Online, and Google Scholar. The search results were then extracted using Microsoft Excel. The data analysis was conducted using STATA version 14. Publication bias was checked by funnel plot, and more objectively through Begg and Egger regression test, with P < 0.05 considered to indicate potential publication bias. A random effect model was used to calculate the pooled prevalence of hygienic food handling practices. Sub-group analysis was done by country and study site.</p><p><strong>Results: </strong>To estimate the pooled prevalence of food hygiene practices in sub-Saharan Africa, 42 reviewed studies and 12,367 study participants were included. The pooled prevalence of food hygiene practices among food handlers in sub-Saharan Africa was found to be 50.68% (95% CI: 45.35, 56.02) in this study. Factors associated with food hygiene practices included lack of food safety training (OR = 2.14 95% CI: 0.68, 6.76), negative attitude (OR: 2.36, 95% CI: 1.36, 4.09), and lack of regular medical checkups (OR: 2.66, 95% CI: 1.52, 4.65) among food handlers.</p><p><strong>Conclusion: </strong>This research found that only half of sub-Saharan Africa's food handlers had good food hygiene practices. Lack of food safety training, a lack of regular medical checkups, and unfavorable attitudes toward food hygiene practices were factors contributing to food hygiene practices. Thus, the authors recommended that food workers receive food safety training about food hygiene and safety procedures.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e13"},"PeriodicalIF":0.0,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470219","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 impact of alternate nostril breathing on the severity and frequency of migraine attacks: a randomized control trial.","authors":"Oğulcan Çöme, Gizim Limnili, Azize Dilek Güldal","doi":"10.1017/S1463423625000064","DOIUrl":"10.1017/S1463423625000064","url":null,"abstract":"<p><strong>Background: </strong>Migraine is a prevalent and debilitating neurological disorder that significantly affects quality of life. While pharmacological treatments exist, they can have limitations such as side effects, contraindications, and incomplete relief, prompting interest in non-pharmacological approaches for better symptom management.</p><p><strong>Objective: </strong>This study aimed to assess the effectiveness of alternate nostril breathing (ANB) as a non-pharmacological intervention to reduce the frequency and severity of migraine attacks and associated disability in adult patients.</p><p><strong>Methods: </strong>A single-center, open-label, two-arm, parallel-group randomized controlled trial was conducted at six Family Health Centers (FHCs) of Dokuz Eylul University, Izmir, Turkey. A total of 86 migraine patients aged 18-50 years, diagnosed with migraine based on ICD-10 criteria, were randomized into control (n = 43) and intervention (n = 43) groups. The intervention group practiced ANB three times daily for three months, while the control group continued their usual care. The primary outcomes were changes in migraine frequency and severity. Secondary outcomes included changes in migraine-related disability, both outcomes measured using the Migraine Disability Assessment Scale (MIDAS).</p><p><strong>Results: </strong>The intervention group showed a significant reduction in migraine attack frequency (<i>P</i> = 0.002) and MIDAS scores (<i>P</i> = 0.003) compared to the control group. Both groups experienced a reduction in attack severity (<i>P</i> = 0.001), though no significant difference was observed between the groups (<i>P</i> = 0.074). Within-group comparisons showed significant improvements in attack frequency, severity, and MIDAS scores in the intervention group (<i>P</i> = 0.001 for all).</p><p><strong>Conclusion: </strong>ANB significantly reduced migraine frequency and disability, making it a promising non-invasive and accessible treatment option for migraine management. Further research with longer follow-up periods is needed to explore its long-term effects and broader applicability.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e12"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416515","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}