The European Journal Of General Practice[JOURNAL]
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200 papers
From subtle symptoms to disclosure: Communication in violence detection in primary care.
Pivert O, Loubrieu C, Magret J … +2 more , Naiditch N, Mignot S
Eur J Gen Pract · 2026 Dec · PMID 42347835 · Full text
BACKGROUND: Identifying victims of interpersonal violence remains a challenge for general practitioners, who must rely on subtle clinical cues and foster an environment conducive to disclosure. OBJECTIVES: To describe th...
BACKGROUND: Identifying victims of interpersonal violence remains a challenge for general practitioners, who must rely on subtle clinical cues and foster an environment conducive to disclosure. OBJECTIVES: To describe the symptoms, behaviours, and communication strategies that facilitate the recognition of interpersonal violence in primary care consultations. METHODS: For this qualitative study, general practice consultations by three physicians in the Poitou-Charentes department, France, were audio-recorded from June to September 2019. Adult patients (≥18 years, fluent in French) were included unless they rejected audio recording. Only the audio-recording of consultations during which interpersonal violence was disclosed were analysed following an inductive approach to identify categories and themes until saturation was reached. RESULTS: In total 25/326 patients disclosed experiences of violence. Detection combined verbal cues (vague somatic complaints, ambiguous trauma references) by the patient and open-ended or direct questions by the general practitioners. Techniques included linking symptoms to violence, broad funnel questions, and most effectively, direct queries, such as 'Did someone hurt you?. The three physicians adapted their approach, balancing respect for the patient readiness and clinical conviction, often revisiting the topic from different perspectives. Empathy and a trusted doctor-patient relationship proved crucial for violence disclosure. CONCLUSION: Our findings highlight the value of the physicians' tenacity and empathic attitude for identifying hidden situations of violence, and suggest that integrating these strategies in routine general practice can enhance detection. The findings underscore the need of training physicians in patient-centred communication and suggest future research avenues for refining detection protocols in primary care.
Breast cancer screening in Europe and the role of general practitioners: A 32-country comparative survey.
Papageorgiou DI, Smyrnakis E, Harris M … +30 more , Skuja I, Adžić ZO, Apostolova G, Bensemmane S, Brekke M, Buczkowski K, Buono N, Burgers J, Danilenko J, Högberg C, Kafadar D, Koskela T, Kral N, Kraxner R, Küppers L, Legoff D, Marzo-Castillejo M, Pless A, Ponzel N, Puia A, Radzevičienė-Jurgutė R, Redmond P, Särgava K, Šter MP, Sulashvili M, Vedsted P, Wöstmann X, Zafirovska M, Zaidan R, Hoffman R
Eur J Gen Pract · 2026 Dec · PMID 42340409 · Full text
INTRODUCTION: Breast cancer is the commonest cancer in women, and screening can allow earlier-stage diagnosis. While there are European recommendations on the age-range and frequency of breast cancer screening, participa...
INTRODUCTION: Breast cancer is the commonest cancer in women, and screening can allow earlier-stage diagnosis. While there are European recommendations on the age-range and frequency of breast cancer screening, participation in these programmes varies substantially, and this could be due to differences in how they are organised and implemented. The role that primary healthcare professionals play in the process is unclear.We aimed to describe the breast cancer screening programmes in European countries and investigate how primary healthcare professionals are involved in this screening process. METHODS: A cross-sectional survey in 32 countries. Key informants with relevant expertise answered online questions about the characteristics of their screening programmes and general practitioners' (GPs') roles in this. Responses were refined through an iterative consensus process. Data were examined to identify patterns in GP engagement. RESULTS: We found important differences between European breast cancer screening systems. While most had population-based screening, four countries relied on opportunistic screening. In 15 countries GPs had little or no involvement in the process of breast cancer screening, and in 13 countries GPs had some involvement, including identifying eligible patients, issuing referrals, and following-up results. Screening uptake rates tended to be higher in countries with well-established population-based screening programmes which give little or no GP involvement. Few countries linked GP engagement to incentives or performance measures. CONCLUSION: Countries with lower screening uptake should consider either enhancing GP involvement or transitioning to a structured, population-based screening system. Further research should explore how best to integrate primary care within national screening strategies.
The power of peers.
Burgers J
Eur J Gen Pract · 2026 Dec · PMID 42206666 · Full text
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Patients' perspectives in German general practice on discussing the environmental impact of medications: A qualitative study.
Neumann D, Müller C, Müller F
Eur J Gen Pract · 2026 Dec · PMID 42189646 · Full text
BACKGROUND: Pharmaceuticals represent a major source of carbon emissions in primary care. General practitioners could avoid prescribing climate-harmful medications and consider eco-friendly alternatives in shared decisio...
BACKGROUND: Pharmaceuticals represent a major source of carbon emissions in primary care. General practitioners could avoid prescribing climate-harmful medications and consider eco-friendly alternatives in shared decision-making processes. However, evidence on patients' perceptions of discussing medication-specific environmental impacts in primary care consultations in Germany remains limited. OBJECTIVES: To explore patients' perceptions of discussing medications' environmental and climate impact during family medicine encounters and their willingness to switch to more eco-friendly options. METHODS: This qualitative study employed semi-structured interviews with patients recruited through GP practices in Northern Germany. Inclusion criteria were long-term use of at least one medication, legal age, and informed consent. Twenty-five interviews were conducted and analysed using structured content analysis according to Kuckartz. RESULTS: Respondents expressed surprise when environment/climate topics were to be discussed in medical encounters but demonstrated openness to these topics and desired more information about their medications' environmental impact. Many interviewees showed willingness to switch to eco-friendly medications despite potential disadvantages including more frequent intake, increased side effect risk, or co-payments. Patients exhibited high trust in provider recommendations and sought greater information and transparency. CONCLUSION: Results suggest opportunities to incorporate climate/environmental aspects into shared decision-making. Understanding patient perspectives enables GPs to address environmental/climate-friendly medication topics in treatment discussions. Patients are receptive to these discussions and willing to accept eco-friendly alternatives despite potential drawbacks. The high level of trust in provider recommendations positions family physicians as key actors in promoting environmental stewardship.
Point-of-care ultrasound teaching in general practice and family medicine: EURACT position paper.
Homar V, Michels NR, Kucera M … +4 more , Bednar J, Ortega Y, Andersen CVA, Granek-Catarivas M
Eur J Gen Pract · 2026 Dec · PMID 42170895 · Full text
Point-of-care ultrasound (POCUS) is an increasingly valuable tool in general practice/family medicine (GP/FM). This position paper from the European Academy of Teachers in General Practice/Family Medicine outlines recomm...
Point-of-care ultrasound (POCUS) is an increasingly valuable tool in general practice/family medicine (GP/FM). This position paper from the European Academy of Teachers in General Practice/Family Medicine outlines recommendations for integrating POCUS education across the continuum of training: undergraduate, specialty, and continuing medical education. POCUS should complement, not replace, the clinical examination. Key priorities include GP/FM-targeted curriculum development, early exposure during basic medical education, mandatory residency training, context-sensitive continuing professional development, train-the-trainer programmes, and GP/FM-led implementation. Integrating POCUS teaching across all stages of GP/FM education may support effective and sustainable adoption in primary care. Educational strategies should be adapted to local contexts and healthcare systems while maintaining a focus on clinically relevant and evidence-informed use. EURACT recommends the longitudinal integration of POCUS education throughout GP/FM training and professional development. These principles aim to guide the effective, sustainable, and context-sensitive implementation of POCUS in primary care.
Interprofessional collaboration in primary care in Germany - collective irresponsibility, one-way-street or colourful bouquet of services? A qualitative study with stakeholders from various professions.
Mink J, Altiner A, Schwill S
Eur J Gen Pract · 2026 Dec · PMID 42165401 · Full text
BACKGROUND: Interprofessional collaboration (IPC) in outpatient care can improve patient outcomes and satisfaction, health prevention and economics. German primary care (PC) is challenged by an ongoing demand for health...
BACKGROUND: Interprofessional collaboration (IPC) in outpatient care can improve patient outcomes and satisfaction, health prevention and economics. German primary care (PC) is challenged by an ongoing demand for health care professionals to extend services. PC in Germany is regularly provided by general practitioners and medical assistants. Models on how to establish interprofessional primary care (IPPC) are scarce. OBJECTIVES: Aim of the study was to explore stakeholders' suggestions on IPC in German PC to support development of an IPPC model. METHODS: Professionals from various nation-wide institutions and associations with professional backgrounds in general practice, medical assistance, nursing, physician assistance, social work and specialist medicine as well as from health insurance and law, were recruited. Semi-structured interviews were performed. Deductively identified main categories included strategies for implementing IPC on system-level, organisational-level, team-level and individual-level and were coded in sub-categories inductively. RESULTS: On system-level professionals predominantly named accountability, funding and remuneration. On organisational level documentation systems, the necessity of coordination and the availability of qualified personnel were discussed. On team-level interviewees focussed on the necessity of a mutual understanding of roles and responsibilities, clear and collaborative distribution of tasks and team leadership as well as patient integration and health literacy support. On individual-level the acceptance of new roles and professions was pointed out. CONCLUSION: To establish IPPC in Germany, remuneration and accountability need to be addressed. Models of IPPC need to integrate suggestions explored, a step-by-step approach for general practitioners to enable change-management and longitudinal support to promote adapted leadership and sustainable implementation.
Preventive strategies for recurrent urinary tract infections in premenopausal women: A scoping review.
Clausen CS, Jørgensen LB, Aabenhus R … +5 more , Arnold SH, Hansen KH, Bjerrum L, Risør MB, Holm A
Eur J Gen Pract · 2026 Dec · PMID 42132404 · Full text
BACKGROUND: Recurrent urinary tract infection (rUTI) in women is common in primary care. Antibiotics can prevent rUTI, but their use is associated with the risk of developing antimicrobial resistance. Thus, non-antibioti...
BACKGROUND: Recurrent urinary tract infection (rUTI) in women is common in primary care. Antibiotics can prevent rUTI, but their use is associated with the risk of developing antimicrobial resistance. Thus, non-antibiotic strategies are needed, yet evidence remains limited due to methodologically weak studies. Consequently, potentially effective strategies lack sufficient evidence for guideline inclusion, leaving healthcare professionals (HCPs) and women with little support. This scoping review synthesises preventive strategies for rUTIs in premenopausal women, mapping recommendations and underlying rationales to guide future research and guideline development. METHODS: This Scoping review was conducted by searching PubMed, Cochrane, EMBASE, Web of Science, and CINAHL. 6170 records were identified for eligibility. A total of 78 publications were included, i.e. reviews, guidelines, and expert reports regarding preventive strategies used for rUTIs for premenopausal women, published between January 2013 and December 2023. RESULTS: 78 publications addressed rUTIs prevention in premenopausal women, encompassing both well-studied strategies, such as antibiotic regimens and cranberry products, and less-studied approaches, including behavioural modifications, vitamin supplements, and increased hydration. Recommendations were often unsupported by evidence, and disagreement among sources was common. DISCUSSION: To support women with rUTIs, HCPs require an overview of preventive strategies including supporting recommendations and evidence. Our findings highlight a clear contrast between well-studied strategies, such as antibiotic regimens, and behavioural strategies, where evidence is limited, often because some cannot feasibly be evaluated in randomised trials rather than due to limited clinical relevance. These findings may help HCPs and guideline developers assess evidence and prioritise future research.
What affects unplanned hospital admissions in older adults according to primary healthcare professionals? A focus group study.
Klunder JH, Kooijmans ECM, Joling KJ … +2 more , Maarsingh OR, van Hout HPJ
Eur J Gen Pract · 2026 Dec · PMID 42095496 · Full text
BACKGROUND: Unplanned hospital admissions are distressing for older persons and are associated with a high risk of adverse outcomes and a burden on health systems. Understanding the risk and protective factors for unplan...
BACKGROUND: Unplanned hospital admissions are distressing for older persons and are associated with a high risk of adverse outcomes and a burden on health systems. Understanding the risk and protective factors for unplanned admissions can help to design new preventive interventions in primary care. OBJECTIVES: To explore primary healthcare professionals' experiences on factors affecting unplanned hospital admissions in community-dwelling older adults and identify opportunities for preventive interventions. METHODS: We performed a focus group study with a purposive sample of Dutch primary healthcare professionals. Four focus groups were conducted with a total of 22 primary healthcare professionals comprising 10 general practitioners (GPs) and 12 other primary healthcare professionals. All focus groups were recorded, transcribed, and thematically analysed. RESULTS: Factors affecting unplanned admissions were grouped into characteristics of the patient, the healthcare professional, and healthcare organisation. Patient-related risk factors included the presence of chronic conditions, health-seeking behaviour, the presence and capacity of an informal caregiver, and cultural expectations of healthcare. Continuity of care, advance care planning, and professional experience as a GP were identified as mitigating professional-related factors for unplanned admissions. Organisational factors that potentially contributed to unplanned admissions were poor informational continuity, suboptimal care coordination, and lack of alternatives to hospitalisation. CONCLUSION: Unplanned hospital admissions in older adults were perceived to be influenced by patient, healthcare professional, and healthcare organisation-related factors. Strategies such as ensuring broad access to patients' clinical information and treatment wishes, improving personal continuity of care, and structural provision of advance care may contribute to reduce unplanned admissions.
Telehealth and access to acute primary care in Europe: Balancing opportunity and equity.
Huibers L
Eur J Gen Pract · 2026 Dec · PMID 42037419 · Full text
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Primary care providers' perspectives of experiences with transgender and gender diverse adults: A scoping review.
Keaney KL, Van Hout MC, McCombe G … +4 more , Ravichandran N, Broughan J, Cullen W, Crowley D
Eur J Gen Pract · 2026 Dec · PMID 42008307 · Full text
BACKGROUND: As a minority group, transgender and gender diverse (TGD) individuals may experience healthcare stressors due to stigma, transphobia and healthcare staff who lack the knowledge about their specific needs, imp...
BACKGROUND: As a minority group, transgender and gender diverse (TGD) individuals may experience healthcare stressors due to stigma, transphobia and healthcare staff who lack the knowledge about their specific needs, impacting primary care entry and attendance. Extant literature is concentrated on TGD individuals' perspectives of primary care with the main message being that it is inadequate. AIM: To explore the primary care provider (PCP) perspective of experiences with adult TGD patients. METHODS: A scoping review was conducted using Arksey and O'Malley's five-step framework to map and de-scribe the literature relating to PCP perspectives' of experiences with TGD adults. Four databases were searched: PubMed, Embase, PsycINFO and CINAHL Plus. The process was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The final dataset ( = 22) were charted and analysed thematically. RESULTS: Following application of exclusion criteria and removal of duplicates, twenty-two studies across five countries were included in the review. Studies include qualitative studies, surveys, mixed methods studies, a retrospective review and a pilot study with a pre- and postintervention analysis. Key themes identified related to the attitudes of PCPs towards TGD individuals, education of PCPs on TGD health issues and the barriers/facilitators to caring for TGD patients from a PCP perspective. CONCLUSION: The review highlights the need for improved access to TGD-specific education. Future research should explore the best way to provide this to PCPs, inform implementation into relevant policies and include a broader range of countries to strengthen global applicability.
The impact of professional characteristics and person-centred care on general practitioners' stress levels. Findings from the cross-sectional PACE GP/FP study in 24 European countries.
Nessler K, Studzinski K, Klemenc-Ketiš Z … +23 more , Rogers HL, Eide TB, Ares Blanco S, Lingner H, Kreitmayer S, González-Lama J, Van Poel E, Kafadar D, Hoffmann K, Frese T, Assenova R, Ungan M, Vuletić G, Zelko E, Megallón-Botaya R, Tomičić M, Lopez FM, Tsimtsiou Z, Mora MJ, Mahtani V, Wójtowicz E, Windak A, Petriček G
Eur J Gen Pract · 2026 Apr · PMID 41978560 · Full text
BACKGROUND: General practitioners (GPs) face numerous challenges that can contribute to stress. Understanding these factors is crucial for developing interventions to support physician wellbeing and maintain high-quality...
BACKGROUND: General practitioners (GPs) face numerous challenges that can contribute to stress. Understanding these factors is crucial for developing interventions to support physician wellbeing and maintain high-quality care. OBJECTIVES: The study aims to explore the factors associated with perceived stress among European GPs, including attitudes towards person-centred care (PCC), demographics, and professional characteristics. METHODS: The PACE GP/FP study is an online, cross-sectional, multi-centred survey conducted in 24 European countries between November 2022 and January 2024. The survey tool included the Perceived Stress Scale (PSS), the Patient-Practitioner Orientation Scale (PPOS), and questions on GPs' demographics and practice characteristics. Linear mixed models analysed the relationship between these variables and perceived stress. RESULTS: In total, 3522 GPs were included in the analysis. The mean PSS score indicated moderate levels of stress. Female gender and younger age were associated with increased stress. Also, a higher number of daily patient contacts and a greater perceived responsibility for vulnerable patient populations (e.g. migrants, those with limited social support, or psychiatric vulnerabilities) were significantly associated with higher stress. A stronger patient-centred orientation was associated with lower perceived stress. CONCLUSION: The findings have implications for interventions to reduce GP stress, such as training programs promoting PCC, optimising patient contact rates, and providing targeted support for GPs caring for vulnerable patients. Further research is needed to explore these factors' complex interplay and impact on GP wellbeing.
Healthcare inequalities in general practice due to educational level: A retrospective cohort study analysing patients' presentation and GP response to requests.
Hulshof S, Hartman TCO, Akkermans R … +2 more , Schers HJ, Uijen AA
Eur J Gen Pract · 2026 Mar · PMID 41978500 · Full text
BACKGROUND: Educational level is an important social determinant of health and may contribute to healthcare inequity by affecting how patients present health problems. OBJECTIVES: Explore the interaction between patients...
BACKGROUND: Educational level is an important social determinant of health and may contribute to healthcare inequity by affecting how patients present health problems. OBJECTIVES: Explore the interaction between patients' educational level (1), their presentation of health problems to general practitioners (GPs) and (2) GP's responses to requested interventions. DESIGN AND SETTING: Retrospective cohort study within a Dutch primary care practice-based research network. METHODS: All new episodes of care of patients' aged ≥25 years between 2014 and 2022 were included. Data were collected on the reason for encounter (RFE) at initial contact within each episode, and patients' educational level. Differences were analysed in incidence of RFE types (symptoms, intervention-requests, self-diagnoses) and GP's policies regarding requested diagnostic and therapeutic interventions among patients with low, medium and high educational levels. RESULTS: Patients with lower educational levels more frequently presented symptoms (59.7% versus 56.5%) and were less likely to present with intervention requests (OR 0.88) or self-diagnosis (OR 0.83). They requested more urine tests (RR 1.28), but fewer blood tests (RR 0.90), diagnostic imaging (RR 0.75) and referrals to primary (RR 0.74) and secondary care (RR 0.87). GPs responded more often to urine test requests (RR 1.25), but less often to referral requests to primary (RR 0.68) and secondary care (RR 0.80) among patients with lower educational levels. CONCLUSION: This study emphasises GPs' need to understand how educational status affects patient's presentation and intervention preferences, which can improve communication, shared decision-making and enhance equitable healthcare delivery by addressing an important social determinant of health.
Understanding the diagnostic process of endometriosis in primary care: An interview study with general practitioners in Denmark using clinical vignettes.
Pencheri M, Hansen KE, Nielsen LJ … +7 more , Dixon S, Hinton L, Prior A, Forman A, Marschall H, Seyer-Hansen M, Kirk UB
Eur J Gen Pract · 2026 Dec · PMID 41914461 · Full text
INTRODUCTION: Endometriosis is a chronic, systemic condition affecting 5-10% of individuals assigned female at birth. Due to its non-specific symptoms, diagnosis is often delayed. OBJECTIVES: This study aims to explore d...
INTRODUCTION: Endometriosis is a chronic, systemic condition affecting 5-10% of individuals assigned female at birth. Due to its non-specific symptoms, diagnosis is often delayed. OBJECTIVES: This study aims to explore diagnostic challenges and decision-making processes that general practitioners (GPs) encounter when managing patients with symptoms suggestive of endometriosis in Denmark. METHODS: A qualitative research approach was employed, incorporating the co-production of three fictional clinical vignettes representing diverse endometriosis presentations. Semi-structured interviews were conducted with 27 practicing GPs (7 males and 20 females) from urban and rural areas. Participants had a mean age of 50 years (range 41-66) and clinical experience ranging from newly qualified to 27 years. Interviews involved engagement with the vignettes, and data were analysed using thematic analysis. RESULTS: Findings reveal the challenge of the non-specific nature of symptoms, the role of cyclical symptom patterns in diagnosis, the influence of diagnostic hierarchies, patient-centred care approaches, the bio-psycho-social perspective in management, the persistent stigma surrounding gynaecological symptoms, and GPs limited trust in general gynaecologists. GPs were more likely to suspect endometriosis when symptoms followed a cyclical pattern, whereas gastrointestinal presentations were less commonly linked to the condition. While many GPs adopted a patient-centred, shared decision-making approach, some still adhered to mind-body dualism in their clinical reasoning. CONCLUSION: Diagnosing endometriosis in primary care is challenging due to non-specific symptoms, diagnostic hierarchies, and stigma. Encouraging GPs to routinely inquire about the cyclical nature of symptoms may serve as a valuable diagnostic tool, particularly in cases involving gastrointestinal complaints.
Gabapentinoids and unexplained death in general practice: Case series and feasibility study arising from a critical incident.
Gabriel A, Fahey T
Eur J Gen Pract · 2026 Dec · PMID 41871002 · Full text
BACKGROUND: Prescribing epidemiology in general practice shows gabapentinoid drugs to be independently associated with unexpected, drug-related death. There is an increasing trend of gabapentinoid deaths throughout Europ...
BACKGROUND: Prescribing epidemiology in general practice shows gabapentinoid drugs to be independently associated with unexpected, drug-related death. There is an increasing trend of gabapentinoid deaths throughout Europe and North America. OBJECTIVES: The overall aim of this study was to assess how patient, practice and health system factors might be associated with gabapentinoid prescribing in primary care. METHODS: Case series following a critical incident of an unexpected death in a patient prescribed a gabapentinoid drug in a single general practice. Unexpected and expected deaths in patients prescribed a gabapentinoid drug deaths over an 11-year period in a single general practice. We examined patient, prescriber and health system factors. Toxicology and post-mortem data were provided by the Coroner. RESULTS: There were 36 deaths (four unexpected and 32 expected deaths) during the study period. Of the four patients who suffered an unexpected death, one of these patients' cause of death could be attributed to drug and alcohol toxicity. Over half of gabapentinoid prescribing ( = 19,53%) was hospital initiated, often 'off-label' ( = 6, 17%) and commonly co-prescribed with opiates ( = 15, 42%) and benzodiazepines ( = 11, 31%) to patients with high multi-morbidity. CONCLUSIONS: Gabapentinoids are often initiated in the outpatient setting in clinically complex patients, often for 'off label' indications, with high polypharmacy. Patient, practice and health-system related factors need to be addressed in relation to gabapentinoid associated deaths and reflected in clinical practice guidelines. There is critical value in using toxicology reports from Coroner's offices in cases of unexplained gabapentinoid death in general practice.
Strengthening Primary Health Care in Europe: A Delphi study towards accessibility, equity and continuity of care.
Gefaell Larrondo I, Ares-Blanco S, Guisado-Clavero M … +9 more , Mira JJ, Pérez Esteve C, Adler L, Bensemmane S, Kostić M, Mortsiefer A, Petrazzuoli F, Gómez-Bravo R, Astier-Peña P
Eur J Gen Pract · 2026 Dec · PMID 41854201 · Full text
INTRODUCTION: Strengthening Primary Health Care (PHC) is essential for building resilient and equitable health systems, but PHC faces barriers in implementation, resource allocation, and political prioritisation. This st...
INTRODUCTION: Strengthening Primary Health Care (PHC) is essential for building resilient and equitable health systems, but PHC faces barriers in implementation, resource allocation, and political prioritisation. This study aimed to develop a strategic roadmap to enhance PHC by identifying core values, priorities, and actionable strategies through expert consensus. METHODS: A two-round Delphi study was conducted with 210 stakeholders from 35 countries, including PHC professionals, policymakers, and public health experts. Participants evaluated the importance, feasibility, and policy prioritisation of key PHC values. Quantitative data were analysed using descriptive statistics. RESULTS: The response rate was 81.4% (171/210) in round one and 73.5% (97/132) in round two. The majority of participants (89%) had a background in medicine. A consensus (>80% agreement) was reached in the first round regarding PHC values. Key recommendations included increasing investment in PHC workforce development, particularly in underserved areas; strengthening health information systems and integrating telehealth solutions; enhancing PHC governance models to support multidisciplinary collaboration and citizen-centred care; and adapting processes to improve chronic care management, end-of-life support, and standardised assessment frameworks. In the second round, when participants assessed the feasibility of these recommendations, agreement levels ranged from 61 to 92%. When asked about the policy prioritisation of these measures, agreement dropped, ranging from 22 to 51%. CONCLUSIONS: This study highlights that PHC stakeholders perceive a critical need to align health policies with the core values of PHC, while addressing systemic barriers to implementation. Future efforts should focus on bridging the perceived gap between expert recommendations and political prioritisation to achieve sustainable PHC improvements.
Population health management within the primary care context - scoping review.
Schaubroeck E, Sessa G, De Maeseneer J … +2 more , Willems S, Decat P
Eur J Gen Pract · 2026 Dec · PMID 41802317 · Full text
BACKGROUND AND OBJECTIVES: Population health management (PHM) is increasingly promoted as a strategy to improve health outcomes, enhance healthcare quality, reduce costs, and, more recently, support clinician well-being...
BACKGROUND AND OBJECTIVES: Population health management (PHM) is increasingly promoted as a strategy to improve health outcomes, enhance healthcare quality, reduce costs, and, more recently, support clinician well-being and advance health equity - the Quintuple Aim. However, how PHM is conceptualised within the primary care context remains unclear. This scoping review explores how PHM is conceptualised within this context. METHOD: Five databases (PubMed, Embase, CINAHL, Web of Science and Scopus) were searched to find publications that conceptually addressed PHM and its interaction with the primary care context. Data extraction focused on definitions and related terms, the bidirectional influence between PHM and general practice, and interpretations of the components 'population' and 'management'. RESULTS: 27 publications were included. Definitions of PHM varied, with few explicitly addressing the primary care practice level. They highlighted the need to proactively address social determinants of health beyond clinical outcomes. Both top-down and bottom-up dynamics make general practices accountable for and increasingly involved in the identification of populations, risk stratification and impact assessment, with both clinical judgement and real-world primary care data. Management involves team-based and technology-supported care. CONCLUSION: Considering PHM within primary care highlighted the importance of general practice's accountability, its consideration of social determinants of health beyond clinical outcomes and its community alignment to enhance equity. What the potential added value of general practitioner's clinical intuition and real-world primary care data in assessing impact warrants additional exploration.
Motivational factors for general practice training and career establishment: A cross-sectional study in Flanders, Belgium.
Coenen LE, Maseman M, Lobbestael J … +4 more , Gielis G, Gils A, Vansintejan J, Van Rossem I
Eur J Gen Pract · 2026 Dec · PMID 41734083 · Full text
BACKGROUND: In Flanders, Belgium, the 3-year specialised training in General Practice includes a specialty training rotation, for which trainees may choose their training site. After graduation, General Practitioners (GP...
BACKGROUND: In Flanders, Belgium, the 3-year specialised training in General Practice includes a specialty training rotation, for which trainees may choose their training site. After graduation, General Practitioners (GPs) decide where to establish their practice. OBJECTIVE: This study explored the factors influencing GP trainees' choice of training location, reasons for settling in a specific region after graduation, and motivations for remaining in or leaving a practice. METHODS: In May 2024, the Interuniversity Centre for Education of General Practitioners distributed an anonymous online survey with closed- and open-ended questions to all GP alumni graduating between 2014 and 2023. Quantitative data were analysed using linear regression; qualitative data underwent content analysis. RESULTS: Of 772 alumni respondents (26.7% response rate), 93.4% were still practising as a GP. Most were female (70.9%), and 37.2% engaged in additional professional roles. Key influences on training location choice and practice settlement included colleague connections, proximity to home, and opportunities to work in group practices. Decisions to stay in or leave a practice were shaped by interpersonal relationships, practice organisation, and work-life balance. Working as a substitute GP was a frequent reason for changing practices, especially among recent graduates, to explore varied working environments. CONCLUSION: Both interpersonal and logistical factors strongly influence training practice choice and later GP practice settlement. High-quality training practices and supportive work environments are essential to promote sustainable GP careers and achieve a more balanced geographical distribution of GPs.
Primary health care policy advocacy in Europe: A cross-sectional study of family medicine associations.
Gómez-Bravo R, Ares-Blanco S, Mamo N … +14 more , Guisado-Clavero M, León-Herrera S, Rasic V, Neves AL, Rochfort A, Harding A, Hummers E, Asenova R, Petrazzuoli F, Poppleton A, Bueno Ortiz JM, Vinker S, Astier-Peña MP, Frese T
Eur J Gen Pract · 2026 Dec · PMID 41733311 · Full text
BACKGROUND: Policy advocacy (PA) in European healthcare has a strong tradition promoting evidence-based policies. Key organisations, including the European Observatory on Health Systems and Policies, the WHO's Evidence-I...
BACKGROUND: Policy advocacy (PA) in European healthcare has a strong tradition promoting evidence-based policies. Key organisations, including the European Observatory on Health Systems and Policies, the WHO's Evidence-Informed Policy Network, and the OECD play pivotal roles in integrating research into policymaking. OBJECTIVES: To assess the involvement of European Family Medicine (FM) Associations in PA, identify key issues, and explore interactions with governmental and institutional bodies related to Primary Health Care (PHC)-defined as first-contact, continuous, comprehensive, and coordinated care provided by general practitioners/family doctors (GPs), in line with the WHO Alma-Ata and Astana declarations-and perceived challenges in PHC advocacy. METHODS: An exploratory descriptive, cross-sectional study was conducted among WONCA Europe Member Organisations and GPs involved in PA. Data collected between November 2023 and February 2024. Content analysis was performed to identify themes related to advocacy priorities. RESULTS: Responses were received from 12 member organisations across 12 countries and 37 participants from 17 countries. Key concerns included workforce shortages, high workloads, inadequate infrastructure, and insufficient financial compensation. Public visibility, gender equality, and the integration of FM into university curricula were also highlighted. Eleven respondents reported active engagement with national governments in policy discussions. CONCLUSION: Respondents highlighted the need for a more unified strategy to address common PHC challenges across Europe. WONCA Europe's Working Party on PA supports national efforts through exchange of best practices, research support, and promoting FM at national and European levels. Continued research and advocacy were viewed as essential for sustaining effective and equitable PHC in Europe.
Correction.
Eur J Gen Pract · 2026 Dec · PMID 41729609 · Full text
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External validation of risk scores and multivariate models for the diagnosis of community-acquired pneumonia in outpatients.
Ebell M, Merenstein DJ, Barrett B … +2 more , Verheij T, Little P
Eur J Gen Pract · 2026 Dec · PMID 41719027 · Full text
BACKGROUND: While several risk scores for the diagnosis of community-acquired pneumonia (CAP) have been developed, they require prospective external validation. OBJECTIVES: To externally validate existing prediction mode...
BACKGROUND: While several risk scores for the diagnosis of community-acquired pneumonia (CAP) have been developed, they require prospective external validation. OBJECTIVES: To externally validate existing prediction models, risk scores, and heuristics for the diagnosis of CAP in adults. METHODS: The Enhancing Antibiotic Stewardship in Primary Care (EAST-PC) study recorded signs, symptoms, demographics, and vitals in 718 adults presenting to primary or urgent care clinics with acute lower respiratory tract infection between 2019 and 2023. C-reactive protein (CRP) was available for 575. The diagnosis of CAP was based on the clinician diagnosis and/or chest radiograph. Literature was searched for previous risk scores. Using the EAST-PC population, the area under the receiver operating characteristic curve (AUROCC), calibration curves, and percentage with CAP in each risk group were calculated for each risk score. RESULTS: We identified 11 studies describing 4 risk scores, 9 multivariate models, and 5 simple heuristics. The Genomics to Combat Resistance Against Antibiotics in Community-acquired LRTI in Europe (GRACE) risk score using the absence of a runny nose, the presence of breathlessness, crackles, diminished vesicular breathing, heart rate > 100/min, temperature >37.8 °C, and CRP > 30 mg/L was the most accurate (AUROCC 0.81). It classified 280 patients as low (0.7% CAP), 265 as moderate (5.7%) and 30 as high risk (33.3%) for CAP. The GRACE score without CRP performed similarly. Other risk scores had poor calibration or failed to accurately classify patients as low or high risk. CONCLUSIONS: The previously derived GRACE risk scores were successfully externally validated in a contemporary US outpatient population.
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