The European Journal Of General Practice[JOURNAL]
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200 papers
Cancer screening in patients with severe psychiatric disorders in France: Towards a coordinated and inclusive approach.
Pellen N, Gouzien B, Troënes M … +3 more , Khelifi S, Ragot G, Le Glaz A
Eur J Gen Pract · 2026 Jan · PMID 41685969 · Full text
BACKGROUND: The close link between mental health and physical health is evident in patients with severe psychiatric disorders (SPD), such as schizophrenia and bipolar disorder. SPD is associated with a reduction in life...
BACKGROUND: The close link between mental health and physical health is evident in patients with severe psychiatric disorders (SPD), such as schizophrenia and bipolar disorder. SPD is associated with a reduction in life expectancy, due to excess mortality from cardiovascular disease and cancer. In patients with SPD, reduced access to cancer screening programs, due to cognitive, organisational and social barriers, leads to late detection and worse prognosis. OBJECTIVES: The objective was to identify the barriers and facilitators to systematic cancer screening in patients with SPD, with a focus on the role of general practitioners (GPs) in improving access to preventive care. METHOD: This study was conducted in the Finistère department, France. A qualitative study based on semi-structured interviews with GPs, recorded, anonymised, transcribed verbatim, and analysed using a grounded theory approach. RESULTS: From October 2023 to February 2024, 25 GPs were interviewed. The analysis highlighted 3 areas for improving access to cancer screening: logistic support, active involvement of the family and professional support networks and coordination among the healthcare providers. Barriers included the patients' lack of autonomy, difficulties in accessing transport, precariousness and complexity of the screening process, particularly for at-home screening tests. Family and friends play a key role, but remain vulnerable to caregiver burnout. CONCLUSION: These results confirm the importance of a multi-professional and integrative approach, with GPs playing a central role in addressing the specific vulnerabilities of this population. More research, involving patients, caregivers and psychiatric teams, is needed to co-construct appropriate, sustainable and ethically sound solutions.
Reducing short-acting beta-agonist overprescribing in general practice: Evaluation of a quality improvement programme in East London.
De Simoni A, Hajmohammadi H, Pfeffer P … +3 more , Cole J, Griffiths CJ, Hull SA
Eur J Gen Pract · 2026 Dec · PMID 41627785 · Full text
BACKGROUND: Overprescribing of short-acting beta-agonist (SABA) inhalers is a worldwide problem. OBJECTIVES: To evaluate the impact of a system-wide quality improvement programme on SABA overprescribing, and to identify...
BACKGROUND: Overprescribing of short-acting beta-agonist (SABA) inhalers is a worldwide problem. OBJECTIVES: To evaluate the impact of a system-wide quality improvement programme on SABA overprescribing, and to identify the most effective strategies. METHODS: All general practices within one East London borough received the intervention between October 2020 and March 2023. Practices in two neighbouring boroughs acted as comparators. Intervention practices engaged in quality improvement activities including: electronic alerts flagging patients prescribed ≥12 SABA inhalers/year; generating lists of patients overprescribed SABA to call for review; a summary guideline for clinicians; electronic patient information leaflets. All practices were offered webinar coaching. Prescribing data were collected from electronic health records, and SABA overprescription evaluated through interrupted times series analysis. Content analysis was applied to survey data and conversations with staff. RESULTS: During the three-year study period all localities introduced programmes to reduce SABA prescribing. We observed a significant decrease in the proportion of asthma patients prescribed more than 6 SABA/year in the study practices. The COVID pandemic triggered a temporary increase in patients on asthma registers, which persisted for 6 months. When implemented by practices the electronic prescribing alerts were effective: 50% of patients who received an active response reduced to <12 SABA in the following year. CONCLUSIONS: This quality improvement programme was associated with a reduction in SABA overuse, which could also decrease hospital admissions. Practices required individual coaching to use the electronic tools effectively. Integrated prescribing alerts reduced overprescribing, and collaborative practice cultures supported faster implementation of improvement strategies.
The role and utility of artificial intelligence and machine learning for diagnostic prediction in general practice.
Hunik L, Uijen AA, Kueper JK … +4 more , Terry AL, Olde Hartman TC, van Laarhoven T, Schers HJ
Eur J Gen Pract · 2026 Dec · PMID 41626765 · Full text
Diagnostic prediction models are commonly used in general practice to support clinical decision-making. Traditionally, these models have been developed using statistical methods such as logistic regression. While these a...
Diagnostic prediction models are commonly used in general practice to support clinical decision-making. Traditionally, these models have been developed using statistical methods such as logistic regression. While these approaches have proven useful, they often produce average risk estimates that may not fully account for the complexity of individual patients. In recent years, the use of machine learning (ML), a subfield of artificial intelligence (AI), has grown in healthcare. We examine the similarities and differences between traditional statistical methods and AI/ML approaches for diagnostic prediction in general practice. Using examples from daily practice, we explore how ML techniques can add value, particularly in handling large, complex datasets such as those derived from electronic health records. We also discuss key challenges that hinder the adoption of AI/ML in general practice, including interpretability, data quality, external validation, clinical relevance, implementation and legal issues, and practical usability. We provide recommendations to overcome these challenges. The potential of AI/ML can only be realised if tools are developed collaboratively with GPs, focused on real-world clinical problems, and rigorously validated in practice settings. GP associations, GPs, patients, and primary care scientists should take an active role in the development, validation, and implementation of AI/ML-based diagnostic prediction tools for general practice.
Correction.
Eur J Gen Pract · 2026 Dec · PMID 41626756 · Full text
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Eur J Gen Pract · 2026 Dec · PMID 41609485 · Full text
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Impact of nurse practitioners in primary care on patients with chronic diseases in rural and underserved areas: A systematic review.
Sacchetti A, Berube M, Pison C … +2 more , Gagnon MA, Bellier A
Eur J Gen Pract · 2026 Dec · PMID 41591865 · Full text
BACKGROUND: Ageing, multimorbidity, and workforce shortages increasingly limit access to primary healthcare, especially in rural and underserved areas. OBJECTIVES: To document impact of nurse practitioners (NPs) in prima...
BACKGROUND: Ageing, multimorbidity, and workforce shortages increasingly limit access to primary healthcare, especially in rural and underserved areas. OBJECTIVES: To document impact of nurse practitioners (NPs) in primary care on patients with chronic diseases. METHODS: Searches were conducted in Medline, EMBASE, CINAHL, and CENTRAL (March 1978-October 2023). This systematic review followed MECIR and PRISMA guidelines (PRISMA 2020 checklist: EQUATOR Network) with SWiM used as a PRISMA extension due to the lack of meta-analysis. The focus was on NPs' roles in chronic disease management and primary care in underserved or remote areas, excluding mental health, cancer, and dental care. RESULTS: Among 3,684 citations, 25 studies were selected, including 10 RCT. NPs may improve access to primary care and chronic disease management, particularly in underserved areas. Although not all studies directly compared NPs to traditional models, they were most often assessed against General Practitioners (GPs) alone. Seven studies also evaluated collaborative NP-GP models versus GP-only care. Patient satisfaction was generally higher with NPs, possibly due to longer consultations and greater patient education. Clinical and biological outcomes were often comparable between NPs and GPs, with the best results in collaborative models, which were also associated with higher costs. CONCLUSION: NPs may enhance access to care, particularly for vulnerable populations. Higher patient satisfaction may be linked to longer consultations and patient education. While clinical outcomes were comparable to those of GPs, collaborative models yielded the best results, though potentially at a higher cost.
Evaluation of Dutch General Practitioners ultrasound referrals and opportunities for point-of-care ultrasound: A retrospective analysis.
Geivers J, Leijenaar RTH, Ramakers L … +4 more , Cals JWL, Zijta FM, Nobel JM, Ottenheijm RPG
Eur J Gen Pract · 2026 Dec · PMID 41528024 · Full text
BACKGROUND: General practitioners (GPs) frequently refer patients for abdominal ultrasound. Depending on the clinical context, a 'triage ultrasound' can assess multiple potential causes of abdominal symptoms, while a 'ta...
BACKGROUND: General practitioners (GPs) frequently refer patients for abdominal ultrasound. Depending on the clinical context, a 'triage ultrasound' can assess multiple potential causes of abdominal symptoms, while a 'targeted ultrasound' (point-of-care ultrasound, POCUS) focuses on specific indications (e.g. cholelithiasis). OBJECTIVE: To assess whether medical questions posed by GPs in abdominal ultrasound referral letters are adequate for radiologists to perform their examination, and to identify indications for POCUS by GPs based on exclusion rates and alternative findings in radiological reports. METHODS: Retrospective study analysing GP referral letters with corresponding radiology reports referred for abdominal ultrasound. Key variables: GP's medical question, indication type and the radiologist's final interpretation, following established diagnostic guidelines. RESULTS: A total of 1,196 referral letters with corresponding reports were reviewed. Of these, 143 (12%) were excluded, primarily due to missing clinical information from the GP (102; 8.5%). The final sample comprised 1053 referral letters with reports (mean age 59.2 years; 60% female). Sixteen percent of referral letters lacked a medical question, and 33% included exclusively guideline-based indications. The most common guideline-based indications were urolithiasis (43%) and cholelithiasis (39%). For guideline-based requests, radiologists excluded the indicated condition in 75% of cases, and an alternative diagnosis was identified in fewer than 10%. CONCLUSION: GPs frequently provide insufficient clinically relevant information in abdominal ultrasound referral letters. Simple cases with well-defined clinical queries like cholelithiasis, urolithiasis, hydronephrosis and abdominal aortic aneurysm seem suitable for POCUS evaluation, as these are often excluded conditions for which the risk of overlooking serious diagnoses is low.
Towards best practice recommendations: Perspectives from Australian GPs to inform the use of general practice data for research - A modified Delphi study.
Green H, Beilby J, Degeling C … +9 more , Adams C, Flack F, Carolan L, Fabrianesi B, Brown A, Nettel Aguirre A, Clarke A, Jung C, Braunack-Mayer A
Eur J Gen Pract · 2026 Dec · PMID 41511392 · Full text
BACKGROUND: General practice medical records offer significant potential for secondary use in research, policy and public health. In Australia, these data remain underused due to concerns around privacy, governance and e...
BACKGROUND: General practice medical records offer significant potential for secondary use in research, policy and public health. In Australia, these data remain underused due to concerns around privacy, governance and ethical use. Understanding the perspectives of GPs is essential to developing best practice recommendations for responsible data use. METHOD: A three-round modified Delphi study was conducted with 22 Australian GPs with experience in research and/or data sharing. Participants rated and commented on 11 recommendations derived from community juries, with consensus defined as ≥75% agreement. Feedback summaries and thematic analysis informed subsequent rounds. RESULTS: Consensus was reached on 10 of 11 recommendations. The panel supported ethical approval, transparency, protection of the doctor-patient relationship and remuneration for practices contributing data. An opt-out approach to consent was endorsed under strict conditions, with clear distinctions made between vulnerable and non-vulnerable populations. The panel also supported the establishment of a governance body and researcher cybersecurity training. However, no consensus was reached on community involvement in research design, despite its growing recognition as best practice by funding bodies. CONCLUSION: This study highlights the need for a nationally agreed remuneration model for general practices that contribute data, clearer ethical guidance for engaging vulnerable populations and reform of statutory frameworks to support responsible data use. The lack of consensus on community involvement is concerning, especially as initiatives such as the Australian Institute of Health and Welfare (AIHW) and Primary Health Networks (PHN) partnership advance national data standards. Bridging this gap is essential to align professional practice with public expectations and ensure inclusive, ethically robust research.
An interprofessional approach to treat bodily distress disorder in Swiss primary care - a quality improvement study.
Di Gangi S, Hennemann J, Brunner E … +2 more , Senn O, Büchi S
Eur J Gen Pract · 2026 Dec · PMID 41503931 · Full text
BACKGROUND: Managing bodily distress disorder (BDD) requires an interprofessional, holistic therapeutic approach, which can be challenging to implement in routine care. OBJECTIVES: The aim was to evaluate a care pathway...
BACKGROUND: Managing bodily distress disorder (BDD) requires an interprofessional, holistic therapeutic approach, which can be challenging to implement in routine care. OBJECTIVES: The aim was to evaluate a care pathway for patients with BDD involving general practitioners (GPs) and physiotherapists. METHODS: Participants were patients aged 18 years or older with BDD symptoms and the PHQ-15 (Patient Health Questionnaire 15-Item) score > 9. The treatment consisted of patient education by GPs about BDD and stress, sleep interventions, physical exercises and support to develop an active lifestyle (> 150 min per week of moderate-intensity physical activity), as measured with the Physical Activity Vital Sign (PAVS). Patient outcomes (PHQ-15 and PAVS) were compared at baseline and after six months. A survey assessed the perspectives of both patients and health professionals about the treatment. RESULTS: A total of 70 patients treated by 11 GPs and 6 physiotherapists were involved. Comparing outcomes at baseline vs. after six months (median [IQR]): PHQ-15 decreased, 14 [11, 17] vs. 8 [5, 12], < 0.001; PAVS increased, 60 [30, 120] vs. 120 [60, 180], < 0.001; GP confidence (scale 0-100) in treating BDD increased, 50 [38, 66] vs. 82 [66, 85], = 0.005. Feedback from patients, GPs and physiotherapists about the intervention was positive. CONCLUSION: The interprofessional care pathway for patients with BDD had a positive impact on patient outcomes, GP treatment confidence, and was well-received by both patients and health professionals. It can be adapted across primary care systems and tailored to local contexts to improve the quality of care.
The future is now: Towards intelligent use of Generative AI in general practice.
Burgers JS, Müller A
Eur J Gen Pract · 2026 Dec · PMID 41498332 · Full text
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How far on the road? The role of family medicine/general practice in 10 Central and Eastern European countries: A mixed-method study.
Oleszczyk M, Stepanovič A, Král N … +5 more , Seifert B, Švab I, Krzysztoń J, Jagiełła N, Windak A
Eur J Gen Pract · 2025 Dec · PMID 41404871 · Full text
INTRODUCTION: Central and Eastern European (CEE) countries began healthcare reforms in the late twentieth century, adopting Family Medicine/General Practice (FM/GP) models. The FATMEE (Family Medicine After Transformatio...
INTRODUCTION: Central and Eastern European (CEE) countries began healthcare reforms in the late twentieth century, adopting Family Medicine/General Practice (FM/GP) models. The FATMEE (Family Medicine After Transformation in Middle and Eastern Europe) study in 2012 found this process advanced but incomplete. This study (FATMEE-2) examines current FM/GP development in the CEE region that follows recent social changes and healthcare challenges. METHODS: A mixed-methods approach combined literature and dataset review with a Key Informant-based survey using the updated FATMEE questionnaire, exploring the FM/GP role in primary care. RESULTS: FM/GP is recognised as a separate medical speciality in all countries with robust legal frameworks. Care comprehensiveness varies, with some systems maintaining separate paediatric and adult services, and a lack of gynaecology and obstetrics services in many. Weighted capitation remains the dominant funding model, supplemented by pay-for-performance and fee-for-service schemes. Electronic medical records and teleconsultations are common. Compared to the previous FATMEE study, changes include increased use of digital tools and diversified financing. Primary care structure and professional roles changed little. CONCLUSION: While the legal and technological foundations of family medicine in CEE countries have strengthened, comprehensiveness and service integration have limitations. There is a visible progress in infrastructure and digitalisation, but the structural and organisational challenges identified in 2012 largely remain. This may indicate that sustained political commitment and systemic reform - beyond legal acknowledgement and technological improvements - are essential for successful transformation. However, the examples of Estonia and Slovenia prove that under a supportive policy, such a transformation is achievable.
Factors influencing appropriate vestibular care: An interview study with general practitioners and patients.
Ngo HTN, Maarsingh OR, Slottje P … +3 more , Blanker MH, Bont J, van Vugt VA
Eur J Gen Pract · 2025 Dec · PMID 41399301 · Full text
BACKGROUND: General practitioners (GPs) frequently prescribe anti-vertigo drugs (AVDs), even though there is limited evidence for their effectiveness. Meanwhile, they rarely apply vestibular rehabilitation, a treatment f...
BACKGROUND: General practitioners (GPs) frequently prescribe anti-vertigo drugs (AVDs), even though there is limited evidence for their effectiveness. Meanwhile, they rarely apply vestibular rehabilitation, a treatment for various vestibular disorders with a strong evidence base. OBJECTIVES: This study aimed to identify barriers and facilitators to appropriate vestibular care in general practice. METHODS: We conducted a qualitative study in Dutch general practice using semi-structured interviews with GPs and patients with vestibular symptoms. We used purposive sampling to select participants. Interviews were audio-recorded, transcribed verbatim, and thematically analysed following the Template Analysis approach using MAXQDA 2022 software. RESULTS: We interviewed 11 GPs and 15 patients. We assessed barriers and facilitators to appropriate vestibular care for GPs (i.e. not prescribing AVDs, advising vestibular exercises) and patients (i.e. not using AVDs, doing vestibular exercises). We identified four themes: competence, mindset, relational determinants, and accessibility to care. Facilitators included adequate knowledge about vestibular disorders, GPs valuing delivering high-value care, positive experiences with physiotherapy, patients' coping skills, personal continuity, close collaboration between GP and colleagues, social support, and sufficient time and availability of providers. Barriers included diagnosis and treatment insecurity among GPs, patients doubting the GPs' competence, patients' desperation for treatment and GPs accommodating these wishes, positive experiences with AVDs, prescriptions by other providers, and insurance not covering physiotherapy. CONCLUSION: Multiple barriers and facilitators shape appropriate vestibular care in general practice. Interventions should strengthen GPs' and patients' knowledge of vestibular management. Internet-based vestibular rehabilitation may address key barriers, particularly logistic and financial ones.
Advancing clinical research in the Spanish primary care service: Challenges, opportunities, and lessons from other European models.
Cárdenas-Quesada J, Remesal-Doblado Á, Garrido-Rodríguez V … +4 more , Lucena MI, Ginel-Mendoza L, Cárdenas-Viedma SL, Sanabria-Cabrera J
Eur J Gen Pract · 2025 Dec · PMID 41396696 · Full text
BACKGROUND: As the first point of contact with the healthcare system, primary care (PC) provides a unique setting for clinical research, enabling longitudinal follow-up, early disease detection, and study of prevalent il...
BACKGROUND: As the first point of contact with the healthcare system, primary care (PC) provides a unique setting for clinical research, enabling longitudinal follow-up, early disease detection, and study of prevalent illnesses. In Spain, however, PC research remains largely untapped, despite the country's leadership in overall clinical trial initiations within the European Union. OBJECTIVES: To analyse the main challenges and opportunities of PC research in Spain and to draw lessons from successful European models to inform future priorities. METHODS: This opinion paper presents a narrative, cross-country comparative synthesis (1993-2025) of peer-reviewed and gray literature. RESULTS: European models demonstrate how interoperable data, dedicated infrastructure, and protected research time enable pragmatic and decentralised trials with high external validity. In Spain, major barriers include heavy workloads, limited research training, uneven infrastructure, and regulatory hurdles. Nevertheless, opportunities are emerging through digital platforms, interoperable registries, remote monitoring, and the integration of patient-reported outcomes (PROs). CONCLUSION: Spain can unlock the untapped research capacity of PC by prioritising four reforms: (1) interoperable registries across care levels; (2) protected time and support roles for PC professionals; (3) targeted, sustained funding and minimum viable infrastructure; and (4) streamlined ethical/regulatory pathways for multicentre and decentralised trials. These steps would align research with daily practice, enhance inclusivity and equity, and strengthen PC as a hub for patient-centered innovation.
Mitigating health inequalities in rural European communities through collaborative primary care research: A position paper of the WONCA Europe network EURIPA.
Dolan M, Petrazzuoli F, Wynn-Jones J … +15 more , Fosse A, Clark CE, Falanga R, Dumitra GG, Gussy M, Lionis C, Colosio C, Payne R, Kenkre J, Javorská K, Tsiligianni I, Kurpas D, Halata D, Glynn L, Sanders T
Eur J Gen Pract · 2025 Dec · PMID 41284378 · Full text
Rural populations in Europe face health inequalities due to a multitude of factors, including the higher prevalence of multi-morbidity, inadequate access to primary and secondary health care services, and widespread heal...
Rural populations in Europe face health inequalities due to a multitude of factors, including the higher prevalence of multi-morbidity, inadequate access to primary and secondary health care services, and widespread health workforce shortages. Although some challenges are also present in other contexts, the multitude and interconnectedness of these factors induce significant health inequalities. Research is a prime tool to demonstrate these, examine potential rural-specific solutions and serve as an essential advocacy instrument for change. Rural primary care remains however significantly underrepresented in European research, contributing further to the health inequities as policies and interventions are often based on urban-centric data. Therefore, advancing evidence-based solutions for rural primary healthcare requires stronger research collaboration. In response, the Rural Health European Academic Network (RHEAN) was established in 2024 to expand academic partnerships beyond the WONCA Europe network EURIPA, the European Rural and Isolated Practitioners Association. This paper identifies rural-specific primary care challenges emerging from key literature and network discussions that shape RHEAN's collaborative research agenda. The agenda will be refined through a mapping survey of rural primary healthcare research and education within the networks.
Primary healthcare providers' knowledge, attitudes, and practices regarding cancer screening recommendation and referral in Georgia, 2023.
Topuridze M, Kareli A, Javashvili G … +6 more , Kiknadze N, Shiukashvili N, Todua T, Melikidze T, Khetsuriani K, Otiashvili D
Eur J Gen Pract · 2025 Dec · PMID 41284371 · Full text
INTRODUCTION: Cancer screening uptake in Georgia is only 13%. We aimed to assess cancer screening recommendations and referral practices among primary health care providers (PHC) and factors associated with these practic...
INTRODUCTION: Cancer screening uptake in Georgia is only 13%. We aimed to assess cancer screening recommendations and referral practices among primary health care providers (PHC) and factors associated with these practices. METHODS: We conducted a cross-sectional survey of 2,958 doctors and nurses in PHC in November 2023, using descriptive, bivariate, and multivariate analyses to assess the association between provider characteristics, system-level factors, and practices in recommending and referring for cancer screening. RESULTS: Respondents were predominantly female (95%), mean age of 57.5 years, family doctors (56%), with >20 years' work experience (60%) and rural practice (67%). Almost all (98%) reported actively recommending and referring patients for cancer screening; however, 64.7% did so for only 1-5 patients per week, while 12% reported none. Predictors of higher recommendation and referral rates (≥6 patients per week) included being a family doctor (AOR 1.36; 95% CI: 1.11-1.67; = 0.003), working in the capital city - Tbilisi (AOR 1.36; 95% CI: 1.14-1.95; = 0.003), receiving comprehensive cancer screening training (AOR 1.49; 95% CI: 1.04-1.68; = 0.024), reporting adequate infrastructure (AOR 1.39; 95% CI: 1.07-1.81; = 0.015), reporting proper public promotion (AOR 1.41; 95% CI: 1.12-1.78; = 0.003), and perceiving screening as part of their role (AOR 1.87; 95% CI: 1.52-2.30; < 0.001). CONCLUSIONS: Despite strong belief in cancer screening, recommendation and referral rates remain low, underscoring the urgent need for policy reforms to enhance education, raise awareness, and improve infrastructure for effective cancer screening initiatives.
Physical activity levels and self-perception among patients living with chronic conditions in France: A population-based cross-sectional study using the ComPaRe cohort.
Triconnet T, Tran VT, Pane I … +1 more , Sidorkiewicz S
Eur J Gen Pract · 2025 Dec · PMID 41284340 · Full text
BACKGROUND: Despite the numerous health benefits associated with physical activity (PA), many patients with chronic conditions remain inactive. We hypothesise that patients often misperceive their PA level, which affects...
BACKGROUND: Despite the numerous health benefits associated with physical activity (PA), many patients with chronic conditions remain inactive. We hypothesise that patients often misperceive their PA level, which affects behaviour change. We aimed to assess PA levels of patients with chronic conditions using the Global Physical activity Questionnaire (GPAQ) and compare their perception of meeting WHO guidelines (150 min of moderate-to-vigorous physical activity per week) with GPAQ measurements. METHODS: We conducted a cross-sectional analysis of the GPAQ in a sample of participants recruited from the ComPaRe e-cohort, a nationwide cohort of adult patients with chronic conditions in France. We used stratified random sampling (based on age, gender and diploma) and non-responder weighting to obtain estimates representative of PA levels of chronic patients in France. Concordance between participants' perception of meeting WHO guidelines and GPAQ measurements was assessed using Cohen's kappa coefficient. RESULTS: We included 629 patients (participation rate: 65.0%). The median age was 57 [46.0-65.4] years, with 348 (55.3%) women. A total of 369 (64.2%) patients were categorised as active (>750 metabolic equivalent tasks (Mets)/week) according to the GPAQ, with PA levels increasing with age among men. A total of 55 (8.6%) participants were unable to estimate their PA level, and 186 (32.4%) misperceived their PA level (cohen's kappa coefficient of 0.38 [0.31-0.45]), with 29 (5.1%) overestimating and 157 (27.4%) underestimating their activity. CONCLUSION: Healthcare professionals should consider accurate screening for inactivity and patients' self-perception of their PA level, as both are key to delivering personalised and impactful counselling.
Improving continuity of care in Finnish primary health care: Insights from a nationwide qualitative study of primary care physicians.
Mikkonen U, Suija K, Koskela T … +2 more , Mäntyselkä P, Tusa N
Eur J Gen Pract · 2025 Dec · PMID 41269884 · Full text
BACKGROUND: Continuity of care (COC) is a core value in general practice. It has been deteriorating in Finnish primary health care, but there are now attempts to improve it. OBJECTIVES: This study focused on gathering in...
BACKGROUND: Continuity of care (COC) is a core value in general practice. It has been deteriorating in Finnish primary health care, but there are now attempts to improve it. OBJECTIVES: This study focused on gathering insights of primary care physicians (PCPs) on how COC can be improved within Finnish primary health care. METHODS: We conducted a nationwide survey targeting all PCPs working in primary health care. A web-based questionnaire was sent to PCPs in Finland from May to October of 2023. The questionnaire included the question 'How would you improve continuity of care in your workplace?' Data were analysed using a descriptive approach that involved iterative and inductive thematic analysis. RESULTS: We received a total of 291 responses from PCPs across Finland (7% response rate). We identified themes related to organisation (e.g. arrangement of practical work including the size of a health centre), practice-level (e.g. autonomy, including the opportunity to perform COC in daily work), and themes related to digital solutions (e.g. data of COC measured and available). PCPs had considerable insight into the development of COC in day-to-day operations. CONCLUSION(S): Enhancing COC for a primary care patient population requires a systemic perspective and structured, goal-oriented development efforts. However, small and discrete steps can also contribute to improving COC for individual patients. Our findings highlight the link between COC enhancement and the development of the health care system as a whole.
Advanced practice nurses and their potential in home care for frail patients in rural France: A qualitative study.
Sacchetti A, Bellier A, Pison C … +1 more , Berube M
Eur J Gen Pract · 2025 Dec · PMID 41247020 · Full text
CONTEXT: The ageing population in Europe, particularly in rural areas, creates new health challenges, including patients with multiple comorbidities and difficult access to care. Advanced Practice Nurses (APNs) could pla...
CONTEXT: The ageing population in Europe, particularly in rural areas, creates new health challenges, including patients with multiple comorbidities and difficult access to care. Advanced Practice Nurses (APNs) could play a key role in improving access and care for frail older patients in France's rural areas, although how to achieve this remains unclear. AIM: This study aimed to identify the healthcare needs of frail patients living at home in rural areas and those of their healthcare providers to assess the potential role of APNs in addressing these needs. METHODS: This interpretive descriptive qualitative study was conducted from June to September 2023, using focus groups (FGs). Three FGs with 20 participants, including healthcare providers and frail older people, were conducted in two French rural areas. Data were analysed using thematic analyse to identify key needs and potential APN contributions. RESULTS: The healthcare needs identified were: improving access to care, maintaining human interactions, and providing coordinated, preventive care. Participants emphasised the importance of interprofessional collaboration and the central role of APNs, whose expanded skillset enables them to coordinate care with caregivers and professionals. However, challenges remain, including a lack of understanding of the APN's skills and concerns about their integration within the care team. CONCLUSION: APNs could support access to person-centred, coordinated home care in rural areas by acting as key references for patients, caregivers, and teams. However, limited awareness of their role and concerns from other professionals remain barriers to their integration.
Variation in the efficiency of English general practices and associated factors: A cross-sectional study of 5069 general practices.
Onwunduba A, Wu J, Painter H … +2 more , Pearce H, Ford J
Eur J Gen Pract · 2025 Dec · PMID 41247001 · Full text
BACKGROUND: Healthcare demand in English general practice exceeds supply, necessitating practice efficiency. To our knowledge, no study has explored factors associated with practice efficiency in England using a quality-...
BACKGROUND: Healthcare demand in English general practice exceeds supply, necessitating practice efficiency. To our knowledge, no study has explored factors associated with practice efficiency in England using a quality-adjusted output. OBJECTIVES: To determine practice-level efficiency in England and identify associated factors using a quality-adjusted output. METHODS: We conducted a cross-sectional study using NHS datasets from 2023. Practice efficiency was determined by comparing input (measured using funding and workforce) with output (measured using clinical quality, patient experience, and service volume). Practices were classified as efficient (low input, high output), neutral (same input and output levels), or inefficient (high input, low output) using K-medoids clustering, a machine learning technique. Multivariable logistic regression was used to identify factors associated with practice efficiency (i.e. efficient or inefficient, excluding neutral). RESULTS: Of 5069 practices, 1117 were classified as efficient, 2773 as neutral, and 1179 as inefficient. Efficiency was lower in practices with a larger patient list (adjusted odds ratio 0.23, 95% CI 0.19-0.28), those with a higher percentage of patients with a chronic condition (0.47, 0.38-0.58) or patients ≥ 65 years (0.63, 0.49-0.81), those in a higher deprivation area (0.25, 0.20-0.32), those that dispense medications (0.52, 0.37-0.73), and those with an alternative provider medical services (vs. general medical services) contract (0.15, 0.07-0.33). Efficiency was higher in urban practices (1.38, 1.00-1.90) and practices with a higher percentage of mixed (1.66, 1.24-2.21) or other ethnicity patients (1.78, 1.22-2.60). CONCLUSION: Smaller practices were more efficient. Therefore, policies that encourage practice mergers may not deliver the efficiency gains expected.
Experiences of supporting primary and community healthcare workers affected by domestic abuse in the United Kingdom: A cross-sectional survey.
Dheensa S, Feder G, Mallen C … +1 more , Gregory A
Eur J Gen Pract · 2025 Dec · PMID 41212654 · Full text
BACKGROUND: Healthcare workers are expected to identify and respond to domestic abuse among patients. However, research has neglected healthcare workers' own experiences of domestic abuse. OBJECTIVES: Focusing on UK prim...
BACKGROUND: Healthcare workers are expected to identify and respond to domestic abuse among patients. However, research has neglected healthcare workers' own experiences of domestic abuse. OBJECTIVES: Focusing on UK primary and community healthcare workers with formal support roles (e.g. line managers, human resources, employee assistance professionals), this exploratory study aimed to illustrate workplace support offered to healthcare colleagues affected by domestic abuse. METHOD: We used an online cross-sectional survey with closed and qualitative free-text questions, advertised via mailing lists and social media, targeting healthcare workers. Our mixed methods embedded design involved quantitative descriptive analysis with content analysis of qualitative free text to explain and interrogate results. RESULTS: Sixty-two people in healthcare roles supporting colleagues responded, mostly from community hospitals, dentistry, and general practice. Few workplaces had staff domestic abuse policies. Support measures were limited. Emotional support, signposting, and adjusted working hours were the most common types of support available. Training on supporting affected colleagues was rare. Few environments had specialist domestic abuse advocates who supported staff. Along with needing policies, training, and in-house support, respondents indicated a need for a cultural shift to address myths about domestic abuse and hierarchical power, particularly regarding healthcare workers who perpetrate abuse. CONCLUSION: Despite several limitations, including substantial missing data, our work highlights that primary and community healthcare workplaces should explore the implementation of practical and emotional support measures; healthcare-based domestic abuse advocates with staff support; and training on supporting colleagues. Further pan-European comparative research should surface good practice and foster cross-learning.
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