Loots FJ, van Vught LA, van den Brande M
… +10 more, Jepma S, Renkema B, van Zanten ARH, Kaasjager K, Bruel AVD, Reitsma JB, Jenniskens K, Ahmad A, Anthierens S, Venekamp RP
Eur J Gen Pract
· 2025 Dec · PMID 41212643
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BACKGROUND: Clinical scoring systems can help predict sepsis and guide treatment. We developed and validated a new sepsis prediction score for acutely ill adult patients visited at home by a general practitioner (GP) of...BACKGROUND: Clinical scoring systems can help predict sepsis and guide treatment. We developed and validated a new sepsis prediction score for acutely ill adult patients visited at home by a general practitioner (GP) of an out-of-hours (OOH) cooperative. AIM: To assess the feasibility and acceptability of implementing this score during OOH home visits. DESIGN AND SETTING: Theory-informed mixed-methods study at two OOH GP cooperatives in the Netherlands between January and June 2024. METHOD: GPs calculated the sepsis score in adult patients during home visits and completed a questionnaire about uptake and usability. Perspectives and experiences were explored through focus groups and semi-structured interviews. RESULTS: 106 GPs visited 271 patients at home, of whom 105 were judged acutely ill by the GP. The score's uptake was 77% in all patients and 85% in those acutely ill. 91% of GPs rated the score as convenient to use, and 66% considered the score reliable and accurate. GPs reported that the score influenced their decision to refer the patient to the hospital in 6% (15/271; 11 referred, four not referred) of all cases and 10% (10/105, all referred) in acutely ill. GPs expressed that they did not solely rely on the score but found it helpful to raise sepsis awareness and as an adjunct to clinical decision-making. CONCLUSION: Implementing a new score for acutely ill adult patients visited at home during OOH primary care is feasible, and deemed acceptable and useful by GPs, however future research focusing on clinical validation and cost-effectiveness is needed.
Matias Mendes T, Lammila-Escalera E, Jácome C
… +1 more, Neves AL
Eur J Gen Pract
· 2025 Dec · PMID 41212617
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BACKGROUND: The growing adoption of digital health applications (apps) presents new opportunities for General Practitioners (GPs) to enhance care and empower patients. However, little is known about how Portuguese GPs in...BACKGROUND: The growing adoption of digital health applications (apps) presents new opportunities for General Practitioners (GPs) to enhance care and empower patients. However, little is known about how Portuguese GPs incorporate these apps into their practice. OBJECTIVES: To identify the distinguishing characteristics of Portuguese GPs recommending the use of digital health apps to patients, and to investigate the facilitators and barriers influencing this behaviour. METHODS: A cross-sectional study was conducted using an online questionnaire distributed to Portuguese GPs between July 2023 and January 2024. Univariate logistic regressions identified predictors of app recommendation. Wilcoxon rank-sum tests compared facilitators and barriers between groups. RESULTS: A total of 126 GPs responded (72.2% women; median age 36 years [IQR: 31.8-43.0]); 45.2% recommended digital health apps. The most common were for apps for physical activity (32.4%), nutrition (21.3%), and chronic disease management (21.3%). Among GPs recommending apps, 70.2% did 1-4 times monthly. Most GPs believed that apps could improve chronic disease self-management (97.6%) and reduce face-to-face consultations (74.6%). GPs recommending apps were more likely to personally use health and fitness apps (OR 3.03), clinical decision apps (OR 3.79), and to believe that apps reduce face-to-face consultations (OR 3.46). GPs not recommending apps more often rated scientific validity as 'very important' (84.1% vs 61.4%, = 0.006). CONCLUSION: Nearly half of Portuguese GPs surveyed recommended digital apps, highlighting their potential to support self-management and reduce face-to-face consultation. Broader adoption may depend on fostering greater physician confidence in app use by strengthening the scientific evidence of apps.
Rennert M, Geier AK, Christ L
… +7 more, Hager S, Scheibe S, Rettich A, Schübel J, Deutsch T, Bleckwenn M, Voigt K
Eur J Gen Pract
· 2025 Dec · PMID 41143623
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BACKGROUND: Recent studies indicate that the synthetic thyroid hormone levothyroxine (LTX) in many cases has no beneficial effects on patients with subclinical hypothyroidism. Still, prescriptions are increasing worldwid...BACKGROUND: Recent studies indicate that the synthetic thyroid hormone levothyroxine (LTX) in many cases has no beneficial effects on patients with subclinical hypothyroidism. Still, prescriptions are increasing worldwide. If there is no clear indication for treatment, patients treated with LTX should be offered a deprescribing trial according to current guidelines. However, there is currently no protocol for deprescribing LTX in primary care. OBJECTIVES: We aimed to explore patients' enablers and barriers towards deprescribing levothyroxine in primary care to inform the further participatory development of a deprescribing strategy. METHODS: Based on the COREQ checklist, focus group discussions were conducted with patients and general practitioners as well as patients only in 2024. Participants ranked the five most crucial enablers and barriers. Transcripts and prioritised elements were examined using the qualitative content analysis method according to Kuckartz. RESULTS: Patients frequently felt misinformed about their condition and the prescription of LTX. A change in their medications raised doubts and uncertainties. However, the potential advantages and opportunities of deprescribing were compelling: a (re)gain of quality of life, a decrease in probable drug side effects, savings of time and cost. Mostly, patients welcomed a gradual and managed deprescribing under their general practitioner's supervision. CONCLUSION: Patients wished for medical information to reduce their doubts concerning deprescribing and expressed confidence in their general practitioner. Our findings indicate a fundamental commitment to deprescribing LTX. For an adherent process in general practitioners' practices, a strategy that considers patients' worries and concerns seems feasible.
Radde M, Oeser P, Wittenstein AS
… +3 more, Blumenauer E, Melz MS, Herrmann WJ
Eur J Gen Pract
· 2025 Dec · PMID 41124074
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BACKGROUND: LGBT* (lesbian, gay, bisexual, trans, others) individuals are known to experience poorer health and restricted access to healthcare compared to cisgender-heterosexual individuals. OBJECTIVE: As General Practi...BACKGROUND: LGBT* (lesbian, gay, bisexual, trans, others) individuals are known to experience poorer health and restricted access to healthcare compared to cisgender-heterosexual individuals. OBJECTIVE: As General Practitioners (GPs) are a patient's first point of contact with the healthcare system in Germany, this study examines GPs' perspectives on LGBT healthcare. METHODS: In this qualitative study, we conducted 19 semi-structured episodic interviews with GPs in urban and rural areas of Germany. The interviews were analysed using framework analysis. RESULTS: Our study shows LGBT* doctors feel more responsible for LGBT* healthcare than their cis-heterosexual colleagues. There is a perceived lack of knowledge and learning opportunities on LGBT* health needs for most interviewees. Cis-heterosexual GPs often feel unprepared to provide specific healthcare interventions to LGBT* patients and believe they lack the resources to improve their education on the topic. LGBT*-specific primary healthcare seems to be delivered by a small number of GP practices and primarily by LGBT* doctors. These LGBT* doctors recommend more widespread knowledge of LGBT* primary care and lives, to allow their colleagues to provide better care for these patients. CONCLUSION: There is a lack of knowledge on LGBT health needs and challenges among GPs in Germany, which needs to be addressed through structured training in medical school, and on a postgraduate level. This lack of knowledge leads to cis-heterosexual GPs feeling more insecure in providing care to LGBT* patients and LGBT* GPs providing a bigger share of LGBT* healthcare than their cis-heterosexual colleagues.
Adler L, Merzon E, Cohen B
… +4 more, Shani M, Zacay G, Kolesnyk P, Vinker S
Eur J Gen Pract
· 2025 Dec · PMID 41091565
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BACKGROUND: The war in Ukraine led to a flood of refugees consisting mainly of women, children and elderly. OBJECTIVES: This study aimed to explore healthcare use by elderly Ukrainian refugees. METHODS: In this retrospec...BACKGROUND: The war in Ukraine led to a flood of refugees consisting mainly of women, children and elderly. OBJECTIVES: This study aimed to explore healthcare use by elderly Ukrainian refugees. METHODS: In this retrospective cohort study, we examined patterns of healthcare services used by elderly Ukrainian refugees in Israel between 30 July 2022 and 1 May 2023 ( = 2269). We compared them to controls, matched for age and gender, among the general Israeli population ( = 2271). We performed Poisson regressions for statistical analysis. RESULTS: The Ukrainian refugee cohort was predominantly female (77.4%) with a mean age of 71.4 ± 7.1 years. Compared to their controls, the refugees were much less likely to participate in face-to-face, digital and video doctor visits (IRR = 0.838, 0.457 and 0.329, respectively; value < 0.001). Across almost all medical fields (except cardiology), refugees were less likely to have consultations with specialists. Additionally, refugees had fewer emergency room visits (IRR = 0.42, value < 0.001), fewer hospitalisations (IRR = 0.54, value < 0.001) and shorter hospitalisations (IRR = 0.489, value < 0.001). CONCLUSIONS: In a healthcare system with full coverage, Ukrainian refugees were less likely to utilise healthcare services. These findings suggest that refugees may face significant barriers to access and may be underutilising needed care. Healthcare systems should adopt proactive and culturally responsive approaches to address these disparities and ensure equitable access. This study highlights the need for targeted interventions and further research to better understand and reduce healthcare barriers among refugee populations.
Eur J Gen Pract
· 2025 Dec · PMID 41081347
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While the development and use of Artificial Intelligence (AI) in health care have literally exploded in recent years, general practitioners (GPs) continue to struggle with a fragmented health care system and complex pati...While the development and use of Artificial Intelligence (AI) in health care have literally exploded in recent years, general practitioners (GPs) continue to struggle with a fragmented health care system and complex patients with multiple conditions and increasing care needs. An ageing population, task shifting from secondary care to ambulatory services without adequate resource allocation, and policy makers pushing for more accessible primary care are examples of factors driving the demand for AI-tools designed to triage patient complaints, improve workflows, ease clinicians' burden and support clinical decision-making. The paradigm shift towards digital solutions may offer answers, yet evidence often trails behind their implementation. The paper will address current challenges in European primary care today, highlight areas where AI can improve administrative tasks and patient outcomes, and discuss the potential benefits and drawbacks of adopting AI. Will AI tools enhance decision-making or simply create new care demands? Will their implementation truly add value to the holistic patient care model in general practice?
Eur J Gen Pract
· 2025 Dec · PMID 41042636
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BACKGROUND: Primary care providers deliver the majority of medical care serving as essential first points of contact and care coordinators. Despite the significant challenges they face, primary care research seems to lag...BACKGROUND: Primary care providers deliver the majority of medical care serving as essential first points of contact and care coordinators. Despite the significant challenges they face, primary care research seems to lag behind and stay low-funded. Since the mid-1990s, academic reforms have emphasised metrics like third-party funding and high-impact publications. Medical schools were encouraged to develop distinct research profiles and to compete both internally and externally, leading to shifts in how research areas were prioritised, potentially disadvantaging primary care research. OBJECTIVES: To investigate the thematic priorities in German medical schools' research, assess the diversification of these priorities, and examine the role of primary care research. METHODS: We conducted an analysis of the research priorities of all 39 German medical schools associated with the German Association of Medical Faculties. Data was extracted from medical school websites in October 2023. Research priorities were categorised and analysed using descriptive statistics and relationship mapping. RESULTS: Research profile topics per medical school ranged from 1 to 7 (mean 3.51, SD 1.41). The most common research priorities were 'Neuroscience & Neurology' (69.2%), 'Immunology/Infectiology/Immunotherapy' (59.0%), and 'Oncology' (51.3%). Only a few institutions, primarily those in rural areas or recently established medical schools, prioritised adjacent primary care research fields such as health services research or community medicine. CONCLUSION: Our analysis reveals a significant concentration of research priorities in a few biomedical fields across German medical schools, with an underrepresentation of primary care research. This suggests a potential misalignment between academic focus and societal healthcare needs.
Odunlami WO, Li E, Greenfield G
… +22 more, Kerr G, El-Osta A, Tsopra R, Lingner H, Memarian E, Hoffman R, Nessler K, Jimenez G, Collins C, Petek D, Clavería A, Fernández MJ, Gusso G, Ungan M, Irving G, Laranjo L, Ghafur S, Fontana G, Car J, Hayhoe B, Majeed A, Neves AL
Eur J Gen Pract
· 2025 Dec · PMID 40948455
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BACKGROUND: Expanding access to self-management via Digital Health Technologies may supplement traditional care, mitigating pressures on primary care through self-management. Primary Care Physicians (PCP) can play a crit...BACKGROUND: Expanding access to self-management via Digital Health Technologies may supplement traditional care, mitigating pressures on primary care through self-management. Primary Care Physicians (PCP) can play a critical role in the integration of digital health technologies into patient care, but it is unclear what factors influence PCPs' recommendation of such technologies. AIMS: To identify the factors associated with PCPs recommending digital health technologies to patients for self-management before and during the pandemic. METHODS: PCPs across 20 countries completed an online questionnaire between June and September 2020. The outcome was a self-report of recommending patients to at least one of six listed forms of digital health technologies. Univariable logistic regression models were performed to explore factors associated with recommending digital health technologies to patients before and during the pandemic. RESULTS: 1,592 PCPs were included. Before the pandemic, the odds of recommending digital health technologies for self-management were lower for PCPs not involved in teaching, or practising in Turkey, Australia, Chile, Colombia, France, Italy, Poland, Portugal, Slovenia, and Spain. During the pandemic, PCPs practising in rural settings had higher odds of starting to recommend digital health technologies, as well as those from Brazil, Colombia, and Italy. There was no significant difference in recommending digital health technologies before and during the pandemic. CONCLUSIONS: Involvement in teaching (pre-pandemic) and practising in a rural setting (during the pandemic) positively influenced the recommendation of digital health technologies. Significant variation in recommending digital health technologies was present across countries.
Gomez-Bravo R, León-Herrera S, Guisado-Clavero M
… +60 more, Gefaell I, Wostmann X, Wössner N, Vinker S, Vassallo La Ferla F, Kırkoç Üçüncü E, Tsigarovski G, Torzsa P, Suija K, Stepanović A, Sentker T, Segernäs A, Seifert B, Sánchez-Castro M, Schneider JG, Repovská A, Petrazzuoli F, Petek D, Perjes A, Parodi López N, Neves AL, Nessler K, Muris J, Mortsiefer A, Moreels S, Meister T, Mäntyselkä P, Murauskienė L, Lingner H, Krztoń-Królewiecka A, Kostic M, Çimen Korkmaz B, Knezevic S, Kazakos S, Karathanos V, Shushman I, Ilkov O, Hoffmann K, Heleno B, Hanževački M, Gjorgjievski D, Frese T, Fournier M, Fitzgerald L, Feldmane S, Dotsenko M, Domeyer PR, Croucher D, Cerny V, Burgers JS, Brutskaya-Stempkovskaya E, Busneag CI, Buono N, Bensemmane S, Bayen S, Bakola M, Assenova R, Adler L, Ares-Blanco S, Astier Peña MP
Eur J Gen Pract
· 2025 Dec · PMID 40889165
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BACKGROUND: The COVID-19 pandemic has significantly impacted global healthcare systems, leading to challenges in managing Long COVID. Variations in definitions and diagnostic criteria across Europe hinder recognition and...BACKGROUND: The COVID-19 pandemic has significantly impacted global healthcare systems, leading to challenges in managing Long COVID. Variations in definitions and diagnostic criteria across Europe hinder recognition and treatment efforts. This study aims to analyse and compare the definitions of Long COVID used in 34 European countries. METHODS: A retrospective descriptive study was conducted involving key informants from 34 European countries, utilising an online questionnaire to gather data on Long COVID definitions. Quantitative and qualitative analyses were employed to assess the variability of definitions and challenges in managing Long COVID. RESULTS: The study found significant variation in Long COVID definitions among the participating countries; the most frequent definition was the other definition (n: 17, 50.0%), followed by the World Health Organisation's definition (n: 16, 47.0%) and the CDC definition (n: 11, 32.3%). Half of the countries reported using multiple definitions simultaneously, indicating a lack of standardisation. Qualitative analyses highlighted challenges such as difficulties in standardising terminology, variability in clinical criteria, and issues with implementing diagnostic codes. CONCLUSION: The findings underscore the need for a unified, yet adaptable, definition of Long COVID. Such a definition would support general practitioners (GPs) by simplifying diagnostic processes, improving continuity of care, and facilitating equitable patient access to multidisciplinary resources. The current lack of consensus complicates patient care, data collection, and resource allocation, impacting health policy development. Future efforts should focus on achieving agreement on definitions to ensure equitable treatment and effective healthcare responses to Long COVID.
Bedri A, Mulderij-Jansen V, Aits I
… +5 more, Berends M, Freitag MH, van der Worp H, Glasner C, Blanker MH
Eur J Gen Pract
· 2025 Dec · PMID 40874535
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BACKGROUND: In the Netherlands and Germany, most antibiotics are prescribed in primary care, with urinary tract infections (UTIs) being the most common reason. The resistance rates of pathogens causing UTIs are rising in...BACKGROUND: In the Netherlands and Germany, most antibiotics are prescribed in primary care, with urinary tract infections (UTIs) being the most common reason. The resistance rates of pathogens causing UTIs are rising in Europe. Differences in clinical practice guidelines may play a role and influence the prevalence of antibiotic resistance and treatment options. Therefore, we aim to explore the reality of general practices, including the diagnosis and management of uncomplicated UTIs in the Northern Dutch-German cross-border region. METHODS: From January 2023 to April 2024, a qualitative study was performed using semi-structured interviews with German and Dutch general practitioners (GPs). The number of interviews was determined when data saturation was reached. The interviews were recorded, transcribed, translated and anonymised. MAXQDA (Version 24.1.0.) was utilised to code the interviews. The analysis was done using structured qualitative content analysis. RESULTS: We recruited 13 GPs in Germany and 10 GPs in the Netherlands. Four main themes were identified: diagnosis, treatment options, decision making and guidelines. Dutch GPs delegated most diagnosis and treatment tasks to practice assistants, which is facilitated by the more stringent use of guidelines. More variety was seen in the types of antibiotics and herbal remedies used by German GPs. CONCLUSIONS: This study provides valuable insights into GPs' decision making regarding the diagnosis and treatment of UTI. Increasing awareness of UTI diagnosis and treatment can help GPs assess their own practices and think more critically of their antibiotic use. Further research is needed to explore the effects on antibiotic resistance in the cross-border region.
Koopman M, Willemsen R, Doggen C
… +8 more, Kietselaer B, van Ooijen P, Gratama JW, Braam R, Dinant GJ, van Bruggen R, van der Harst P, Vliegenthart R
Eur J Gen Pract
· 2025 Dec · PMID 40864665
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BACKGROUND: Computed tomography coronary calcium scoring (CT-CCS) shows higher sensitivity for obstructive coronary artery disease (OCAD) detection than exercise electrocardiography (x-ECG), but its role as initial diagn...BACKGROUND: Computed tomography coronary calcium scoring (CT-CCS) shows higher sensitivity for obstructive coronary artery disease (OCAD) detection than exercise electrocardiography (x-ECG), but its role as initial diagnostic test in primary care remains unclear. OBJECTIVE(S): This study assessed patients' perspectives on CT-CCS or x-ECG testing and diagnostic results. METHODS: In this one-year pilot study, 38 general practitioner practices were included. After cluster randomisation, 19 practices were assigned to refer patients with atypical angina pectoris or non-specific thoracic complaints for CT-CCS and 19 practices were assigned to request x-ECG. Patients' management remained at the discretion of the GPs. Patients' perspectives on the diagnostic test were assessed through a questionnaire, and clinical data were collected using electronic patient records. Outcome measures included patients' perspectives, OCAD diagnosis and initiation of cardiovascular risk management (CVRM). RESULTS: 101 patients (25 x-ECG; 76 CT-CCS) were included. Overall, CT-CCS patients were more satisfied with the test compared to x-ECG patients ( < 0.001), found the test easier to undergo ( < 0.001), had a higher willingness to retest ( = 0.01) and better perception of the information received from the GP ( = 0.03). Four of 17 CT-CCS patients (24%) with CT-CCS ≥100 were diagnosed with OCAD, and 14 (82%) started CVRM. The only patient with a positive x-ECG out of 25 (4%) was included in CVRM but not diagnosed with OCAD. CONCLUSION: CT-CCS patients were overall more satisfied with their test than x-ECG patients. Coronary calcium scoring is a promising diagnostic tool for detecting OCAD in primary care.
Eur J Gen Pract
· 2025 Dec · PMID 40799138
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BACKGROUND: Research is vital for progress and development of healthcare and may help relieve current health service pressures through improvements and efficiencies. Research in primary care is not well established and i...BACKGROUND: Research is vital for progress and development of healthcare and may help relieve current health service pressures through improvements and efficiencies. Research in primary care is not well established and is not part of routine practice. This study aims to investigate the barriers and facilitators to primary care staff conducting research. METHOD: A systematic literature review was conducted in CINAHL, Medline, APA, PsycInfo, AHMED and EMBASE from inception to April 2023. Searches were for studies involving clinical or non-clinical staff working in primary care where barriers or facilitators to conducting research were examined. RESULTS: Twenty-one studies were included from 2000 to 2022. The QuADs quality appraisal method found that papers were of varying, often low quality. Five themes were found - research beliefs & understanding, time, funding & recognition, skills & knowledge, administration & support, ethics & understanding and communication & people. Staff thought research useful but optional and were impeded by time and funding. They need training and support to carry out research. Communication from the researchers before, during and after study completion would prevent problems and lead to more research participation in the future. CONCLUSION: Improved communication at all stages would serve as a facilitator to primary care staff conducting research. Clear, appropriate training for all staff would allow them to complete appropriate tasks for their roles and prevent one individual taking full responsibility. Embedding research in primary care with protected time and resources to complete it would remove barriers to taking part.
Kornder N, Hill VJ, Groffebert SN
… +3 more, Becker A, Viniol A, Lindner N
Eur J Gen Pract
· 2025 Dec · PMID 40748038
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BACKGROUND: Musculoskeletal pain is a leading reason for primary care visits and often requires pharmacological treatment. Despite rising prescription rates for non-opioid analgesics in Germany, little is known about GPs...BACKGROUND: Musculoskeletal pain is a leading reason for primary care visits and often requires pharmacological treatment. Despite rising prescription rates for non-opioid analgesics in Germany, little is known about GPs' broader prescribing behaviour beyond opioid-related discussions. Understanding how GPs navigate pain management is key to supporting evidence-based prescribing. OBJECTIVES: This study explored GPs' decision-making strategies when prescribing for musculoskeletal pain and identified clinical challenges. METHODS: A qualitative study using semi-structured interviews was conducted with 15 GPs from Central and Northern Hesse, Germany. Participants were purposively recruited via a regional practice network. Interviews were analysed using Braun and Clarke's thematic analysis, applying a combined deductive-inductive approach. RESULTS: Five major themes emerged: (1) prescribing approaches, (2) medication preferences, (3) doctor-patient relationship, (4) addressing psychosomatic factors, and (5) support needs. GPs preferred cautious prescribing, favouring metamizole and NSAIDs over opioids. Chronic pain was viewed as complex and required individualised, multimodal treatment and shared decision-making. Decision-making strategies were mainly shaped by guidelines like the WHO analgesic ladder and personal clinical experience; other guidelines were rarely mentioned. The doctor-patient relationship was considered essential, particularly in chronic pain contexts. Challenges included managing psychosomatic aspects and aligning treatment expectations. CONCLUSION: GPs' prescribing decisions are shaped by a combination of clinical judgement, patient dynamics, and systemic factors. The findings highlight the need for practical support tools that are integrated into daily workflows and emphasise shared decision-making, especially for chronic pain management. These insights can inform future interventions aimed at optimising prescribing practices in primary care.
Eur J Gen Pract
· 2025 Dec · PMID 40728745
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BACKGROUND: Disclosure ('coming out') is an ongoing process for LGBT+ individuals, impacting various aspects of their lives. While research underscores the importance of disclosure for the health and well-being of LGBT+...BACKGROUND: Disclosure ('coming out') is an ongoing process for LGBT+ individuals, impacting various aspects of their lives. While research underscores the importance of disclosure for the health and well-being of LGBT+ people, concerns about stigma and discrimination often lead to non-disclosure, affecting healthcare access and outcomes. In Slovenia, where general practitioners (GPs) play a pivotal role in healthcare, understanding the dynamics of disclosure within primary healthcare settings is crucial. METHODS: This qualitative study utilised an online survey with open-ended questions to explore the experiences and expectations of both LGBT+ individuals and GPs regarding disclosure. Thematic analysis was employed to identify key themes and subthemes from the data collected between October and December 2021. RESULTS: Among 214 LGBT+ participants and 28 GPs, four main themes emerged: the necessity and relevance of disclosure; fear, insecurity, or neutrality towards non-disclosure; characteristics and actions of GPs helpful for disclosure; and GPs' self-evaluation of reactions to disclosure. Some participants viewed disclosure as essential for quality healthcare, disclosing their sexual orientation when necessary for medical treatment or to establish a trusting relationship with their GP, but others feared discrimination and preferred non-disclosure. GPs' characteristics and actions, such as creating a safe environment and using inclusive language, were crucial for facilitating disclosure. CONCLUSIONS: Our findings reinforce the significance of GP engagement in fostering safe and supportive environments for disclosure, ultimately improving healthcare access and outcomes for LGBT+ individuals in Slovenia.
Vukas J, Brisnik V, Sanftenberg L
… +3 more, Henningsen P, Gensichen J, Dreischulte T
Eur J Gen Pract
· 2025 Dec · PMID 40704912
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BACKGROUND: Long-term use of antidepressants frequently extends beyond clinical guidelines, with limited structured support for deprescribing in primary care. Little is known about the factors that influence general prac...BACKGROUND: Long-term use of antidepressants frequently extends beyond clinical guidelines, with limited structured support for deprescribing in primary care. Little is known about the factors that influence general practitioners (GPs) in Germany regarding deprescribing of antidepressants. OBJECTIVES: To identify barriers and facilitators that influence GPs in Germany regarding antidepressant deprescribing. To provide points of departure for developing a targeted intervention to address these challenges. METHODS: We conducted semi-structured interviews with 20 GPs in Bavaria and purposively sampled for diversity in gender and professional experience. The interview topic guide was informed by the Capability-Opportunity-Motivation-Behaviour (COM-B) model and the Theoretical Domains Framework (TDF). Interviews were transcribed verbatim. Thematic analysis was conducted using a structured coding approach. RESULTS: Key barriers to deprescribing included time constraints, limited practical tools, and inadequate collaboration with specialists, as well as uncertainty about when to deprescribe. Social and psychological factors, such as patient fears, were also significant. Facilitators included strong GP-patient communication, the use of digital tools, pharmacist support, and positive attitudes towards deprescribing. CONCLUSION: Antidepressant deprescribing in German primary care is shaped by systemic, social, and behavioural factors. Addressing time constraints, enhancing interdisciplinary collaboration, and integrating decision-support tools into clinical practice could facilitate deprescribing. These insights inform targeted interventions to promote safe and evidence-based antidepressant use. Further research is recommended to develop an intervention suitable for real-world usage.