The European Journal Of General Practice[JOURNAL]
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200 papers
Seven ways to optimise prevention in general practice and family medicine - a EUROPREV position paper to spark debate on prevention.
Piessens V, Rodriguez Benito L, Öztora S … +2 more , Martins C, Brodersen JB
Eur J Gen Pract · 2025 Dec · PMID 40698523 · Full text
Prevention is a fundamental aspect of the work of general practitioners (GPs) and family doctors (FDs); however, its implementation poses significant challenges due to conflicting guidelines, time constraints, competing...
Prevention is a fundamental aspect of the work of general practitioners (GPs) and family doctors (FDs); however, its implementation poses significant challenges due to conflicting guidelines, time constraints, competing demands, and equity concerns. This position paper proposes seven guiding principles to help GPs and FDs navigate preventive care effectively. It encourages GPs/FDs to recognise the intrinsic preventive value of high-quality general practice and adopt a critical approach to the evidence underpinning preventive recommendations. Prioritising a limited number of preventive services with a strong evidence base and targeting those patients most likely to benefit will contribute to sustainable, evidence-based, and equitable patient care.
'I felt I belonged': A qualitative study of role modelling and team integration as key drivers of primary care career choice.
Pfarrwaller E, Laurent C, Sommer J … +3 more , Baroffio A, Haller DM, Maisonneuve H
Eur J Gen Pract · 2025 Dec · PMID 40643433 · Full text
BACKGROUND: Clinical placements significantly impact medical students' career choices. Primary care physicians supervising these placements can influence students' career decisions through role modelling and by creating...
BACKGROUND: Clinical placements significantly impact medical students' career choices. Primary care physicians supervising these placements can influence students' career decisions through role modelling and by creating supportive learning environments. OBJECTIVES: This qualitative study aimed to identify factors contributing to role modelling and students' sense of integration during placements and their influence on career decisions, with a focus on primary care. METHODS: Semi-structured interviews were conducted with postgraduate trainees selected based on interest in primary care, exploring their experiences during undergraduate clinical placements and factors influencing career choices. Data were thematically analysed to identify key themes related to student integration, well-being, and supervisor role modelling. RESULTS: Analysis revealed four key domains where primary care physicians can positively influence students' career interest: onboarding students effectively, fostering positive and inclusive team dynamics, involving students in patient care, and providing high-quality supervision and feedback. Students reported that feeling valued and socially included contributed to their well-being and professional self-efficacy, which in turn impacted their career choices. CONCLUSION: Supportive and inclusive learning environments during placements are critical to fostering students' professional growth. While relevant across clinical settings, this study's findings hold particular significance for primary care due to the challenge of balancing clinical and practice management duties and teaching. Implementing structured onboarding, team integration, and effective supervision can enhance students' experiences and promote interest in primary care. Future research should extend these findings beyond primary care. The proposed roadmap could both spark interest in primary care and promote future collaboration between primary and secondary care.
Trajectories towards poor mental health: Can general practice contribute to prevention of bad outcomes for young children?
Wilson P
Eur J Gen Pract · 2025 Dec · PMID 40608863 · Full text
Factors present in early life account for much of the variation in mental wellbeing in adulthood. In regions where general practitioners (GPs) provide first-contact care for pregnant women and children, there are many op...
Factors present in early life account for much of the variation in mental wellbeing in adulthood. In regions where general practitioners (GPs) provide first-contact care for pregnant women and children, there are many opportunities to identify children at risk of later psychiatric problems. These risks are contingent on genetic and antenatal factors, parent-child interaction and family functioning, and are influenced by poverty, the neighbourhood and the educational environment. Depending on the context in which they work, GPs may be able to offer support or referral to specialist services to prevent adverse outcomes. GPs are not able to predict accurately which children will be at developmental risk, so it is important to ensure that systems exist to identify neurodevelopmental problems in the whole population, whether in general practice or elsewhere. When developmental surveillance takes place outside general practice, there are strong arguments for data sharing. Awareness and systematic recording of risk factors for later psychopathology, along with appropriate intervention when available, offer the potential for substantial benefits to population mental health in the long term.
A narrative approach for the management of low back pain in general practice: An in-depth patient interviews study.
Dalle G, Aloiso Alves C, Clerc P … +1 more , Le Breton J
Eur J Gen Pract · 2025 Dec · PMID 40601438 · Full text
BACKGROUND: The broad range of definitions of low back pain (LBP) and the many associated risk factors on which management strategies are based do not seem to be relevant for general practitioners. OBJECTIVES: Given the...
BACKGROUND: The broad range of definitions of low back pain (LBP) and the many associated risk factors on which management strategies are based do not seem to be relevant for general practitioners. OBJECTIVES: Given the challenges of treating LBP and its impact on individuals' life, we aimed to explore the lived experiences of LBP patients to better understand their feelings, needs, and the internal and external resources they use for coping and treatment. METHODS: We used a comprehensive, qualitative, biographical approach to understand the patient's life events and the origins of these events in social life. First, each patient's life story was analysed individually to understand how they constructed their experiences. Then, a joint analysis identified common themes and overlapping patterns across different patient trajectories. RESULTS: We identified two main action profiles. The first ('risk-taking') reflected a desire for personal independence, where patients struggled to change their habits despite experiencing pain. In the second profile ('quest for meaning'), painful experiences led patients to reflect on their lifestyle and self-functioning, prompting adjustments in their daily habits. CONCLUSION: A comprehensive approach to understanding the patients' behaviour in relation to their LBP can improve care strategies. General practitioners should consider not only the physical symptoms but also the patient's social and personal context, including relationships, living environment, work activity, limitations, and guiding values.
General Practice-led urgent care practice vs. emergency room - satisfaction of ambulatory patients with low urgency medical problems.
Schmalstieg-Bahr K, Bessert B, Peters PS … +4 more , Bobardt JS, Mayer-Runge U, Scherer M, Oltrogge-Abiry J
Eur J Gen Pract · 2025 Dec · PMID 40577002 · Full text
BACKGROUND: Emergency room (ER) utilisation by ambulatory patients with low urgency medical problems leads to ER-capacity use and long waiting times. Establishing General Practice (GP)-led urgent care practices (UCP) adj...
BACKGROUND: Emergency room (ER) utilisation by ambulatory patients with low urgency medical problems leads to ER-capacity use and long waiting times. Establishing General Practice (GP)-led urgent care practices (UCP) adjacent to ERs allows to triage patients from the ER to the UCP. However, patients may perceive themselves as ER-cases and expect ER-treatment including extensive diagnostics. OBJECTIVES: To assess UCP-patients' satisfaction compared to ambulatory ER-patients. METHODS: Sub-analysis (11/2019-01/2020) of a prospective, monocentric observational study at the University Medical Centre Hamburg-Eppendorf ER and co-located UCP focusing on patient survey data including demographics, waiting time and diagnoses. Satisfaction, uncertainty and appropriateness of waiting time was assessed with 4-point Likert-scales. RESULTS: Analysing 1196 UCP- and 597 ER-patients, patient satisfaction correlated positively with perceived appropriate waiting time in both groups. But more UCP-patients deemed their waiting time appropriate (76.7% vs. 70.4%; = 0.004) and reported to be very satisfied with the treatment (64.7% vs. 55.8%; < 0.001). Time until the first physician contact was nearly equal, but the entire length of stay was shorter in the UCP (104 ± 88.0 min vs. 179 ± 301 min; < 0.001). In both groups, satisfaction was reduced by on-going uncertainty after the visit, but uncertainty was higher among UCP-patients (32% vs. 25%; = 0.003). Age, gender or diagnosis had no influence on patients' satisfaction. More UCP-patients stated that today's problem could have been treated by a GP (57% vs. 15%; < 0.001) and were advised to follow up in an outpatient setting. CONCLUSIONS: Treating patients in an UCP does not lead to overall dissatisfaction.
Generative artificial intelligence for general practice; new potential ahead, but are we ready?
Geersing GJ, de Wit NJ, Thompson M
Eur J Gen Pract · 2025 Dec · PMID 40478782 · Full text
BACKGROUND: Generative AI (Gen AI) is frequently cited as an innovation to address the current challenges in healthcare, also for primary care. Examples include automating tasks like voice-to-notes transcription or chatb...
BACKGROUND: Generative AI (Gen AI) is frequently cited as an innovation to address the current challenges in healthcare, also for primary care. Examples include automating tasks like voice-to-notes transcription or chatbots using large language models. Additionally, it may facilitate a learning healthcare system by generating personalised learning resources and real-time literature summaries. Yet - probably with the highest expectations - Gen AI may extend diagnostic and therapeutic capabilities in general practice by integrating complex, multimodal patient data for personalised care, enabling earlier disease detection, and providing real-time guidance for diagnostics, prognostics and treatments. METHOD & DISCUSSION: The authors of this opinion paper recently hosted a workshop at the WONCA Europe 2024 conference. From discussions at that workshop, three priorities emerge: practice support, education support, and clinical decision-making support. In this opinion paper, we argue that GPs and academic departments of primary care should lead in evaluating Gen AI across these three priorities. Primary care research must prioritise rigorous scientific evaluations, to ensure that developed tools actually work for GPs and their patients. CONCLUSION: Hereto, a coordinated effort, driven by the primary care academic community, is needed, starting with research agenda drafting. A broad, international follow-up is scheduled following this WONCA Europe 2024 workshop.
Identifying opportunities for shared decision-making through patients' and physicians' perceptions on the diagnostic process: A qualitative analysis of malpractice claims in general practice.
Jacobse S, Rijkels-Otters H, Eikens-Jansen M … +5 more , van der Weijden T, Elwyn G, van den Broek W, Bindels P, Zwaan L
Eur J Gen Pract · 2025 Dec · PMID 40456007 · Full text
BACKGROUND: Shared decision-making (SDM) is considered the preferred communication model, yet its applicability in the diagnostic process is understudied. OBJECTIVE: To identify clinical situations in the diagnostic proc...
BACKGROUND: Shared decision-making (SDM) is considered the preferred communication model, yet its applicability in the diagnostic process is understudied. OBJECTIVE: To identify clinical situations in the diagnostic process that could benefit from SDM. METHODS: An observational study of closed malpractice claims against general practitioners (2012-2020) related to problems of diagnosis, obtained from a liability insurance company in the Netherlands. We established SDM-selection criteria, specified for the diagnostic process (i.e. diagnostic uncertainty, multiple options and clinical equipoise). Phase 1: We selected and categorised eligible cases, using summarised information from a claim database. Phase 2: We analysed 90 fully documented claims and extracted information from GPs and patients related to the diagnostic process. Using this data, we conducted an inductive thematic analysis. RESULTS: Phase 1: 261 out of 1477 claims (18%) met the SDM-selection criteria. The main reason for complaints was (omitted) test-ordering (155 claims, 59.4%). The most frequent final diagnoses were: fracture (49%), malignancy (10%), infection (9%), tendon rupture (8%) and cardiovascular disease (4%). Phase 2: Six types of diagnostic considerations emerged from the data: diagnostic uncertainty, using time as a diagnostic tool, management consequences, information about test indication or procedure, indications for re-evaluation and individual patient context. Contradictory statements from GPs and patients demonstrated a lack of shared understanding. CONCLUSION: The diagnostic process could benefit from SDM in several areas, including discussing diagnostic options, test conditions (e.g. timing and procedure) and follow-up. SDM training programs should be tailored to encourage clinicians to apply SDM in diagnostic decisions.
Long-term prognosis of adults with moderately severe SARS-CoV-2 lower respiratory tract infection managed in primary care: Prospective cohort study.
Platteel TN, Koelmans JC, Cianci D … +5 more , Broers NJH, de Bont EGPM, Cals JWL, Venekamp RP, Verheij TJM
Eur J Gen Pract · 2025 Dec · PMID 40455596 · Full text
BACKGROUND: Information about the incidence of persisting symptoms after COVID-19 and its impact on patients treated in primary care are scarce. OBJECTIVES: To determine differences in health-related quality of life (HRQ...
BACKGROUND: Information about the incidence of persisting symptoms after COVID-19 and its impact on patients treated in primary care are scarce. OBJECTIVES: To determine differences in health-related quality of life (HRQoL) and symptomatology between adults with and without SARS-CoV-2 moderately severe lower respiratory tract infection (LRTI) in the 12 months following their primary care visit. METHODS: Prospective cohort study in 35 Dutch practices. Individuals aged ≥18 years who presented to their general practitioner (GP) with a moderately severe LRTI during the first COVID-19 waive in The Netherlands (March-June 2020, = 277; 268 (97%) with complete follow-up) were included between September and December 2020, then underwent serology testing (participants, GPs and study personnel remained blinded for serology outcomes during study conduct) and completed baseline and follow-up questionnaires. Main outcome measures: (1) SF-36 scores, and (2) risk of persisting symptoms during 12 months follow-up. RESULTS: The change in SF-36 PSC ( = 0.13), MCS ( = 0.30) during 12 months follow-up did not differ between SARS-CoV-2 serology positive and negative participants after adjusting for sex, age, BMI, diabetes, and chronic pulmonary conditions. The risk of any persisting symptom during 12 months follow-up did not significantly differ between the groups (aHR 0.61, 95% CI 0.33-1.15), nor did the risk of individual symptoms. CONCLUSIONS: In the 12 months following their moderately severe LRTI, primary care patients with and without confirmed SARS-CoV-2 infection had a comparable HRQoL profile. A substantial proportion of participants reported persisting symptoms, indicating that persisting symptoms can occur following LRTIs irrespective of causative pathogen.
Pain and feasibility of capillary self-blood collection in general practice: A cross-sectional investigative study.
Schuchardt C, Müller F, Hafke A … +5 more , Hummers E, Schanz J, Dopfer-Jablonka A, Behrens GMN, Schröder D
Eur J Gen Pract · 2025 Dec · PMID 40408243 · Full text
BACKGROUND: Capillary self-blood collection (SBC) with mailed samples enables remote laboratory monitoring without in-person healthcare visits. This approach may improve continuity of care for patients, especially with c...
BACKGROUND: Capillary self-blood collection (SBC) with mailed samples enables remote laboratory monitoring without in-person healthcare visits. This approach may improve continuity of care for patients, especially with chronic conditions. OBJECTIVES: Compare pain perception between venous blood draws and capillary SBC and evaluate the usability and blood volume yield of SBC devices. METHODS: In this cross-sectional study, general practice patients from mid of Germany, Germany performed SBC using the Tasso+ upper-arm device and mailed samples to a laboratory. Pain, usability, SBC volume, and associated factors were analysed using bivariate and general linear models. RESULTS: Of 106 patients, 57.5% performed SBC without assistance. Self-perceived pain was lower among SBC draws (0.13, SD = 0.42) versus venous draws (1.21, SD = 1.60) ( < .001). 59.4% self-collected ≥130 μL blood plasma. Patient characteristics were not associated with SBC volume in regression analysis. Overall, the mean System Usability Scale (SUS) score was 86.2, indicating high usability. Lower school education was associated with lower usability scores, while lower fear of blood and needles were associated with higher usability scores in regression analysis. CONCLUSIONS: Capillary SBC had high feasibility and usability and caused less pain than venous draws in the general practice setting. SBC shows promises for enabling remote laboratory monitoring.
30th Anniversary of the .
Burgers JS, de Sutter A, Windak A
Eur J Gen Pract · 2025 Dec · PMID 40243011 · Full text
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Burnout among Catalan general practitioners. A repeated cross-sectional study, during and after the COVID-19 pandemic.
Castellanos MM, Fernández-San-Martín MI, Rodríguez-Barragán M … +4 more , Santos E Silva Caldeira Marques MT, Sisó A, Basora J, Aragonès E
Eur J Gen Pract · 2025 Dec · PMID 40208687 · Full text
BACKGROUND: COVID-19 pandemic caused a significant impact on healthcare workers' mental health and burnout, which continues after the pandemic. OBJECTIVES: To assess the levels of burnout in general practitioners (GP) in...
BACKGROUND: COVID-19 pandemic caused a significant impact on healthcare workers' mental health and burnout, which continues after the pandemic. OBJECTIVES: To assess the levels of burnout in general practitioners (GP) in Catalonia at three different times. METHODS: Cross-sectional study involving members of the GPs' Catalan Society ( = 4700). A self-administered survey was sent via institutional email in June-July 2021 (T1), in March-April 2022 (T2), and in May-June 2023 (T3). Probable burnout was assessed through Maslach Burnout Inventory (MBI) test, with three independent dimensions: emotional exhaustion, depersonalisation, and personal achievement. A descriptive analysis was performed, as well as a comparison between T1, T2, and T3 results. RESULTS: 500 GPs responded in T1, 454 in T2, and 386 in T3. Samples were similar in demographic variables. Regarding burnout dimensions, the level of emotional exhaustion was 67.5% in T1, with a statistically significant decrease in T2 and T3 (56.4 and 58.1%, respectively, = 0.001); levels of depersonalisation were 42.7% in T1, 37.0% in T2 and 36.7% in T3 ( = 0.091); levels of personal achievement were 29.9% in T1, 30.4% in T2 and 24.2% in T3 ( = 0.086). Starting at high levels of emotional exhaustion and depersonalisation, the prevalence decreased significantly over time in two groups: women and GPs who worked <10 years at the same workplace. CONCLUSION: Catalan GPs experienced significant burnout during the COVID-19 pandemic with emotional exhaustion being particularly high. Although the prevalence of burnout decreased slightly over time, over half of the participants consistently reported high levels of emotional exhaustion.
Correction.
Eur J Gen Pract · 2025 Dec · PMID 40168253 · Full text
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European general practitioners' attitudes towards person-centred care and factors that influence its implementation in everyday practice: The protocol of the cross-sectional PACE GP/FP study in 24 European countries.
Petriček G, Klemenc-Ketiš Z, Ožvačić Adžić Z … +53 more , Cerovečki V, Willems S, Tsimtsiou Z, Zelko E, Collins C, Hoffmann K, Eide TB, Ares Blanco S, Frese T, Lingner H, Assenova R, Torzsa P, Seifert B, Ungan M, Bayen S, Windak A, Azeredo J, Stavrikj K, Kreitmayer S, Kostić M, Busneag IC, Koskela T, Serafini A, Butterworth J, Zwart DLM, González-Lama J, Vuletić G, Van Poel E, Tušek Bunc K, Tuz C, Mevsim V, Seifert M, Dahli M, Hrabač P, Hanževački M, Rakić Matić J, Tomičić M, Rađa M, Heleno B, Studzinski K, Becze Á, Megallón-Botaya R, Rogers HL, Brütting C, Kafadar D, Lerma Irureta D, Fornacciari D, Nessler K, Soleski K, Méndez-López F, Çöme O, Ahmad A, Petek D
Eur J Gen Pract · 2025 Dec · PMID 40008619 · Full text
BACKGROUND: Person-centred care (PCC) is a fundamental principle in general practice, emphasising practices tailored to individual patient preferences, needs, and values. Despite the importance of PCC, general practition...
BACKGROUND: Person-centred care (PCC) is a fundamental principle in general practice, emphasising practices tailored to individual patient preferences, needs, and values. Despite the importance of PCC, general practitioners (GPs) face obstacles in effectively implementing it, with associated factors remaining unclear. OBJECTIVES: The PACE GP/FP study aims to explore GPs' attitudes towards PCC and the factors facilitating or hindering its implementation in daily practice across European countries. This paper outlines the PACE GP/FP study protocol. METHODS: The cross-sectional design with data collection an online survey distribution to GPs in 24 European countries. Study instruments include two validated questionnaires (Perceived Stress Scale (PSS) and Patient Physician Orientation Scale (PPOS)) and additional items covering general information about the doctor and their practice, as well as facilitators and barriers to PCC. These additional items were specifically developed for the study, translated using the forward-backward method, evaluated through cognitive debriefing, and integrated into the REDCap platform to create language and country-specific survey links. The STROBE checklist guides the reporting of the manuscript. CONCLUSION: The PACE GP/FP study will provide a comprehensive exploration of GPs' attitudes towards PCC and the factors shaping its practice in Europe. The findings from the PACE GP/FP study will provide evidence for designing future implementation strategies and guide targeted interventions to promote PCC in primary care across Europe.
Potential overtreatment in elderly patients with diabetes mellitus: Results from a cross-sectional study in German general practice.
Weise S, Oelschläger C, Unverzagt S … +3 more , Abendroth J, Heise M, Frese T
Eur J Gen Pract · 2025 Dec · PMID 39964188 · Full text
BACKGROUND: It is important for general practitioners (GPs) to protect elderly patients with diagnosis of diabetes type 2 (DM2) from overtreatment. OBJECTIVE: To analyse the metabolic control and treatment of elderly pat...
BACKGROUND: It is important for general practitioners (GPs) to protect elderly patients with diagnosis of diabetes type 2 (DM2) from overtreatment. OBJECTIVE: To analyse the metabolic control and treatment of elderly patients with DM2 in general practices. METHODS: This cross-sectional study involved 46 general practices in a federal state of Germany. Inclusion criteria for patients were diagnosis of DM2, age of 70 years or above, no palliative care and at least one practice contact within the last six months. A study nurse randomly selected 10 eligible patients and extracted data on haemoglobin A1c (HbA1c), diabetes treatment, secondary prevention and GP's characteristics. Risk of overtreatment was defined as having a HbA1c <47.5 mmol/mol (6.5%) and receiving glucose-lowering drugs, and overtreatment as being at risk of overtreatment and being aged 80 years or above or living in a nursing home. RESULTS: Among 460 participants, 36.0% received oral-antidiabetic drugs, 16.7% insulin, 16.2% both and 31.1% received diet/exercise. Overtreatment occurred in 12% of elderly patients with DM2, risk of overtreatment in 24%. Overtreatment was significantly associated with urban residency (OR 2.17). Female elderly patients with DM2 were significantly less often at risk of overtreatment (OR 0.59). Cluster effects were evident between general practices' treatment and monitoring of elderly patients with DM2 in quantitative data. CONCLUSION: Overtreatment is a relevant problem in elderly patients with DM2 for which GPs should regularly check and start deprescribing. Cluster effects suggest heterogeneity between general practices in diabetes management and monitoring.
From trainee to general practitioner: A qualitative study of transition experiences of Flemish GP trainees.
Tisseghem E, Fleer J, Horlait M … +2 more , Pype P, Lauwerier E
Eur J Gen Pract · 2025 Dec · PMID 39772933 · Full text
BACKGROUND: The transition from trainee to professional marks a key milestone in a family doctor's career, bringing both emotional and mental challenges. This critical period of specialisation shapes how young doctors ad...
BACKGROUND: The transition from trainee to professional marks a key milestone in a family doctor's career, bringing both emotional and mental challenges. This critical period of specialisation shapes how young doctors adapt and influences their future career choices. OBJECTIVES: We explored trainees' experiences during their first year of advanced medical training in family medicine/general practice, including barriers and facilitators. METHODS: Using qualitative methodology, we conducted ten focus group interviews with 111 trainees. These group interviews were held as part of small-group sessions integrated into a self-guided reflection course. All interviews were held between February 2021 and March 2021, conducted online via MS Teams, recorded, and transcribed verbatim for analysis. FINDINGS: Our analysis uncovered two adaptational processes during this transition period: personal adaptation and professional socialisation. We interpreted this as a complex balancing act, with impact on mental health aspects such as energy, exhaustion, and self-confidence. Multiple elements at different levels influenced these processes, including the workplace (e.g. interactions with colleagues and patients), the educational program (e.g. assignments, courses), and societal expectations (e.g. role expectations, support). CONCLUSION: The findings highlight the importance of understanding both personal adaptation and professional socialisation to support trainees effectively during their transition into practice. Future studies should validate these findings and explore their evolution over time, particularly in relation to adaptation and career choices.
Cross-sectional study of partners' tobacco consumption during their spouse's pregnancy.
Fortin F, Verrez C, Hacquart T … +2 more , Pereira B, Laporte C
Eur J Gen Pract · 2025 Dec · PMID 39688430 · Full text
BACKGROUND: A smoking partner is a major risk factor for passive smoking and continued maternal smoking. OBJECTIVE: To assess the smoking habits, knowledge, and information received to stop smoking of smoking partners du...
BACKGROUND: A smoking partner is a major risk factor for passive smoking and continued maternal smoking. OBJECTIVE: To assess the smoking habits, knowledge, and information received to stop smoking of smoking partners during their spouse's pregnancy. METHOD: This was a cross-sectional study of partners who smoked at the start of pregnancy and whose spouses had just given birth. Recruitment was carried out in maternity hospitals in the Auvergne-Rhône-Alpes region from June 2021 to December 2021. Data were collected using a self-administered questionnaire. RESULTS: A total of 105 men using tobacco were recruited, average age 34 years (± 6.4). Of these, 46 (44%) had modified their consumption during pregnancy: 11 (10.5%) had stopped smoking until maternity hospital entry, 24 (23%) had cut down and 11 (10.5%) had relapsed after initial total cessation. A multivariate analysis revealed a statistically significant relationship between men's change in smoking behaviour during pregnancy and a first pregnancy, an overweight participant, not living in a rural area, and information provided by the General Practitioner (GP). GPs are the first point of contact for participants looking for help to quit smoking. Among men who have not changed their smoking habits, 46% have not received any information from health professionals. CONCLUSIONS: Intervention and medical information provided by GPs to smoking partners may be associated with changes in smoking habits during pregnancy. Additional prospective, comparative studies are needed to support a robust conclusion.
Barriers and potential solutions for collaboration between primary and secondary care in patients with persistent somatic symptoms and functional disorders: A nominal group technique study.
Mamo N, Rosmalen JGM, Hanssen DJC … +2 more , Tak LM, Hartman TCO
Eur J Gen Pract · 2024 Dec · PMID 39655691 · Full text
BACKGROUND: Persistent somatic symptoms and functional disorders (PSS/FD) are complex conditions requiring collaboration between healthcare professionals. This is especially true at the interface between primary and seco...
BACKGROUND: Persistent somatic symptoms and functional disorders (PSS/FD) are complex conditions requiring collaboration between healthcare professionals. This is especially true at the interface between primary and secondary care interface. The current fragmentation of care is a major barrier to this, leading to poor experiences and outcomes and high costs for healthcare and society. OBJECTIVES: The aim is to identify barriers and possible solutions for collaboration between primary and secondary care in patients with PSS/FD. METHODS: In two sessions, using the nominal group technique, a mix of primary and secondary care professionals identified barriers and possible solutions to collaboration between primary and secondary care in PSS/FD care. Barriers to collaboration were identified during session one, with potential solutions identified during session two in response to the top eight barriers. Each session ended with a voting round ranking the barriers and solutions. RESULTS: A total of 102 healthcare professionals participated in two sessions. In the first session, 55 participants provided a list of 22 barriers, while in the second session, 47 participants provided 18 possible solutions. The top barriers related to shared language and protocols, referral quality, expectations and responsibilities between healthcare professionals and patients, and time pressure. The top solutions identified related to general practitioners using electronic consultations with specialists and shared terminology with patients. CONCLUSION: The identified barriers and possible solutions for collaboration between primary and secondary care need attention when considering collaboration in PSS/FD care and related settings, both in new and ongoing collaborations.
General practitioners' experiences with chronic abdominal symptoms and a faecal calprotectin guided referral strategy in children: A Dutch qualitative study.
Ansems SM, Berger MY, van Tol DG … +2 more , Olthof M, Holtman GA
Eur J Gen Pract · 2024 Dec · PMID 39620469 · Full text
BACKGROUND: General practitioners (GPs) often struggle to distinguish functional gastrointestinal disorders (FGID) from organic disorders in children with chronic abdominal symptoms. A referral strategy guided by faecal...
BACKGROUND: General practitioners (GPs) often struggle to distinguish functional gastrointestinal disorders (FGID) from organic disorders in children with chronic abdominal symptoms. A referral strategy guided by faecal calprotectin (FCal) testing may help. OBJECTIVE: This study explores GPs' experiences with these children and the strategy. METHODS: GPs were sampled purposively to data saturation. Ultimately, we conducted one focus group session and 13 semi-structured interviews with 17 Dutch GPs who had been involved in a randomised controlled trial evaluating an FCal-testing strategy. The online focus group and interviews were recorded, transcribed verbatim, and subject to thematic content analysis. RESULTS: Four themes arose: diagnostic confidence, fear of missing something severe, reassurance and managing FGID in primary care. Although GPs typically felt confident during the diagnostic process, they did fear missing somatic or psychosocial conditions. They felt more diagnostically confident due to FCals clear indications, high diagnostic accuracy, and non-invasiveness. Reassurance was considered crucial in children with FGID, either by labelling symptoms, providing explanatory models, or offering medical interventions (e.g. FCal testing). When helping children with FGID proved too difficult, GPs referred to specialist care. Besides the integration of FCal during reassurance, the testing strategy did not help GPs manage children with FGID. CONCLUSION: While the FCal-strategy improved diagnosis according to GPs, they found the primary challenge to be managing children with FGID. Nevertheless, they found the FCal-strategy beneficial, likely due to its integration into reassurance strategies. Further research focusing on enhancing communication and interventions for paediatric FGID in primary care is warranted.
Setting targets for antibiotic use in general practice in Europe: A scoping review.
Garzón-Orjuela N, Roche K, Vornhagen H … +5 more , Moran A, Walkin S, Cullen W, Blake C, Vellinga A
Eur J Gen Pract · 2024 Dec · PMID 39607900 · Full text
BACKGROUND: National Action Plans (NAPs) aim to address antimicrobial resistance (AMR) understanding and awareness but struggle to translate targets into clinically relevant guidance for general practice. OBJECTIVE: To i...
BACKGROUND: National Action Plans (NAPs) aim to address antimicrobial resistance (AMR) understanding and awareness but struggle to translate targets into clinically relevant guidance for general practice. OBJECTIVE: To identify and map antibiotic use targets in European general practice and explore if and how these targets are linked to NAPs. METHODS: A systematic search was carried out in MEDLINE (OVID), EMBASE and SCOPUS, with additional manual searches. The research questions were: What are existing targets for antibiotic use in general practice in the 31 European countries? and How are these targets linked to the NAPs on AMR?. The results are presented narratively. RESULTS: 77 reports were included, of which 33 focused on national targets and general practice or linking national and local targets. Reports describe local strategies to achieve targets, such as prescriber feedback, benchmarking systems and financial incentives. However, these reports provide aggregated targets for general practice, such as a percentage reduction of antibiotics prescribed. These targets are set in general, for a specific type of antibiotic, for an amount per number of patients, in defined daily doses or items. None of the reports translate national targets into clinically relevant or practical targets for general practitioners. CONCLUSION: Most European countries have an NAP with established targets, but the type and implementation of these targets vary between nations. Translating national targets into daily clinical practice is challenging and often lacks the involvement of prescribers. Aligning national and local targets would enhance coherence and more effectively contribute to improvements in antibiotic use.
Exploring the experiences of GPs in establishing and operating the chronic disease management programme in clinical practice in Ireland. A qualitative study.
Buckley S, O' Flynn J, Foley T
Eur J Gen Pract · 2024 Dec · PMID 39607886 · Full text
BACKGROUND: The management of chronic diseases, in the context of an ageing population and increasing life expectancy, is one of the major challenges facing the Irish health system. In 2020, a chronic disease management...
BACKGROUND: The management of chronic diseases, in the context of an ageing population and increasing life expectancy, is one of the major challenges facing the Irish health system. In 2020, a chronic disease management programme [CDM] was introduced in Irish general practice as part of a transformation in health policy to meet the changing needs of the population. OBJECTIVES: To explore GPs' experiences and perceptions of the impact of the introduction of CDM on general practice in Ireland. METHODS: 18 semi-structured interviews were conducted with GPs in clinical practice from across Ireland. GPs were purposefully recruited to capture the differing experiences faced by GPs in large and small practices in both urban and rural settings. Interviews were analysed using reflexive thematic analysis. RESULTS: GPs were enthusiastic about aspects of CDM, which they felt provided an improved framework for their approach to the management of chronic diseases. However, they described several challenges to implementation, especially around capacity constraints. CDM could have unintended consequences for aspects of routine GP care. GPs described how practice nurses had taken on a central role in both clinical and administrative aspects of the programme. CONCLUSIONS: GPs value the framework provided by CDM for their approach to the management of chronic disease. However, challenges around practice capacity and its impact both on the delivery of CDM and aspects of routine care highlight the importance for policy makers to provide continued support to strengthen the general practice infrastructure.
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