The European Journal Of General Practice[JOURNAL]
Sun
200 papers
Biomarkers for predicting atrial fibrillation: An explorative sub-analysis of the randomised SCREEN-AF trial.
Schmalstieg-Bahr K, Gladstone DJ, Hummers E … +6 more , Suerbaum J, Healey JS, Zapf A, Köster D, Werhahn SM, Wachter R
Eur J Gen Pract · 2024 Dec · PMID 38497412 · Full text
BACKGROUND: Atrial fibrillation (AF) is a common treatable risk factor for stroke. Screening for paroxysmal AF in general practice is difficult, but biomarkers might help improve screening strategies. OBJECTIVES: We inve...
BACKGROUND: Atrial fibrillation (AF) is a common treatable risk factor for stroke. Screening for paroxysmal AF in general practice is difficult, but biomarkers might help improve screening strategies. OBJECTIVES: We investigated six blood biomarkers for predicting paroxysmal AF in general practice. METHODS: This was a pre-specified sub-study of the SCREEN-AF RCT done in Germany. Between 12/2017-03/2019, we enrolled ambulatory individuals aged 75 years or older with a history of hypertension but without known AF. Participants in the intervention group received active AF screening with a wearable patch, continuous ECG monitoring for 2x2 weeks and usual care in the control group. The primary endpoint was ECG-confirmed AF within six months after randomisation. High-sensitive Troponin I (hsTnI), brain natriuretic peptide (BNP), N-terminal pro-B-type natriuretic peptide (NT-pro BNP), N-terminal pro atrial natriuretic peptide (NT-ANP), mid-regional pro atrial natriuretic peptide (MR-pro ANP) and C-reactive protein (CRP) plasma levels were investigated at randomisation for predicting AF within six months after randomisation. RESULTS: Blood samples were available for 291 of 301 (96.7%) participants, including 8 with AF (3%). Five biomarkers showed higher median results in AF-patients: BNP 78 vs. 41 ng/L ( = 0.012), NT-pro BNP 273 vs. 186 ng/L ( = 0.029), NT-proANP 4.4 vs. 3.5 nmol/L ( = 0.027), MR-pro ANP 164 vs. 125 pmol/L ( = 0.016) and hsTnI 7.4 vs. 3.9 ng/L ( = 0.012). CRP levels were not different between groups (2.8 vs 1.9 mg/L, = 0.1706). CONCLUSION: Natriuretic peptide levels and hsTnI are higher in patients with AF than without and may help select patients for AF screening, but larger trials are needed.
Series: Public engagement with research. Part 2: GPs and primary care researchers working inclusively with minoritised communities in health research to help address inequalities.
Masood Y, Alvarez Nishio A, Starling B … +5 more , Dawson S, Salsberg J, Blackburn S, van Vliet E, Pittens CACM
Eur J Gen Pract · 2024 Dec · PMID 38477291 · Full text
Public engagement in health research is vital for addressing health disparities and promoting inclusivity among minoritised communities who often face barriers to accessing healthcare. Minoritised communities are groups,...
Public engagement in health research is vital for addressing health disparities and promoting inclusivity among minoritised communities who often face barriers to accessing healthcare. Minoritised communities are groups, which have been made minorities by a dominant culture, race, ethnic group and/or social class and may experience health inequalities as a result. By incorporating diverse perspectives and lived experiences of minoritised communities, this approach aims to achieve contextually relevant research outcomes that reduce health inequalities and improve overall well-being. However, underrepresentation and lack of inclusivity challenges persist, necessitating the establishment of inclusive partnerships and grassroots participatory methodologies. To foster inclusive public engagement, it is important to overcome structural and cultural barriers, address socioeconomic challenges, and build trust with minoritised communities. This can be achieved by promoting a cultural shift that values inclusivity, providing comprehensive training to researchers, and collecting rigorous data on engagement demographics for transparency and accountability. Involving minoritised communities in decision-making through participatory research approaches enhances trust and yields successful outcomes. Additionally, allocating sufficient resources, collaborating in co-production, and prioritising the diverse needs and perspectives of stakeholders contribute to fostering inclusive public engagement in research. Overall, inclusive engagement practices particularly in primary care research have the potential to reduce health inequalities and cater to the unique requirements of minoritised communities, thereby creating more impactful outcomes and promoting equitable healthcare access.
Relationship between patient-perceived quality of primary care and self-reported hospital utilisation in China: A cross-sectional study.
Zhong C, Huang J, Li L … +5 more , Luo Z, Liang C, Zhou M, Hu N, Kuang L
Eur J Gen Pract · 2024 Dec · PMID 38407121 · Full text
BACKGROUND: Reducing avoidable hospital admissions is a global healthcare priority, with optimal primary care recognised as pivotal for achieving this objective. However, in developing systems like China, where primary c...
BACKGROUND: Reducing avoidable hospital admissions is a global healthcare priority, with optimal primary care recognised as pivotal for achieving this objective. However, in developing systems like China, where primary care is evolving without compulsory gatekeeping, the relationship between patient-perceived primary care quality and hospital utilisation remains underexplored. OBJECTIVES: This study aimed to explore the association between patient-perceived primary care quality and self-reported hospital utilisation in China. METHODS: Data were collected from 16 primary care settings. Patient-perceived quality of primary care was measured using the Assessment Survey of Primary Care scale across six domains (first-contact care, continuity, comprehensiveness, accessibility, coordination, and patient-centredness). Hospital utilisation included patient self-reported outpatient visits, hospital admissions, and emergency department (ED) visits in the last six months. Logistic regression analyses were examined associations between self-reported hospital utilisation and perceived primary care quality adjusted for potential confounders. RESULTS: Of 1,185 patients recruited, 398 (33.6%) reported hospital utilisation. Logistic regression analyses showed that higher total scores for patient-perceived quality of primary care were associated with decreased odds of hospital utilisation (adjusted odds ratio(AOR): 0.417, 95% confidence interval (CI): 0.308-0.565), outpatient visits (AOR: 0.394, 95% CI: 0.275-0.566) and hospital admissions (AOR: 0.496, 95% CI: 0.276-0.891). However, continuity of care was positively associated with ED visits (AOR: 2.252, 95% CI: 1.051-4.825). CONCLUSION: Enhanced patient-perceived quality of primary care in China is associated with a reduction in self-reported overall hospital utilisation, including outpatient visits and hospital admissions. However, better continuity of care may be associated with increased ED visits. Further research is warranted for precise insights and validation of these findings.
Social Experiences and Health Needs of Patients with Severe Mental Illness and their Caregivers during the first year of the COVID-19 pandemic in Spain.
Ramos-Ruiz JA, Pérez-Milena A, Noguera-Cuenca C … +1 more , Ruiz-Díaz B
Eur J Gen Pract · 2024 Dec · PMID 38345069 · Full text
BACKGROUND: The strict isolation measures for the population imposed by the health authorities caused a prolonged disruption of informal social support networks. Both this new social situation and the decrease in accessi...
BACKGROUND: The strict isolation measures for the population imposed by the health authorities caused a prolonged disruption of informal social support networks. Both this new social situation and the decrease in accessibility to health care have generated new needs in people with severe mental illness (SMI) and their caregivers. OBJECTIVES: This study provides insight into life experiences and health needs of a population with SMI during the first year of the COVID-19 pandemic in Spain. METHODS: Qualitative design using semi-structured dyadic interviews, conducted from January through December 2022. A purposive sampling of patients with SMI and their caregivers was carried out through key informants in rural and urban localities in southern Spain. Verbatims were identified and classified by triangulation after the evaluation of the interview transcripts. The codes were defined through content analysis using the NVivo software. RESULTS: Semi-structured dyadic interviews (21), identifying three main categories: 1. Social isolation: increased, causing greater personal vulnerability, exacerbation of psychiatric symptoms and exhaustion in caregivers. 2. Accessibility to Health Services decreased with fewer face-to-face consultations, with difficulty in managing urgent situations and telephone attention in decompensated and disabled patients. 3. Continuity of healthcare: decreased with distrust in health professionals due to lack of communication between primary care and the hospital. CONCLUSION: COVID-19 confinement exacerbated loneliness and worse health self-perception in SMI people. Greater formal social support was required. GPs role is key to avoiding delays in appointments and lack of coordination between primary and specialised care.
The revised European Definition of General Practice/Family Medicine. A pivotal role of One Health, Planetary Health and Sustainable Development Goals.
Windak A, Rochfort A, Jacquet J
Eur J Gen Pract · 2024 Dec · PMID 38334099 · Full text
Abstract loading — click title to view on PubMed.
Why are our medicines so expensive? Spoiler: Not for the reasons you are being told….
Torreele E
Eur J Gen Pract · 2024 Dec · PMID 38299574 · Full text
Often described as a natural economic trend, the prices that pharmaceutical companies charge for new medicines have skyrocketed in recent years. Companies claim these prices are justified because of the 'value' new treat...
Often described as a natural economic trend, the prices that pharmaceutical companies charge for new medicines have skyrocketed in recent years. Companies claim these prices are justified because of the 'value' new treatments represent or that they reflect the high costs and risks associated with the research and development process. They also claim that the revenues generated through these high prices are required to pay for continued innovation.This paper argues that high prices are not inevitable but the result of a societal and political choice to rely on a for-profit business model for medical innovation, selling medicines at the highest price possible. Instead of focusing on therapeutic advances, it prioritises profit maximisation to benefit shareholders and investors over improving people's health outcomes or equitable access.As a result, people and health systems worldwide struggle to pay for the increasingly expensive health products, with growing inequities in access to even life-saving medicines while the biopharmaceutical industry and its financiers are the most lucrative business sectors.As the extreme COVID-19 vaccine inequities once again highlighted, we urgently need to reform the social contract between governments, the biopharmaceutical industry, and the public and restore its original health purpose. Policymakers must redesign policies and financing of the pharmaceutical research and development ecosystem such that public and private sectors work together towards the shared objective of responding to public health and patients' needs, rather than maximising financial return because medicines should not be a luxury.
mHealth technologies for pregnancy prevention: A challenge for patient-centred contraceptive counselling in Dutch general practice.
Algera E, Leusink P, Gerrits T … +2 more , Pols J, Ravesloot JH
Eur J Gen Pract · 2024 Dec · PMID 38264977 · Full text
BACKGROUND: A general practitioner (GP) standardly provides contraceptive counselling and care in the Netherlands. Recent years have seen the rise of mobile health technologies that aim to prevent pregnancy based on fert...
BACKGROUND: A general practitioner (GP) standardly provides contraceptive counselling and care in the Netherlands. Recent years have seen the rise of mobile health technologies that aim to prevent pregnancy based on fertility awareness-based methods (FABMs). We lack high-quality evidence of these methods' effectiveness and clarity on how healthcare professionals include them in contraceptive counselling. OBJECTIVES: To analyse how Dutch healthcare professionals include pregnancy-prevention mobile health technologies (mHealth contraception) in contraceptive counselling and to propose practice recommendations based on our findings. METHODS: We used ethnographic methods, including semi-structured interviews with nine professionals who were recruited using purposive sampling, 10 observations of contraceptive counselling by four professionals, six observations of teaching sessions in medical training on contraception and reproductive health, one national clinical guideline, and seven Dutch patient decision aids. Data were collected between 2018 and 2021 and analysed inductively using praxiographic and thematic analysis. RESULTS: In contraceptive counselling and care, professionals tended to blend two approaches: 1) individual patient-tailored treatment and 2) risk minimisation. When interviewed about mHealth contraception, most professionals prioritised risk minimisation and forewent tailored treatment. Some did not consider mHealth contraception or FABMs as contraceptives or deemed them inferior methods. CONCLUSION: To minimise risk of unintended pregnancy, professionals hesitated to include mHealth contraception or other FABMs in contraceptive consultations. This may hamper adequate patient-centred counselling for patients with preference for mHealth contraception.Based on these results, we proposed recommendations that foster a patient-tailored approach to mHealth contraceptives.
Comment on: Climate change is a health issue. The general practitioner and planetary health by Stoffers & Muris 2023.
Brady Bates O, Freeman N
Eur J Gen Pract · 2024 Dec · PMID 38264966 · Full text
Abstract loading — click title to view on PubMed.
Evaluation of the psychometric performance of the Spanish and Catalan versions of the patient reported experiences and Outcomes of Safety in Primary Care (PREOS-PC)-Compact questionnaire.
Fiol-deRoque MA, Valderas JM, Arias de la Torre J … +6 more , Serrano-Ripoll MJ, Gens-Barberà M, Sánchez-Freire E, Martín-Luján FM, Olry de Labry A, Ricci-Cabello I
Eur J Gen Pract · 2024 Dec · PMID 38197321 · Full text
BACKGROUND: Patients provide a unique, irreplaceable, and essential perspective in evaluating patient safety. The suite of Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) tools are a notabl...
BACKGROUND: Patients provide a unique, irreplaceable, and essential perspective in evaluating patient safety. The suite of Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) tools are a notable exception to the scarcity of patient-reported patient safety measures. Full evaluation of their performance has only been attempted for the English version, thereby limiting its international applicability. OBJECTIVES: To assess the psychometric performance of the Spanish and Catalan versions of the PREOS-PC-Compact. METHODS: Cross-sectional validation study. We used Classical Test Theory methods to examine scale score distribution, internal consistency, and construct validity; and Item Response Theory (IRT) methods to further explore construct validity. RESULTS: 3287 patients completed the Spanish version, and 1007 the Catalan version. Similar results were obtained for both versions. Confirmatory Factor Analysis supported a single construct for each scale. The correlations between PREOS-PC-Compact scales and known group analysis suggested adequate construct validity (inconclusive for known groups at the provider level). All four multi-item scales demonstrated adequate internal consistency reliability (α > 0.7), which was only confirmed for test-retest reliability for 'Practice activation.' A sample between 60-90 patients per practice was estimated sufficient to produce scores with reliability > 0.7 for all scales except for harm scales. IRT models showed disordered thresholds for 'Practice activation' and 'Harm burden' but showed excellent fit after reducing the response categories. CONCLUSION: The Spanish and Catalan versions of the PREOS-PC-Compact are broadly valid and reliable tools to measure patient safety in Spanish primary care centres; confirmation of lower-than-expected test-rest reliability merits further examination .
The experiences of transgender and nonbinary adults in primary care: A systematic review.
Holland D, White LCJ, Pantelic M … +1 more , Llewellyn C
Eur J Gen Pract · 2024 Dec · PMID 38197305 · Full text
BACKGROUND: Transgender and nonbinary (TNB) people face barriers to primary care, which remains the main entry point for accessing gender-affirming healthcare in the UK. OBJECTIVES: This systematic review aims to summari...
BACKGROUND: Transgender and nonbinary (TNB) people face barriers to primary care, which remains the main entry point for accessing gender-affirming healthcare in the UK. OBJECTIVES: This systematic review aims to summarise the evidence regarding TNB people's experiences of primary care to inform improvements in service and patient outcomes. METHODS: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. A systematic literature search was conducted across articles from 2005 to April 2023 across Ovid Medline, Ovid Embase and PsychInfo using established keywords relating to gender identity, primary care and experiences. Qualitative data were thematically analysed and quantitative data were compiled using a descriptive narrative. RESULTS: Following eligibility criteria, 16 articles were included in this review. This review identified both facilitators and limitations and barriers experienced by TNB people related to primary care provider knowledge; the patient-provider relationship, and healthcare settings. Quantitative findings reported up to 54.4% of participants were uncomfortable discussing TNB issues with their physician. Overall findings suggest TNB people face discrimination on a systemic level utilising primary care services, though positive healthcare encounters at a local level were reported. Participants expressed a desire for primary care-led gender-affirming healthcare services, with involvement from local TNB communities. CONCLUSION: This review demonstrates TNB people's mixed experiences of primary care alongside their recommendations for service improvement. This is the first systematically reviewed evidence on the topic, emphasising the need for clinicians and policymakers to centre the voices of the TNB community in service design and improvement.
Monitoring COVID-19 in Belgian general practice: A tool for syndromic surveillance based on electronic health records.
Vos B, Debouverie L, Doggen K … +4 more , Delvaux N, Aertgeerts B, De Schreye R, Vaes B
Eur J Gen Pract · 2024 Dec · PMID 38186340 · Full text
BACKGROUND: COVID-19 may initially manifest as flu-like symptoms. As such, general practitioners (GPs) will likely to play an important role in monitoring the pandemic through syndromic surveillance. OBJECTIVES: To prese...
BACKGROUND: COVID-19 may initially manifest as flu-like symptoms. As such, general practitioners (GPs) will likely to play an important role in monitoring the pandemic through syndromic surveillance. OBJECTIVES: To present a COVID-19 syndromic surveillance tool in Belgian general practices. METHODS: We performed a nationwide observational prospective study in Belgian general practices. The surveillance tool extracted the daily entries of diagnostic codes for COVID-19 and associated conditions (suspected or confirmed COVID-19, acute respiratory infection and influenza-like illness) from electronic medical records. We calculated the 7-day rolling average for these diagnoses and compared them with data from two other Belgian population-based sources (laboratory-confirmed new COVID-19 cases and hospital admissions for COVID-19), using time series analysis. We also collected data from users and stakeholders about the syndromic surveillance tool and performed a thematic analysis. RESULTS: 4773 out of 11,935 practising GPs in Belgium participated in the study. The curve of contacts for suspected COVID-19 followed a similar trend compared with the curves of the official data sources: laboratory-confirmed COVID-19 cases and hospital admissions but with a 10-day delay for the latter. Data were quickly available and useful for decision making, but some technical and methodological components can be improved, such as a greater standardisation between EMR software developers. CONCLUSION: The syndromic surveillance tool for COVID-19 in primary care provides rapidly available data useful in all phases of the COVID-19 pandemic to support data-driven decision-making. Potential enhancements were identified for a prospective surveillance tool.
Democratising the design and delivery of large-scale randomised, controlled clinical trials in primary care: A personal view.
Butler CC
Eur J Gen Pract · 2024 Dec · PMID 38180050 · Full text
BACKGROUND: Rapid identification of effective treatments for use in the community during a pandemic is vital for the well-being of individuals and the sustainability of healthcare systems and society. Furthermore, identi...
BACKGROUND: Rapid identification of effective treatments for use in the community during a pandemic is vital for the well-being of individuals and the sustainability of healthcare systems and society. Furthermore, identifying treatments that do not work reduces research wastage, spares people unnecessary side effects, rationalises the cost of purchasing and stockpiling medication, and reduces inappropriate medication use. Nevertheless, only a small minority of therapeutic trials for SARS-CoV-2 infections have been in primary care: most opened too late, struggled to recruit, and few produced actionable results. Participation in research is often limited by where one lives or receives health care, and trial participants may not represent those for whom the treatments are intended. INNOVATIVE TRIALS: The ALIC4E, PRINCIPLE and the ongoing PANORAMIC trial have randomised over 40,500 people with COVID-19. This personal view describes how these trials have innovated in: (by using novel adaptive platform designs); (by complementing traditional site-based recruitment ('the patient comes to the research') with mechanisms to enable sick, infectious people to participate without having to leave home ('taking research to the people'), and by addressing the 'inverse research participation law,' which highlights disproportionate barriers faced by those who have the most to contribute, and benefit from, research, and; in by evaluating nine medicines to support guidelines and care decisions world-wide for COVID-19 and contribute to antimicrobial stewardship. CONCLUSION: The PRINCIPLE and PANORAMIC trials represent models of innovation and inclusivity, and exemplify the potential of primary care to lead the way in addressing pressing global health challenges.
Diagnostic flow for all patients referred with non-specific symptoms of cancer to a diagnostic centre in Denmark: A descriptive study.
Damhus CS, Brodersen JB, Nielsen GL
Eur J Gen Pract · 2024 Dec · PMID 38179994 · Full text
BACKGROUND: Since 2012, Cancer Patient Pathways for Non-specific Symptoms and Signs of Cancer (NSSC-CPP) have been implemented in Scandinavia and UK. OBJECTIVES: This study aimed to describe the diagnostic flow for all p...
BACKGROUND: Since 2012, Cancer Patient Pathways for Non-specific Symptoms and Signs of Cancer (NSSC-CPP) have been implemented in Scandinavia and UK. OBJECTIVES: This study aimed to describe the diagnostic flow for all patients referred from 1 January to 30 June 2020 to the NSSC-CPP in the Diagnostic Centre in Farsø (DC-F), Denmark. METHODS: During the study period, we prospectively recorded information on the diagnostic flow, including: pathway trajectory, symptoms and findings leading to referral, diagnostic procedures and diagnoses at the end of DC Farsø work-up and within 6-months for all patients referred to the NSSC-CPP in DC Farsø using electronic patient files and the Danish National Patient Registry (DNPR). RESULTS: Of the 314 referrals to DC Farsø, 227 had diagnostic work-up in DC Farsø, the remaining were redirected to other CPPs ( = 11), outpatient clinics ( = 45) or redirected to general practice ( = 25). Of total referrals, 25 (8%) received a malignant diagnosis, 20 (6%) a non-malignant but clinically relevant diagnosis with initiation of treatment, 16 (5%) a non-malignant diagnosis but no treatment needed and in 253 (81%) referrals no severe new condition was diagnosed. Two (1%) additional malignancies were diagnosed within a 6-month follow-up period. CONCLUSION: By tracking all patients referred to the NSSC-CPP in DC Farsø, including those redirected, this is the first study to describe the diagnostic flow for all patients referred to a diagnostic centre in Denmark. This knowledge is important for further organisation and planning of the NSSC-CPP.
Validation of the Lithuanian multimorbidity treatment burden questionnaire (MTBQ) and its association with primary care patient characteristics.
Vasiliauskienė O, Vasiliauskas D, Duncan P … +5 more , Kontrimiene A, Jaruseviciene L, Cesnuleviciene A, Urbonas G, Liseckiene I
Eur J Gen Pract · 2023 Dec · PMID 38010870 · Full text
BACKGROUND: The increasing prevalence of multimorbidity among older people in Lithuania and other Central-Eastern European countries leads to a greater patient treatment burden and puts additional pressure on healthcare...
BACKGROUND: The increasing prevalence of multimorbidity among older people in Lithuania and other Central-Eastern European countries leads to a greater patient treatment burden and puts additional pressure on healthcare services. OBJECTIVES: This study aimed to validate the Lithuanian version of the Multimorbidity Treatment Burden Questionnaire (MTBQ). METHODS: The Lithuanian version of the MTBQ was tested (2021-2022) with 789 patients from seven Lithuanian primary care centres who had two or more long-term conditions. The questionnaire translation's reliability, validity and dimensionality of the were assessed with Spearman's rank correlation, Cronbach's alpha, and factor reduction analysis. Treatment burden and its associations with sociodemographic and other indicators were analysed. RESULTS: Lithuanian version of MTBQ had good internal reliability (Cronbach's alpha 0.711), validity, factor reduction applicability, and interpretability. The MTBQ scores of the questionnaire had a negative association with the quality-of-life scale (r=-0.327, 95% CI [-0.389, -0.264]) and positive associations with the self-rated health scores ( = 0.230, 95% CI [0.163, 0.297]) and with the number of comorbidities ( = 0.164, 95% CI [0.097, 0.233]). Distribution of treatment burden was identified (none (19,4%), low (46,6%), medium (25%), high (9%)). High treatment burden was found to be associated with having five or more long-term diseases, taking five or more medications, having anxiety or depression and living in a rural area. CONCLUSION: The study's findings show that the MTBQ is applicable in assessing the treatment burden of multimorbid patients in Lithuania. Furthermore, the study demonstrates that Lithuanian patients with multimorbidity have average treatment burden scores similar to or higher than participants in previous MTBQ validation studies.
Patients' perceptions of climate-sensitive health counselling in primary care: Qualitative results from Germany.
Griesel S, Schwerdtle PN, Quitmann C … +2 more , Danquah I, Herrmann A
Eur J Gen Pract · 2023 Dec · PMID 38010828 · Full text
BACKGROUND: Climate change is the greatest threat to global health in the twenty first century, yet combating it entails substantial health co-benefits. Physicians and other health professionals have not yet fully embrac...
BACKGROUND: Climate change is the greatest threat to global health in the twenty first century, yet combating it entails substantial health co-benefits. Physicians and other health professionals have not yet fully embraced their responsibilities in the climate crisis, especially about their communication with patients. While medical associations are calling on physicians to integrate climate change into health counselling, there is little empirical evidence about corresponding perceptions of patients. OBJECTIVES: This study aimed to explore primary care patients' perceptions of climate-sensitive health counselling. METHODS: From July to December 2021, 27 qualitative interviews with patients were conducted and analysed using thematic analysis. A purposive sampling technique was applied to identify patients who had already experienced climate-sensitive health counselling in Germany. RESULTS: Patients' perceptions of climate-sensitive health counselling were characterised by a high level of acceptance, which was enhanced by stressing the link between climate change and health, being credible concerning physician's own climate-friendly lifestyle, building upon good therapeutic relationships, creating a sense of solidarity, and working in a patient centred manner. Challenges and risks for acceptance were patients' disinterest or surprise, time constraints, feared politicisation of consultations, and evoking feelings of guilt and shame. CONCLUSION: These findings suggest that primary care patients can accept climate-sensitive health counselling, if it follows certain principles of communication, including patient-centredness. Our findings can be useful for developing communication guidelines, respective policies as well as well-designed intervention studies, which are needed to test the health and environmental effects of climate-sensitive health counselling.
Transitioning from face-to-face to distance education. Part 2: A qualitative study in the former Yugoslavia during COVID-19.
Petek D, Zakarija-Grković I, Stepanović A … +5 more , Tomičić M, Adžić ZO, Cerovečki V, Švab I, Homar V
Eur J Gen Pract · 2023 Dec · PMID 38010726 · Full text
BACKGROUND: Similar to other countries, Departments of Family Medicine in the former Yugoslavia had to transition from face-to-face to distance education during COVID-19. OBJECTIVES: To elucidate obstacles and facilitato...
BACKGROUND: Similar to other countries, Departments of Family Medicine in the former Yugoslavia had to transition from face-to-face to distance education during COVID-19. OBJECTIVES: To elucidate obstacles and facilitators of the transition from face-to-face to distance education. METHODS: A cross-sectional, multicentre, qualitative study design was used to analyse nine open-ended questions from an online survey using inductive thematic analysis. The questionnaire was distributed to 21 medical schools, inviting them to involve at least two teachers/students/trainees. Data were collected between December 2021 and March 2022. RESULTS: In 17 medical schools, 23 students, 54 trainees and 40 teachers participated. The following themes were identified: facilitators and barriers of transition, innovations for enhancing distance education, convenience of distance education, classical teaching for better communication, the future of distance education, reaching learning outcomes and experience of online assessment. Innovations referred mainly to new online technologies for interactive education and communication. Distance education allowed for greater flexibility in scheduling and self-directed learning; however, participants felt that classical education allowed better communication and practical learning. Teachers believed knowledge-related learning outcomes could be achieved through distance education but not teaching clinical skills. Participants anticipated a future where a combination of teaching methods is used. CONCLUSION: The transition to distance education was made possible thanks to its flexible scheduling, innovative tools and possibility of self-directed learning. However, face-to-face education was considered preferable for fostering interpersonal relations and teaching clinical skills. Educators should strive to strike a balance between innovative approaches and the preservation of personal experiences.
Transitioning from face-to-face to distance education. Part 1: A cross-sectional study in the former Yugoslavia during COVID-19.
Zakarija-Grković I, Stepanović A, Petek D … +5 more , Tomičić M, Ožvačić Z, Cerovecki V, Švab I, Homar V
Eur J Gen Pract · 2023 Dec · PMID 38010419 · Full text
BACKGROUND: The countries of the former Yugoslavia have health and education systems with the same tradition but these have changed over the years. Little is known about how family medicine teaching transitioned from fac...
BACKGROUND: The countries of the former Yugoslavia have health and education systems with the same tradition but these have changed over the years. Little is known about how family medicine teaching transitioned from face-to-face to distance education during the COVID-19 pandemic. OBJECTIVES: to investigate student/teacher experience in transitioning from face-to-face to distance education. METHODS: A cross-sectional, online survey was conducted among 21 medical schools of the former Yugoslavia between December 2021 and March 2022. Under/postgraduate teachers and students who taught/studied family medicine during the academic year 2020/2021 were invited to participate. Of 31 questions for students and 35 for teachers, all but nine open questions were analysed using descriptive statistics. RESULTS: Seventeen of 21 medical schools contributed data involving 117 participants representing all countries of the former Yugoslavia. At the beginning of the pandemic, 30%, 26% and 15% of teachers, students and trainees, respectively, received formal preparation in distance education. Of these, 92% of teachers and 58% of students/trainees felt they were not adequately prepared. Synchronous teaching was the main method used, with a third using hybrid methods. All participants were least confident about online assessment. More than 75% of respondents agreed that lectures could be kept online, not patient consultations or practical skills' classes. CONCLUSION: Teachers used various old and new methods to provide learning opportunities despite COVID-19 constraints. Effective technology-based strategies are essential to ensure assessment integrity and enhance the learning environment.
Climate change is a health issue. The general practitioner and planetary health.
Stoffers J, Muris J
Eur J Gen Pract · 2023 Dec · PMID 37982393 · Full text
Abstract loading — click title to view on PubMed.
Direct-to-patient digital diagnostics in primary care: Opportunities, challenges, and conditions necessary for responsible digital diagnostics.
Villalobos-Quesada M, Ho K, Chavannes NH … +1 more , Talboom-Kamp EP
Eur J Gen Pract · 2023 Dec · PMID 37947197 · Full text
BACKGROUND: Diagnostics are increasingly shifting to patients' home environment, facilitated by new digital technologies. Digital diagnostics (diagnostic services enabled by digital technologies) can be a tool to better...
BACKGROUND: Diagnostics are increasingly shifting to patients' home environment, facilitated by new digital technologies. Digital diagnostics (diagnostic services enabled by digital technologies) can be a tool to better respond to the challenges faced by primary care systems while aligning with patients' and healthcare professionals' needs. However, it needs to be clarified how to determine the success of these interventions. OBJECTIVES: We aim to provide practical guidance to facilitate the adequate development and implementation of digital diagnostics. STRATEGY: Here, we propose the quadruple aim (better patient experiences, health outcomes and professional satisfaction at lower costs) as a framework to determine the contribution of digital diagnostics in primary care. Using this framework, we critically analyse the advantages and challenges of digital diagnostics in primary care using scientific literature and relevant casuistry. RESULTS: Two use cases address the development process and implementation in the Netherlands: a patient portal for reporting laboratory results and digital diagnostics as part of hybrid care, respectively. The third use case addresses digital diagnostics for sexually transmitted diseases from an international perspective. CONCLUSIONS: We conclude that although evidence is gathering, the often-expected value of digital diagnostics needs adequate scientific evidence. We propose striving for evidence-based 'responsible digital diagnostics' (sustainable, ethically acceptable, and socially desirable digital diagnostics). Finally, we provide a set of conditions necessary to achieve it. The analysis and actionable guidance provided can improve the chance of success of digital diagnostics interventions and overall, the positive impact of this rapidly developing field.
Effectiveness of the spirometry-based motivational intervention to quit smoking: RESET randomised trial.
Martín-Luján F, Santigosa-Ayala A, Pallejà-Millán M … +4 more , Rey-Reñones C, Villalobos F, Solà R, researchers of the RESET study
Eur J Gen Pract · 2023 Dec · PMID 37933978 · Full text
BACKGROUND: The effectiveness of providing feedback on spirometry results for smoking cessation remains inconclusive according to the current evidence. OBJECTIVES: To assess the effectiveness of a motivational interventi...
BACKGROUND: The effectiveness of providing feedback on spirometry results for smoking cessation remains inconclusive according to the current evidence. OBJECTIVES: To assess the effectiveness of a motivational intervention based on spirometry results in achieving prolonged smoking abstinence (12 months post-intervention). DESIGN AND SETTING: A randomised, controlled, observer-blinded, multicentre clinical trial was conducted (from January 2012 to December 2015) in 20 primary healthcare centres in the Tarragona province, Spain. METHODS: Participants, active smokers aged 35-70 without known respiratory disease, were recruited from primary healthcare centres by family doctors and nurses. They were randomly assigned to either the intervention group (IG = 308) or the control group (CG = 306). Both groups received brief smoking cessation counselling. Additionally, the IG underwent spirometry and received detailed information about the results, including lung age. The primary outcome was prolonged abstinence, defined as lasting at least 12 months and validated through cotinine measurement in urine. RESULTS: The prolonged abstinence rate was 7.8% in the IG, compared to 2.6% in the CG ( = 0.004). At 12 months, in the multivariate analysis, the intervention was identified as an independent factor for smoking cessation ( 2.8; 95% 1.2 to 7.7), a trend maintained throughout the follow-up ( 2.74; 95% 1.13 to 6.62). Moreover, according to the Prochaska and DiClemente model, the preparation or action phase to quit was also associated with smoking cessation ( 2.55, 95% 1.07 to 6.09). CONCLUSION: A primary care-delivered intervention involving brief counselling and detailed spirometry information proves effective in increasing abstinence rates among active smokers without known respiratory disease. Additionally, smoking cessation is also influenced by the individual's stage of change. TRIAL REGISTRATION: ClinicatTrials.gov NCT02153047.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe