BJGP Interviews

Today, we’re speaking to Dr Charlotte Archer, Research fellow in primary care mental health based at the University of Bristol.

Title of paper: GPs’ views of prescribing beta- blockers for people with anxiety disorders: a qualitative study

Available at: https://doi.org/10.3399/BJGP.2024.0091

Beta-blockers are licensed for managing the symptoms of anxiety, and new prescriptions for patients with anxiety have increased substantially in recent years. However, National Institute for Health and Care Excellence guidance for anxiety does not recommend beta-blockers as a treatment for anxiety, and recent reports have highlighted risks associated with the beta-blocker propranolol. Our research found that GPs prescribe beta-blockers for anxiety because they consider them to be low risk, a quicker solution than other treatments, and useful for managing associated physical symptoms.

Today, we speak to Dr Jet Klunder, a GP trainee and a PhD candidate based at the Department of General Practice at Amsterdam University Medical Centre in the Netherlands. 

Title of paper: Predicting unplanned admissions to hospital in older adults using routinely recorded general practice data: development and validation of a prediction model

Available at: https://doi.org/10.3399/BJGP.2023.0350

Unplanned hospital admissions in older adults are a critical concern for patients, family caregivers, healthcare professionals, and service planners. In this study a robust and easy-to-use prediction model has been developed and validated using routinely recorded data from general practices to predict the risk of unplanned hospital admissions in community-dwelling older adults. Identifying older adults at high risk can facilitate targeted preventive interventions, such as case management, telemedicine, or anticipatory care planning. Moreover, the model could also be utilised by policymakers for capacity planning of hospital beds.

In this episode, we talk to Dr Holly Smith, Research Fellow in Perinatal Mental Health based at the Department of Primary Care and Population Health at University College London. 

Title of paper: The first 100 days after childbirth: cross-sectional study of maternal clinical events and health needs from primary care

Available at: https://doi.org/10.3399/BJGP.2023.0634

The first 100 days after childbirth are a crucial time for women as they recover mentally and physically from pregnancy and birth. Previous studies have sought to identify common postnatal conditions and symptoms women may experience after birth, but no studies, to the authors’ knowledge, have used electronic health records from primary care to examine women’s actual care use in this time. The current study found that women most commonly use primary care for: a post natal check or visit, monitoring (such as a blood pressure reading), and contraception. The study adds useful knowledge on women’s primary care use following childbirth.

In this episode, we talk to Dr Michelle Rickett, a Research Associate on the NIHR funded EXTEND study based at the School of Medicine at Keele University. 

Title of paper: Collaboration across the primary/specialist interface in early intervention in psychosis services: a qualitative study

Available at: https://doi.org/10.3399/BJGP.2023.0558

Early Intervention in Psychosis (EIP) service users may be referred from, and discharged back to, primary care. There is limited research on patient and carer experience of discharge to primary care from EIP services and little guidance around planning and implementation of discharge. This paper explores experiences of EIP care and discharge from the perspectives of service users, carers and healthcare professionals in EIP services and primary care. It explores the patient journey through EIP services, highlights the lost connection with primary care, and makes recommendations for more collaboration between primary and specialist care, particularly around physical health monitoring and management, which might improve patient experience and outcome.

In this episode, we talk again with Jen MacLellan, a qualitative researcher based within the Nuffield Department of Primary Care Health Sciences at the University of Oxford. 

Title of paper: Unpacking complexity: GP perspectives on addressing the contribution of trauma to women’s ill health

Available at: https://doi.org/10.3399/BJGP.2024.0024

Significant challenges and uncertainties reside in how best to manage the link between mind and body in communication with patients and in healthcare pathways. Lack of supportive resources to deliver holistic, trauma informed care risks practitioners (inadvertently) avoiding discussion of the contribution of distress in the illness presentation. A trauma informed systems level approach would support integration of psychological support within multiple care pathways and support wellbeing of practitioners providing care.

This study was funded by the National Institute for Health and Care Research (NIHR) Policy Research Programme (NIHR202450). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

We're taking a summer break but will be back with our BJGP interview podcast on Tuesday 3 September.

We're taking a summer break but will be back with our BJGP interview podcast on Tuesday 3 September.

In this episode, we talk to Professor Clare Turnbull, Professor in Cancer Genetics at the Institute for Cancer Research and Honorary Consultant based at the Marsden. 

Title of paper: Breast cancer risk assessment for prescription of menopausal hormone therapy in women with a family history of breast cancer: an epidemiological modelling study

Available at: https://doi.org/10.3399/BJGP.2023.0327

Prospective longitudinal studies (such as the Collaborative Group on Hormonal Factors in Breast Cancer [CGHFBC]) have enabled the estimation of relative risks of breast cancer associated with different durations of exposure to and formulations of menopausal hormonal therapy (MHT). Risk models such as BOADICEA enable prediction of age-related breast cancer risk according to the extent and pattern of breast cancer family history. This study undertook integration of these two data sources (namely the CGHFBC datasets and the BOADICEA model) in order to model annual and 5-year risks for breast cancer incidence for the age window 50–80 years for hypothetical unaffected female consultands with different patterns of MHT exposure and different patterns of breast cancer family history, also generating predictions for breast cancer-specific death. This study modelled combined and oestrogen-only MHT but lacked data for analyses of newer types of MHT such as micronised progesterone or non-oral preparations.

In this episode, we talk to Dr Joe Hutchinson, who is a salaried GP and an academic GP working within the Centre for Primary Care and Health Services Research at the University of Manchester. 

Title of paper: Trends in full-time working in general practice: repeated cross-sectional study

Available at: https://doi.org/10.3399/BJGP.2023.0432

General practice is under increasing pressure, in part due to a lack of GPs. There is contention as to the proportion of GPs working full-time. We find that average hours and sessions worked per week by GPs in England have declined, whilst average hours per session has increased. Over half (55%) of GPs work at least the NHS Digital standard full-time definition of 37.5 hours per week. Average hours worked per session in 2021 was 51% greater than the BMA standard definition of a session’s duration. We recommend removing sessions as a definition of full-time working. However, if full-time work commitment continues to be defined in terms of the number of sessions worked, alignment with the NHS definition of 37.5 hours per week could be achieved by recognising that 6.0 sessions per week of 6.2 hours constitutes full-time work.

In this episode, we talk to Dr Anna Wilding, a Research Fellow based at Health Organisation, Policy and Economics at the University of Manchester. 

Title of paper: Geographic inequalities in need and provision of social prescribing link workers

Available at: https://doi.org/10.3399/BJGP.2023.0602

Social prescribing link workers were proposed in the 2019 NHS Long Term Plan to address health inequalities. Using national administrative data, we find that the subsequent roll-out of link workers has not been sufficiently targeted at areas of highest need. Higher need areas require additional support for employing link workers to tackle health inequalities and better support population needs.