BJGP Interviews

In this episode, we talk to Maria Mathews, who is a Professor in the Department of Family Medicine at Western University in Canada. 

Title of paper: Strengthening the integration of primary care in pandemic response plans: A qualitative interview study of Canadian family physicians

Available at: https://doi.org/10.3399/BJGP.2022.0350

Previous pandemic plans have largely overlooked the important role of primary care in a pandemic response. The COVID-19 pandemic presents a novel opportunity to examine the key roles family physicians play during a pandemic, and sheds light on existing barriers and supports. Findings from this study highlight the need for greater incorporation of primary care in the development of strengthened pandemic plans.

In this episode, we talk to Professor Lucy Ziegler, Professor of Palliative Care and head of the St Gemma’s Academic Unit of Palliative Care at the University of Leeds.

Title of paper: What characterises good home-based end-of-life care: Analysis of 5-year data from a nationwide mortality follow-back survey in England

Available at: https://doi.org/10.3399/BJGP.2022.0315

Determinants of high quality care for patients living at home during their last three months of life are not well understood. We analysed 5-year data from a large, nationally representative bereavement survey collecting information on experiences and quality of end-of-life care for adults with advanced disease, in England. The importance of good continuity of care from general practitioners on positive outcomes is identified as a potentially modifiable factor. Inequity in access to good end-of-life care is highlighted, with patients from lower socio-economic and minority ethnic groups less likely to receive good end-of-life care.

In this episode, we talk to Dr Simon Beerten, who is a GP and a research fellow from the Department of Public Health and Primary Care at KU Leuven in Belgium. 

Title of paper: Trends in the registration of anxiety in Belgian primary care from 2000 to 2021: A registry-based study

Available at: https://doi.org/10.3399/BJGP.2022.0196

Figures on anxiety in general practice are scarce. This study shows increasing incidence and prevalence of physician-registered anxiety. Patients with anxiety had an increasing number of comorbidities over time. Treatment of anxiety in this setting seems very dependent on medication, particularly SSRIs and anxiolytics.

In this episode, we talk to Professor Niro Siriwardena, Professor of Primary and Pre-hospital Health care at the School of Health and Social Care at the University of Lincoln. 

Title of paper: Academic performance of ethnic minority versus White doctors in the MRCGP assessment 2016-2021: cross sectional study

Available at: https://doi.org/10.3399/BJGP.2022.0474

Differential attainment is widely found in undergraduate and postgraduate medical examinations. It has been suggested that subjective bias due to racial in discrimination clinical skills assessments may be a cause of examination failure for UK trained ethnic minority candidates and international medical graduates. No previous study has examined differential attainment in all components of GP licensing assessments including workplace-based assessment, taking into account scores at selection in GP specialty training. Ethnicity did not reduce the chance of passing GP licensing tests once Sex, place of primary medical qualification, declared disability and selection (multispecialty recruitment assessment) scores were taken into account. Doctors admitted to GP speciality training who are in the lowest MSRA score bands may need additional support during training to maximise their chances of achieving licensing regardless of their ethnicity or other demographic characteristics.

In this episode, we talk to Professor Joe Kai, who is a GP and Clinical Professor in the Centre for Academic Primary Care at the University of Nottingham. 

Title of paper: Women’s experiences of heavy menstrual bleeding and medical treatment: Qualitative study

Paper available at: https://doi.org/10.3399/BJGP.2022.0460

Heavy menstrual bleeding (HMB) is known to significantly affect women’s health and quality of life, with pressure to conceal symptoms. Recent evidence on women’s experiences of HMB and its treatment after seeking primary care is lacking. This research shows the debilitating impacts of HMB on women, and the challenges they can still face, including overcoming taboo and low general awareness that treatment can help. Women had widely differing experiences of current medical treatments for HMB in general practice, and emphasised how they valued patient-centred communication and involvement in decisions in helping them.

In this episode, we talk to Kelly Lloyd, who is a research fellow within the Leeds Institute of Health Sciences at the University of Leeds.

Title of paper: A factorial randomised trial investigating factors influencing general practitioners’ willingness to prescribe aspirin for cancer preventive therapy in Lynch syndrome: a registered report

Available at: https://doi.org/10.3399/BJGP.2021.0610

National Institute for Health and Care Excellence (NICE) guidance for England and Wales recommends daily aspirin for colorectal cancer prevention in people with Lynch syndrome, and it is likely that prescribing will occur in primary care. GPs may be reluctant to prescribe due to concerns about the side-effects, supporting evidence and lack of awareness of the NICE guidance. In a randomised factorial trial, providing GPs with information on these factors did not increase willingness to prescribe, or comfort discussing harms and benefits. Alternative strategies targeting multiple levels of prescribing behaviour among unwilling GPs may support prescribing.

In this episode, we talk to Dr Sarah Tonkin-Crine, an Associate Professor and Health Psychologist based within the Nuffield Department of Primary Care Health Sciences at the University of Oxford. 

Title of paper: Implementing antibiotic stewardship in high prescribing English general practices: a mixed-methods study

Available at: https://doi.org/10.3399/BJGP.2022.0298

An intervention to support the implementation of three evidence-based antimicrobial stewardship (AMS) strategies was evaluated in nine high antibiotic prescribing general practices in England. General practice teams received intervention materials and chose to use them in substantially different ways in real-life settings, outside of trial conditions. AMS strategies are complex interventions that require sufficient understanding and engagement by clinicians for successful adoption and use, to obtain the full benefit in reducing antibiotic prescribing. This study highlights that remote, one-sided delivery of AMS strategies should be done cautiously to avoid misunderstanding and sub-optimal use.

In this episode, we talk to Dr Bianca Perera, a GP in Tasmania who is undertaking a PhD at Monash University.

Title of paper: General practice management of COPD patients following acute exacerbations: a qualitative study

Available at: https://doi.org/10.3399/BJGP.2022.0342

The period immediately following an acute exacerbation of COPD is a high-risk period for recurrence and a critical time to intervene. Hospital-initiated, guideline-based care bundles have been previously proposed to optimise post-exacerbation care and reduce readmission, however convincing evidence of effectiveness has been lacking. As post-exacerbation care is mainly delivered by GPs in Australia, this study describes detailed insights from their perspectives regarding factors affecting the provision of evidence-based care in the period following hospital discharge. The findings highlight factors that should be addressed to enhance care of COPD patients to prevent future exacerbations and hospital readmissions.

In this episode, we talk to Dr Karin Smit, who is a GP trainee and PhD student at the Department of General Practice at Utrecht University in The Netherlands.

Title of paper: Home monitoring by pulse oximetry of primary care patients with COVID-19 - a pilot randomised controlled trial

Available at: https://doi.org/10.3399/BJGP.2022.0224

During the course of the pandemic, home or remote monitoring of COVID-19 patients by pulse oximetry took off. However, studies on its use are scarce. Our pilot randomised controlled trial showed that home monitoring of moderate-severe COVID-19 patients with a validated pulse oximeter is feasible; adherence was high, patients reported a high feeling of safety, while the number of primary care consultations remained similar to usual care. We believe these pragmatic findings form an important building block for safe implementation of pulse oximetry as a home monitoring tool in primary care.

In this episode, we talk to Dr Sarah Sowden, an Advanced Academic Clinical Fellow and honorary consultant in Public Health at Newcastle University. 

Title of paper: Which non-pharmaceutical primary care interventions improve mental health amongst socioeconomically disadvantaged populations? Systematic review

Available at: https://doi.org/10.3399/BJGP.2022.0343

New models of healthcare and clinical practice, such as social prescribing and collaborative care, are increasingly used as non-pharmaceutical alternatives for treating common mental disorders (CMDs) in primary care. However, there is a lack of evidence available to GPs about the effectiveness of these types of interventions for socioeconomically disadvantaged patients, among whom CMDs are most prevalent. This systematic review synthesised the international evidence exploring the impact on CMD outcomes for socioeconomically disadvantaged patients. Although the evidence base was weak, there was evidence for an overall positive effect on anxiety, depression, self-reported mental health and wellbeing.