BJGP Interviews

In this episode we speak to Anouk Weghorst who is a doctoral candidate in the Department of General Practice and Elderly Care Medicine, University of Groningen, Netherlands.

Paper: Oral ondansetron for paediatric gastroenteritis in primary care: a randomised controlled trial

https://doi.org/10.3399/BJGP.2021.0211

Ondansetron was found to be effective in reducing vomiting in secondary care, but this effect has never been evaluated in primary care. Based on the findings of this study, ondansetron use is effective in reducing vomiting from 42.9% to 19.5%, seems safe and is positively evaluated by parents. Therefore, ondansetron could be considered by general practitioners as an additional treatment in the management of dehydration due to acute gastroenteritis, when the child predominantly vomits. Future research should disentangle the key factors leading to hospital referrals and consider ways to administer ORT more effectively in primary care or at home.

In this episode we speak to Professor Adrian Edwards who is Professor of General Practice and Director of PRIME Centre Wales and Director of Wales Covid-19 Evidence Centre at Cardiff University.

Paper: Managing lower urinary tract symptoms in primary care: qualitative study of GPs’ and patients’ experiences

https://doi.org/10.3399/BJGP.2020.1043

Lower urinary tract symptoms (LUTS) in males can usually be treated effectively in primary care; however, referrals to urology services are increasing. This study explores in detail the experiences of GPs and patients in relation to the management of LUTS in primary care. Difficulty establishing causes and differentiating symptoms were identified as key challenges; therefore, treatment was often a process of trial and error, and no patient’s symptoms were completely resolved. A diagnostic tool for use by GPs, together with greater exploration of non-pharmacological treatment approaches, could support effective management of LUTS in primary care settings.

This study aimed to explore GPs’ experiences of diagnosing and managing LUTS, together with patients’ experiences of and preferences for treatment of LUTS in primary care. Tell us a little more about the background to the

Telephone interviews were conducted with GPs and patients from GP practices involved in the PriMUS (Primary care Management of lower Urinary tract Symptoms in men: development and validation of a diagnostic and clinical decision support tool) study16 across three UK regions: Newcastle upon Tyne, Bristol, and South Wales. PriMUS is a prospective diagnostic accuracy study aimed at developing a decision tool to help GPs more accurately diagnose and manage LUTS in males.

In this episode we talk to Dr Sharon Dixon, GP and researcher, at the Nuffield Department of Primary Care Health Sciences, University of Oxford. The research was funded by the NIHR School of Primary Care Research.

Paper: Navigating possible endometriosis in primary care: a qualitative study of GP perspectives

https://doi.org/10.3399/BJGP.2021.0030

There are documented time lags between women presenting to primary care with symptoms suggesting endometriosis and receiving a diagnosis. It has been suggested that increasing GPs awareness will improve this situation. As GPs perspectives on these care journeys are not known, how best to educate health professionals to reduce delays in diagnosis is unclear. Even with awareness of the possibility of endometriosis, GP accounts suggest that journeys are complex and can involve navigating significant uncertainties, including when managing women whose symptoms are well controlled with primary care treatment or who do not want to have referral or operative investigation.

In this episode we speak to Dr Faraz Mughal who is a National Institute for Health Research (NIHR) doctoral fellow at Keele University.

Paper: Experiences of general practice care for self-harm: a qualitative study of young people’s perspectives

https://doi.org/10.3399/BJGP.2021.0091

Young people who self-harm present to GPs in the NHS, but their perceptions of care remain largely unexplored. This qualitative study indicated that young people sought help from a variety of services, including non-statutory services and NHS services. Young people described mixed experiences of consulting GPs, which can influence help-seeking from general practice. A relationship with one GP who listens, appears to understand, and offers proactive follow-up is an important facilitator for young people who access general practice for self-harm.

In this episode we speak to Dr Ian Bennett-Briton who is a Clinical Research Fellow in Primary Health Care at the Centre for Academic Primary Care at the University of Bristol.

Paper: Understanding the benefits and limitations of continuous, risk-based, consultation peer-review in out-of-hours general practice: A qualitative interview study

https://doi.org/10.3399/BJGP.2021.0076

Unwarranted variation in clinical practice is an area of increasing interest due to the costs and harms of too much or too little healthcare. Effective systems to detect and minimise unwarranted variation in clinician practice are crucial to ensure clinicians in increasingly multidisciplinary healthcare workforces are supported to practise to their full potential. Such systems are limited in English general practice settings, with implications for the efficiency and safety of care.

Continuous, risk-based, consultation peer-review provides a mechanism to detect and minimise unwarranted variation in clinician practice, and a potential methodology to support clinicians in an increasingly multidisciplinary general practice workforce to efficiently and safely practise to their full potential.

This episode is a quick update from BJGP Editor, Euan Lawson, as we are taking a break for a couple of weeks and we will back in August with more interviews. We would love you to get involved. Why not write us an article for BJGP Life? Check out the links for more details.

• BJGP Life Call for Summer articles: https://bjgplife.com/2021/07/26/bjgp-life-call-for-summer-articles/
• BJGP.org eLetters: https://bjgp.org/letters
• Sign up for the print BJGP: https://www.bjgplife.com/print

In this episode we talk to Dr Julian Treadwell who is a GP and doctoral research fellow at the Nuffield Department of Primary Care Health Sciences, Radcliffe Observatory Quarter, Woodstock Road, Oxford.

Paper: GPs’ use and understanding of the benefits and harms of treatments for long-term conditions: a qualitative interview study

https://doi.org/10.3399/BJGP.2020.1027

Research has shown that doctors, including GPs, often have poor knowledge of quantitative benefits and harms of treatments, such as absolute risk reduction and numbers needed to treat. Yet this kind of information is considered key to shared decision making and optimal management of polypharmacy. This qualitative study explored the attitudes and understanding of GPs in the UK with regard to this issue, and reveals a complex set of behaviours and feelings. These findings will be of interest to doctors wishing to reflect on their own practice, and to authors of guidelines and information resources.

Links

https://www.nice.org.uk/about/what-we-do/our-programmes/nice-guidance/nice-guidelines/shared-decision-making 

In this episode I speak to Dr Marta Wanat who is a Senior Qualitative Researcher at the Nuffield Department of Primary Care Health Sciences, University of Oxford.

Paper: Transformation of primary care during the COVID-19 pandemic: experiences of healthcare professionals in eight European countries

https://doi.org/10.3399/BJGP.2020.1112

Previous qualitative studies exploring the experiences of healthcare professionals during the COVID- 19 pandemic have mainly focused on secondary care. This study explored the experiences of primary care healthcare professionals’ (PCPs) experiences of primary care transformation during the first peak of COVID-19 pandemic in England, Belgium, the Netherlands, Ireland, Germany, Poland, Greece and Sweden. PCPs described rapidly adapting to new circumstances by making decisions in how to transform primary care delivery for both COVID-19 and non-COVID-19 patients, with limited training and resources. Flexibility and autonomy are necessary ingredients in primary care provision that should be preserved, coupled with provision of practical information on how to adapt services, ongoing training, and mental health support services for PCPs.

In this episode I am joined by our Associate Editor Dr Nada Khan for some conversation. The July issue has been published and we talk over some of the highlights in this month's issue.

JULY ISSUE: https://bjgp.org/content/71/708

In this episode we have two guests from Australia. We have Erin Oldenhof who is a doctor of psychology (clinical) candidate, at the School of Psychology, Deakin University, Geelong and a benzodiazepine counsellor in Melbourne. We are also joined by Dr Petra Staiger who is an associate professor, School of Psychology, Deakin University.

Paper: Role of the prescriber in supporting patients to discontinue benzodiazepines: a qualitative study

https://doi.org/10.3399/BJGP.2020.1062

The introduction of prescription monitoring programmes (PMPs) has highlighted the need for increased support and guidance to ensure GPs improve on current deprescribing practice. This study revealed the importance of GPs understanding how to empower patients through patient-centred care, to foster a willingness to try reducing, build motivation, and promote confidence in the patients’ ability to reduce. By understanding the patient experience with their prescriber involved in long-term BZD use, this study advances current knowledge of the ‘patient-centredness’ of deprescribing interventions and offers GPs clearer guidance on how to deliver these strategies effectively.