BJGP Interviews

In this episode Professor Tammy Hoffmann talks about research into the natural history of uncomplicated urinary tract infections that could have a big impact on conversations with women and treatment with antibiotics. She is a professor of Clinical Epidemiology and leads the Centre for Evidence-Informed Health Decisions in the Institute of Evidence-Based Healthcare, Bond University.

Natural history of uncomplicated urinary tract infection without antibiotics: a systematic review

Read the paper: https://doi.org/10.3399/bjgp20X712781

Uncomplicated urinary tract infections (UTIs) are a very common reason for general practice consultations and one of the most common reasons for the prescription of antibiotics. Informed decision making should consider the benefit/harm trade-off of antibiotic use and the natural course of the illness. The studies reviewed in this paper, which focused solely on women, demonstrated that UTI symptoms resolve spontaneously in approximately a third of women in the first 7–10 days. Current guideline recommendations from the National Institute for Health and Care Excellence are to delay prescribing by two days but the findings of this systematic review indicate that this may be too short a timeframe.

In this episode, we talk about research that explores the perspectives of GPs and considers how we can help women and girls who are at risk or have experienced female genital mutilation (FGM). Dr Sharon Dixon is a GP and researcher at the Nuffield Department of Primary Care Health Sciences, University of Oxford.

Supporting patients with female genital mutilation in primary care: a qualitative study exploring the perspectives of GPs' working in England

Read the paper: https://doi.org/10.3399/bjgp20X712637

There are an estimated 137,000 women and girls born in countries where FGM is traditionally practised who are permanently resident in England and Wales in 2011. Though there was a significantly higher prevalence in urban areas, it was estimated that there would be no local authority areas without any women affected by FGM.

The authors are unaware of any previous work considering GPs’ perspectives on supporting women with female genital mutilation (FGM) in primary care, including the impacts of recent English policy which includes a mandatory reporting policy and FGM Enhanced Dataset. GPs described tensions between their caring role and the policy requirements placed on them. The provision of specialist support, and holistic education could support GPs when caring for those from communities affected by FGM.

In this episode we talk to Professor Samuel Wong about his research into COVID-19 and its impact on loneliness and mental health in a cohort of older adults in Hong Kong. Professor Wong is a clinician with training in both Family Medicine and Public Health. He is the Director of the School of Public Health and Primary Care at the Chinese University of Hong Kong.

Impact of COVID-19 on loneliness, mental health, and health service utilisation: a prospective cohort study of older adults with multimorbidity in primary care

Read the full paper at: https://doi.org/10.3399/bjgp20X713021

Although evidence suggests that social distancing measures are effective in controlling the spread of the novel coronavirus, there are likely to be adverse effects on psychological, social, and physical health, among one vulnerable population in particular — older adults with multimorbidity.

Using pre- and peri- COVID-19 data from a cohort of older patients (≥60 years) with multimorbidity in primary care, this study aimed to understand changes in loneliness, mental health problems, and attendance to scheduled medical care among the cohort.

It was found that older patients with multiple chronic conditions had increased loneliness, anxiety, and insomnia. They also had increased missed scheduled appointments for chronic disease care. Being female, living alone, and having more than four chronic conditions were risk factors. Interventions such as teleconsultations are needed for loneliness, mental health, and health service accessibility.

The article highlights the importance of continuity of care in general practice, particularly for patients with multimorbidity conditions. The missed appointments observed in the current study can potentially lead to serious complications or adverse events if not addressed, as well as creating additional burden on the already stretched healthcare system considering the current climate of COVID-19. Future research attention is needed to provide alternative strategies for people with multiple chronic conditions.