BJGP

BJGP

@bjgp.org

We are the BJGP - the British Journal of General Practice. We publish primary care research + comment to serve the international community. Editor: @euanlawson.social here on Bluesky. BJGP: bjgp.org | BJGPLife: bjgplife.com

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BJGP
@bjgp.org

Preventing #RecurrentUTI without resorting to antibiotics. A review of vaginal oestrogen, methenamine hippurate and more doi.org/10.3399/BJGP... #BJGP #AntibioticStewardship #MenopauseHealth #PrimaryCare

BJGP
@bjgp.org

BJGPLife: Doctor, will you truly see me? Maslow, self-transcendence, and the hidden calling of general practice bjgplife.com/doctor-... #GeneralPractice #PrimaryCare #FamilyMedicine

BJGP
@bjgp.org

BJGPLife: Yonder: Sleep apnoea, persistent physical symptoms, health inequalities by language proficiency, and new-onset diabetes bjgplife.com/yondern... #GeneralPractice #PrimaryCare #FamilyMedicine

BJGP
@bjgp.org

BJGPLife: Who benefits from artificial intelligence in health care? A right-to-health perspective from the Global South bjgplife.com/who-ben... #GeneralPractice #PrimaryCare #FamilyMedicine

BJGP
@bjgp.org

Patient abuse/violence leaves #PrimaryCare staff feeling unsafe at work & in their personal lives. It drives workforce pressures from increased staff turnover, lower morale & reduced capacity for healthcare delivery doi.org/10.3399/BJGP... @violenceprevention.bsky.social @shihningchou.bsky.social

doi.orgExperience and impacts of violence and abuse by patients towards general practice staffBackground: General practice (family medicine) experiences more violence and abuse by patients and the public than general hospital settings. Qualitative accounts on how violence and abuse are experienced and perceived remain limited in both breadth and depth. Aims: To explore 1. direct and indirect experiences of violence and abuse that general practice staff have encountered from patients and the public, and 2. its perceived impacts on staff well-being and their practice. Design and Setting: This qualitative study was the second part of a mixed methods project, following an online nationwide survey. Participants were invited to an interview at the end of the survey. Method: Data were collected via semi-structured interviews conducted between August and December 2023. Quantitative survey responses were extracted to describe the characteristics of participants, their experience of violence and abuse and feelings of safety and support at work. Interviews were transcribed and thematically analysed following the framework approach. Results: Twenty-three general practice staff members participated, including 17 women and six men. Fifteen participants were in non-clinical roles and eight were clinicians. Six themes were identified: violence and abuse through direct interactions, violence and abuse beyond direct interactions, increased risk, individual impacts, occupational impacts, and impacts on care and services. Conclusion: Violence and abuse by patients and the public includes a wide range of behaviours. It has profound, and in some instances longstanding, impacts on staff, including constantly feeling unsafe and affected personal or social life, but also on clinical services, including staff turnover, and reduced service capacity.
BJGP
@bjgp.org

Increased awareness, monitoring, and supported behavioural change are required to improve cardiovascular risk reduction in women following adverse #Pregnancy outcomes doi.org/10.3399/BJGP... @penseewu.bsky.social @dclovesgp.bsky.social #GeneralPractice #PrimaryCare #SystematicReview #Qualitative

doi.orgPrimary care cardiovascular risk reduction after pregnancy complications: a qualitative systematic reviewBackground Adverse pregnancy outcomes (APOs) affect approximately 30% of pregnancies and confer lifelong elevated cardiovascular disease (CVD) risk. Behavioural interventions may mitigate this risk. Aim To systematically review qualitative literature on women’s experiences of behavioural change for cardiovascular risk reduction following APOs, with a focus on health equity. Design and setting Qualitative systematic review, limited to high-income countries with universal access to health care. Method A systematic search of PubMed, Embase, and CINAHL from inception to March 2025 identified primary studies. Thematic synthesis followed Thomas and Harden’s three-stage approach. Themes were mapped onto the COM-B (Capability, Opportunity, Motivation-Behaviour) framework to theoretically ground and structure analysis. Results Eighteen studies involving 339 women met inclusion criteria. Women who were minority ethnic formed the majority in only two studies. Demographic data regarding socioeconomic status, ethnicity, or both were absent from five. Experiences shaping behaviour change aligned with COM-B domains. Delayed physical and psychological recovery after APOs reduced women’s capability to initiate changes. Competing demands, including childcare, household responsibilities, and work, restricted opportunity to focus on long-term cardiovascular health. Opportunities improved when behaviour changes were easily integrated into family life and offered shared benefits. Motivation was strengthened by awareness of increased CVD risk, the responsibilities of parenthood, and personalised advice from healthcare professionals. Tailored, proactive follow-up supported engagement, especially for minority ethnic and socioeconomically disadvantaged groups. Conclusion Prevention of CVD after APOs requires structured, system-level support to prioritise family-based behaviour change. High-risk groups are underrepresented in research; coproducing interventions with these groups may help to avoid widening health inequalities.
BJGP
@bjgp.org

This #SystematicReview found that local incentive schemes in #GeneralPractice had a positive impact on process measures but limited impact on health outcome measures doi.org/10.3399/BJGP... #PrimaryCare

doi.orgImpact of local enhanced incentive schemes on the performance of general practices within the UK: a systematic reviewBackground To drive improvements in healthcare quality and to reduce inequalities, pay-for-performance (P4P) schemes have become widespread internationally. In recent years, most local commissioning bodies in the UK have developed their own local general practice incentive schemes. Aim To examine the use and effectiveness of local incentive schemes and their alignment to the national Quality and Outcomes Framework. Design and setting Systematic review of quantitative studies related to local incentive schemes with a P4P structure within UK general practice published after 2004. Method Searches were conducted via Ovid across the Embase and MEDLINE databases. Risk of bias was assessed using the Cochrane Effective Practice and Organisation of Care criteria and a narrative synthesis was undertaken. Results In total, 17 studies were identified, which were focused on 14 local incentive schemes. All studies were from England, except one from Scotland. Five studies included only tailored indicators, and seven studies included both aligned and tailored indicators. Quality assessment suggested the current evidence was of mixed quality. All studies that reported on process measures ( n = 15) demonstrated positive impacts, but health outcome measures were only evaluated in nine studies showing inconsistent findings. Eight studies addressed impact on health inequalities and no studies addressed cost-effectiveness, patient-reported outcomes, or experience measures. Conclusion There is an emerging evidence base that local incentive schemes in general practice lead to improvements in process measures, although methodological quality of studies is mixed. Future studies should utilise more robust methods to evaluate effectiveness and examine impacts on health inequalities, cost-effectiveness, and variation by practice.
BJGP
@bjgp.org

For non-antibiotic interventions for the prevention of recurrent urinary tract infections, this #SystematicReview found evidence for cranberry and methenamine hippurate, vaginal oestrogen in postmenopausal women, and increased fluid intake in women with low fluid intake doi.org/10.3399/BJGP... #UTI

doi.orgNon-antibiotic interventions to prevent recurrent urinary tract infections in women: overview of systematic reviews of randomised controlled trialsBackground Recurrent urinary tract infections (rUTI), i.e. 2 or more UTIs in last 6 months or 3 or more in last 12 months, are common, have substantial impact on quality of life and cause major antibiotic use. Design Overview of systematic reviews of randomised controlled trials (RCTs) of non-pharmaceutical and pharmaceutical (non-antibiotic) interventions for preventing rUTI in women. Methods We searched MEDLINE, EMBASE, CINAHL, Google Scholar and Cochrane from January 2014 to May 2025 for systematic reviews of RCTs assessing effectiveness of community-based non-antibiotic interventions for preventing UTI in women aged 16 or over with rUTI. We excluded studies in intensive care units, people with indwelling catheters or comparing different oral antibiotic regimens. There were no limitations regarding outcome measures or language. Findings 27 systematic reviews met inclusion criteria evaluating probiotics (9), D-mannose (7), vaginal oestrogen (7), cranberry (6), methenamine hippurate (3), herbal medicine (3), increased fluid intake (2), systemic oestrogen (4), acupuncture (2), vaccines (2). Eight examined combination strategies. Cranberry and methenamine hippurate use are supported by systematic reviews, as is vaginal oestrogen amongst postmenopausal women, although questions remain around dose, duration and treatment adherence. Reviews of probiotics, D-mannose, herbal medicine, acupuncture and vaccines concluded that stronger evidence is needed. Increased fluid intake benefits women with low intake, but further research is needed on optimal intake. There was little information on treatment adherence or acceptability for many interventions. Conclusions For effective interventions, questions remain about optimal use and for many stronger evidence is needed.
BJGP
@bjgp.org

Participants emphasised the importance of tailored training, targeted funding, mentorship, coaching, and increased visibility of successful Black researchers to inspire and support career development for Black researchers in academic primary care. Figure = recommendations doi.org/10.3399/BJGP...

BJGP
@bjgp.org

Evidence of local GP incentive schemes suggests they impact processes but have limited impact on health outcomes. doi.org/10.3399/BJGP... #PayForPerformance #QualityOutcomesFramework #GeneralPractice

BJGP
@bjgp.org

If in doubt, sit them out: concussion management in the community Improving outcomes for concussion requires greater public awareness, practical tools tailored to the realities of general practice, and the development of community-based concussion services. bjgp.org/content/76/... #BJGP #PrimaryCare

BJGP
@bjgp.org

Childbirth trauma is an important consideration in #MaternalMentalHealth, particularly childbirth-related PTSD, which can have serious and severe outcomes. An analysis outlines clinical considerations doi.org/10.3399/BJGP... #BirthTrauma #PostnatalCare #GeneralPractice

BJGP reposted

RCGP InnovAiT Journal
@rcgp-innovait.bsky.social

October 26 issue of InnovAiT is here: look inside The October issue of InnovAiT will lead you through the diagnosis and management of palliative care emergencies, atrial fibrillation, hypertension and diabetic foot problems in general practice. You'll also find essential guidance for registrars on…

rcgpinnovait.wordpress.comOctober 26 issue of InnovAiT is here: look insideThe October issue of InnovAiT will lead you through the diagnosis and management of palliative care emergencies, atrial fibrillation, hypertension and diabetic foot problems in general practice. You'll also find essential guidance for registrars on the rules around prescribing in general practice, as well as the complexities of prescribing for older patients. A proposal on how to manage patient demand effectively and responsibly is a subject that every GP will have a view on.
BJGP
@bjgp.org

BJGPLife: Design Thinking for Healthcare: A practical guide to healthcare transformation, by Daniel Steenstra. bjgplife.com/design-... #GeneralPractice #PrimaryCare #FamilyMedicine

BJGP
@bjgp.org

Challenges to diagnosing PMDD Primary care has a pivotal role in facilitating earlier identification and improving outcomes for women affected by the serious condition of Premenstrual dysphoric disorder. bjgp.org/content/76/... #BJGP #PrimaryCare

BJGP
@bjgp.org

The October issue looks at continuity of care - premenstrual dysphoric disorder, concussion in kids, novel measures of continuity, and sustaining a GP career. Plus, male UTI symptom management, managing vague symptoms in cancer, and tango in medicine. bjgp.org/content/76/... #BJGP #PrimaryCare

BJGP
@bjgp.org

Higher actual income is associated with job satisfaction, but there was little evidence of its association with intentions to quit. doi.org/10.3399/BJGP... #BJGP #PrimaryCare #GPJobSatisfaction

BJGP reposted

RCGP InnovAiT Journal
@rcgp-innovait.bsky.social

New InnovAiT podcast: Beyond the prescription: a holistic GP approach to obesity and weight loss medications   In this podcast episode, Ben Tyler, a GP from Derbyshire, discusses his article 'Beyond the Prescription', focusing on a holistic approach to obesity and weight loss medications. to help…

rcgpinnovait.wordpress.comNew InnovAiT podcast: Beyond the prescription: a holistic GP approach to obesity and weight loss medications  In this podcast episode, Ben Tyler, a GP from Derbyshire, discusses his article 'Beyond the Prescription', focusing on a holistic approach to obesity and weight loss medications. to help GPs in supporting patients using weight loss medication. Dr Tyler provides an insightful approach on how to help patients make sustainable lifestyle changes and improve long term health outcomes.   He explores the transformative impact of new GLP-1 medications, such as Tirzepatide and Semaglutide, not only for weight loss but also for fostering positive behaviour change in patients.