Chest x-ray (CXR) is the first line investigation for lung cancer in many healthcare systems. Understanding of the consequences of false negative CXRs on time to diagnosis, stage and survival […]» Read more
Impact of COVID-19 on Migrants’ Access to Primary Care and Implications for Vaccine Roll Out: A National Qualitative Study.
The COVID-19 pandemic has prompted considerable changes in delivery of UK primary care, including rapid digitalisation, yet the impact upon marginalised migrant groups is unknown.To understand the impact of the […]» Read more
Clinical prediction tools to identify patients at highest risk of myeloma in primary care: a retrospective open cohort study.
Patients with myeloma experience substantial delays in their diagnosis, which can adversely affect their prognosis.To generate a clinical prediction rule to identify primary care patients who are at highest risk […]» Read more
GPs’ and patients’ views on the value of diagnosing anxiety disorders in primary care: a qualitative interview study.
In the UK between 1998 and 2008, GPs’ recording of anxiety symptoms increased, but their recording of anxiety disorders decreased. The reason for this decline is not clear, nor are […]» Read more
Measuring the complexity of general practice consultations: a Delphi and cross-sectional study in English primary care.
The complexity of general practice consultations may be increasing and varies in different settings. A measure of complexity is required to test these hypotheses.To develop a valid measure of general […]» Read more
Bariatric surgery is the most effective treatment for severe obesity. However, without recommended follow-up it has long-term risks.To investigate whether nutritional and weight monitoring in primary care meets current clinical […]» Read more
Promoting physical activity is an important part of patient care in primary care and has been investigated in many studies with a wide range of intervention characteristics, often including external […]» Read more
The readability of general practice websites: a cross-sectional analysis of all general practice websites in Scotland.
General practice websites are an increasingly important point of interaction, but their readability is largely unexplored. One in four adults struggle with basic literacy, and there is a socioeconomic gradient. […]» Read more
Collaborative improvement in Scottish GP clusters after the Quality and Outcomes Framework: a qualitative study.
Scotland abolished the Quality and Outcomes Framework (QOF) in April 2016, prior to implementing a new Scottish GP contract in April 2018. Since 2016, groups of practices (GP clusters) have […]» Read more
The extent of medication-related harm in general practice is unknown.To identify and describe all medication-related harm in electronic general practice records.Retrospective cohort records review study in 44 randomly selected New […]» Read more
The Fast Track FIT study: diagnostic accuracy of faecal immunochemical test for haemoglobin in patients with suspected colorectal cancer.
The faecal immunochemical test (FIT) is now available to support clinicians in the assessment of patients at low risk of colorectal cancer (CRC) and within the Bowel Cancer Screening Programme.To […]» Read more
The use of gut feelings to guide clinical decision making in primary care has been frequently described but is not considered a legitimate reason for cancer referral.To explore the role […]» Read more
Impact of changes to national guidelines on hypertension-related workload: an interrupted time series analysis in English primary care.
In 2011, National Institute for Health and Care Excellence (NICE) guidelines recommended the routine use of out-of-office blood pressure (BP) monitoring for the diagnosis of hypertension. These changes were predicted […]» Read more
Patient-centred innovation for multimorbidity care: a mixed-methods, randomised trial and qualitative study of the patients’ experience.
Patient-centred interventions to help patients with multimorbidity have had mixed results.To assess the effectiveness of a provider-created, patient-centred, multi-provider case conference with follow-up, and understand under what circumstances it worked, […]» Read more
Primary care consultations after hospitalisation for pneumonia: a large population-based cohort study.
Up to 70% of patients report ongoing symptoms 4 weeks after hospitalisation for pneumonia; the impact on primary care is poorly understood.To investigate the frequency of primary care consultations after […]» Read more
Antimicrobial stewardship during the COVID-19 epidemic: population-based cohort study and interrupted time series analysis in the United Kingdom.
The COVID-19 pandemic has altered the context for antimicrobial stewardship in primary care.To assess the effect of the pandemic on antibiotic prescribing, accounting for changes in consultations for respiratory and […]» Read more
Effectiveness and perceptions of using templates in long-term condition reviews: a systematic synthesis of quantitative and qualitative studies.
Review templates are commonly used in long-term condition (LTC) consultations to standardise care for patients and promote consistent data recording. However, templates may affect interactions during the review and potentially […]» Read more
Exploring commissioners’ understandings of early Primary Care Network development: qualitative interview study.
Primary Care Networks (PCNs) are financially incentivised groupings of General Practices (GP) in the English NHS. Their purpose is to deliver a number of policy goals set out in the […]» Read more
Are more GPs associated with a reduction in emergency hospital admissions? A quantitative study on GP referral in England.
Recent studies have found an association between access to primary care and accident and emergency attendances, with better access associated with fewer attendances. Analyses of an association with emergency admissions, […]» Read more
Effect of the OPTIMAL programme on self-management of multimorbidity in primary care: a randomised controlled trial.
Effective primary care interventions for multimorbidity are needed.To evaluate the effectiveness of a group-based, 6-week, occupational therapy-led self-management support programme (OPTIMAL) for patients with multimorbidity.A pragmatic parallel randomised controlled trial […]» Read more
Effect of weight loss on cardiometabolic risk: observational analysis of two randomised controlled trials of community weight-loss programmes.
Guidelines recommend that clinicians identify individuals at high cardiometabolic risk and support weight loss in those with overweight or obesity. However, we lack individual level data quantifying the benefits of […]» Read more
Experience of implementing and delivering group consultations in UK general practice: a qualitative study.
Group consultations are a relatively new concept in UK primary care and are a suggested solution to current workload pressures in general practice. Little is known about the experience of […]» Read more
Is there an association between long-term antibiotics for acne and subsequent infection sequelae and antimicrobial resistance? A systematic review.
Antimicrobial resistance (AMR) is a global health priority. Acne vulgaris is a common skin condition for which antibiotic use ranges from a few months to years of daily exposure.To systemically […]» Read more
C-reactive protein point-of-care testing (CRP-POCT) has been shown to reduce antibiotic use in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in primary care by 26%, without compromising […]» Read more
In the UK, the majority of primary care contacts are uncomplicated. However, safety incidents resulting in patient harm occur, such as failure to recognise a patient’s deterioration in health.We aimed […]» Read more
In England, general practitioners (GPs) are independent contractors working to a national contract. Since 2017 the contract requires GPs to use electronic tools to proactively identify moderate and severe frailty […]» Read more
An exploration of GP care in outreach settings for people experiencing homelessness: a qualitative study.
Although people experiencing homelessness (PEH) have the worst health outcomes in society, they have a low uptake of primary care services. GP outreach has developed as a way of increasing […]» Read more
Remote primary care consultations for people living with dementia during the COVID-19 pandemic: experiences of people living with dementia and their carers.
COVID-19 has accelerated remote healthcare provision in primary care, with changes potentially permanent. The implementation of remote provision of healthcare needs to hear from vulnerable populations, such as people living […]» Read more
Guidance impact on primary care prescribing rates of simple analgesia: an interrupted time series analysis in England.
In March 2018, NHS England published guidance for clinical commissioning groups (CCGs) to encourage implementation of policy to reduce primary care prescriptions of over-the-counter medications, including simple analgesia.To investigate the […]» Read more
Inequalities in health-related quality of life: repeated cross-sectional study of trends in general practice survey data.
After decades of steady progress, life expectancy at birth has stalled in England. Inequalities are also rising, and life expectancy has fallen for females living in the most deprived areas. […]» Read more