Tag Archives: older people

Top 10 most read BJGP research articles published in 2016

16Jan_Top10_research_2015_BJGP_smThese are the top 10 most read research articles based on full text downloads from bjgp.org in 2016.

1. Overdiagnosis of asthma in children in primary care: a retrospective analysis. 
http://bjgp.org/content/66/644/e152

Overdiagnosis of childhood asthma is common in primary care, leading to unnecessary treatment, disease burden, and impact on quality of life. However, only in a small percentage of children is a diagnosis of asthma confirmed by lung function tests.

2. Telephone triage systems in UK general practice: analysis of consultation duration during the index day in a pragmatic randomised controlled trial. 
http://bjgp.org/content/66/644/e214

Telephone triage is not associated with a reduction in overall clinician contact time during the index day. Nurse-led triage is associated with a reduction in GP contact time but with an overall increase in clinician contact time. Individual practices may wish to interpret the findings in the context of the available skill mix of clinicians.

3. Primary care clinician antibiotic prescribing decisions in consultations for children with RTIs: a qualitative interview study.
http://bjgp.org/content/66/644/e207

Prognostic uncertainty remains an important driver of health care professionals’ antibiotic prescribing. Experience and training in recognising severe respiratory tract infections (RTIs), together with more evidence to help professionals identify the children at risk of future illness deterioration, may support identification of the children most and least likely to benefit from antibiotics.

4. Continuity of care in primary care and association with survival in older people: a 17-year prospective cohort study.
http://bjgp.org/content/66/649/e531

This study demonstrates that low continuity of care in general practice is associated with a higher risk of mortality, strengthening the case for encouragement of continuity of care.

5. Nursery sickness policies and their influence on prescribing for conjunctivitis: audit and questionnaire survey.
http://bjgp.org/content/66/650/e674

Most of the childcare providers’ sickness policies contain requirements that are inconsistent with Public Health England guidance. The requirements of childcare sickness policies are likely to be resulting in unnecessary primary care consultations and thousands of prescriptions for antibiotics with little demonstrable clinical or public health benefit.

6. Unrecognised bipolar disorder among UK primary care patients prescribed antidepressants: an observational study.
http://bjgp.org/content/66/643/e71

Among people aged 16–40 years prescribed antidepressants in primary care for depression or anxiety, there is a substantial proportion with unrecognised bipolar disorder. When seeing patients with depression or anxiety disorder, particularly when they are young or not doing well, clinicians should review the life history for evidence of unrecognised bipolar disorder. Some clinicians might find the Mood Disorder Questionnaire to be a useful supplement to non-standardised questioning.

7. Identifying depression among adolescents using three key questions: a validation study in primary care.
http://bjgp.org/content/66/643/e65

Depression in teenagers can have serious consequences and the incidence seems to be increasing. Three short questions, suitable for use in general practice, are useful for identifying depression in adolescents in primary health care.

8. Barriers to effective management of type 2 diabetes in primary care: qualitative systematic review.
http://bjgp.org/content/66/643/e114

Although resources are important, many barriers to improving care are amenable to behaviour change strategies. Improvement strategies need to account for differences between clinical targets and consider tailored rather than ‘one size fits all’ approaches. Training targeting knowledge is necessary but insufficient to bring about major change; approaches to improve diabetes care need to delineate roles and responsibilities, and address clinicians’ skills and emotions around treatment intensification and facilitation of patient behaviour change.

9. Comparison of brief interventions in primary care on smoking and excessive alcohol consumption: a population survey in England.
http://bjgp.org/content/66/642/e1

Whereas approximately half of smokers in England visiting their GP in the past year report having received advice on cessation, less than 10% of those who drink excessively report having received advice on their alcohol consumption.

10. Molluscum contagiosum and associations with atopic eczema in children: a retrospective longitudinal study in primary care.
http://bjgp.org/content/66/642/e53

Consultations for molluscum contagiosum in primary care are common, especially in 1–9-year-olds, but they declined significantly during the decade under study. A primary care diagnosis of atopic eczema is associated with an increased risk of a subsequent primary care diagnosis of molluscum contagiosum.

 

New on Twitter: the GP Journal Club

image1Lucy Pocock is an NIHR Academic Clinical Fellow in Primary Care and is on Twitter @drpoco

I have attended my fair share of journal clubs whilst a junior doctor in hospital jobs. However, as a GP trainee there has been little opportunity to read and discuss new and interesting research with peers. Whilst on maternity leave (looking for something to keep me entertained in the dead of night when I was feeding baby!), I discovered Twitter.

Initially I used it just to have a rant about the proposed changes to the junior doctors’ contract, but I began to see other, perhaps more educational, uses for it. I was introduced to the Geriatric Medicine Journal Club (@GeriMedJC) and the GIM Journal Club (@GIMJClub) and wondered if the same approach would work for primary care.

@GPJournalClub was born on 10th December 2015 and had over 100 followers in the first 24 hours; it seemed there was definitely an appetite! Thankfully, the nice folk at the BJGP have offered their support and so a blog about each month’s tweet chat will be hosted here, along with a link to the transcript of the chat afterwards. I hope that we can have a rotating chair each month, who will choose a recent, primary care related paper or guideline to discuss (please get in touch if you’re interested!).

The first tweet chat

Iliffe S, Kendrick D, Morris R, et al. Promoting physical activity in older people in general practice: ProAct65+ cluster randomised controlled trial. Br J Gen Pract 2015;65(640):e731-8.

The first tweet chat will take place on Sunday 10th January at 8pm. I have chosen the first paper (http://bjgp.org/content/65/640/e731) and will be chairing the chat, along with Dr Liam Farrell from #irishmed. I have an interest in care of older people, so my choice reflects this.

I’m hoping that we can have a lively and engaging debate on Sunday, so please join us (search for #gpjc) and encourage all your colleagues to do the same.