Family practice
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Observational Study
Recent life events and adverse childhood experiences in predicting antenatal depression and anxiety: cross-sectional study.
Antenatal depression and anxiety are associated with preterm labour, low birth weight, and postpartum depression, and can impact the emotional and mental development of the child. Both adverse childhood experiences and recent stressful events are linked to negative health outcomes. However, certain events may be more impactful than others. ⋯ Recent stressful life events have a stronger association with postnatal mental health than adverse childhood events, implying that it might be useful for clinicians providing routine antenatal care to gather information on recent stressors.
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During coronavirus disease 2019 (COVID-19), people managing multiple chronic conditions (MCCs) experienced barriers to obtaining needed medications. The purposes of this paper are to (i) determine risk factors for difficulty obtaining medications during COVID-19, (ii) document reasons for the difficulty, and (iii) evaluate the impact on later physical and mental health outcomes. ⋯ People with socioeconomic disadvantages experienced a disproportionate impact of difficulty obtaining medications and poorer health outcomes due to COVID-19. They may be at greater risk in the event of future pandemics and other societal disruptions.
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The Australian National Bowel Cancer Screening Program sends an immunochemical faecal occult blood test to Australians aged 50-74 years to screen for bowel cancer, but uptake is low (40.9%). The SMARTscreen trial demonstrated that sending a short messaging services (SMS) prompt from the participant's general practitioner (GP) increased the proportion of kit returns by 16.5%. This research aimed to determine the acceptability and feasibility of implementing SMARTscreen. ⋯ The SMS-based intervention was widely accepted by GP staff and participants. Future research should test the SMS with and without the weblink, and send the SMS at a more convenient time of the day/week.
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Relational continuity is a fundamental component of primary care. The 'Quality in General Practice Trial' (EQuIP-GP), was a 12-month cluster randomized trial, designed to investigate whether financial incentives can improve relational continuity in primary care. ⋯ Incentive models should be suitably flexible to accommodate diversity in patient and practice needs. Small changes can be made to existing practice routines that will improve awareness and conscientiousness of relational continuity. Further research should examine how feasible these routine changes would be in practices that do not already focus on continuity.
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Shifting tasks from General practitioners (GPs) to practice nurses (PNs) could help address the shortage of GPs in Europe. Internationally, PN-led care (PNLC) is feasible and offers similar health outcomes to usual care. However, PN-led consultations (PN-cons) or as PN-led dosage changes for permanent medication (PN-DCPM) are uncommon in German general practice offices (GPO). ⋯ Participants showed openness towards PN-cons and were more reserved towards PN-DCPM in German GPO. Further quantitative studies should assess how acceptance and rejection of PN-led care are distributed among patients, GPs, and PNs.