The British journal of general practice : the journal of the Royal College of General Practitioners
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Review
Barriers to effective management of type 2 diabetes in primary care: qualitative systematic review.
Despite the availability of evidence-based guidance, many patients with type 2 diabetes do not achieve treatment goals. ⋯ 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.
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Multicenter Study Observational Study
Unrecognised bipolar disorder among UK primary care patients prescribed antidepressants: an observational study.
Bipolar disorder is not uncommon, is associated with high disability and risk of suicide, often presents with depression, and can go unrecognised. ⋯ 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 MDQ to be a useful supplement to non-standardised questioning.
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Multicenter Study
Lost to the NHS: a mixed methods study of why GPs leave practice early in England.
The loss of GPs in the early stages of their careers is contributing to the GP workforce crisis. Recruitment in the UK remains below the numbers needed to support the demand for GP care. ⋯ To improve retention of young GPs, the pace of administrative change needs to be minimised and the time spent by GPs on work that is not face-to-face patient care reduced.