The British journal of general practice : the journal of the Royal College of General Practitioners
-
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.
-
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.
-
Suicide is a major public health issue. GPs are often on the front line in responding to a suicide. They are called on to support individuals and families in the aftermath of suicide yet there is a dearth of research, particularly from patients' perspectives, on how to provide optimal care for those grieving a suicide in the primary care setting. ⋯ Suicide can result in prolonged, complex grief generating specific patient needs. Stigma may function as a barrier to help seeking. The GP should consider initiating contact with the bereaved. Recommendations have been made to support GPs in their care of the suicide bereaved.