The British journal of general practice : the journal of the Royal College of General Practitioners
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It is recognised that medical tests are overused in primary care; however, it is unclear how best to reduce their use. ⋯ This review indicates that it is possible to reduce the use of low-value medical tests in primary care, especially by using multiple components including reminders, audit/feedback, and patient-targeted interventions. To implement these strategies widely in primary care settings, more research is needed not only to investigate their effectiveness, but also to examine adverse events, cost-effectiveness, and patient-reported outcomes.
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Observational Study
Variability in size and characteristics of primary care networks in England: observational study.
General practices in England have been encouraged by national policy to work together on a larger scale by creating primary care networks (PCNs). Policy guidance recommended that they should serve populations of 30 000-50 000 people to perform effectively. ⋯ More than 40% of the PCNs were not of the recommended size, and there was substantial variation in their composition and characteristics. This high variability between PCNs is a risk to their future performance.
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Risk of harm from drinking increases with age as alcohol affects health conditions and medications that are common in later life. Different types of information and experiences affect older people's perceptions of alcohol's effects, which must be navigated when supporting healthier decisions on alcohol consumption. ⋯ Later life is a time when older people may be open to making changes to their alcohol use, particularly when suggested by practitioners. Older people can struggle to recognise potential risks or perceive little gain in acting on perceived risks. Such perceptions may be challenging to navigate in supportive discussions.