The British journal of general practice : the journal of the Royal College of General Practitioners
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Advance care planning (ACP) is rare among ethnic minorities for social, cultural, and religious reasons. ⋯ Despite an initial lack of knowledge about ACP, many older adults with Moroccan backgrounds were willing to talk about it after receiving information in their native language. GPs should facilitate ACP discussions for these patients, paying attention to individual needs and preferences.
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A polygenic risk score (PRS) quantifies the aggregated effects of common genetic variants in an individual. A 'personalised breast cancer risk assessment' combines PRS with other genetic and non-genetic risk factors to offer risk-stratified screening and interventions. Large-scale studies are evaluating the clinical utility and feasibility of implementing risk-stratified screening; however, GPs' views remain largely unknown. ⋯ The results suggest limited knowledge of PRS and risk-stratified screening among GPs. Training - preferably using online learning formats - was identified as the top priority for future implementation. GPs felt positive about the potential impact of risk-stratified screening; however, there was hesitance and disagreement towards a low-risk screening pathway.
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General practice has a diverse training programme. It is majority female (57%) and more than half of all trainees are from an ethnic minority, according to the GMC workforce report 2022. However, we are not seeing the same representation of ethnic minorities in academic general practice, with 85.1% of GP professors being White. ⋯ With such a diverse training scheme, we need to have a better representation of ethnic minorities in GP academia. There is a clear problem recruiting or attracting people from ethnic minorities to an academic career and work needs to be done to understand and overcome those barriers.
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A range of measures to improve service delivery have been introduced among persisting concerns about staff shortages in general practice. Innovations include practice networks, multidisciplinary roles, and use of digital technologies. Yet challenges remain that affect both patient care delivery and staff. Therefore, identifying what matters from a workforce perspective will help identify what matters to those delivering services. ⋯ The top 10 service delivery priorities require future policy solutions that are holistic and address underlying causes. Future research needs to explore interdependencies across the patient-workforce-service delivery nexus.
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The misuse of pregabalin has been the subject of increasing concerns for several years. The effects sought are multiple and it is rarely taken as a single drug. The most frequent association is with opioids, which may increase the risk of fatal overdose. ⋯ This study has highlighted a rarely documented profile of pregabalin misuse: self-medication among a group of new immigrants, most of whom have no previous history of opioid-related disorders. Measures should be taken to improve access to health and social care for this population, considering all their biopsychosocial vulnerabilities.