The British journal of general practice : the journal of the Royal College of General Practitioners
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Chronic kidney disease (CKD) is prevalent in the UK, associated with significant mortality and morbidity, and disproportionately affects minority ethnic groups. The most common causes for CKD are diabetes and hypertension. An estimated glomerular function (eGFR) blood test and an albumin creatinine ratio (uACR) urine test can be used to assess the level of CKD and predict the risk of adverse outcomes such as cardiovascular disease, end stage renal failure, and death. However, UK National CKD audit data suggest that only 30% of those with hypertension have a recorded uACR. Our quality improvement project working with community stakeholders and Healthy.io digital enterprise will evaluate the feasibility of uACR self-testing in the community. ⋯ Improving equity in uACR testing through quality improvement tools can deliver a sustainable project for improving patient renal care. Leveraging innovative methods provides the potential for effective, equitable, and efficient services.
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Primary care professionals deliver the majority of end-of-life care to patients. However, extensive pressures and constraints can contribute to variable and substandard care quality. We will report on the preliminary results from an independent evaluation of the 'Daffodil Standards for Advanced Serious Illness and End-of-Life Care', created by the Royal College of General Practitioners and Marie Curie. ⋯ The results will be used to inform and refine the design illustrative case studies to capture best available learning and identify exemplars of best practice for later phases of the study.
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GPs in the UK are at increasing risk of burnout. Peer support (PS) is defined as resources provided by colleagues, such as informational or emotional support, which is either organisationally mandated (formal) or informal. PS has been described in the literature as a method of mitigating burnout. However, little is known about how GPs support one another and what optimises PS in primary care. ⋯ This qualitative research fills a literature gap regarding moderating factors for engaging with PS in GPs and highlights the unique interactions of these factors. The proposition of a novel model to visualise the interplay of moderators provides basis for evidence-based interventions to test, target, and facilitate better PS in primary care.
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Social prescribing link workers are being employed in primary care through the Additional Roles Reimbursement Scheme. ⋯ Dominance of a medical model approach to service delivery may not be conducive to uncovering and supporting people with their non-medical problems, or to promoting a wider understanding of health. Tensions between fitting into a setting dominated by medical discourse and practices, compared to feeling they belong, is something that link workers can encounter when providing social prescribing services in primary care.
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Weather and seasons, or stressful periods associated with their education could affect young people's mental health. Members of a young person's advisory group asked us to investigate whether there are particular periods in the year when adolescents have more mental health issues. ⋯ There were higher rates of antidepressant prescribing, depression, and anxiety at the start of the school year in adolescents. Support around mental health issues from GPs and schools should be focused during this period. Future studies should examine whether these results apply to younger children and develop interventions to lessen their impacts on adolescents.