The British journal of general practice : the journal of the Royal College of General Practitioners
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Diverting patients to the community is one of the solutions to mitigate overcrowding in emergency departments, which is the role of the Frailty In-Reach service. ⋯ We successfully improved the triage system within the Frailty In-Reach service with digital technology.
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App-based treatment for female urinary incontinence (UI) is a cost-effective alternative to care as usual. For successful implementation it is of major importance to involve stakeholders like care providers. ⋯ Our results add to the existing knowledge about eHealth-related barriers and facilitators. These findings can be used to optimise implementation strategies for other apps and to enhance the uptake of app-based treatment for UI in the Netherlands.
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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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Problematic polypharmacy is an increasingly common clinical scenario in part due to increasing multimorbidity and application of multiple single condition guidelines. It is a challenging problem requiring a multifaceted management approach. This includes deprescribing, which is the structured dose reduction or stopping of medications. Qualified GPs struggle with deprescribing due to existing barriers, but little is known about how trainee GPs feel about this skill. ⋯ This study explored the complex area of problematic polypharmacy and deprescribing as relating to final year GP trainees. It identified key skills that trainees feel they need to manage this task in practice. Importantly, it also recognises barriers to be overcome before confident deprescribing can be performed. Potential improvements in training are identified with suggestions for educational opportunities.
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GPs have been shown to be important providers of medical care during pregnancy, however, little evidence exists on their awareness of pregnancy when prescribing medication to women. ⋯ Results of this study indicate a potential issue with GP awareness about pregnancy status at the time medication with potential safety risks is prescribed. Although pregnancy registration by GPs improved over the years, inadequate use still seems to be made of the available information systems for appropriate drug surveillance.