The British journal of general practice : the journal of the Royal College of General Practitioners
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Irritable bowel syndrome (IBS) can cause troublesome symptoms impacting patients' quality of life and incur considerable health service resource use. Guidelines suggest low-dose amitriptyline for IBS as second line treatment, but this is rarely prescribed in primary care. ⋯ Patients and GPs felt the potential benefits from trying low-dose amitriptyline for IBS outweighed their concerns. When offering low-dose amitriptyline for IBS, GPs could address patient concerns about taking an antidepressant for IBS, highlighting the low and flexible dosage and other potential benefits of amitriptyline such as improved sleep.
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Background Clinical guidance recommends promotion of physical activity during general practice consultations. The frequency and content of physical activity discussions in UK general practice are poorly understood. Aim To explore the content of physical activity discussions during routine consultations between patients and general practitioners (GPs). ⋯ Conclusion Physical activity advice, following national guidance, was potentially relevant to over half of GP consultations; GPs were able to deliver advice of varying depth in a third of these consultations. Future work should explore ways of delivering physical activity advice effectively, efficiently and equitably within the constraints of general practice. Keywords Physical activity; general practice; video recording.
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Background Paediatric otorrhoea (PO) is a symptom-based diagnosis encompassing acute and chronic ear infections which cause otorrhoea in children and young people (CYP). Aim To understand the burden of PO on primary care services. Design and Setting A longitudinal population study in UK primary care. ⋯ Conclusions This is the first longitudinal population-based study investigating PO which demonstrates the burden on primary care. Antimicrobial prescribing predominantly follows NICE guidelines using oral amoxicillin. Aminoglycosides are the most frequently prescribed topical antibiotic despite the concern of ototoxicity.
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Background Living in socioeconomically deprived areas is associated with shorter lives, in worse health. GPs working in these areas face additional challenges. Aim Establishing GPs' motivation for working in these areas, what the challenges are, and insights from GPs on potential improvements and changes. ⋯ Improvements focused on providing more flexible access, increased mental health provision and future training and recruitment, particularly around widening participation in medicine. Conclusion Improving the environmental conditions, empowering individuals and investing in communities are essential to achieving health. The current model of providing reactionary acute care is leading to GPs experiencing powerlessness and feelings of helplessness at the 'Deep End'.
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Background Self-harm is a growing problem in young people. General practitioners (GPs) are usually the first point of healthcare contact for young people aged 16-25 years after self-harm. GPs can experience barriers to supporting young people and behaviour change theory can help to understand these barriers, and the influences on GP behaviour. ⋯ GPs reported motivation to help young people, but this was influenced by their daily workload. Unmet training needs around communication, knowledge, and optimising safety were identified. Conclusion Future GP-led interventions need to improve the capabilities, opportunities, and motivations of GPs to support young people to avoid future self-harm.