The British journal of general practice : the journal of the Royal College of General Practitioners
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Background Since 2022, general practice has shifted from responding to the acute challenges of COVID-19 to restoring full services, using remote and digital modalities as well as traditional in-person care. Aim To examine how quality domains are addressed in contemporary UK general practice. Design and setting Multi-site, mostly qualitative longitudinal case study, placed in national policy context. ⋯ Many staff are stressed and demoralised. Conclusion Contemporary hybrid general practice features changes with the unintended effect of dehumanising, compromising and fragmenting care. Risks to patients and the core values of general practice should be urgently addressed.
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Safety netting advice (SNA) can help in the management of acutely ill children. ⋯ Paper SNA (with oral SNA) may reduce antibiotic use and return visits. Video, oral, and online SNA, may improve parental knowledge while video SNA and web-based modules may increase parental satisfaction.
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Randomized Controlled Trial
Should I Take Aspirin? (SITA): RCT of a decision aid for cancer chemoprevention.
Australian guidelines recommend that people aged 50-70 years consider taking low-dose aspirin to reduce their risk of colorectal cancer (CRC). ⋯ The decision aid improved informed decision making but this did not translate into long-term regular use of aspirin to reduce CRC risk. In future research, decision aids should be delivered alongside various implementation strategies.
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Increased time to diagnosis in sarcoma is associated with poor prognosis and patient outcomes. Research is needed to identify whether opportunities to expedite the diagnosis of sarcoma in general practice exist. ⋯ Patients with sarcoma have increased GP clinical activity from 6 months pre-diagnosis, indicating a diagnostic window where potential opportunities exist for earlier diagnosis. Interventions to help identify patients and promote appropriate use of imaging and direct specialist centre referrals could improve earlier diagnosis and patient outcomes.