Listen to BJGP Interviews for the latest updates on primary care and general practice research. Hear from researchers and clinicians who will update and guide you to the best practice. We all want to deliver better care to patients and improve health through better research and its translation into practice and policy.
The BJGP is a leading international journal of primary care with the aim to serve the primary care community. Whether you are a general practitioner or a nurse, a researcher, we publish a full range of research studies from RCTs to the best qualitative literature on primary care. In addition, we publish editorials, articles on the clinical practice, and in-depth analysis of the topics that matter. We are inclusive and determined to serve the primary care community.
BJGP Interviews brings all these articles to you through conversations with world-leading experts.
The BJGP is the journal of the UK's Royal College of General Practitioners (RCGP). The RCGP grant full editorial independence to the BJGP and the views published in the BJGP do not necessarily represent those of the College.
For all the latest research, editorials and clinical practice articles visit BJGP.org (https://www.bjgp.org).
If you want all the podcast shownotes plus the latest comment and opinion on primary care and general practice then visit BJGP Life (https://www.bjgplife.com).
The NICE traffic light system to assess sick children is not suitable for use as a clinical tool in general practice
In this episode we talk to Amy Clark who is a final year medical student at Cardiff and Dr Kathryn Hughes who is a GP and senior clinical lecturer at PRIME Centre Wales at the School of Medicine at Cardiff University.
Paper: Accuracy of the NICE traffic light system in children presenting to general practice: a retrospective cohort study
The National Institute for Health and Care Excellence (NICE) traffic light system is widely used in general practice for the assessment of unwell children; however, the majority of previous studies validating this tool have been conducted in secondary care settings. To that authors’ knowledge, no studies have validated this tool within UK general practice. This study found that the traffic light system cannot accurately detect or exclude serious illness in children presenting to UK general practice with an acute illness. The conclusion reached was that it cannot be relied on by clinicians for the assessment of acutely unwell children and that it is unsuitable for use as a clinical decision tool.
The GP workforce crisis - how are outcomes associated with different professionals?
In this episode we talk to Dr Jon Gibson who is a research fellow at the School of Health Sciences at the University of Manchester.
Paper: Primary care workforce composition and population, professional, and system outcomes: a retrospective cross-sectional analysis
The increasing number of staff from diverse healthcare backgrounds is changing the general practice workforce in England. These changes provide a new opportunity to investigate whether, and how, workforce composition may be associated with outcomes. This analysis indicated that professional, population, and system outcomes show a variety of associations with primary care workforce composition. The findings demonstrated that different types of health professionals are not substitutes for each other, and the quantity and quality of primary care services delivered will depend on who is employed to work in this setting.
PRINCIPLE trial findings on the use of colchicine for COVID-19 in the community
In this episode we speak to Professor Chris Butler who is a GP and professor of primary care at the Nuffield Department of Primary Care Health Science at the University of Oxford. He is also Co-Chief Investigator for the PRINCIPLE trial and the PANORAMIC trial.
Paper: Colchicine for COVID-19 in the community (PRINCIPLE): a randomised, controlled, adaptive platform trial
Colchicine has been proposed as treatment for COVID-19 due to its anti-inflammatory properties, but evidence to support its use is inconclusive, and its effect on time to recovery in the community has not been evaluated. The RECOVERY trial found no benefit with colchicine use among people hospitalised with COVID-19, while the COLCORONA trial found some evidence of a 1.1% and 1.4% absolute reduction in hospitalisations/deaths among adults with suspected or confirmed COVID-19 in the community respectively. In this national, platform adaptive randomised controlled trial, we found evidence of no meaningful benefit with colchicine on time to recovery, and because the threshold for futility on time to recovery was met, randomisation to colchicine was stopped before collecting substantial data on hospitalisations and death, leading to imprecise estimates for that outcome. Our findings add to the evidence currently available and suggest that colchicine should not be recommended for treating symptoms of COVID-19.
The rise in prescribing for anxiety in primary care
In this episode we speak to Dr Charlotte Archer who is senior research associate in primary care mental health at Bristol Medical School at the University of Bristol.
Paper: Rise in prescribing for anxiety in UK primary care between 2003 and 2018: a population-based cohort study using Clinical Practice Research Datalink
Previous studies have found substantial increases in the prescribing of antidepressants for any indication, and for depression, over the past two decades.
The current study found increases in incident prescribing for anxiety in most anxiolytic drug classes, and an increase in the number of new patients starting treatment is more likely to explain the overall increase rather than increases in long-term use. Increases in prescribing were most notable in young adults, with a marked rise in benzodiazepine prescriptions for this group. Increases in incident prescribing may reflect better detection of anxiety or an earlier unmet need; however, some of this prescribing is not based on robust evidence of effectiveness, some may contradict guidelines, and there is limited evidence on the overall impact associated with taking antidepressants long term, and therefore, there may be unintended harm.
GP wellbeing during the COVID-19 pandemic
In this episode we talk to Dr Laura Jefferson who is a Research Fellow at the Department of Health Sciences at the University of York.
Paper: General practitioner wellbeing during the COVID-19 pandemic: A systematic review.
Many GPs have reported stress and burnout over recent years, which is potentially damaging not just to doctors themselves, but also to patients and healthcare systems. The coronavirus pandemic has presented new challenges and there is a need to evaluate the impact on GP wellbeing. This review synthesises the international evidence base exploring primary care doctors’ psychological wellbeing during the pandemic. Studies have highlighted multiple sources of stress during this time and reported experiences of stress, burnout, anxiety, depression, fear of COVID, reduced job satisfaction and physical symptoms. Gender and age differences may warrant further research to identify interventions targeted to the needs of specific groups.
Austin O'Carroll talks about the Triple F**k Syndrome
In this episode we interview Dr Austin O'Carroll who is a GP based in Dublin and founder of Safetynet Ireland and North Dublin City GP Training, and co-founder GPCareForAll.
Paper: The Triple F**k Syndrome: How medicine contributes to the systemic oppression of people born into poverty
Link to article: https://bjgplife.com/the-triple-fk-syndrome-how-medicine-contributes-to-the-systemic-oppression-of-people-born-into-poverty/ (https://bjgplife.com/the-triple-fk-syndrome-how-medicine-contributes-to-the-systemic-oppression-of-people-born-into-poverty/)
Austin argues that the label of personality disorder is inappropriate and harmful to patients who have suffered adverse social environments in childhood. By simultaneously ignoring social causation and denying the possibility of therapy the diagnosis perpetrates a systematic injustice against those who are labelled.