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).
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Domestic abuse among female doctors
In this episode we talk to Dr Emily Donovan, a NIHR GP academic fellow from the School of Primary Care, Population Sciences and Medical Education at the University of Southampton.
Paper: Domestic abuse among female doctors: thematic analysis of qualitative interviews in the UK
Read the paper: https://doi.org/10.3399/BJGP.2020.0795 (https://doi.org/10.3399/BJGP.2020.0795)
Previous qualitative research has focused on a doctor’s role in supporting victim-survivors of domestic abuse (DA) reinforcing the stereotype in which the doctor helps others experiencing DA rather than being a victim-survivor themselves. This study explored single doctor mothers’ lived experience of DA and identified several unique barriers to seeking help. Healthcare professionals need to be aware of these in order to better support patients who are medical doctors.
Chronic kidney disease and the high burden of co-morbidity
In this episode we talk to Clare MacRae, a GP at the Centre for Population Health Sciences, Usher Institute of Population Health Sciences and Informatics in Edinburgh.
Main paper: Comorbidity in chronic kidney disease:a large cross-sectional study of prevalence in Scottish primary care and this is at: https://doi.org/10.3399/bjgp20X714125 (https://doi.org/10.3399/bjgp20X714125)
Additional paper discussed: Potentially inappropriate prescribing in people with chronic kidney disease: cross-sectional analysis of a large population cohort and this is at: https://doi.org/10.3399/BJGP.2020.0871 (https://doi.org/10.3399/BJGP.2020.0871)
Chronic kidney disease (CKD) is common and results in significant mortality and morbidity, and is known to be commonly associated with hypertension, diabetes, and cardiovascular disease. Despite research indicating that people with CKD and comorbidity, of any type, are at increased risk of adverse clinical outcomes, little is known about the prevalence of discordant physical and mental health conditions in people with CKD. The present study found that almost all people with CKD have coexisting comorbidities, and that extreme comorbidity is >40 times more common in adults with CKD compared with age-, sex-, and deprivation-adjusted controls. The majority of discordant physical and mental health conditions were more common in people with CKD.
Highlights from the February 2021 issue of the BJGP
In this episode I am joined by two of our Associate Editors, Nada Khan and Tom Round, for some conversation. The February issue has just been published and we talk over some of the highlights in this month's issue.
FEBRUARY ISSUE: https://bjgp.org/content/71/703 (https://bjgp.org/content/71/703)
EDITORIAL: COVID-19 vaccination programme: a central role for primary care https://doi.org/10.3399/bjgp21X714929 (https://doi.org/10.3399/bjgp21X714929)
EDITORIAL: Long COVID and the importance of the doctor–patient relationship https://doi.org/10.3399/bjgp21X714641 (https://doi.org/10.3399/bjgp21X714641)
EDITORIAL: Integrating primary care across the prison and community interface https://doi.org/10.3399/bjgp21X714653 (https://doi.org/10.3399/bjgp21X714653)
RESEARCH: Identifying patients at risk of psychosis: a qualitative study of GP views in South West England https://doi.org/10.3399/bjgp20X713969 (https://doi.org/10.3399/bjgp20X713969)
LIFE and TIMES: The MRCGP Recorded Consultation Assessment: time to drop 10 minutes as standard? https://doi.org/10.3399/bjgp21X714725 (https://doi.org/10.3399/bjgp21X714725)
LIFE and TIMES: The trolley problem, 2021 style https://doi.org/10.3399/bjgp21X714773 (https://doi.org/10.3399/bjgp21X714773)
Visit BJGP Life: https://www.bjgplife.com/contribute (www.bjgplife.com/contribute)
Book mentioned: On Immunity by Eula Bliss
Getting the right treatment to people in primary care with depression
In this episode we talk to Professor Jane Gunn, chair of primary care research, Department of General Practice, Melbourne Medical School, University of Melbourne, Australia.
The paper is: Matching depression management to severity prognosis in primary care: results of the Target-D randomised controlled trial
Read the paper: https://doi.org/10.3399/BJGP.2020.0783 (https://doi.org/10.3399/BJGP.2020.0783)
Depression is a leading contributor to the global burden of disease and a significant problem in primary care, where it is typically identified and managed. Stepped care approaches are recommended but difficult to implement in routine care, due in part to a lack of effective tools to guide GPs in matching intervention intensity to patient need. Therefore, a clinical prediction tool was developed, which was embedded into a person-centred e-health platform, that matches depression management options to symptom severity prognosis. This randomised controlled trial showed using this platform results in greater improvement in depressive symptoms at 3 months compared to usual care. This approach could be implemented in routine care to support more efficient and effective depression care without adding to GPs’ workload.
How quickly are people with symptomatic lung cancer getting a pre-diagnostic chest X-ray?
In this episode we talk to Dr Garth Funston, a Clinical Research Fellow, from the Primary Care Unit, Department of Public Health and Primary Care at the University of Cambridge.
The paper is: Time from presentation to pre-diagnostic chest X-ray in patients with symptomatic lung cancer: a cohort study using electronic patient records from English primary care.
Read the paper: https://doi.org/10.3399/bjgp20X714077 (https://doi.org/10.3399/bjgp20X714077)
England’s national cancer referral guidelines recommend that patients attending general practice with unexplained symptoms possibly caused by lung cancer, such as persistent cough, shortness of breath, and weight loss, have a chest X-ray promptly (within 14 days) to aid timely diagnosis. Only 35% of patients with lung cancer in this study had a chest X-ray within the recommended 14 days; and time between attending general practice with symptoms and having an X-ray was longer among people who smoke, females, and older patients. This research highlights a potential source of delayed lung cancer diagnosis and could inform initiatives aiming to achieve earlier diagnosis and improve outcomes.
Identifying patients at risk of psychosis
In this episode we talk to Daniela Strelchuk from Population Health Sciences at the University of Bristol and Professor Stan Zammit from the Centre for Academic Mental Health, also at Bristol.
The paper is: Identifying patients at risk of psychosis: a qualitative study of GP views in South West England
Read the paper: https://doi.org/10.3399/bjgp20X713969 (https://doi.org/10.3399/bjgp20X713969)
Previous research has shown that GPs have limited knowledge about the insidious symptoms of psychosis but little is known about the difficulties that GPs face in identifying patients at risk of psychosis. This study used semi-structured interviews to explore GPs’ experiences of this patient group, and found that some GPs were not familiar with the concept of being at risk of developing psychosis.
Whereas this could, in itself, be a barrier to identifying these patients, other barriers were present that related to patients not consulting or disclosing psychotic symptoms, lack of continuity of care, and high thresholds for accessing secondary care services.