Collaboration amongst general practitioners and gynaecologists working in primary health care in Germany: a cross-sectional study

Abstract Aim: This cross-sectional study is the first one to explore the collaboration of the influencing factors thereof amongst general practitioners (GPs) and gynaecologists (Gyns) working in primary care in urban and rural settings in Germany. Background: The number of women aged ≥ 50 years is predicted to increase in the next years in Germany. This coincides with the ageing of primary care specialists providing outpatient care. Whereas delegation of tasks to nurses as a form of interprofessional collaboration has been the target of recent studies, there is no data regarding collaboration amongst physicians in different specialisations working in primary care. We explored collaboration amongst GPs and Gyn regarding the healthcare provision to women aged ≥ 50 years. Methods: A quantitative postal survey was administered to GPs and Gyns in three federal states in Germany, focusing on care provision to women aged ≥ 50 years. A total of 4545 physicians, comprising 3514 GPs (67% of the total GP population) randomly selected, and all 1031 Gyns practicing in these states received the postal survey in March 2018. A single reminder was sent in April 2018 with data collection ending in June 2018. Multiple logistic regressions were performed for collaboration, adjusted by age and sex, alongside descriptive methods. Findings: The overall response rate was 31% (1389 respondents): 861 GPs (25%) and 528 Gyns (51%), with the mean respondent age being 54.4 years. Seventy-two per cent were female. Key competencies of collaboration are associated with working in rural federal states and with network participation. Physicians from rural states [odds ratio (OR) = 1.5, 95% confidence interval (CI) = 1.2, 1.9] and physicians in networks (OR = 3.0, CI = 2.3, 3.9) were more satisfied with collaboration. Collaboration to deliver services for women aged ≥ 50 years is more systematic amongst GPs and Gyns who are members of a network; increased networking could improve collaboration, and ultimately, outcomes too.

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Chronic non-cancer pain in primary care: an Italian cross-sectional study

10.22514/sv.2020.16.0111 ◽

2020 ◽

Keyword(s):

Primary Care ◽

Chronic Pain ◽

Cancer Pain ◽

General Practitioners ◽

Care Delivery ◽

Cross Sectional Study ◽

Italian Population ◽

Sectional Study ◽

Cross Sectional ◽

Clinical Records

Chronic non-cancer pain is a complex health condition that affects more than a quarter of the Italian population who mainly refers to general practitioners and primary care for their treatment. There are little information on the epidemiological and clinical characteristics and types of treatments for these patients who suffer from chronic pain. The aim of the study was to provide epidemiological and clinical information about patients with chronic non-cancer pain who refers to GPs for their treatment. An observational, multicentre, cross-sectional study was carried out using retrospectively reviewed clinical records from 29 GPs. Some pharmacoeconomic aspects were also investigated. A total of 1,007 patients who had chronic pain were selected for the study. Chronic pain was more common in women than in men (ratio 2.7 : 1) (P = 0.002). With regard to incomes, the women earned less than the men (P = 0.017). The chronic pain was musculoskeletal (73.4%), mixed (21.4%), neuropathic (4.9%) and visceral (0.3%). More women than men had pain in two or more sites, and 33.5% of the patients reported more than one diagnosis that related to chronic pain. The general practitioners had prescribed nonsteroidal anti-inflammatory drugs for 71.8% of the cases, opioids for 16.9%, adjuvants for 9.0% and acetaminophen for 2.4%, and about pharmacoeconomic aspects, the total cost for the sample was € 111,331.42. Primary care is the essential frontline for patients who suffer from non-cancer pain. An interdisciplinary assessment and approach should start in primary care delivery to maximize the clinical outcomes.

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Hyperemesis gravidarum in the primary care setting: Cross-sectional study of general practitioners

BJGP Open ◽

10.3399/bjgpo.2021.0119 ◽

2021 ◽

pp. BJGPO.2021.0119

Author(s):

Melanie Nana ◽

Holly Morgan ◽

Haroon Ahmed ◽

Catherine Williamson

Keyword(s):

Primary Care ◽

General Practitioners ◽

Hyperemesis Gravidarum ◽

Cross Sectional Study ◽

Evidence Based ◽

Sectional Study ◽

Cross Sectional ◽

Confidence Levels ◽

Obstetrics And Gynaecology ◽

In Pregnancy

BackgroundHyperemesis gravidarum (HG), if untreated, can lead to malnutrition, dehydration and Wernicke’s encephalopathy. Fetal complications include low birth weight and neurodevelopmental delay. Recent evidence supports increased rates of termination of pregnancy and suicidal ideation. Drivers included difficulty in accessing medications which thus contributed to poor perception of care.AimIdentify factors that may influence prescribers’ confidence and knowledge regarding pharmacological therapy for HG.Design & settingCross-sectional study of qualified GPs (General Practitioners) and GP trainees in Wales.MethodDistribution of a 22-item online survey. Statistical analysis was carried out using SPSS.Results241 responses were received with 216 included in the analysis (59% qualified GPs, 41% GP trainees). In total, 93% of respondents correctly identified cyclizine as being safe in pregnancy, but no other drug recommended in the Royal College of Obstetrics and Gynaecology guidance was considered safe by more than 58%. Those reporting higher confidence levels in managing HG were more likely to correctly report guideline recommended drugs as safe in pregnancy (P=0.04). Additional qualifications related to obstetrics and gynaecology and/or prior clinical experience increased confidence levels (P=0.0001 and P=0.0002 respectively). Only 19% of participants routinely screened for signs of mental health complications and prior experience/education did not increase likelihood of this happening. 87% of participants would like additional education/access to evidence-based resources.ConclusionThis study demonstrates a demand for improved dissemination of evidence-based education to support those working in primary care. The extent to which HG is covered in pre-existing educational programmes should also be revisited.

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