Weight assessment and the provision of weight management advice in primary care: a cross-sectional survey of self-reported practice among general practitioners and practice nurses in the United Kingdom

Abstract Aims To examine how often general practitioners (GPs) and practice nurses (PNs) working in primary care discuss alcohol with patients, what factors prompt discussions, how they approach patient discussions and whether the Chief Medical Officers’ (CMO) revised low-risk drinking guidelines are appropriately advised. Methods Cross-sectional survey with GPs and PNs working in primary care in the UK, conducted January–March 2017 (n = 2020). A vignette exercise examined what factors would prompt a discussion about alcohol, whether they would discuss before or after a patient reported exceeded the revised CMO guidelines (14 units per week) and whether the CMO drinking guidelines were appropriately advised. For all patients, participants were asked how often they discussed alcohol and how they approached the discussion (e.g. used screening tool). Results The most common prompts to discuss alcohol in the vignette exercise were physical cues (44.7% of participants) or alcohol-related symptoms (23.8%). Most practitioners (70.1%) said they would wait until a patient was exceeding CMO guidelines before instigating discussion. Two-fifths (38.1%) appropriately advised the CMO guidelines in the vignette exercise, with PNs less likely to do so than GPs (odds ratio [OR] = 0.77, P = 0.03). Less than half (44.7%) reportedly asked about alcohol always/often with all patients, with PNs more likely to ask always/often than GPs (OR = 2.22, P < 0.001). Almost three-quarters said they would enquire by asking about units (70.3%), compared to using screening tools. Conclusion Further research is required to identify mechanisms to increase the frequency of discussions about alcohol and appropriate recommendation of the CMO drinking guidelines to patients.

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Knowledge of features of inflammatory back pain in primary care in the West Midlands: a cross-sectional survey in the United Kingdom

Rheumatology International ◽

10.1007/s00296-018-4058-5 ◽

2018 ◽

Vol 38 (10) ◽

pp. 1859-1863 ◽

Cited By ~ 4

Author(s):

T. Adizie ◽

S. Elamanchi ◽

A. Prabu ◽

A. V. Pace ◽

R. Laxminarayan ◽

...

Keyword(s):

Primary Care ◽

United Kingdom ◽

Back Pain ◽

Inflammatory Back Pain ◽

Cross Sectional Survey ◽

The West ◽

Cross Sectional ◽

The United Kingdom ◽

West Midlands

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The experience of burnout across different surgical specialties in the United Kingdom: A cross-sectional survey

Surgery ◽

10.1016/j.surg.2011.09.035 ◽

2012 ◽

Vol 151 (4) ◽

pp. 493-501 ◽

Cited By ~ 32

Author(s):

Dominic Upton ◽

Victoria Mason ◽

Bethany Doran ◽

Kazia Solowiej ◽

Uttam Shiralkar ◽

...

Keyword(s):

United Kingdom ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The United Kingdom

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Task shifting from general practitioners to practice assistants and nurses in primary care: a cross-sectional survey in 34 countries

Primary Health Care Research & Development ◽

10.1017/s1463423621000657 ◽

2021 ◽

Vol 22 ◽

Author(s):

Peter P. Groenewegen ◽

Wienke G. W. Boerma ◽

Peter Spreeuwenberg ◽

Bohumil Seifert ◽

Willemijn Schäfer ◽

...

Keyword(s):

Primary Care ◽

General Practitioners ◽

Professional Training ◽

Institutional Development ◽

Task Shifting ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Independent Variables ◽

Nurse Prescribing ◽

Number Of Patients

Abstract Aim: To describe variation in task shifting from general practitioners (GPs) to practice assistants/nurses in 34 countries, and to explain differences by analysing associations with characteristics of the GPs, their practices and features of the health care systems. Background: Redistribution of tasks and responsibilities in primary care are driven by changes in demand for care, such as the growing number of patients with chronic conditions, and workforce developments, including staff shortage. The need to manage an expanding range of services has led to adaptations in the skill mix of primary care teams. However, these developments are hampered by barriers between professional domains, which can be rigid as a result of strict regulation, traditional attitudes and lack of trust. Methods: Data were collected between 2011 and 2013 through a cross-sectional survey among approximately 7200 GPs in 34 countries. The dependent variable ‘task shifting’ is measured through a composite score of GPs’ self-reported shifting of tasks. Independent variables at GP and practice level are: innovativeness; part-time working; availability of staff; location and population of the practice. Country-level independent variables are: institutional development of primary care; demand for and supply of care; nurse prescribing as an indicator for professional boundaries; professionalisation of practice assistants/nurses (indicated by professional training, professional associations and journals). Multilevel analysis is used to account for the clustering of GPs in countries. Findings: Countries vary in the degree of task shifting by GPs. Regarding GP and practice characteristics, use of electronic health record applications (as an indicator for innovativeness) and age of the GPs are significantly related to task shifting. These variables explain only little variance at the level of GPs. Two country variables are positively related to task shifting: nurse prescribing and professionalisation of primary care nursing. Professionalisation has the strongest relationship, explaining 21% of the country variation.

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Reactions to Standardized Cigarette Packs With Varying Structural Designs, and the Association With Smoking Susceptibility: A Postimplementation Cross-Sectional Survey With Never-Smoking Adolescents in Scotland

Nicotine & Tobacco Research ◽

10.1093/ntr/ntaa109 ◽

2020 ◽

Vol 22 (11) ◽

pp. 2041-2050 ◽

Cited By ~ 1

Author(s):

Danielle Mitchell ◽

Nathan Critchlow ◽

Crawford Moodie ◽

Linda Bauld

Keyword(s):

United Kingdom ◽

Cross Sectional Survey ◽

Cross Sectional ◽

The United Kingdom ◽

Cigarette Pack ◽

The Mean ◽

Never Smokers ◽

Smoking Susceptibility ◽

Similar Legislation ◽

Cigarette Packs

Abstract Introduction From May 20, 2017, cigarettes in the United Kingdom must be sold in standardized (plain) packaging. We explore postimplementation reactions to standardized cigarette packaging among never-smokers in Scotland, whether reactions vary in relation to permitted variations in pack structure, and whether reactions are associated with susceptibility. Aims and Methods A cross-sectional survey with 12–17-year-old never-smokers (n = 507) in Scotland, conducted November 2017–November 2018. Participants were shown one “regular” standardized cigarette pack (flip-top lid and straight-edged pack, similar to designs in Australia) and three standardized packs with varied pack structures (beveled-edges, slim pack, and shoulder box), which are permitted postimplementation in the United Kingdom. Participants rated each pack on eight five-point reaction measures (eg, attractiveness). Participants also indicated which pack, if any, they would choose. Smoking susceptibility was the outcome. Results The mean reaction scores for all four packs were mostly negative, however the shoulder box was consistently rated less negatively than the regular, slim, or beveled-edge packs. Most participants (87%) said they would not select any of the four packs, although susceptible participants were more likely to select one than nonsusceptible participants (25% vs. 7%; χ 2 = 29.70; p < .001). For all four packs, not finding them off-putting was associated with susceptibility (Adjusted Odds Ratio range: 2.73–3.69), albeit only a minority of adolescents did not find each pack off-putting. Conclusions Adolescents have negative reactions to the standardized cigarette packs implemented in the United Kingdom, albeit permitted variations in structure can reduce the extent of negativity. Most reactions to standardized packaging had no association with susceptibility. Implications We provide the first empirical evidence that adolescents find the standardized cigarette packs implemented in the United Kingdom unappealing and that most pack reactions have no association with susceptibility among never-smokers, with the exception of the minority who did not think that they would put them off smoking. This suggests that the legislation is achieving one of its primary aims, to reduce the appeal of packaging. That permitted variations in pack structure (eg, shoulder boxes) somewhat reduce negative reactions suggests that the United Kingdom, and other countries introducing similar legislation, should ensure that all aspects of pack design are fully standardized.

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