The British journal of general practice : the journal of the Royal College of General Practitioners
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People with physical-mental comorbidity have a poorer quality of life, worse clinical outcomes and increased mortality compared to people with physical conditions alone. South Asians (SAs) are the largest minority group in the UK and are more likely to have long-term conditions (LTCs) such as diabetes and heart disease. SAs are less likely to recognise symptoms which may represent mental health problems. ⋯ Experiences of emotional distress: multiple forms of inequality, distress at diagnosis of their LTC, cultural factors, and gender differences. Help-seeking behaviour: self-management, seeking help from family, friends, and faith, and inadequate clinical support. This review provides a greater understanding of SAs' conceptualisation of emotional distress in the context of LTCs, to support improvement in its recognition and management.
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Trans and gender-diverse people face multiple barriers within health care. Primary care practitioners are key to providing health care to trans and gender-diverse people but they often lack training in, and understanding of, trans identities and healthcare options. Few studies have examined health professionals' understanding of the barriers that exist in health care for trans and gender-diverse people. ⋯ There is an urgent need to address the barriers trans and gender-diverse people face in health care. Structural-level solutions include health policy, professional education, and standards; at the practice level, GPs can act as potential drivers of change in addressing the cultural and technical barriers to better meet the needs of their trans and gender-diverse patients.
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There is no published algorithm predicting asthma crisis events (accident and emergency [A&E] attendance, hospitalisation, or death) using routinely available electronic health record (EHR) data. ⋯ This externally validated algorithm has acceptable predictive ability for identifying patients at high risk of asthma-related crisis events and excluding those not at high risk.