The British journal of general practice : the journal of the Royal College of General Practitioners
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Identifying and responding to patients affected by domestic violence and abuse (DVA) is vital in primary care. There may have been a rise in the reporting of DVA cases during the COVID-19 pandemic and associated lockdown measures. Concurrently general practice adopted remote working that extended to training and education. IRIS (Identification and Referral to Improve Safety) is an example of an evidence-based UK healthcare training support and referral programme, focusing on DVA. IRIS transitioned to remote delivery during the pandemic. ⋯ The authors recommend a hybrid DVA training model for general practice, including remote information delivery alongside a structured face-to-face element. This has broader relevance for other specialist services providing training and education in primary care.
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GPs regularly prescribe lifelong treatments for long-term conditions, supported by clinical guidelines and encouraged by performance measures. However, GPs have a poor understanding of the absolute benefits and harms of these treatments, impairing their ability to engage in genuine shared decision making or optimally manage polypharmacy. There are few easily accessible and understandable sources of this kind of quantitative information. ⋯ It is possible to communicate quantitative information about the clinical evidence base behind treatments in a way that will be usable in practice and that complements existing clinical guidelines and normative practice. This has the potential to support shared decision making, improve the management of polypharmacy, and increase GPs' confidence in this area of practice.
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Pelvic floor symptoms, such as lower urinary tract symptoms, defecation problems, sexual dysfunction, pelvic pain, and pelvic organ prolapse in females, are common and frequently co-occur. Despite negatively affecting quality of life, few patients seek help. Most studies assessing help-seeking behaviour have focused on a single pelvic floor symptom. ⋯ Males and females have more similarities than differences in help-seeking behaviour. Healthcare providers should be aware that patients who seek help for one symptom probably have multiple pelvic floor symptoms that the patient has not reported.
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Prostate cancer mortality in Black males is disproportionately high. This problem may be overcome by reducing delays in the pathway to diagnosis, particularly those occurring before initial medical help seeking. A greater understanding of symptom appraisal and help seeking could support the development of targeted interventions for improving early presentation among Black males. ⋯ Cognitive biases, cultural stigmas, and everyday interpersonal interactions should be important areas at which to target strategies seeking to reduce delays and improve early presentation in males with possible prostate cancer, particularly Black males.
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There is evidence showing that healthcare organisations that take part in research demonstrate better performance. However, most evidence derives from hospital settings and these findings may not extend to general practice. The relationships between research activity and outcomes across general practices in England were explored. ⋯ Similar to hospital settings, general practice research activity is associated with a range of positive outcomes, although it is difficult to claim that research is causing those improvements. This study identified no negative impacts, suggesting that research activity is something that high-quality practices are able to deliver alongside their core responsibilities. There is a need to explore ways by which additional impacts of research can be maximised.