The British journal of general practice : the journal of the Royal College of General Practitioners
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Advance care planning is rare among older adults with a migration background because of social, cultural, and religious reasons. ⋯ Healthcare providers in Belgium should provide tailored information about advance care planning to Turkish-origin adults with palliative care needs. Advance care planning discussions should also explore the individual's health-related knowledge and personal values, paying attention to social and religious cues. Healthcare professionals should also recognise the salience of Turkish families in end-of-life care.
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Treatment-resistant depression (TRD) is when antidepressants do not work and affects 55% of British primary care users with depression. People with TRD should be referred to secondary care but there are long wait times. This means most people are managed by GPs, but primary care guidelines are not standardised. Thus, how GPs manage people with TRD may vary, and there is limited evidence for how quality care may look. As a result of this variation, an investigation into how GPs manage people might be valuable. ⋯ TRD can be a contested diagnosis in the same way as ADHD, ME, and long-COVID. GP training and continuing professional development may support GP awareness of TRD and help them in confidently making the diagnosis.
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Diagnosing cancer early is crucial in improving patient outcomes. Primary care networks are encouraged to audit routes to cancer diagnosis, as suggested by the Network Contract Directed Enhanced Service Early Cancer Diagnosis Guidance. ⋯ It is promising that the majority of cancers are diagnosed through 2WW and screening; however, improving patient engagement, streamlining referrals, and thorough clinical examination and documentation will reduce delayed or missed diagnoses.
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Almost every patient and every healthcare condition are seen within primary care, but research is not yet embedded in general practice in the same way it is in secondary care. There is no well-defined pathway for a career combining research delivery and active clinical general practice. ⋯ National recognition for education on research has been achieved and a career pathway for GPs to train in and then work in research has been established. This will help embed research expertise and interest within primary care. This should increase research delivery and hence a cycle of increased research funding for further similar posts.
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Medication reviews are considered an opportunity for reducing polypharmacy. However, there is little evidence about their impact in a real-world setting. ⋯ Although a majority (>50%) of people had a recorded medication review in 2019, these reviews had a small overall impact on polypharmacy in this study population.