The European journal of general practice
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Transgender and nonbinary (TNB) people face barriers to primary care, which remains the main entry point for accessing gender-affirming healthcare in the UK. ⋯ This review demonstrates TNB people's mixed experiences of primary care alongside their recommendations for service improvement. This is the first systematically reviewed evidence on the topic, emphasising the need for clinicians and policymakers to centre the voices of the TNB community in service design and improvement.
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Task shifting from general practitioners (GPs) to other health professionals could solve the increased workload, but an overview of the evidence is lacking for out-of-hours primary care (OOH-PC). ⋯ The level of safety and efficiency of care provided by other health professionals in OOH-PC seems like that of GPs, although they mainly see patients presenting with less urgent and less complex health problems.
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Review Case Reports
Navigating sarcoidosis: Recognizing, managing, and supporting patients in primary care.
Sarcoidosis is a chronic multisystem inflammatory disease of unknown aetiology, characterised by noncaseating granulomas and a variable clinical presentation. Despite its global distribution, sarcoidosis is relatively rare, with the highest prevalence in northern Europe. This poses challenges for primary care physicians due to its broad spectrum of symptoms, from organ-specific manifestations to general complaints like fatigue and concentration difficulties. ⋯ Primary care physicians play a critical role in managing sarcoidosis, particularly in early recognition and monitoring. Given the absence of standardised treatment protocols, a flexible, holistic approach that includes psychosocial support is essential. This article provides a practical framework for general practitioners to address the challenges of sarcoidosis management and improve patient outcomes.
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There is a paucity of prognostic models for COVID-19 that are usable for in-office patient assessment in general practice (GP). ⋯ We derived a risk model using readily available variables at GP assessment to predict hospital admission for COVID-19. It performed accurately across regions and waves. Further validation on cohorts with acquired immunity and newer SARS-CoV-2 variants is recommended.
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Reducing avoidable hospital admissions is a global healthcare priority, with optimal primary care recognised as pivotal for achieving this objective. However, in developing systems like China, where primary care is evolving without compulsory gatekeeping, the relationship between patient-perceived primary care quality and hospital utilisation remains underexplored. ⋯ Enhanced patient-perceived quality of primary care in China is associated with a reduction in self-reported overall hospital utilisation, including outpatient visits and hospital admissions. However, better continuity of care may be associated with increased ED visits. Further research is warranted for precise insights and validation of these findings.