cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.27926878
title: Setting targets for antibiotic use in general practice in Europe: A scoping review

description: National Action Plans (NAPs) aim to address antimicrobial resistance (AMR) understanding and awareness but struggle to translate targets into clinically relevant guidance for general practice. To identify and map antibiotic use targets in European general practice and explore if and how these targets are linked to NAPs. A systematic search was carried out in MEDLINE (OVID), EMBASE and SCOPUS, with additional manual searches. The research questions were: What are existing targets for antibiotic use in general practice in the 31 European countries? and How are these targets linked to the NAPs on AMR?. The results are presented narratively. 77 reports were included, of which 33 focused on national targets and general practice or linking national and local targets. Reports describe local strategies to achieve targets, such as prescriber feedback, benchmarking systems and financial incentives. However, these reports provide aggregated targets for general practice, such as a percentage reduction of antibiotics prescribed. These targets are set in general, for a specific type of antibiotic, for an amount per number of patients, in defined daily doses or items. None of the reports translate national targets into clinically relevant or practical targets for general practitioners. Most European countries have an NAP with established targets, but the type and implementation of these targets vary between nations. Translating national targets into daily clinical practice is challenging and often lacks the involvement of prescribers. Aligning national and local targets would enhance coherence and more effectively contribute to improvements in antibiotic use. Translating targets into daily clinical practice is challenging and often lacks the involvement and input of prescribers. Future research should prioritise collaborations with GPs for setting antibiotic use targets in general practice and development into clinically relevant and practical targets that align with NAP targets.
DOI: 10.6084/m9.figshare.27926878.v1
title: Setting targets for antibiotic use in general practice in Europe: A scoping review

description: National Action Plans (NAPs) aim to address antimicrobial resistance (AMR) understanding and awareness but struggle to translate targets into clinically relevant guidance for general practice. To identify and map antibiotic use targets in European general practice and explore if and how these targets are linked to NAPs. A systematic search was carried out in MEDLINE (OVID), EMBASE and SCOPUS, with additional manual searches. The research questions were: What are existing targets for antibiotic use in general practice in the 31 European countries? and How are these targets linked to the NAPs on AMR?. The results are presented narratively. 77 reports were included, of which 33 focused on national targets and general practice or linking national and local targets. Reports describe local strategies to achieve targets, such as prescriber feedback, benchmarking systems and financial incentives. However, these reports provide aggregated targets for general practice, such as a percentage reduction of antibiotics prescribed. These targets are set in general, for a specific type of antibiotic, for an amount per number of patients, in defined daily doses or items. None of the reports translate national targets into clinically relevant or practical targets for general practitioners. Most European countries have an NAP with established targets, but the type and implementation of these targets vary between nations. Translating national targets into daily clinical practice is challenging and often lacks the involvement of prescribers. Aligning national and local targets would enhance coherence and more effectively contribute to improvements in antibiotic use. Translating targets into daily clinical practice is challenging and often lacks the involvement and input of prescribers. Future research should prioritise collaborations with GPs for setting antibiotic use targets in general practice and development into clinically relevant and practical targets that align with NAP targets.
DOI: 10.6084/m9.figshare.25499177
title: Moving forward after the COVID-19 pandemic: Lessons learned in primary care from the multi-country PRICOV-19 study

description: The COVID-19 pandemic has accentuated the indispensable role of primary care. <b>Objectives:</b> Recognising this, the PRICOV-19 study investigated how 5,489 GP practices across 38 countries (Austria, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Israel, Italy, Kosovo*, Latvia, Lithuania, Luxembourg, Malta, Republic of Moldova, Netherlands, North Macedonia, Norway, Poland, Portugal, Romania, Serbia, Slovenia, Spain, Sweden, Switzerland, Turkey, Ukraine, and United Kingdom) adapted their care delivery during the pandemic. Based on a series of discussions on the results of the PRICOV-19 study group, eight recommendations to enhance primary care’s preparedness for future crises were formulated and endorsed by EQuiP and WONCA Europe. The recommendations underscore the importance of recognising and sustaining the substantial strides made in patient safety within GP practices during the pandemic in current daily practices; acknowledging and supporting the pivotal role of GP practices in addressing health inequalities during crises; adopting interprofessional care models to enhance practices’ resilience and adaptability to change; supporting training practices; creating healthy working environments; investing in infrastructure that supports adequate and safe care; and increasing funding for research on patient safety and primary care quality to inform evidence-based health policies and fostering international knowledge exchange among healthcare professionals and policymakers. Policymakers, primary care associations, and the broader healthcare system are urged to collaboratively take responsibility and increase support for GP practices to enhance their resilience, adaptability, and capacity to deliver safe and equitable healthcare during future crises. Governments should recognise the critical role of family medicine in addressing inequity and prioritise carers’ wellbeing to maintain quality care during crises. Associations for practitioners should lead in crisis management developments and advocate for primary care. PC facilities should participate in health system design to answer challenges posed by crises.
DOI: 10.6084/m9.figshare.25499177.v1
title: Moving forward after the COVID-19 pandemic: Lessons learned in primary care from the multi-country PRICOV-19 study

description: The COVID-19 pandemic has accentuated the indispensable role of primary care. <b>Objectives:</b> Recognising this, the PRICOV-19 study investigated how 5,489 GP practices across 38 countries (Austria, Belgium, Bosnia and Herzegovina, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Israel, Italy, Kosovo*, Latvia, Lithuania, Luxembourg, Malta, Republic of Moldova, Netherlands, North Macedonia, Norway, Poland, Portugal, Romania, Serbia, Slovenia, Spain, Sweden, Switzerland, Turkey, Ukraine, and United Kingdom) adapted their care delivery during the pandemic. Based on a series of discussions on the results of the PRICOV-19 study group, eight recommendations to enhance primary care’s preparedness for future crises were formulated and endorsed by EQuiP and WONCA Europe. The recommendations underscore the importance of recognising and sustaining the substantial strides made in patient safety within GP practices during the pandemic in current daily practices; acknowledging and supporting the pivotal role of GP practices in addressing health inequalities during crises; adopting interprofessional care models to enhance practices’ resilience and adaptability to change; supporting training practices; creating healthy working environments; investing in infrastructure that supports adequate and safe care; and increasing funding for research on patient safety and primary care quality to inform evidence-based health policies and fostering international knowledge exchange among healthcare professionals and policymakers. Policymakers, primary care associations, and the broader healthcare system are urged to collaboratively take responsibility and increase support for GP practices to enhance their resilience, adaptability, and capacity to deliver safe and equitable healthcare during future crises. Governments should recognise the critical role of family medicine in addressing inequity and prioritise carers’ wellbeing to maintain quality care during crises. Associations for practitioners should lead in crisis management developments and advocate for primary care. PC facilities should participate in health system design to answer challenges posed by crises.
DOI: 10.6084/m9.figshare.25714412
title: Development and validation of a risk prediction model for hospital admission in COVID-19 patients presenting to primary care

description: There is a paucity of prognostic models for COVID-19 that are usable for in-office patient assessment in general practice (GP). To develop and validate a risk prediction model for hospital admission with readily available predictors. A retrospective cohort study linking GP records from 8 COVID-19 centres and 55 general practices in the Netherlands to hospital admission records. The development cohort spanned March to June 2020, the validation cohort March to June 2021. The primary outcome was hospital admission within 14 days. We used geographic leave-region-out cross-validation in the development cohort and temporal validation in the validation cohort. In the development cohort, 4,806 adult patients with COVID-19 consulted their GP (median age 56, 56% female); in the validation cohort 830 patients did (median age 56, 52% female). In the development and validation cohort respectively, 292 (6.1%) and 126 (15.2%) were admitted to the hospital within 14 days, respectively. A logistic regression model based on sex, smoking, symptoms, vital signs and comorbidities predicted hospital admission with a c-index of 0.84 (95% CI 0.83 to 0.86) at geographic cross-validation and 0.79 (95% CI 0.74 to 0.83) at temporal validation, and was reasonably well calibrated (intercept −0.08, 95% CI −0.98 to 0.52, slope 0.89, 95% CI 0.71 to 1.07 at geographic cross-validation and intercept 0.02, 95% CI −0.21 to 0.24, slope 0.82, 95% CI 0.64 to 1.00 at temporal validation). 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. A general practice prediction model based on signs and symptoms of COVID-19 patients reliably predicted hospitalisation. The model performed well in second-wave data with other dominant variants and changed testing and vaccination policies. In an emerging pandemic, GP data can be leveraged to develop prognostic models for decision support and to predict hospitalisation rates.
DOI: 10.6084/m9.figshare.25714412.v1
title: Development and validation of a risk prediction model for hospital admission in COVID-19 patients presenting to primary care

description: There is a paucity of prognostic models for COVID-19 that are usable for in-office patient assessment in general practice (GP). To develop and validate a risk prediction model for hospital admission with readily available predictors. A retrospective cohort study linking GP records from 8 COVID-19 centres and 55 general practices in the Netherlands to hospital admission records. The development cohort spanned March to June 2020, the validation cohort March to June 2021. The primary outcome was hospital admission within 14 days. We used geographic leave-region-out cross-validation in the development cohort and temporal validation in the validation cohort. In the development cohort, 4,806 adult patients with COVID-19 consulted their GP (median age 56, 56% female); in the validation cohort 830 patients did (median age 56, 52% female). In the development and validation cohort respectively, 292 (6.1%) and 126 (15.2%) were admitted to the hospital within 14 days, respectively. A logistic regression model based on sex, smoking, symptoms, vital signs and comorbidities predicted hospital admission with a c-index of 0.84 (95% CI 0.83 to 0.86) at geographic cross-validation and 0.79 (95% CI 0.74 to 0.83) at temporal validation, and was reasonably well calibrated (intercept −0.08, 95% CI −0.98 to 0.52, slope 0.89, 95% CI 0.71 to 1.07 at geographic cross-validation and intercept 0.02, 95% CI −0.21 to 0.24, slope 0.82, 95% CI 0.64 to 1.00 at temporal validation). 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. A general practice prediction model based on signs and symptoms of COVID-19 patients reliably predicted hospitalisation. The model performed well in second-wave data with other dominant variants and changed testing and vaccination policies. In an emerging pandemic, GP data can be leveraged to develop prognostic models for decision support and to predict hospitalisation rates.
DOI: 10.6084/m9.figshare.26048257
title: ‘Male cystitis does not exist’: A qualitative study of general practitioners’ experiences and management of male urinary tract infections in France

description: Male urinary tract infections (mUTIs) are rare in primary care. The definition of mUTIs varies across countries. The therapeutic management of mUTIs in France is based on a 14-day course of fluoroquinolones despite a high risk of antimicrobial resistance. The objective of this qualitative study was to explore general practitioners’ (GPs) experiences and behaviours regarding the diagnostic and therapeutic management of mUTIs. GPs were recruited by convenience sampling in Haute Normandie (France) and interviewed individually with semi-structured guides. GPs’ experiences and behaviours were recorded and analysed using an interpretive phenomenological approach. From March 2021 to May 2022, 20 GPs were included in the study. Defining a mUTI was perceived as a diagnostic challenge. A diagnosis based on clinical evidence alone was insufficient and complementary tests were required. For GPs: ‘male cystitis does not exist’. A mUTI was considered an unusual disease that could reveal an underlying condition. GPs considered fluoroquinolones to be ‘potent’ antibiotics and treated all patients with the same 14-day course. GPs implemented improvement strategies for antibiotic stewardship and followed the guidelines using a computerised decision support system. GPs’ experiences of mUTIs are limited due to low exposure and variable clinical presentations in primary care, representing a diagnostic and therapeutic challenge. In order to modify GPs’ antibiotic prescribing behaviours, a paradigm shift in the guidelines will need to be proposed.
KEY MESSAGESDefining a male urinary tract infection represents a diagnostic challenge for GPs.A diagnosis based on clinical evidence alone is insufficient and complementary tests are required.A male urinary tract infection is an unusual disease in primary care and suggests a more serious underlying condition. Defining a male urinary tract infection represents a diagnostic challenge for GPs. A diagnosis based on clinical evidence alone is insufficient and complementary tests are required. A male urinary tract infection is an unusual disease in primary care and suggests a more serious underlying condition.
DOI: 10.6084/m9.figshare.26048257.v1
title: ‘Male cystitis does not exist’: A qualitative study of general practitioners’ experiences and management of male urinary tract infections in France

description: Male urinary tract infections (mUTIs) are rare in primary care. The definition of mUTIs varies across countries. The therapeutic management of mUTIs in France is based on a 14-day course of fluoroquinolones despite a high risk of antimicrobial resistance. The objective of this qualitative study was to explore general practitioners’ (GPs) experiences and behaviours regarding the diagnostic and therapeutic management of mUTIs. GPs were recruited by convenience sampling in Haute Normandie (France) and interviewed individually with semi-structured guides. GPs’ experiences and behaviours were recorded and analysed using an interpretive phenomenological approach. From March 2021 to May 2022, 20 GPs were included in the study. Defining a mUTI was perceived as a diagnostic challenge. A diagnosis based on clinical evidence alone was insufficient and complementary tests were required. For GPs: ‘male cystitis does not exist’. A mUTI was considered an unusual disease that could reveal an underlying condition. GPs considered fluoroquinolones to be ‘potent’ antibiotics and treated all patients with the same 14-day course. GPs implemented improvement strategies for antibiotic stewardship and followed the guidelines using a computerised decision support system. GPs’ experiences of mUTIs are limited due to low exposure and variable clinical presentations in primary care, representing a diagnostic and therapeutic challenge. In order to modify GPs’ antibiotic prescribing behaviours, a paradigm shift in the guidelines will need to be proposed.
KEY MESSAGESDefining a male urinary tract infection represents a diagnostic challenge for GPs.A diagnosis based on clinical evidence alone is insufficient and complementary tests are required.A male urinary tract infection is an unusual disease in primary care and suggests a more serious underlying condition. Defining a male urinary tract infection represents a diagnostic challenge for GPs. A diagnosis based on clinical evidence alone is insufficient and complementary tests are required. A male urinary tract infection is an unusual disease in primary care and suggests a more serious underlying condition.
DOI: 10.6084/m9.figshare.28000314
title: Development of the face-to-face component and recruitment strategy of a primary care digital social intervention for patients with asthma: Qualitative focus groups and interviews with stakeholders

description: 5.4 million people in the UK have asthma, with one third experiencing suboptimal control, leading to co-morbidities and increased healthcare use. A quarter of people with long-term conditions informally access peer support through online health communities (OHCs). However, integrating online peer support into primary care services to facilitate self-management is a new concept. To develop together with stakeholders the content, delivery, and recruitment strategy of a digital social intervention to promote use of online peer support amongst asthma patients in primary care. Data was collected by qualitative, audio-recorded, one-to-one interviews with clinicians, and focus groups with patients with asthma from East London general practices. The topic guide was informed by patient and public involvement work. Data collected was iterative (i.e. new ideas were added to subsequent interviews and focus groups). Verbatim transcripts were uploaded to NVivo12 and thematically analysed. Twenty patients from several ethnicities participated across five focus groups, and three general practitioners and three practice nurses were interviewed. The study’s outputs included: the intervention’s face-to-face content; content of clinician training; patient-facing leaflets/material; and a survey to recruit eligible patients. An intervention consisting of a structured consultation with a primary care clinician followed by OHC engagement, was developed based on three generated themes: ‘introducing OHCs’, describing how clinicians should introduce OHCs; ‘OHC engagement’, describing factors influencing OHC engagement; and ‘clinician training’. Findings will assist clinicians in consultations about supporting self-management of patients through OHCs. Future research should evaluate feasibility, effectiveness, and cost-effectiveness of such support. Promoting online peer support in primary care consultations is a novel concept. The study developed the content of a digital social intervention for patients with asthma. The findings of the current study will inform primary care clinicians’ consultations on digital social interventions and will be tested in a trial.
DOI: 10.6084/m9.figshare.28000314.v1
title: Development of the face-to-face component and recruitment strategy of a primary care digital social intervention for patients with asthma: Qualitative focus groups and interviews with stakeholders

description: 5.4 million people in the UK have asthma, with one third experiencing suboptimal control, leading to co-morbidities and increased healthcare use. A quarter of people with long-term conditions informally access peer support through online health communities (OHCs). However, integrating online peer support into primary care services to facilitate self-management is a new concept. To develop together with stakeholders the content, delivery, and recruitment strategy of a digital social intervention to promote use of online peer support amongst asthma patients in primary care. Data was collected by qualitative, audio-recorded, one-to-one interviews with clinicians, and focus groups with patients with asthma from East London general practices. The topic guide was informed by patient and public involvement work. Data collected was iterative (i.e. new ideas were added to subsequent interviews and focus groups). Verbatim transcripts were uploaded to NVivo12 and thematically analysed. Twenty patients from several ethnicities participated across five focus groups, and three general practitioners and three practice nurses were interviewed. The study’s outputs included: the intervention’s face-to-face content; content of clinician training; patient-facing leaflets/material; and a survey to recruit eligible patients. An intervention consisting of a structured consultation with a primary care clinician followed by OHC engagement, was developed based on three generated themes: ‘introducing OHCs’, describing how clinicians should introduce OHCs; ‘OHC engagement’, describing factors influencing OHC engagement; and ‘clinician training’. Findings will assist clinicians in consultations about supporting self-management of patients through OHCs. Future research should evaluate feasibility, effectiveness, and cost-effectiveness of such support. Promoting online peer support in primary care consultations is a novel concept. The study developed the content of a digital social intervention for patients with asthma. The findings of the current study will inform primary care clinicians’ consultations on digital social interventions and will be tested in a trial.