British Journal of General Practice最新文献

Background: Despite epidemiological data on anaemia being available on a global scale, the prevalence of anaemia in the UK is not well described.

Aim: To describe anaemia prevalence and testing patterns for haemoglobin and other blood parameters.

Design and setting: This study was a descriptive population-based cohort study using data drawn from the Clinical Practice Research Datalink Aurum database in 2019.

Method: Demographic data were extracted for each person who was registered at their current practice during 2019, including linked data on Index of Multiple Deprivation. Anaemia prevalence in 2019 was calculated based on World Health Organization-specified age and gender thresholds for haemoglobin. Anaemia was classified based on mean corpuscular volume and ferritin. People with anaemia were followed up for up to 1 year to investigate longitudinal testing patterns for haemoglobin.

Results: The cohort contained 14 million people. Anaemia prevalence in England in 2019 was 4.1% (583 847/14 207 841) (5.1% [363 438/7 121 614] females and 3.1% [220 409/7 086 227] males). Prevalence was higher in people aged >65 years, people of Black and Asian ethnicities, and people living in areas with higher social deprivation. Only half of people with anaemia and a mean corpuscular volume of ≤100 fL had an accompanying ferritin value recorded. About half of people with anaemia had a follow-up haemoglobin test within 1 year, most of which still indicated anaemia.

Conclusion: Anaemia is prevalent in the UK with large disparities between levels of demographic variables. Investigation and follow-up of anaemia is suboptimal in many patients. Health interventions aimed at improving anaemia investigation and treatment are needed, particularly in the most at-risk groups.

Background: Clinical guidance recommends promoting physical activity during general practice consultations. The frequency and content of physical activity discussions in UK general practice are poorly understood.

Aim: To explore the content of physical activity discussions during routine consultations between patients and GPs.

Design and setting: Secondary analysis was undertaken of video-recorded UK general practice consultations from the One in a Million study, which was conducted in the West of England.

Method: In total, 294 consultation transcripts were available; these were screened to identify consultations that included or omitted physical activity advice when recommended by National Institute for Health and Care Excellence guidance. The content, quality, and depth of advice provided by GPs were scored to ascertain how meaningful the advice was.

Results: Physical activity was relevant to management according to clinical guidance in 175/294 (59.5%) consultations. In 64 (36.6%) of these consultations, physical activity was discussed as part of clinical management; the depth of discussion was judged as 'meaningful' in 22 (12.6%) consultations. Although physical activity advice tended to be given most often for musculoskeletal problems, depth of advice did not appear to be related to the presenting problem. When physical activity advice was relevant and omitted, consultations prioritised another overriding presenting problem, or clinical management focused on another intervention.

Conclusion: Physical activity advice, following national guidance, was potentially relevant to more than half of GP consultations; GPs delivered advice of varying depth in a third of these consultations. Future work should explore ways of delivering physical activity advice effectively, efficiently, and equitably within the constraints of general practice.