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The use of online consultation tools for common mental health conditions in UK primary care: a qualitative interview study of patient and practitioner perspectives. 在英国初级保健中使用在线咨询工具治疗常见精神健康状况:对患者和医生观点的定性访谈研究。
IF 2.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2026-02-05 DOI: 10.1186/s12875-026-03206-8
Charlotte Archer, David Kessler, Louise Ting, Nicola Wiles, Katrina Turner
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引用次数: 0
Effect of a physical activity promotion intervention based on the transtheoretical model on blood pressure in patients with hypertension attending primary care: a randomized controlled trial. 基于跨理论模型的身体活动促进干预对参加初级保健的高血压患者血压的影响:一项随机对照试验
IF 2.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2026-02-04 DOI: 10.1186/s12875-026-03199-4
Jannett Padilla-López, Laura Torres-Duque, Sergio Muñoz, Carlos A Prado-Aguilar, Claudia I Astudillo-García, Segundo Moran, Gloria Martínez-Andrade, Jenny Vilchis-Gil, Ximena Duque
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引用次数: 0
Construction of an index system for workplace services by family doctors in China: a two-round Delphi study. 中国家庭医生工作场所服务指标体系构建:两轮德尔菲研究。
IF 2.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2026-02-03 DOI: 10.1186/s12875-026-03192-x
Jing Guo, Jiaojiao Yu, Junqiao Guo, Jiewen Xiao, Xiangyang Yan, Hong Liang, Ying Qian, Jiaoling Huang

Background: Primary health care for young and middle-aged individuals is often overlooked, with insufficient placed on workplace services provided by family doctors. This study aims to establish expert consensus on a comprehensive set of scientific and systematic indicators for workplace services provided by family doctors.

Methods: Based on prior literature and the established Structure-Process-Outcome (SPO) model, we designed two rounds of expert consultation using the Delphi method. A panel of 35 experts from diverse fields-including academia, medical institutions, and relevant health authorities-was composed, collectively possessing substantial expertise in healthcare delivery. The experts indicated their levels of agreement regarding the importance of different indicators for assessing workplace services provided by family doctors. Consensus was defined as achieving a threshold of 70% agreement.

Results: After two Delphi rounds, 42 out of 46 indicators reached high consensus, with authority coefficients > 0.7 and coefficients of variation < 0.25. Consensus on high importance (scores 7-9) ranged between 71.43% and 97.14% across four dimensions: organizational structure and management (5 indicators, 88.57%-94.29% consensus); content and form of services (17 indicators, 77.14%-94.29% consensus); synergy, incentive, and feedback mechanisms (10 indicators, 85.71%-97.14% consensus); and effectiveness of services (10 indicators, 71.43%-85.71% consensus).

Conclusions: This study establishes four dimensions and 42 potential indicators that serve as a foundational framework for assessing and improving workplace services offered by family doctors, and provide essential guidance for health management among individuals in the workplace. The high consensus achieved among experts concerning specific indicators associated with such workplace services prompts their practical implementation to provide an objective basis for evidence-based health management within workplace populations.

背景:青年和中年人的初级卫生保健往往被忽视,对家庭医生提供的工作场所服务重视不足。本研究旨在为家庭医生提供工作场所服务建立一套全面、科学、系统的指标,建立专家共识。方法:基于已有文献和建立的结构-过程-结果(SPO)模型,采用德尔菲法设计两轮专家咨询。专家组由来自不同领域的35名专家组成,包括学术界、医疗机构和相关卫生当局,他们共同拥有医疗保健服务方面的大量专业知识。专家们表示,他们对评估家庭医生提供的工作场所服务的不同指标的重要性的同意程度。共识被定义为达到70%的共识阈值。结果:经过2轮德尔菲分析,46个指标中有42个指标的权威系数为> 0.7,变异系数为> 0.7。结论:本研究建立了4个维度和42个潜在指标,可作为评估和改进家庭医生工作场所服务的基础框架,为工作场所个体健康管理提供必要的指导。专家们就与这类工作场所服务有关的具体指标达成高度共识,促使这些指标的实际实施,为工作场所人群的循证健康管理提供客观基础。
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引用次数: 0
Incidence of hyperkalaemia and major creatinine elevation after renin-angiotensin system inhibitor initiation in a Singapore primary care cohort. 在新加坡初级保健队列中,肾素血管紧张素系统抑制剂启动后高钾血症和主要肌酐升高的发生率。
IF 2.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2026-02-02 DOI: 10.1186/s12875-026-03195-8
Michael Warren Lim, Anna Szücs, Desmond Ong, Stephanie C C Van Der Lubbe

Background: Renin-angiotensin system inhibitors (RASis), including ACE inhibitors (ACEis) and angiotensin receptor blockers (ARBs), are commonly initiated in primary care for various clinical indications. However, the risk of hyperkalaemia and increased serum creatinine levels after initiation has not been well studied in Asian populations.

Methods: We conducted a retrospective cohort study of all patients aged 18 years and older who initiated RASi treatment at National University Polyclinics, a network of seven primary care clinics in Singapore, between 28 September 2020 and 31 June 2024. The study outcomes were the incidence of hyperkalaemia and elevated serum creatinine levels after RASi initiation. Multivariable regression was used to evaluate the covariates associated with these outcomes.

Results: The cohort comprised 9,926 patients whose baseline creatinine and post-initiation creatinine or potassium data were available. Within our cohort, 181 patients (1.8%) had hyperkalaemia, comprising 149 (1.5%) mild cases, 28 (0.3%) moderate cases and 4 (< 0.1%) severe cases; 249 (2.5%) patients had a major elevation in serum creatinine of 30% or more from baseline. Risk factors for hyperkalaemia include age, Indian or 'Other' ethnicity, increased baseline serum creatinine and increased baseline serum potassium. For major serum creatinine elevation, risk factors included 'Other' ethnicity, comorbid diabetes mellitus and concomitant diuretic use.

Conclusion: Hyperkalaemia and major serum creatinine elevation are uncommon adverse events following RASi initiation.

背景:肾素-血管紧张素系统抑制剂(RASis),包括ACE抑制剂(ACEis)和血管紧张素受体阻滞剂(ARBs),通常在初级保健中用于各种临床适应症。然而,在亚洲人群中,高钾血症和血清肌酐水平升高的风险尚未得到很好的研究。方法:我们对2020年9月28日至2024年6月31日期间在新加坡国立大学综合诊所(由7家初级保健诊所组成的网络)接受RASi治疗的所有18岁及以上患者进行了回顾性队列研究。研究结果是RASi开始后高钾血症的发生率和血清肌酐水平升高。使用多变量回归来评估与这些结果相关的协变量。结果:该队列包括9,926例基线肌酐和起始后肌酐或钾数据可用的患者。在我们的队列中,181例(1.8%)患者患有高钾血症,其中149例(1.5%)轻度病例,28例(0.3%)中度病例和4例(结论:高钾血症和血清肌酐升高是RASi开始后罕见的不良事件。
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引用次数: 0
Managing diagnostic uncertainty in primary care: a mixed-methods study of family physicians' experiences in Türkiye. 初级保健诊断的不确定性管理:<s:1>基耶家庭医生经验的混合方法研究。
IF 2.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2026-02-02 DOI: 10.1186/s12875-026-03196-7
Mehmet Akif Nas, Harun Karahan, Ersan Gürsoy
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引用次数: 0
Investigating predictive factors of participation in colorectal cancer screening based on the Preventive Health Model (PHM) and health literacy. 基于预防健康模式(PHM)和健康素养调查参与结直肠癌筛查的预测因素。
IF 2.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2026-02-02 DOI: 10.1186/s12875-026-03203-x
Maryam Mohammadi, Sahar Mohammadnabizadeh
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引用次数: 0
From 'quarterback' to 'coach': the policy implications of family physicians' evolving role in team-based care. 从“四分卫”到“教练”:家庭医生在团队护理中角色演变的政策含义。
IF 2.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2026-01-31 DOI: 10.1186/s12875-026-03202-y
Myles Leslie, Anita McDonald

Background: Project Colourful, an innovative model for delivering team-based care and improving access to family physicians at a specific Canadian clinic, provided a window on how physician-led primary care teams are evolving. Colourful allowed an action research team to draw out broadly applicable policy lessons as family physicians moved from exclusively 'quarterbacking' direct patient care to also taking on a more off-field role as 'coaches' of registered nurses.

Methods: Participant observations (n = 12) of Colourful's design and implementation were supplemented with semi-structed interviews (n = 11) that focused on the project's origins; plans for scaling; and interprofessional teamwork issues. Transcribed interviews were analysed using an interpretive descriptive approach.

Results: The shift from quarterback to coach requires not only payment reform, but cultural change and training for physicians and other team members. Specific training here focuses on developing human resource skills and capacities that span: hiring, scope-of practice education, team dynamics, team member retention, and change management.

Conclusions: Key support, resource, and governance considerations for policy makers looking to scale care models like Colourful include education to: flatten traditional interprofessional hierarchies; enable the communication required for successful teamwork; as well as, bolster the HR skills of physician coaches; ensure an optimized interprofessional mix; and empower team members to renegotiate scopes of practice at clinical and provincial levels.

背景:“多彩项目”是一种创新模式,旨在提供基于团队的护理,并改善在加拿大特定诊所获得家庭医生的机会,它为了解医生领导的初级保健团队如何发展提供了一个窗口。随着家庭医生从专门负责直接病人护理的“四分卫”转变为在场外扮演注册护士“教练”的角色,五颜六色让一个行动研究小组得出了广泛适用的政策教训。方法:参与者观察(n = 12)的设计和实施,辅以半结构化访谈(n = 11),重点关注项目的起源;扩展计划;以及跨专业团队合作问题。使用解释性描述方法对记录的访谈进行分析。结果:从四分卫到教练的转变不仅需要薪酬改革,还需要文化变革和对医生和其他团队成员的培训。这里的具体培训侧重于开发人力资源技能和能力,包括:招聘、实践范围教育、团队动态、团队成员保留和变更管理。结论:政策制定者在寻求扩大像五颜六色这样的护理模式时,需要考虑的关键支持、资源和治理因素包括教育,以扁平化传统的跨专业等级;进行团队合作所需的沟通;同时,加强医师教练的人力资源技能;确保最佳的跨专业组合;并授权团队成员在临床和省级层面重新协商实践范围。
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引用次数: 0
The predictive value of complete blood count and the systemic immune-inflammation index (SII) for diagnosing malignancy in patients undergoing colonoscopy. 全血细胞计数和全身免疫炎症指数(SII)对结肠镜检查患者恶性肿瘤诊断的预测价值。
IF 2.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2026-01-31 DOI: 10.1186/s12875-026-03189-6
İrem Güzelyüz Bodur, Ufuk Ünlü, Bülent Koca, Abdullah Özgür Yeniova, Reşit Doğan Köseoğlu
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引用次数: 0
Increasing community orientation of primary care health professionals: analysis of the training plan of a community health strategy. 加强初级保健保健专业人员的社区导向:社区保健战略培训计划分析。
IF 2.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2026-01-31 DOI: 10.1186/s12875-026-03198-5
Marta Domínguez-García, Begoña Vilches-Urrutia, Natalia Enríquez-Martín, María Luz Lou-Alcaine, Bárbara Oliván-Blázquez, Rosa Magallón-Botaya, Elena Melús-Palazón, Carmen Belén Benedé-Azagra
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引用次数: 0
Development and validation of a machine learning based suitability assessment model for primary healthcare facilities in metropolitan China. 基于机器学习的中国大城市初级卫生保健设施适宜性评估模型的开发与验证。
IF 2.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2026-01-30 DOI: 10.1186/s12875-026-03194-9
Xin Huang, Qingqing Zhou, Zhenzhen Zhu, Jingya Zhang, Liqun Wu, Weilin Zhu, Qiannan Tian, Xin Liu, Ning Zhang, Junyao Zheng, Fang Du, Huatang Zeng, Bin Zhu
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BMC primary care
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