Podcasts about bjgp

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this edition, we look at three new pieces of research.First, in the BMJ, a paper exploring whether a GP-led psychological intervention can help PTSD symptoms in our patients after ICU. Could this also be successful for other forms of trauma?Second, in the Lancet, research looking at whether semaglutide can improve walking distance in patients with diabetes and intermittent claudication.Finally, in the BJGP, can a practice-led physical activity intervention improve symptoms in survivors of cancer? Will anyone actually want to do it? The answer, and who, may surprise you.ReferencesPoor by Katriona O'SullivanBMJ PTSD paperLancet GLP1ra and PADBJGP Physical activity and cancer survivorsMoving Medicinewww.nbmedical.com/podcast

Send us a textGrab your trainers, your dog lead, your gardening clothes or a cuppa and join us for some free CPD as we have another relaxed round up of recent Red Whale primary care Pearls of wisdom.  In the first of two episodes this month, Fiona and Nik discuss: Anabolic steroid use. Body image concerns and pursuing an increasingly muscular appearance is becoming a growing issue, particularly for men and boys. Nature… so important that we should prescribe it? Yes! Special guest Hussain Al-Zubaidi joins us to talk about the power of nature and green social prescribing in transforming patient health.Listen as soon as you can to ensure you have full access to all the free resources. The rest of the Pearls from March will be covered next week along with a new best intentions story to put a smile on your face.Anabolic steroid useBJGP 2015;65:626 BJGP 2024;74(741):187 BMJ 10-minute consultation (BMJ 2016;355:i5023) Green social prescribingThe National Academy for Social Prescribing:Full toolkit on green social prescribing RCGP - parkrun practice initiative VideosRed Whale Knowledge - green social prescribing Send us your feedback podcast@redwhale.co.uk or send a voice message Sign up to receive Pearls here. Pearls are available for 3 months from publish date. After this, you can get access them plus 100s more articles when you buy a one-day online course from Red Whale OR sign up to Red Whale Unlimited. Find out more here. Follow us: X, Facebook, Instagram, LinkedInDisclaimer: We make every effort to ensure the information in this podcast is accurate and correct at the date of publication, but it is of necessity of a brief and general nature, and this should not replace your own good clinical judgement, or be regarded as a substitute for taking professional advice in appropriate circumstances. In particular, check drug doses, side-effects and interactions with the British National Formulary. Save insofar as any such liability cannot be excluded at law, we do not accept any liability for loss of any type caused by reliance on the information in this podcast....

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we are joined by Dr Stephen Bradley, lead author of a new paper published in the BJGP looking at rates of CXR use in general practice and how this influences lung cancer stage at diagnosis and mortality. He discusses the findings of his research and how this might influence our practice. In other research, we look at a new paper in the BMJ on orthostatic HYPERtension - yes, you read that correctly - does treatment help, and does it really matter in the first place? And from the Lancet, research looking at the role of urodynamic studies in women with refractory overactive bladder - does it improve outcomes, or should it be stopped?ReferencesBMJ Orthostatic hypertension and BP treatmentBMJ OH editorialLancet Refractory overactive bladder & urodynamic studiesBJGP CXR in GP & lung cancer staging and mortalitywww.nbmedical.com/podcast

Today, we're going to do something a bit different and take a look back at the recent BJGP Research Conference, which was held on the 21st of March 2025 in Manchester. I'm going to discuss some of the highlights and really focus on what the conference is about and how to get involved in the future.Here are some of the links I discussed in the podcast:Linkshttps://journals.sagepub.com/doi/full/10.1177/1609406918797475https://bjgplife.com/write-for-bjgp-life/

Today, we're speaking to Dr Louise Clarke, a GP and researcher based at the University of Nottingham.Title of paper: Barriers to diagnosing and treating vulval lichen sclerosus: a survey studyAvailable at: https://doi.org/10.3399/BJGP.2024.0360Previous research has identified a significant diagnostic delay and misdiagnosis of vulval lichen sclerosus (VLS), a condition most commonly presenting to primary care. Health care professionals (HCPs) in primary care share the concerns of women with VLS citing frequent misdiagnosis, embarrassment and lack of knowledge as barriers to diagnosis. In this survey, 92.6% of HCPs felt further education would be useful with 37.7% never having participated in learning on vulval skin disease, self-directed or otherwise. Key enablers identified to facilitate timely VLS diagnosis and treatment include: a comprehensive education programme for HCPs, implementation of standardised pathways of care and development of a VLS diagnostic criteria to be implemented in primary care workflow.

Today, we're speaking to Dr Victoria Tzortziou Brown, a GP and Reader in Primary Healthcare and Health Policy at Queen Mary University of London, and Vice Chair for External Affairs at the Royal College of General Practitioners.Title of paper: Language of primary medical qualification and differential MRCGP exam attainment: an observational studyAvailable at: https://doi.org/10.3399/BJGP.2024.0296To the authors' knowledge, this is the first study on the association between the language of the primary medical qualification and attainment in the Membership of the Royal College of General Practitioners (MRCGP) examination. It shows that undertaking undergraduate clinical training in a country where the native language is not English can statistically significantly and negatively affect examination performance in MRCGP exams. The study also shows statistically significant positive correlations between Multi- Specialty Recruitment Assessment, International English Language Testing System, and Professional and Linguistic Assessments Board scores and the MRCGP exam scores; this suggests that past performance in these assessments can help with the identification of those international medical graduate registrars who may find tailored support beneficial.

Today, we're speaking to Professor Helen Atherton, Professor of Primary Care Research at the University of Southampton. Title of paper: Supporting patients to use online services in general practice: focused ethnographic case studyAvailable at: https://doi.org/10.3399/BJGP.2024.0137Use of, and access to, online services are increasing within general practice in England. Current approaches to digital facilitation as observed in this study, appeared to be ad hoc and fitted around multiple services. Reception staff were key to supporting patients to use these platforms, but training, resources and support for such staff were not readily available. Enabling patients to have the best chance of using online services requires vision, strategy and investment of time and money. As practices and patients increasingly use online approaches to healthcare provision, practices should be mindful of patient groups who may find accessing services online to be a challenge and who thus require targeted help and support.

Today, we're speaking to Dr Sam Merriel, a GP, and NIHR Academic Clinical Lecturer in General Practice based at the University of Manchester.Title of paper: Factors affecting prostate cancer detection through asymptomatic PSA testing in primary care in England: Evidence from the 2018 National Cancer Diagnosis AuditAvailable at: https://doi.org/10.3399/BJGP.2024.0376Asymptomatic, informed choice prostate specific antigen (PSA) testing occurs in primary care in the UK in the absence of a national prostate cancer screening programme. This study shows that four fifths of prostate cancers are diagnosed following symptomatic presentation rather than from asymptomatic PSA testing. There is a 13-fold variation in asymptomatic PSA test detected prostate cancer between English GP practices, without clear explanatory practice-level factors. Patient factors amongst men diagnosed with prostate cancer, including ethnicity, age, deprivation, and multi-morbidity, have a significant impact on the likelihood of being diagnosed following asymptomatic PSA testing.

Today, we're speaking to Dr Pete Edwards, a GP and NIHR Research Fellow based at the University of Bristol. Pete has published a research article in the February issue of the BJGP titled,' Safety-netting advice documentation in out-of-hours primary care: a retrospective cohort from 2013 to 2020' along with an editorial about safety netting that we're going to discuss today.Title of paper: Safety-netting advice documentation in out-of-hours primary care: a retrospective cohort from 2013 to 2020Available at: https://doi.org/10.3399/BJGP.2024.0057Title of editorial: Safety netting in primary care : managing the low incidence, high uncertainty of severe illnessAvailable at: https://doi.org/10.3399/bjgp25X740529Previous research has reported on safety-netting advice (SNA) documented in patient records during in-hours practice but this, to the authors' knowledge, is the first large-scale (>1000 consultations) longitudinal analysis of the type of safety-netting documented advice during out-of-hours (OOH) primary care. This study demonstrated an increasing frequency of documented SNA in OOH records and increasing utility of specific advice over time. In contrast to previous reports of verbalised safety-netting during in-hours practice, this study found a higher frequency of SNA in records from face-to-face compared with telephone encounters. This study also showed safety-netting advice was more likely to be documented for patients with possible infections, but less frequently for mental health consultations. That is a possible area for improvement, in line with current UK policy for ‘parity of esteem' between physical and mental health conditions.

Today, we're speaking to Professor Anne Slowther, Emeritus Professor of Clinical Ethics based at the University of Warwick.Title of paper: Experiences of using the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) in English general practice: a qualitative study among key primary health and social care professionals, patients, and their relativesAvailable at: https://doi.org/10.3399/BJGP.2024.0248The Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) is a specific model of emergency care treatment planning now used in primary care and hospitals, and in many areas of the UK. It has been evaluated in hospital settings, but little is known about how it is understood and operationalised in general practice. Our research found a consensus that ReSPECT could facilitate a person-centred approach to future treatment decision making, but there are specific challenges in implementing ReSPECT in a community setting. A revised approach needs to consider uncertainty of illness trajectories over time and to emphasise patient values to facilitate decision making in an emergency.

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. This week we look at three new pieces of research. First, we have a paper in the BMJ exploring arterial thrombosis risk with modern hormonal contraceptives including newer treatments such as the combined patch and ring. Second, we have a BJGP paper looking at which type of safety net advice is the most effective. Finally, a new paper in JAMA Internal Medicine collates trials on anti-virals for influenza. Can any of them provide genuine benefit? And don't forget our NB Plus offer - £25 discount on an annual subscription until the 17th of February.ResourcesBMJBJGPJAMAHealthier Together patient infowww.nbmedical.com/podcast

In this episode, we talk to Professor Paul Little, Professor in Primary Care Research at the University of Southampton.Title of paper: A randomised controlled trial of a digital intervention (Renewed) to support symptom management, wellbeing and quality of life in cancer survivorsAvailable at: https://doi.org/10.3399/BJGP.2023.0262There are increasing numbers of cancer survivors who have finished their primary treatment whose quality of life remains consistently poor over years. There is limited robust evidence for pragmatic, brief interventions to support cancer survivors in primary care - which is where most participants are managed, and where resources are increasingly stretched. Cancer survivors quality of life improved with detailed generic online support. Robustly developed bespoke digital support provided limited additional benefit for cancer survivors in the short term, but modest additional longer term benefit in enabling symptom management and self-rated health, and with significantly reduced costs to the health service.

It's that time of the year again! This episode, we have a round table discussion with the editorial team of Sam Merriel, Tom Round and Nada Khan. This collection of the BJGP's top 10 research most read and published in 2024 brings together high-profile primary care research and clinical innovation.And here are the top 10 most read papers of 2024:10. Patient experiences of an online consultation system: a qualitative study in English primary care post-COVID-19Available at: https://doi.org/10.3399/BJGP.2023.00769. Does shortage of GPs matter? A cross-sectional study of practice population life expectancyAvailable at: https://doi.org/10.3399/BJGP.2023.01958. Primary care provision for young people with ADHD: a multi-perspective qualitative studyAvailable at: https://doi.org/10.3399/BJGP.2023.06267. Breast cancer risk assessment for prescription of Menopausal Hormone Therapy in women who have a family history of breast cancerAvailable at: https://doi.org/10.3399/BJGP.2023.03276. Training needs for staff providing remote services in general practice: a mixed-methods studyAvailable at: https://doi.org/10.3399/BJGP.2023.02515. Long-term cardiovascular risks and the impact of statin treatment on socioeconomic inequalities: a microsimulation modelAvailable at: https://doi.org/10.3399/BJGP.2023.01984. Exploring GPs views on beta-blocker prescribing for people with anxiety disorders: a qualitative studyAvailable at: https://doi.org/10.3399/BJGP.2024.00913. Optimising the use of the prostate- specific antigen blood test in asymptomatic men for early prostate cancer detection in primary care: report from a UK clinical consensusAvailable at: https://doi.org/10.3399/BJGP.2023.05862. First Contact Physiotherapy: An evaluation of clinical effectiveness and costsAvailable at: https://doi.org/10.3399/BJGP.2023.05601. Risk of Parkinsons disease in people with New Onset Anxiety over 50 years - Incidence and Associated FeaturesAvailable at: https://doi.org/10.3399/BJGP.2023.0423

Welcome to the Hot Topics podcast with Dr Neal Tucker. This is the third in our series of special podcasts where we talk to interesting and influential people from the world of general practice.In this interview, we talk to Dr Euan Lawson, GP and editor of the BJGP. The journal will be familiar to all clinicians in general practice and has gone from strength to strength over the past few years. We talk about his career and how he became editor, discuss the world of research including the most influential papers published during his tenure, consider the importance of inclusion health in the changing face of GP, and discuss his vision for the future.And remember our recent NB Clinic in Inclusion Health can be watched on demand here.www.nbmedical.com/podcast

The BJGP podcast is back for a new season! Today, we're speaking to Professor Joanne Reeve, who is a GP and Professor of Primary Care Research at Hull York Medical School. Joanne has published an editorial in the recent January edition of the BJGP titled, ‘Standing up for general practice', and today we're going to speak about this article and what it means to be a GP. Title of paper: Standing up for general practiceAvailable at: https://doi.org/10.3399/bjgp25X740373

We're taking a break over Christmas and new year, but we'll be back at the end of January 2025 with a new BJGP podcast. Look forward to seeing you then!

Today, we're speaking to Dr Rebecca Payne and Professor Trish Greenhalgh. Rebecca is a GP and an NIHR In Practice Fellow, and works alongside Trish at the Nuffield Department of Primary Health Care Sciences at the University of Oxford. Title of paper: What are the challenges to quality in modern, hybrid general practice? A multi-site longitudinal studyAvailable at: https://doi.org/10.3399/BJGP.2024.0184Quality in primary care is a multidimensional construct embracing effectiveness, efficiency, safety, patient-centredness, equity, continuity, accessibility, and more. We report on how UK practices have striven to deliver on these aspects of quality as they move to a hybrid model that combines in-person with remote and digital care. The context for quality is currently very challenging, with resource constraints, staff shortages, and weak infrastructure. Digital systems intended to increase efficiency have produced some benefits for some people but have created new forms of inefficiency, increased fragmentation of care, contributed to staff stress, and widened inequities of access.

Today, we're speaking to Dr Dan Butler, a portfolio GP completing his PhD at Queen's University Belfast. Title of paper: “Challenging but ultimately rewarding”: A qualitative analysis of Deep End GPs' experiencesAvailable at: https://doi.org/10.3399/BJGP.2024.0167GPs working in the highest need, socioeconomically deprived areas, the “Deep End”, face additional challenges. This paper looks at the NI context and explores why, despite the challenges, GPs choose to work in these areas. The main issues relate to wider healthcare failings and the challenges of patient populations some of whom generally frequently use (‘medicalised' group) and those who underuse (‘missingness' group) health services. GPs tend to relate to ‘Deep End' areas, either due to personal connections or feelings of duty and social responsibility. No amount of General Practice focused funding will ‘solve' the issues, instead a far greater holistic approach improving the physical conditions people are born, live and work in, is needed.

Today, we're speaking to Dr Carol Sinnott, a GP and a Senior Clinical Research Associate based at The Healthcare Improvement Studies Institute. Title of paper: Understanding access to general practice through the lens of candidacy: a critical review of the literatureAvailable at: https://doi.org/10.3399/BJGP.2024.0033Dominant conceptualisations of access to health care are often framed in terms of speed and supply — these approaches risk obscuring important aspects of people's experiences of access. The Candidacy Framework was developed to study access to health care by people in vulnerable groups. This study confirms the salience of the Candidacy Framework for understanding access in the setting of general practice, offering new insights for policy and practice.

Today, we're speaking to Dr Sarah Sullivan, a Senior Research Fellow based within the Centre for Academic Mental Health at the University of Bristol. Title of paper: External validation of a prognostic model to improve prediction of psychosis in primary careAvailable at: https://doi.org/10.3399/BJGP.2024.0017This paper reports the external validation of the only psychosis risk prediction algorithm to be used in primary care. External validation of prediction algorithms is essential to provide evidence of transportability i.e. that the algorithm can be used outside its training environment. This vital step for prediction algorithms is often missed.

Welcome to the latest Hot Topics Podcast from NB Medical with Dr Neal Tucker. In this episode, we look at two new papers on the drugs de jour: GLP1 receptor agonists and SGLT2 inhibitors. Can the former reduce pain in knee osteoarthritis and can the latter prevent recurrent renal stones? Our third paper is a consensus paper published in the BJGP on optimising PSA testing for the early detection of prostate cancer in asymptomatic men. Sponsored by Prostate Cancer UK, Neal is joined by Dr Alex Norman, a GP, and Dr Oliver Hulson, a consultant radiologist who undertakes prostate biopsy, to discuss the outcomes of this paper and the latest research in this area. For further information from Prostate Cancer UK including educational resources and webinars see the links below.ReferencesNEJM Semaglutide & knee OABMJ SGLT2i & renal stonesBJGP Consensus Paper on PSA Testing in Asymptomatic MenNB Podcast on role of DRE in identifying prostate cancerPCUK Prostate Cancer Education for Health ProfessionalsPCUK Consensus Paper Webinarwww.nbmedical.com/podcast

Today, we're speaking to Dr Sophie Ansems, a GP and PhD candidate, and Dr Lianne Mulder, both based at the Department of Primary and Long-term Care at the University of Groningen in the Netherlands. Title of paper: General practitioners' perspectives on diagnostic testing in children with persistent non-specific symptomsAvailable at: https://doi.org/10.3399/BJGP.2023.0683It is known that GPs employ diagnostic tests in adults with persistent non-specific symptoms for motives beyond strictly diagnostic purposes, but comparable research has not been conducted in children. This study adds that although GPs want to limit unnecessary invasive procedures in children, non-diagnostic motives to test are considered important, for example to provide reassurance or secure the GP-patient relationship. The decision to conduct diagnostic tests in children with persistent non-specific symptoms is based on a complex trade-off among medical considerations, psychosocial factors, consultation management, and efficient resource utilization. Awareness amongst GPs of the motives underlying their own testing behaviour in children with PNS could prompt changes in their testing practices.

Today, we're speaking to Dr Amy Clark and Dr Kathryn Hughes. Amy is a resident doctor in North West Anglia Foundation Trust, and Kathryn who is a GP and a Senior Clinical Lecturer based at PRIME Centre Wales within Cardiff University. Title of paper: Assessing acutely ill children in general practice using the National PEWS and LqSOFA clinical scores: a retrospective cohort studyAvailable at: https://doi.org/10.3399/BJGP.2023.0638The validity of the current NICE-recommended scoring system for identifying seriously ill children in general practice, the Traffic Light system, was recently investigated and shown to perform poorly. A new National PEWS (Paediatric Early Warning Score) has just been introduced in hospital settings with hopes for subsequent implementation in general practice, to improve the identification of seriously unwell children. To the authors' knowledge, the score has not previously been validated in general practice. This study found that the National PEWS would not accurately identify children requiring hospital admission within two days of presenting to general practice with an acute illness and therefore should not be recommended for this purpose without adjustment. Another score, the Liverpool quick Sequential Organ Assessment (Lq-SOFA), was also investigated and found to perform poorly in general practice.

Today, we're speaking to Professor Carolyn Chew-Graham, Professor of General Practice Research at Keele University. Title of paper: People from ethnic minorities seeking help for Long Covid: a qualitative study.Available at: https://doi.org/10.3399/BJGP.2023.0631People from ethnic minority groups are less likely to present to primary healthcare for Long Covid. This study explored the lived experiences of Long Covid amongst people from ethnic minority groups. Participants were often previously unaware of Long Covid or available support and some described not feeling worthy of receiving care. Experiences of stigma and discrimination contribute to a lack of trust in healthcare professionals and services, and are common in previous negative healthcare encounters. Receiving empathy, validation, and fairness in recognition of symptoms, and support is needed to enhance trust and safety in healthcare.

Today, we're speaking to Marije Splinter, an epidemiologist and sociologist based at the Department of Epidemiology at Erasmus University Medical Centre in the Netherlands. Title of paper: Healthcare avoidance during the early stages of the COVID-19 pandemic and all-cause mortality: a longitudinal community-based studyAvailable at: https://doi.org/10.3399/BJGP.2023.0637During the COVID-19 pandemic, trends of reduced healthcare-seeking behaviour were observed alongside global patterns of excess mortality, raising concerns about the consequences of healthcare avoidance for population health. This study found that individuals who avoided healthcare during COVID-19 were at an increased risk of all-cause mortality. Importantly, these individuals were characterised by underlying symptoms of depression and anxiety, as well as poor self-appreciated health. The findings of this study emphasise the need for targeted interventions to safeguard access to primary and specialist care for these vulnerable individuals, during and beyond healthcare crises.

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we have three exciting new papers. Firstly, in the BMJ a network meta-analysis on acute migraine treatments - can the new GEPANTs drugs beat existing therapies? Secondly, a paper in NEJM does screening for prostate cancer using MRI actually help? Finally in the BJGP can first contact physio be better than a GP appointment? Listen on! ReferencesBMJ Acute migraine therapiesNEJM Prostate cancer screening with MRIBJGP First contact physio in GPwww.nbmedical.com/podcast

Today, we're speaking to Dr Charlotte Archer, Research fellow in primary care mental health based at the University of Bristol.Title of paper: GPs' views of prescribing beta- blockers for people with anxiety disorders: a qualitative studyAvailable at: https://doi.org/10.3399/BJGP.2024.0091Beta-blockers are licensed for managing the symptoms of anxiety, and new prescriptions for patients with anxiety have increased substantially in recent years. However, National Institute for Health and Care Excellence guidance for anxiety does not recommend beta-blockers as a treatment for anxiety, and recent reports have highlighted risks associated with the beta-blocker propranolol. Our research found that GPs prescribe beta-blockers for anxiety because they consider them to be low risk, a quicker solution than other treatments, and useful for managing associated physical symptoms.

Today, we speak to Dr Jet Klunder, a GP trainee and a PhD candidate based at the Department of General Practice at Amsterdam University Medical Centre in the Netherlands. Title of paper: Predicting unplanned admissions to hospital in older adults using routinely recorded general practice data: development and validation of a prediction modelAvailable at: https://doi.org/10.3399/BJGP.2023.0350Unplanned hospital admissions in older adults are a critical concern for patients, family caregivers, healthcare professionals, and service planners. In this study a robust and easy-to-use prediction model has been developed and validated using routinely recorded data from general practices to predict the risk of unplanned hospital admissions in community-dwelling older adults. Identifying older adults at high risk can facilitate targeted preventive interventions, such as case management, telemedicine, or anticipatory care planning. Moreover, the model could also be utilised by policymakers for capacity planning of hospital beds.

In this episode, we talk to Dr Holly Smith, Research Fellow in Perinatal Mental Health based at the Department of Primary Care and Population Health at University College London. Title of paper: The first 100 days after childbirth: cross-sectional study of maternal clinical events and health needs from primary careAvailable at: https://doi.org/10.3399/BJGP.2023.0634The first 100 days after childbirth are a crucial time for women as they recover mentally and physically from pregnancy and birth. Previous studies have sought to identify common postnatal conditions and symptoms women may experience after birth, but no studies, to the authors' knowledge, have used electronic health records from primary care to examine women's actual care use in this time. The current study found that women most commonly use primary care for: a post natal check or visit, monitoring (such as a blood pressure reading), and contraception. The study adds useful knowledge on women's primary care use following childbirth.

In this episode, we talk to Dr Michelle Rickett, a Research Associate on the NIHR funded EXTEND study based at the School of Medicine at Keele University. Title of paper: Collaboration across the primary/specialist interface in early intervention in psychosis services: a qualitative studyAvailable at: https://doi.org/10.3399/BJGP.2023.0558Early Intervention in Psychosis (EIP) service users may be referred from, and discharged back to, primary care. There is limited research on patient and carer experience of discharge to primary care from EIP services and little guidance around planning and implementation of discharge. This paper explores experiences of EIP care and discharge from the perspectives of service users, carers and healthcare professionals in EIP services and primary care. It explores the patient journey through EIP services, highlights the lost connection with primary care, and makes recommendations for more collaboration between primary and specialist care, particularly around physical health monitoring and management, which might improve patient experience and outcome.

In this episode, we talk again with Jen MacLellan, a qualitative researcher based within the Nuffield Department of Primary Care Health Sciences at the University of Oxford. Title of paper: Unpacking complexity: GP perspectives on addressing the contribution of trauma to women's ill healthAvailable at: https://doi.org/10.3399/BJGP.2024.0024Significant challenges and uncertainties reside in how best to manage the link between mind and body in communication with patients and in healthcare pathways. Lack of supportive resources to deliver holistic, trauma informed care risks practitioners (inadvertently) avoiding discussion of the contribution of distress in the illness presentation. A trauma informed systems level approach would support integration of psychological support within multiple care pathways and support wellbeing of practitioners providing care.This study was funded by the National Institute for Health and Care Research (NIHR) Policy Research Programme (NIHR202450). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

We're taking a summer break but will be back with our BJGP interview podcast on Tuesday 3 September.

We're taking a summer break but will be back with our BJGP interview podcast on Tuesday 3 September.

In this episode, we talk to Professor Clare Turnbull, Professor in Cancer Genetics at the Institute for Cancer Research and Honorary Consultant based at the Marsden. Title of paper: Breast cancer risk assessment for prescription of menopausal hormone therapy in women with a family history of breast cancer: an epidemiological modelling studyAvailable at: https://doi.org/10.3399/BJGP.2023.0327Prospective longitudinal studies (such as the Collaborative Group on Hormonal Factors in Breast Cancer [CGHFBC]) have enabled the estimation of relative risks of breast cancer associated with different durations of exposure to and formulations of menopausal hormonal therapy (MHT). Risk models such as BOADICEA enable prediction of age-related breast cancer risk according to the extent and pattern of breast cancer family history. This study undertook integration of these two data sources (namely the CGHFBC datasets and the BOADICEA model) in order to model annual and 5-year risks for breast cancer incidence for the age window 50–80 years for hypothetical unaffected female consultands with different patterns of MHT exposure and different patterns of breast cancer family history, also generating predictions for breast cancer-specific death. This study modelled combined and oestrogen-only MHT but lacked data for analyses of newer types of MHT such as micronised progesterone or non-oral preparations.

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. Have you ever walked into a pharmacy and wondered whether those nasal sprays suggesting they can stop the common cold actually do anything? Ahead of the inevitable coughs and colds of the autumn, the Lancet Respiratory provides some answers and they won't be the ones you think... Still, right now it's the summer and time to get outside and active - especially if you have recurrent back pain. We look at a paper in the Lancet exploring whether just simply walking can be the problem. Finally, from the BJGP we examine a paper looking at what being a "full-time GP" means and how, sometimes, definitions can be REALLY important. ResourcesBJGP Trends in Full-Time Working in GPLancet Effectiveness of Walking for Back PainLancet Resp Nasal Sprays for URTIswww.nbmedical.com/podcast

In this episode, we talk to Dr Joe Hutchinson, who is a salaried GP and an academic GP working within the Centre for Primary Care and Health Services Research at the University of Manchester. Title of paper: Trends in full-time working in general practice: repeated cross-sectional studyAvailable at: https://doi.org/10.3399/BJGP.2023.0432General practice is under increasing pressure, in part due to a lack of GPs. There is contention as to the proportion of GPs working full-time. We find that average hours and sessions worked per week by GPs in England have declined, whilst average hours per session has increased. Over half (55%) of GPs work at least the NHS Digital standard full-time definition of 37.5 hours per week. Average hours worked per session in 2021 was 51% greater than the BMA standard definition of a session's duration. We recommend removing sessions as a definition of full-time working. However, if full-time work commitment continues to be defined in terms of the number of sessions worked, alignment with the NHS definition of 37.5 hours per week could be achieved by recognising that 6.0 sessions per week of 6.2 hours constitutes full-time work.

In this episode, we talk to Dr Anna Wilding, a Research Fellow based at Health Organisation, Policy and Economics at the University of Manchester. Title of paper: Geographic inequalities in need and provision of social prescribing link workersAvailable at: https://doi.org/10.3399/BJGP.2023.0602Social prescribing link workers were proposed in the 2019 NHS Long Term Plan to address health inequalities. Using national administrative data, we find that the subsequent roll-out of link workers has not been sufficiently targeted at areas of highest need. Higher need areas require additional support for employing link workers to tackle health inequalities and better support population needs.

In this episode, we talk to Lisa Davies, a PhD candidate based at Utrecht University. Title of paper: Patients' perspectives about the role of primary healthcare providers in long-term opioid therapy: a qualitative study in Dutch primary careAvailable at: https://doi.org/10.3399/BJGP.2023.0547Previous research has shown the pivotal role of primary healthcare providers in managing long-term opioid use for patients with chronic non-cancer pain. This study adds the patient's perspective, underscoring the importance of improved communication, medication management, regular assessments, and a patient-centred approach, especially during opioid tapering. Clinicians should prioritise these aspects to enhance patient care and outcomes for patients in chronic non-cancer pain management.

In this episode, we talk to Juan Carlos Bazo-Alvarez, a Senior Research Fellow within the Department of Primary Care and Population Health at University College London. Title of paper: Risk of Parkinson's disease in people with New Onset Anxiety over 50 years - Incidence and Associated FeaturesAvailable at: https://doi.org/10.3399/BJGP.2023.0423Presence of anxiety is known to be increased in the prodrome of Parkinson's disease (PD). This study investigated the risk of developing PD in people with anxiety compared with those without anxiety, accounting for a number of confounding variables. The results suggest that there is a strong association between anxiety and later diagnosis of PD in patients aged ≥50 years who present with a new diagnosis of anxiety. This provides evidence for anxiety as a prodromal presentation of PD.

In this episode, we talk to Dr Meena Rafiq, Academic GP and Clinical Research Fellow within the Institute of Epidemiology and Health at University of Melbourne. Title of paper: Clinical activity in general practice before sarcoma diagnosis: an Australian cohort studyAvailable at: https://doi.org/10.3399/BJGP.2023.0610Sarcoma is challenging to diagnose with delays associated with poor patient outcomes and experiences. This study has shown that patients with sarcoma often have multiple GP visits and imaging requests in the year before their diagnosis. Clinical activity in general practice increases from 6 months before sarcoma diagnosis, primarily in the form of imaging requests, indicating that opportunities for a timelier diagnosis may exist in some patients. Primary care interventions to increase awareness of sarcoma symptoms and streamline diagnostic pathways, including promoting and clarifying guidelines to optimise the use of appropriate imaging and direct specialist centre referrals, could improve earlier diagnosis and patient outcomes.

Welcome to a new episode of the Hot Topics Podcast from NB Medical with Dr Neal Tucker. Today is election results day but we're not talking about politics, we're focusing on the research. We look at a paper in the latest BJGP which looks at which factors influence a patient's decision to discontinue anti-depressants, explore a paper in the Lancet on whether a symptom-clinic led by GPs can improve outcomes for patients with multiple and persistent symptoms, and discuss trends in cardiovascular disease in the UK over the past 20 years, published in the BMJ this week. ReferencesNB Blog on Discontinuation of AntidepressantsBJGP Discontinuation of antidepressantsLancet Symptom clinicBMJ CVD trendswww.nbmedical.com/podcast

In this episode, we talk to Dr Abi Eccles, Assistant Professor within Warwick Applied Health at Warwick Medical School. Title of paper: The GP's role in supporting women with anal incontinence after childbirth injuryAvailable at: https://doi.org/10.3399/BJGP.2023.0356Anal incontinence after childbirth injury has profound impacts on women's lives and many find they cannot access healthcare and support. GPs can play a crucial role, but we know that very few women speak to their GPs about their symptoms. In combining GPs' and women's views, we show how anal incontinence after childbirth injury is often missed in a primary care setting. Drawing on these findings, we highlight the key ways GPs can provide support for such womenClick here for the RCGP course on anal incontinence after childbirth.

In this episode, we talk to Dr Ed Tyrell, a GP and Clinical Assistant Professor within the Faculty of Medicine and Health Sciences at the University of Nottingham. Title of paper: Primary care consultation patterns before suicide: a nationally representative case–control studyAvailable at: https://doi.org/10.3399/BJGP.2023.0509Although increased primary care utilisation in the preceding year has been linked with death by suicide, longer-term consulting patterns and primary care-recorded reasons for consulting have not been previously examined. This large, nationally representative sample from England showed rates of consulting among patients who died by suicide continuously rose in the 5 years before suicide, especially in the last 3 months. Suicide risk was significantly increased among those who consulted more than once every month in the final year, irrespective of any sociodemographic characteristics and irrespective of the presence (or absence) of known psychiatric comorbidities. Common reasons why patients who died by suicide consulted before their death included medication review, depression, and pain.

Welcome to the Hot Topics Podcast from NB Medical with Dr Neal Tucker. It's election time but we're going to put aside politics and focus on the latest medical research! In this episode, we look at an important BJGP paper highlighting the rates of follow-up after a significant asthma attack, a paper in the Journal of Infection showing the high rates of second antibiotic prescription in ongoing cough, and a RCT in JAMA examining if, as suggested by observational data, aspirin can truly prevent recurrence or metastasis of breast cancer.ReferencesBJGP Post-hospitalisation asthma management in primary careBJGP  Editorial Asthma Deaths in ChildrenJ of Infection Repeat Antibiotics for CougheCancer Aspirin for CancerJAMA Aspiring & Breast Cancer Recurrencewww.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode we think about the GP workforce courtesy of four papers in this month's BJGP - does more GPs boost life expectancy (of the patients...)? do PCNs help health inequalities? is practice-based continuity as good as individual continuity? For a more directly clinical update, we look at new research in the BMJ on which is the best oral option in T2DM after metformin. Can the SGLT2 inhibitors prove their worth?ReferencesBJGP Does the shortage of GPs matter?BJGP PCNs, deprivation and fundingBJGP Continuity in GPBJGP Continuity in Norwegian GPBMJ Best drug after metformin in T2DMwww.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. To DRE or not to DRE? This is the question and the main event in this episode. We have a fantastic interview with Amy Rylance, Head of Improving Care at Prostate Cancer UK, and Sam Merriel, GP and academic clinical lecturer, discussing their recent Clinical Practice paper in the BJGP: Is the digital rectal exam any good as a prostate cancer screening test? In other research, we have two papers with a common theme. Firstly, a paper in the BMJ looking at long-term outcomes after diagnosis with atrial fibrillation, and secondly, a paper in the BJGP examining the role of BNP testing as a marker for future cardiovascular disease in patients with a new diagnosis of hypertension. Both show that while these conditions make us think of stroke and MI, we also should be thinking about heart failure. ResourcesBJGP Clinical Practice paper on DRE for prostate cancer screeningProstate Cancer UK Patient Risk CheckerEuropean Urology Oncology Journal Performance of DRE in PCa ScreeningNEJM 2004 Prevalence of PCa in men with a PSA

Welcome back to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode, we consider the current state of general practice in the UK and what lessons the countries can learn from each other. We examine a new paper in the BJGP on how patients feel about general practice in Scotland since the introduction of the 2018 GP contract. Is it meeting patient and policymaker goals? In other research, we see what lessons a new paper in JAMA on weight loss and cancer association can tell us about a seemingly obvious connection, and from the NEJM what effect testosterone replacement for hypogonadism has on men's fracture risk.ReferencesBJGP Patient experiences of Scottish GP paperBJGP Family physician's moral distress when managing health inequalitiesJAMA Cancer diagnoses after weight lossNEJM Testosterone replacement for hypogonadism and fracture riskwww.nbmedical.com/podcast

Welcome to the Hot Topics podcast from NB Medical with Dr Neal Tucker. In this episode we talk to Dr Jessica Watson, lead author of the Why Test study, published in the BJGP exploring the use of blood tests in general practice and how often they make a difference - positive or negative.In other research we look at a BMJ paper comparing rosuvastatin and atorvastatin for secondary prevention, and in the Lancet, the PATHFINDER study, exploring the role of multi-cancer early detection blood tests - will this be useful for diagnosing cancers earlier?Plus the usual news, views, and a song about vaccinations.www.nbmedical.com/podcast ReferencesBJGP Why Test StudyPACT - primary care academic collaborative websiteBMJ Rosuva vs Atorva for secondary preventionLancet PATHFINDER MCED studyLancet EditorialRCGP Manifesto Seven Steps To Rebuild General Practice and Save the NHSwww.nbmedical.com/podcast

Welcome to Season 5 of the Hot Topics podcast from NB Medical with Dr Neal Tucker. Despite celebrating our 25th birthday (don't forget to check out our NB Plus birthday special here) the world of medical news and research never stops. In this episode we look at research in the BJGP about the motivations behind being a GP, whether adding NSAIDs may improve efficacy of emergency contraception, and whether we should be worried about cancer in patients with reflux.www.nbmedical.comReferencesBJGP Mapping GP MotivationsLancet Levonorgestrel + piroxicam for ECBMJ Non-erosive reflux and oesophageal cancer riskwww.nbmedical.com/podcast

Welcome back to the Hot Topics podcast.  In this episode we reflect on the Prime Ministers Primary Care Recovery Plan, then move on to more useful things like research.  We have new papers in the BJGP on who may be more likely to develop fatigue after mild covid and the NEJM on using a peanut patch to desensitive toddlers at risk of anaphylaxis. We also have the next in our series of Just One More Thing - this time we chat about allergy with Dr Matt Doyle, GP and chair of the primary care committee of the British Society of Allergy and Clinical Immunology. ReferencesBSACI websitePrime Ministers Primary Care Recovery PlanBJGP Post-covid fatigueNEJM Peanut allergy patch