The aim of this study was to determine the relationship between the physical activity levels and cognitive perceptions of physicians and the frequency of exercise prescribed by primary care physicians.

This cross-sectional study was conducted with 221 primary care physicians. A questionnaire of three sections was administered, including questions prepared according to the American College of Sports Medicine (ACSM) recommendations evaluating the current practices of the physicians on the subject of prescribing exercise, the General Practice Physical Activity Questionnaire (GPPAQ), Cognitive Behavioural Physical Activity Questionnaire (CBPAQ).

A significant relationship was determined between the daily physical activity of the physician and exercise prescribing rates (P = 0.005). From the data obtained from the GPPAQ and the CBPAQ, it was determined that as the activity level increased, so the Outcome Expectation (P < 0.001), Self-regulation (P < 0.001), Total Cognitive Activity (P < 0.001) points increased. The frequency of prescribing exercise was found to be <20% for all chronic diseases for which exercise is known to be effective. A significant relationship was determined between prescribing exercise and the total number of correct responses to the questions measuring the level of knowledge according to the ACSM recommendations (P < 0.001). Mann-Whitney U and Kruskal-Wallis tests were used for non-normally distributed data, while Pearson, likelihood ratio, and chi-square tests were used for analyzing relationships between categorical variables.

Incorporating exercise prescription training into the core medical and family medicine curricula may increase physicians’ self-efficacy and contribute to overcoming barriers in prescribing exercise.

DIALOG is a patient-reported outcome and experience measure. We analysed anonymised DIALOG scores routinely collected from East London NHS Foundation Trust. We aimed to (a) examine changes in DIALOG scores through the patient journey (‘assessment’, ‘review’ and ‘discharge’); and (b) assess the impact of community mental health (CMH) transformation by comparing pre- and post-DIALOG scores. We analysed 11 198 DIALOG scores from 5007 patients in 2018–2019 and 2021–2022.

DIALOG scores improved across treatment stages in both years. There was no clear difference pre- and post-CMH transformation, although in 2021–2022 there were lower satisfaction scores at referral.

DIALOG showed sensitivity to change, supporting the utility of this scale in the evaluation of mental health services. The impact of CMH transformation was difficult to assess, due to potential confounders such as the COVID-19 pandemic. Routinely collected DIALOG data can help evaluate patient outcomes over time and inform service improvements.

This study examined gaps in adherence to preventive care recommendations for adults with Down Syndrome (DS) in Connecticut and explored the underlying factors collecting caregiver and primary care physician (PCP) perspectives.

Primary healthcare plays a vital role in preventing health issues. Despite well-defined clinical guidelines for adults with DS, studies show gaps in preventive care delivery for this population.

A mixed-methods study included chart reviews, a focus group and a survey of PCPs. Chart reviews examined records of adults with DS who received care between January 1, 2017, and December 31, 2022, for adherence to recommended preventive services. The focus group explored caregivers’ experiences with preventive care, and the survey assessed PCPs’ knowledge of prevention needs for adults with DS.

Chart reviews of 241 adults with DS found low adherence to preventive care guidelines. Only 2.1% met the wellness visit benchmark, and 30.7% met the thyroid test benchmark. Themes from the caregiver focus group included challenges accessing care, clinicians’ lack of DS-specific knowledge and difficulties maintaining health and wellness outside the office setting. Of 81 PCPs surveyed, most reported feeling inadequately prepared to care for adults with DS. Only 27% reported relevant training, and 53% were unaware of annual thyroid function test recommendations.

The study reveal gaps in preventive care for adults with DS and underlying reasons from a caregiver and provider perspective. Further analysis of care for adults with DS and targeted interventions will contribute to improved preventive care for this population.

This study aims to assess the perspectives of patients with chronic conditions on the use of the Assessment of Burden of Chronic Conditions (ABCC) tool during consultations with their healthcare providers in primary care.

The increasing prevalence of chronic conditions, including multimorbidity, poses major challenges to healthcare systems today, particularly in primary care where most chronic care takes place. Effective management strategies are crucial for improving quality of life (QoL). The ABCC tool offers a unique approach to chronic disease management by facilitating shared decision-making and self-management.

This qualitative phenomenological study involved semi-structured interviews. Fourteen patients with chronic obstructive pulmonary disease (COPD), asthma, type 2 diabetes mellitus (T2DM) and/or chronic heart failure (CHF) were recruited from a previously conducted quasi-experimental study on the effectiveness of the ABCC tool.

Participants generally expressed satisfaction with the comprehensive questionnaire, user-friendly design and clear visualisation. They appreciated the opportunity to facilitate discussions with healthcare providers and help with monitoring. However, some confusion around the grey balloons in the tool highlighted the need for clearer explanations. Participants had limited awareness of advanced treatment recommendation functions.

This study provides valuable insights into patients’ experiences with the ABCC tool. Despite challenges such as recall bias and limited awareness of certain features, participants generally expressed satisfaction with using the tool. Based on these findings, the tool can be further improved and its use should be further supported. However, the ABCC tool shows promise as a valuable instrument for improving consultations in clinical practice.

Mass casualty incidents (MCI) are a challenge for prehospital response. The global response may include primary health care teams (PHCT), even more in remote and rural areas. As training in MCI response is complex, it is essential to simplify it when focused in PHCT as it is a low frequency phenomenon in their context. Our objective is to measure self-perception and the impact of a brief training experience using a mass casualty incident tabletop game with primary care doctors and nurses.

Descriptive study of the impact of a training intervention on 27 primary care physicians and nurses in the Principality of Asturias. A 2-h training experience was carried out using a tabletop game. Self-perception was measured using a Likert’s scale on methodology, knowledge and skills, as well as a multiple-choice knowledge test after two months. Strengths and weaknesses of the methodology were also identified using open-ended questions, as well as attitudes towards incidents with mass casualty incidents.

85% of participants improved their level of knowledge without providing them study material. Self-perception measured 27 items in 3 dimensions: methodology (Median = 9; interquartile range (IQR) = 2), knowledge (Median = 10; IQR = 1), and skills (Median = 9; IQR = 1). All items except one had a median greater than or equal to 9.

Gamification using the MassCas tabletop game for mass casualty incidents is perceived by primary care doctors and nurses as a useful tool in their training for mass casualty incidents, as well as for acquiring specific knowledge and skills in this area.

The aim of this study was to describe nurses’ experiences of competence development in home care.

Home care services are increasingly used to support clients’ coping at home. As the number of clients with multiple diseases is growing, continuous competence development is needed.

Qualitative cross-sectional study. Four registered nurses (RNs) and seven licenced practical nurses (LPNs) from one well-being services county in Finland participated in interviews. The data were analysed with thematic analysis.

Three themes were found in the analysis: having adequate competence to work as a nurse in home care, being a competent and developing licenced practical nurse, and being an improving and developing registered nurse. Competence development requires continuous training. Nurses need various practises to update their knowledge and skills. Managers have an important role in supporting, organizing, and timing competence development opportunities.

Depression is the most common mental illness globally and is a leading cause of years lived with disability. The manifestation of depressive symptoms can vary among ethnic groups. Individuals in South Asian countries experience higher levels of somatic symptoms than those in other regions, but it is not known whether this pattern extends to the South Asian diaspora.

To provide a qualitative synthesis of what is known regarding depression symptoms among the South Asian diaspora in English-speaking countries.

A systematic scoping review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines, based on a pre-registered protocol (doi.org/10.17605/OSF.IO/5E6ZK). The review included qualitative, quantitative and mixed-methods primary research, reporting depression symptoms based on samples of adults of the South Asian diaspora in English-speaking countries with substantial South Asian populations. Qualitative content analysis was used to identify widely reported symptoms of depression among the South Asian diaspora.

Commonly reported symptoms included physical pain, heart-related symptoms and repetitive negative thinking, none of which are included in ICD-11 diagnostic criteria for depressive disorders. Sleep-related disturbances are also widely reported in research into experiences of depression among the South Asian diaspora.

Current diagnostic criteria for depression might not capture symptoms of some South Asian individuals, which may cause missed opportunities for intervention.

This paper aims to describe what constitutes good-quality, accessible, affordable and acceptable primary care for migrants. This includes identifying system adaptations and offering evidence- and practice-based recommendations and guidance for primary care organizations and professionals on how to deliver such care.

Migration has significantly diversified European populations. Migrants often face structural, linguistic, cultural, and systemic barriers in accessing appropriate primary care. While these challenges are well-documented, implementation of effective, inclusive care remains inconsistent across countries.

This position paper presents a narrative synthesis of existing literature, expert opinions, and recent policy developments. It draws on evidence from healthcare research, policy analyses, and recommendations developed by the European Forum for Primary Care working group on migrants, primarily covering developments from the past decade.

High-quality primary care for migrants requires coordinated action across care delivery, capacity building, and system-level structures. Care delivery must be person-centred and comprehensive, supported by interprofessional collaboration and professional interpretation. Capacity building depends on training and education that embed diversity-sensitive care, cultural humility, and structural competency. At the system level, policies should guarantee equitable access, continuity of care, and inclusive quality monitoring, while fostering intersectoral partnerships and community engagement.

Embedding person-centred, diversity-sensitive, and community-oriented principles into primary care systems is essential for achieving equitable healthcare for migrant populations. This is an urgent plea to healthcare policymakers, organizations, and professionals to undertake action to realise these reforms as they not only improve care for migrants but contribute to stronger, sustainable and more resilient health systems overall.

This study aimed to analyse respiratory infection rates (RI) in a representative cohort and evaluate if tumour size, pre-existing respiratory co-morbidities, smoking history, and tracheostomy predicted postoperative infection.

A retrospective observational study at a London tertiary head and neck oncology centre reviewed six years of patient data. BMJ Best Practice guidelines for hospital-acquired pneumonia (2022) were applied to medical records alongside postoperative RI prescriptions.

RI occurred in 32% of patients, more often in those with tracheostomy (36%) than intubation (12%). Infected patients were older (p=0.025), had tracheostomy (p=0.045), and underwent bilateral neck dissection (p<0.001). ICU (p=0.008) and hospital LOS (p<0.001) were significantly higher. Age, smoking, respiratory disease, tumour stage, and airway type were not predictors.

RI were more frequent in tracheostomised patients, though assessed risk factors were not predictive. Further research should explore additional contributors and evaluate targeted interventions to reduce incidence.

To identify key factors associated with varying levels of Medicare’s Chronic Care Management (CCM) programme implementation in rural primary care practices in the United States.

Despite demonstrated benefits for both patients and providers, CCM implementation remains low nationwide. While previous studies have examined payment-related challenges, limited research exists on other implementation factors such as leadership engagement, organizational culture, and provider training, particularly in rural settings.

This mixed-methods study examined CCM implementation across six rural primary care practices in Wyoming. Thirteen healthcare professionals participated in semi-structured interviews guided by the Consolidated Framework for Implementation Research (CFIR). Practice performance data collected over three consecutive months were used to categorize sites as high or low implementers based on care coordinator productivity, percentage of care coordinated, and programme sustainability. Interview transcripts were analysed using CFIR constructs to identify factors that distinguished high from low-implementing sites, with each factor rated based on its impact (positive, negative, or neutral) and strength of influence.

Three CFIR constructs strongly distinguished between high and low implementation sites: networks and communication, leadership engagement, and reflecting and evaluating. High-implementing sites demonstrated effective team communication, supportive leadership, and regular programme evaluation practices. In contrast, low-performing sites faced poor communication, minimal leadership support, and weak feedback mechanisms. Further research is needed to examine the effectiveness of targeted interventions designed to strengthen these organizational factors in rural primary care settings, particularly focusing on developing scalable strategies that account for resource limitations and geographic isolation.

Depression screening in primary care has been widely discussed, but its economic implications have remained largely unexplored. The GET.FEEDBACK.GP randomised controlled trial evaluated feedback interventions after depression screening in primary care. The study arms were (a) feedback provided to the general practitioner; (b) feedback to both the patient and the treating general practitioner; and (c) a control group without feedback. Analysis of clinical effectiveness revealed that feedback interventions were not associated with decreased depression severity. Their economic implications were the subject of this study.

To evaluate the economic impact of general-practitioner- and patient-targeted feedback following depression screening for adults in German primary care.

A cost-effectiveness analysis from a societal perspective of feedback interventions after depression screening with a time horizon of 12 months was conducted. Direct and indirect costs were estimated. Quality-adjusted life years were calculated on the basis of the EQ-5D-5L, and incremental cost-effectiveness ratios and cost-effectiveness acceptability curves based on the net monetary benefit were constructed. Sensitivity analyses and post hoc explorative subpopulation analyses were performed. Trial registration: ClinicalTrials.gov, NCT03988985.

In total, 987 participants who screened positive for at least moderate depression were included. Feedback provision was not significantly associated with changes in costs or quality-adjusted life years during follow-up. Cost-effectiveness probabilities of feedback interventions were lower than 50% compared with no feedback. Higher cost-effectiveness probabilities were observed in patients whose suspected depression was confirmed 1 month post-screening and in those with previous depression.

The analysed feedback interventions cannot be considered to be cost-effective for the investigated population. Patient-targeted feedback was potentially cost-effective for subpopulations, particularly patients with a later confirmed depression diagnosis; this requires further research.

Understanding the characteristics of older patients in primary care is important to develop appropriate and targeted programs.

We describe the characteristics of older adults (aged 70+) accessing primary care in three Canadian provinces.

Participants (n = 594) completed a survey package comprising demographics, health system usage, presence of chronic conditions, and a quality-of-life measure, the EQ-5D-5L. Frailty was assessed using a deficit accumulation frailty index (FI).

The most common chronic conditions reported were high blood pressure (51.1%), osteoarthritis (37.2%), diabetes (22.8%), and heart disease (21.8%). Mean FI was .153; 22.9 per cent were frail (FI > 0.21). Females reported higher levels of pain/discomfort and anxiety/depression than males; females also reported lower levels of education and income. Mean self-rated health was similar for males and females, but a higher proportion of men reported optimal health across the EQ-5D-5L dimensions.

Our study provides benchmark and baseline data helpful to others planning primary care for older adults.