Tag: general practice

RAPID-Test trial completes recruitment early

Posted on by capcbristol

A major clinical trial investigating whether GP use of rapid diagnostic tests for respiratory (chest) infections can reduce same-day antibiotic prescribing in primary care has completed recruitment early.

Home testing for respiratory infection as mum puts swab into the nose of her son sitting on a kitchen desk.

The RAPID-TEST trial, led by Professor Alastair Hay at the Centre for Academic Primary Care, University of Bristol, originally aimed to complete recruitment of 514 patients by September 2024. With enormous interest in the trial from GP practices across the Bristol, Bath, Swindon, North/North East Somerset, South Gloucestershire, Gloucestershire and Wiltshire areas, the target was met five months early.

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CHICO intervention helps GPs decide whether to prescribe antibiotics for children with respiratory infections

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Clinicians have found the ‘CHIldren with acute COugh’ (CHICO) intervention valuable in supporting decision-making around antibiotic prescribing and facilitating discussions with carers about concerns and treatment options, according to University of Bristol led research published in the British Journal of General Practice.

A young boy (18 months) with a nasty cough, coughing with his mouth open and tongue poking out

Childhood respiratory tract infections (RTIs) are common, often leading to unnecessary antibiotic use and contributing to antimicrobial resistance. The qualitative study aimed to explore how clinicians implemented the CHICO intervention, using interviews to understand its acceptability and use.

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Call to reduce repeat ‘within-episode’ antibiotic prescriptions for respiratory tract infections in primary care

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A new study exploring the use of repeat antibiotic prescriptions for the same respiratory tract infection (RTI) episode – known as repeat ‘within-episode’ prescriptions – in primary care has found high rates of their use in England, despite evidence that they are of little benefit. The study authors, from the Universities of Bristol and Bath, King’s College London, and University Medical Center Utrecht, are calling for a reduction in their use and to make them a target for antimicrobial stewardship interventions.

Pills scattered on a white table top next to a white pill container.

RTIs are one of the most common reasons people visit a GP in the UK. Many RTIs are caused by viruses and current primary care guidelines recommend a no or delayed antibiotic prescribing strategy in the vast majority of patients. Despite this, 54% of RTI consultations in UK primary care result in an antibiotic prescription, and RTIs account for 60% of antibiotic prescribing in primary care worldwide. As such, RTIs are one of the key drivers of antimicrobial resistance.

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Improving access to healthcare for and with people with multiple disadvantage

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General practice teams changed their services to better include patients with severe and multiple disadvantage (SMD) after facilitated collaboration with people with lived experience according to a paper published in the British Journal of General Practice. Implementing these changes brought joy and satisfaction to general practice staff and increased connections with patients and community organisations.

People sitting on a beach watching the sunset with their hands joined together to make a heart shape.

The changes which were implemented using existing funding available to general practices included:

  • using care coordinators and a micro-team to advocate and work with a specially created patient list
  • prioritising flexible access and longer appointments to patients in greater need
  • promoting a trauma-informed approach throughout the whole practice team.

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£2.2M for clinical trial to improve general practice response to men and children affected by domestic abuse

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A new clinical trial of a general practice programme to improve the identification and referral of men and children affected by domestic abuse begins in May thanks to a £2.2 million National Institute for Health and Care Research (NIHR) award to University of Bristol researchers, in partnership with Oxford University and the social enterprise IRISi.

A family group in a living room. Mother and children sitting unhappily on the floor. Father sitting on a sofa with a drink in hand in the background.

The programme, IRIS+, is an expanded version of the successful IRIS (Identification and Referral to Improve Safety) general practice training and support programme, which has been shown to increase referrals of women experiencing domestic violence and abuse (DVA) to specialist services. IRIS+ broadens the scope of the intervention to include men and children, without diminishing the response to women.

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Sharing prescription medications is common and a public health concern

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Sharing prescription medications is common and a public health concern, according to researchers at the Universities of Bristol and Sheffield, whose study investigating the behaviour was published in the British Journal of General Practice (BJGP) today [20 February].

Blister packs of pills of different colours and sizes.

The study reviewed data from 19 primary research studies. Prevalence of the behaviour occurring in a person’s lifetime ranged from 13% to 78% in the studies reviewed. Painkillers were found to be the most commonly shared, followed by antibiotics and allergy medications.

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IRIS+ programme extends the health care response to domestic abuse

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Expanding the IRIS (Identification and Referral to Improve Safety) domestic abuse programme to include men and children and young people is both feasible and potentially cost-effective, University of Bristol researchers have found.

Shot of a little girl looking unhappy as her parents argue in the background.

Success in identifying women affected by domestic abuse through IRIS — a specialist domestic violence and abuse (DVA) training, support and referral programme for general practices — is growing. However, men and children and young people are rarely identified and referred for specialist support. Recognising this gap, a study by researchers from Bristol’s Centre for Academic Primary Care has looked at the feasibility of expanding the scope of support to include them.

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Patients face uncertainty during diagnostic process for coeliac disease

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Patients experience uncertainty when following the traditional diagnostic pathway for coeliac disease, according to a study published in the British Journal of General Practice (BJGP).

Close up of person having stomach pain

The study team from the Centre for Academic Primary Care, University of Bristol and NIHR ARC West suggested that GPs could improve this by:

  • keeping coeliac disease in mind as a possible diagnosis
  • sharing information on blood tests.

Researchers also discussed how the uncertainty patients experience during testing for coeliac disease needs to be addressed when considering diagnostic pathway changes, such as a move towards using only blood test results for diagnosis.

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Germ Defence study shows how an intervention can be rolled out rapidly during a pandemic

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A newly published randomised controlled trial (RCT) used an innovative trial design to rapidly roll out a behavioural intervention aimed at reducing infections during the COVID-19 pandemic. Though the trial’s results, published in Implementation Science, found the Germ Defence website did not appear to reduce infections during the pandemic, they do show how trusted research environments (TREs) can be used to evaluate new treatments safely and quickly.

Germ Defence website.

This was the first RCT where follow up was conducted entirely within a TRE. The study’s novel design meant GP practices and patients did not have to return any data, as all analysis was conducted via the OpenSAFELY TRE. OpenSAFELY TRE gives researchers access to 40% of the English population’s anonymous health records.

Germ Defence is a behaviour change website that gives practical advice on how to reduce the spread of infection in the home. It was found to be effective in reducing the spread of seasonal and swine flu in a previous RCT.

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RCGP Fellowship awards for CAPC researchers

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The Royal College of General Practitioners (RCGP) has awarded Fellowships to three Centre for Academic Primary Care (CAPC) researchers: Professor Katrina Turner, Dr Jessica Watson and Dr Ciaran Conway.

Professor Katrina Turner, Dr Jessica Watson and Dr Ciaran Conway.
Professor Katrina Turner and Dr Ciaran Conway (standing). Dr Jessica Watson (inset).

RCGP Fellowships are the highest grade of membership, and a mark of excellence and recognition of distinguished contribution to general practice.

The awards were presented at a ceremony in London on 17 November.

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