BJGP Open

Background Uncomplicated urinary tract infections (uUTIs) are common bacterial infections. Aim Evaluate the burden of uUTI in England for 1) potential determinants of disease progression; 2) extent and impact of antimicrobial prescribing non-concordant with treatment guidelines; and 3) economic burden and costs. Design &amp; setting Retrospective cohort study utilising patient data from the Clinical Practice Research Datalink (CPRD) linked to English Hospital Episodes Statistics. Method Female patients aged≥12 years with a new uUTI between 2018–2019,≥14 months’ continuous CPRD enrolment (≥12 months baseline,≥2 months follow-up), and≥1 oral antibiotic prescription±5 days of uUTI diagnosis were included. Baseline characteristics were described in patients with/without disease progression (hospitalisation for acute pyelonephritis/bacteraemia/sepsis). Treatment non-concordance with current English guidelines was assessed. Burden (all-cause and UTI-related healthcare resource use [HCRU] and costs) was evaluated in a 1:1 age-/comorbidity-matched uUTI-free cohort. Results Of 120,519 patients, 207 (0.2%) had disease progression requiring hospitalisation (during index uUTI episode); determinants included older age, index home consultation, prior hospitalisation and medications prescribed for comorbid conditions in the prior 12 months (British National Formulary classes: cardiovascular, eye, other). Non-concordant treatment was observed in 43.5% of patients. All-cause HCRU burden and costs were significantly higher in patients with uUTI versus age-/comorbidity-matched controls ( P &lt;0.001) at 28 days (£160.06 versus £37.63) and in the 12-month follow-up (£1206.77 versus £460.97). Conclusion All-cause HCRU burden and costs were significantly higher in uUTI patients versus matched controls ( P &lt;0.001). Hospitalisation for acute pyelonephritis, bacteraemia, or sepsis following uUTI was uncommon.

Mark H Wilcox

Dave Heaton

Aruni Mulgirigama

Ashish V Joshi

Viktor Chirikov

Daniel C Gibbons

David Webb

Xiaocong L Marston

Myriam Na Alexander

Fanny S Mitrani-Gold

Treatment patterns and burden of uncomplicated urinary tract infection in England

英格兰单纯性尿路感染的治疗模式及负担

Background The General Practice Community Pharmacist Consultation Service (GP CPCS) was established to allow patients with certain minor illnesses to be referred to a community pharmacy for assessment and treatment. Aim To explore patients’ experiences of the GP CPCS. Design &amp; setting An online survey in two regions of England. Method 25 general practices invited patients to take part in an exploratory survey. Descriptive statistics were used for the analysis. Results The response rate was 5.1% (72/1423). Prior to contacting their general practice, 14.1% (9/64) had tried to speak to a pharmacist. Most respondents accepted the CPCS referral (77.3%, 51/66), received a pharmacy consultation on the same day (80.0%, 40/50) and were largely satisfied with the amount of time the pharmacist spent with them (82.5%, 33/40) the consultation format (68.3%, 28/41) and the privacy provided during the consultation (80.9%, 38/47). However, most respondents (56.5%, 39/69) felt poorly informed by the general practice on why they were being advised to speak to a pharmacist and did not feel that it was appropriate that they had been advised to speak to a community pharmacist (54.2%, 39/72). Only 33.3% (16/48) felt that their consultation fully met their health needs and 27.1% (13/48) of patients described being re-referred from pharmacy back to their general practice. Conclusion In this exploratory study patients were largely accepting of the GP CPCS. Improvements in terms of explaining GP CPCS to patients, selecting patients appropriate for referral to the service and the appointment process may be of benefit.

Julia Gauly

Catherine Grimley

Jeremy Dale

Paramjit Gill

Helen Atherton

General practice community pharmacist consultation service: an exploratory patient survey

全科实践社区药剂师咨询服务：一项探索性患者调查

Background With most of the antibiotic prescriptions occurring in primary care, antimicrobial stewardship (AMS) interventions must be known, welcomed, and used by primary care physicians (PCPs). Aim The main objective of this study was to evaluate the present awareness about, use of, and perceived acceptability, appropriateness, and feasibility of a broad range of interventions. Design &amp; setting A cross-sectional survey was distributed to Swiss PCPs from December 2023 to February 2024. Method The survey focused on eight AMS interventions: shared decision-making tools, factsheets for physicians, Swiss Federal Office of Public Health (FOPH) information material, national antibiotic guidelines website, audit and feedback, communication skills training, as well as the use of point-of-care C-reactive protein (POC-CRP) and procalcitonin (POC-PCT) to guide prescription. PCPs’ perceived acceptability, appropriateness, and feasibility were assessed using five-point Likert scales. General expectations regarding AMS were evaluated via qualitative analysis of free-text answers. Results Out of 7456 potentially eligible primary care physicians, 355 PCPs answered at least one question (response rate 4.7%). PCPs were most aware of biomarkers to guide antibiotic prescription in RTIs, such as POC-PCT (67.6%) and POC-CRP (61.1%), the FOPH awareness campaign (57.3%) and the national guidelines website (52.7%). All interventions were rated as acceptable, appropriate, and feasible, with respective mean scores out of five of 3.89, 3.91, and 3.81. Conclusion Despite the high perceived acceptability, appropriateness, and feasibility of AMS interventions available for RTIs, their real-life impact may be hindered by insufficient awareness. Additional promotion of those tools could increase their uptake by physicians.

Simeon Schaad

Jelena Dunaiceva

Arnaud Peytremann

Sophie Gendolla

Lauren Clack

Catherine Plüss-Suard

Anne Niquille

Anna Nicolet

Joachim Marti

Noémie Boillat-Blanco

Aline Wolfensberger

Yolanda Mueller

Perception of antimicrobial stewardship interventions in swiss primary care: a mixed-methods survey

瑞士初级医疗中抗菌药物管理干预措施的认知：一项混合方法调查

Adam Grice

Hajira Dambha-Miller

The future of peer review: an editorial

同行评审的未来：一篇社论

Michael Naughton

Frank Moriarty

Patrick Redmond

Potentially inappropriate prescribing in middle-aged adults: a significant problem with a lack of action and evidence to address it

中年成人潜在不适当用药：一个缺乏行动和证据的重大问题

Background Adherence to statins for the primary prevention of cardiovascular disease (CVD) is low. There is evidence that some facets of the initiation consultation, or the initiating clinician, are associated with adherence. CVD risk estimation is fundamental to statin initiation and shared decision making (SDM), because the benefits of statins are proportional to CVD risk. Absence of a recorded CVD score before statin initiation therefore indicates SDM is unlikely. Aim To investigate whether SDM, using CVD risk score as a proxy measure, is associated with adherence to statins and CVD outcomes. Design &amp; setting A retrospective cohort study using a database of English primary care records. Method The cohort will include statin naïve patients aged 40-84 years initiated on statins for primary prevention between 2017 and 2020, categorised by the presence or absence of a CVD risk score at statin initiation. Statin adherence and persistence will be determined from subsequent statin prescriptions. Multivariable modelling, accounting for potential confounders, will determine the association between a recorded CVD risk score and subsequent statin adherence and with statin persistence. A secondary analysis will investigate the relationship to subsequent CVD outcomes and death. Conclusion This research uses a record of CVD risk score as a proxy for SDM, to investigate the link between SDM and medication adherence. It will shed light on relationship between how the initiation consultation is performed and subsequent adherence and persistence with treatment.

Samuel Finnikin

Brian Willis

Rani Khatib

Tim Evans

Tom Marshall

Cardiovascular risk estimation and statin adherence: an historical cohort study protocol

心血管风险评估与他汀类药物依从性：一项历史性队列研究方案

Abbreviation	BJGP Open
Journal Impact	2.44
Quartiles(Global)	PRIMARY HEALTH CARE(Q2)

ISSN	2398-3795
h-index	24

Publication Information	Publisher: Royal College of General Practitioners，Publishing cycle: ，Journal Type: journal，Open Access Journals: Yes
Basic data	Year of publication: 2017，Proportion of original research papers: 0.00%，Self Citation Rate:4.00%， Gold OA Rate: 98.18%
Journal Fees	$Details
Average review cycle	22 weeks

BJGP Open

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Treatment patterns and burden of uncomplicated urinary tract infection in England

General practice community pharmacist consultation service: an exploratory patient survey

Perception of antimicrobial stewardship interventions in swiss primary care: a mixed-methods survey

The future of peer review: an editorial

Potentially inappropriate prescribing in middle-aged adults: a significant problem with a lack of action and evidence to address it

General practice community pharmacist consultation service: an exploratory patient survey

Treatment patterns and burden of uncomplicated urinary tract infection in England

The future of peer review: an editorial

Perception of antimicrobial stewardship interventions in swiss primary care: a mixed-methods survey

Cardiovascular risk estimation and statin adherence: an historical cohort study protocol