GP Training Research Articles

General practitioner professional identity formation: Much needed, (still) oft forgotten.

Professional identity formation (PIF) as a general practitioner (GP) enhances the experience of meaning at work, reduces burnout, promotes patient-centred decision making and strengthens advocacy for the unique role of family medicine within the healthcare system. Unfortunately, there is insufficient emphasis on PIF in GP residency programs; it often remains a hidden curriculum. External factors limiting GP trainees' exposure to their own general practice community of practice further impede PIF. Thus, fostering general practice PIF requires deliberate, focused efforts; however, there is little empiric evidence on the GP professional identity or how to foster it. The aim of this paper is to discuss strategies for effective GP PIF in family medicine residency. The authors recommend explicit attention to PIF in three key areas: curriculum; teaching and learning; andfaculty development. Additionally, the authors encourage GPs tounite as a community to provide continuing and coordinated support for GP residents ontheir PIF journey.

Barriers to diagnosing and treating vulval lichen sclerosus: a survey study.

Background Vulval lichen sclerosus (VLS) is a chronic inflammatory condition that is frequently misdiagnosed and under-recognised. To date, qualitative research focuses on lived experience of VLS, with women attributing diagnostic delay to poor interactions with health care professionals (HCPs) often due to lack of knowledge. In the UK, women with VLS are most likely to present to primary care. Aim To establish HCPs perspectives on identification, management and education of vulval skin disease, with a focus on VLS. Design and Setting A survey was distributed to HCPs working in primary care. Method The survey was distributed via professional networks and at events. Analysis comprised of descriptive statistics, Spearman's rank correlations, and thematic analysis. Results Of 122 respondents, 53 were General Practitioners (GPs) and 59 were GP trainees. 37.7% of respondents had never participated in teaching nor learning on vulval skin disease. Confidence in the identification of vulval skin disease positively correlated with experience, exposure and female gender. The top identified barriers to diagnosis and treatment included lack of knowledge, embarrassment, and absence of VLS diagnostic criteria. Almost all participants (97.5%) felt VLS diagnostic criteria would be helpful in clinical practice. Conclusion This study provides insight into the barriers to diagnosing and treating VLS in primary care. HCPs recognise deficiencies in training, referral pathways and lack of tools to support VLS diagnosis. Training should include skills to address stigma and embarrassment. This study highlights the importance of developing interventions to overcome barriers, expediting diagnosis and treatment, such as reproducible diagnostic criteria.

Routes for GPs into clinical research

This article sets out to provide those considering speciality training in general practice, and those already established as GP trainees or GPs, with a framework to consider involvement in research. The world of academia can seem mysterious and inaccessible to the outsider, and this article aims to demystify the options for adding research to your career portfolio. Academic general practice can provide a complementary role to the busy, demanding challenges of clinical practice. Academic general practice brings something different to the day-to-day of clinical work, enabling us to think outside the confines of our consulting rooms, to engage with new ideas from a host of interdisciplinary perspectives, develop and contribute to change, shaping the context for future general practice.

Consequences of career progression barriers experienced by doctors in GP training: an interpretative phenomenological study

ABSTRACT Background Despite commitment across national medical education and training bodies to tackle differential attainment (DA), alongside a wealth of research into contributing factors and solutions, progression in narrowing the gap has lagged. This study explores the lived experiences of doctors facing DA, career progression barriers and their wider consequences. Methods Interpretative phenomenological analysis was chosen as the methodological framework. The six doctors interviewed were released from General Practice training before enrolling in a ‘targeted’ intervention scheme designed to support them with training completion. Results The cohort included four international medical graduates and two graduates from the United Kingdom. Three participants were neurodiverse. Three inter-related themes were identified. 1) ‘Career insecurity’ is defined as uncertainty about career prospects and attainment of career goals. At varying points along their journey navigating through progression barriers, participants frequently questioned their futures and the decision to persist in the arduous pursuit of training completion. 2) ‘Psychological injury’ featured prominently in the experiences of the ‘targeted trainees’. Feelings of worthlessness, helplessness, low energy and mood, and ‘traumatic’ experiences were described. 3) ‘Social injury’ illustrates consequences to doctors’ familial and social contexts (including relationships), as well as wider societal consequences (such as attrition). Conclusion Our research evidences the consequences of DA and career progression barriers. We highlight the urgent need for escalated efforts in addressing the challenges faced by different groups of doctors and narrowing the attainment gap. Recommendations for interventions are included in our study.

Registrars as teachers: a qualitative study exploring the experiences of Australian general practice registrars in teaching roles

BackgroundGP registrars (specialist vocational trainees in general practice) are interested in teaching, and there are considerable benefits to teaching during training. There are, however, significant barriers for registrars as teachers, including inadequate funding, time pressures, and limited teacher training. Current evidence does not include medical educator (ME) perspectives or compare teaching settings (e.g. university vs. in-practice). Further evidence is needed to inform programs supporting registrar teaching roles.This project aimed to explore the experiences of Australian GP registrars as teachers in different contexts and from multiple stakeholder perspectives.MethodsA qualitative study with GP registrars, GP supervisors, MEs, and medical students was conducted. Participants were registrars and new (within 12 months) Fellows with teaching experience during training, supervisors who supervised a registrar in the preceding 12 months, Royal Australian College of General Practitioner MEs, and medical students with experiences of being taught by registrars. Recruitment was open to participants nationwide and sampling was purposive, aiming for a maximum variation sample. Data collection was performed via videoconference and analysed using reflexive thematic analysis.FindingsInterviews were conducted with 15 registrars, 10 supervisors, and one ME. Two focus groups involved four MEs and five medical students respectively. Registrar participants taught in a variety of settings, including in-practice, universities, hospitals, and at educational workshop days. Three had experience in GP academic posts and one as a registrar ME. There were four major themes. 1) Near-peer teaching by registrars is valuable - both for medical students and registrars. 2) Teaching makes you a better GP - participants noted the transferability of teaching skills to clinical practice. 3) The importance of the teaching context– this was identified as an important determinant for registrars in teaching roles. 4) Registrar teaching strengthens the GP workforce – participants noted that teaching could elevate general practice as a specialty and increase interest in GP training.ConclusionsStudy participants saw teaching as a core skill for GPs, with transferability to their clinical practice. Registrar participants wanted greater promotion and support for teaching opportunities that counted towards attainment of Fellowship. These findings have implications for teaching practices, MEs, universities, and training providers.

Caring for Long Covid patients in primary healthcare: a cross-sectional study on general practitioners’ knowledge, perception and experience in Belgium and Malta

BackgroundAt least 10% of Covid-19 recovered individuals experience persistent symptoms (Long Covid). Primary healthcare and general practitioners (GPs) are at the forefront in their care. In this study, GPs’ knowledge, perceptions and experiences with Long Covid, and the definition used in two countries, are investigated to provide insight into GPs’ care for Long Covid patients at a cross-country level.MethodsA cross-sectional study targeted towards GPs was conducted in Belgium and Malta during spring and early summer 2022. An online survey consisting of 15 questions on Long Covid was disseminated. Additionally, country-specific practice and demographic characteristics were collected. Descriptive and logistic regression analyses were performed.ResultsA total of 150 GPs (Belgium = 105; Malta = 45) responded. Female GPs represented 58.0%, median age was 49 years (IQR: 37–61). Concerning GPs’ knowledge and perception on Long Covid, in both countries, most GPs reported insufficient scientific knowledge and information on Long Covid diagnosis and treatment. Access to educational material was limited and an awareness-rising campaign on Long Covid was deemed necessary. Moreover, two out of three GPs stated that Long Covid patients were not well followed up by primary healthcare in mid-2022. For diagnosing Long Covid, 54.7% required a positive Covid-19 test, more often among Belgian GPs than Maltese (64.3% vs. 45.2%, p = 0.036). To assess Long Covid, GPs mainly applied diagnostic criteria by themselves (47.3%) in combination with persistent symptoms (4 weeks to 5 months). Most GPs had experience with Long Covid patients in their practice, regardless of practice type and GPs’ country, sex or age (p = 0.353; p = 0.241; p = 0.194; p = 0.058). Although most GPs (94.7%) stated that Long Covid patients should follow multidisciplinary approach, 48.3% reported providing care for these patients themselves or with GP colleagues and only 29.8% by multidisciplinary cooperation. ConclusionsGPs frequently provide (multidisciplinary) care to Long Covid patients and GPs’ care showed similarities at cross-country level. Although GPs perceive lack of scientific knowledge and educational material on Long Covid, similar diagnostic criteria among GPs were noted. Uniform evidence-based guidelines, scientific support and training for GP across Europe must be a priority to enhance their treatment approach to Long Covid.

Dementia Rehabilitation Training for General Practitioners and Practice Nurses: Does It Make a Difference?

Rehabilitation helps reduce disability in dementia. The Australian National Dementia Action Plan identifies a gap in clear treatment pathways post-diagnosis, affecting the quality of life for those with dementia. This study assessed the impact of a one-day dementia training course and follow-up on GPs' and practice nurses' knowledge, attitudes, and confidence regarding dementia rehabilitation. The training, led by two experienced GPs and an academic physiotherapist, covered dementia diagnosis, allied health roles, care planning, and referrals. The follow-up involved applying the learnt material and completing a reflective task. Three longitudinal surveys (Dementia Knowledge Assessment Scale-DKAS, General Practitioners' Attitudes and Confidence towards Dementia Survey-GPACS-D, and Dementia Rehabilitation Scale) and Likert-scale statements were conducted pre-course, post-course, and at four-month follow-up, alongside a focus group. Descriptive and regression analyses were applied to survey data, and content analysis was used for focus group data. Seventeen participants (14 GPs, 3 nurses) completed the pre-post-course survey, with eight (6 GPs, 2 nurses) participating in follow-up and focus group discussions. Post-course, DKAS scores increased by 12.1%, GPACS-D by 10.1%, and the dementia rehabilitation scale by 9.4%. Likert-scale statements improved by 8-79%. At the four-month follow-up, there was a slight, non-significant decline in most measures. Focus groups highlighted the training's impacts, useful components, barriers, and suggestions for improvement. Training GPs and practice nurses in dementia rehabilitation enhances knowledge, awareness, and confidence. Ongoing efforts are needed to sustain benefits and address referral barriers for better access to dementia rehabilitation services.

Enhancing the role of general practitioner trainers in supporting antibiotic stewardship initiatives.

Enhancing the role of general practitioner trainers in supporting antibiotic stewardship initiatives.

Survey of GP registrars' training experience and confidence in managing children and adolescents with mental health conditions in primary care.

The aim of thisstudy is to assess General Practitioner (GP) trainees' training experience, and confidence in assessing and managing children and adolescents with common mental health conditions in primary care in Ireland. An online anonymous questionnaire was distributed to third and fourth year GP registrars enrolled in the Irish College of General Practitioners training schemes. The online questionnaire evaluated participants' training experiences and confidence levels in key areas of child and adolescent mental health in primary care. Sixty participants completed the survey out of 406, yielding a response rate of 14.8%. The majority (88%) reported no formal training or experience working in Child and Adolescent Mental Healthcare Services (CAMHS) during their GP training scheme. Responses indicated that many participants rated their competency, skills, and knowledge in essential areas of Child and Adolescent Mental Health as needing improvement. Similarly, their awareness of referral pathways and specialty services was below expectations, with poor perceived access to services. A large proportion (91.7%) expressed a definite need for further training in child and adolescent mental health disorders. The results highlight the need for enhanced training and support for GP trainees in the field of Child and Adolescent Mental Health, ensuring their ability to effectively and confidently address these common issues in primary care.

The refugee and migrant health "global competency standards for health workers": results of a survey in general practitioner trainees in Sicily.

Refugees and migrants may represent the most vulnerable communities in many societies. Health systems should be sensitive to needs of refugees and migrants. The document "The Refugee and Migrant Health: Global Competency Standards for Health Workers (the Standards)" identifies the competencies and areas of practice of health workers working with refugees and migrants. The aim of this study is to provide an analysis of these competences and training needs, identifying the educational priorities for the implementation of the Standards in Sicily, Italy. A cross-sectional analytical pilot study was conducted by administering a questionnaire, in electronic format "Google Form ®," to doctors attending the Medical Training Course for General Practitioners in Sicily (Italy). Data obtained were collected in a Microsoft Excel database and analyzed with IBM SPSS Software 24 version. Absolute and relative frequencies were calculated for relevant categorical variables. Univariate analysis of the selected variables was subsequently carried out. The significance level chosen was a p value <0.05 (two-tailed). A total of 192 General Practitioner (GP) trainees responded to the questionnaire. They were asked if their training course comprised a Global Health Course that included the topic of health protection and social and health care for migrant populations and the 65.4% of them answered "No" or "Do not Know." GP trainees were also asked if they considered useful to include a Global Health Course dedicated to the management of patients with a migratory background within the training course in general medicine. Of the total 192 participants, 81.9% answered "Yes." Overall, in a simple regression model, the perception of having addressed migrants' health needs is positively correlated with having attended a Global Health Course (OR = 3.34 95%CI 1.2-9.1; p = 0.018). This study identified educational priorities for the implementation of the Standards in Sicily for doctors attending the Medical Training Course for General Practitioners. We hope that the results of this study will guide and inform possible future projects to implement the Standards at a national level.

Percepção do transtorno disfórico pré-menstrual entre universitários de medicina de Curitiba/PR

Introduction: Premenstrual Dysphoric Disorder (PMDD) is a severe form of Premenstrual Syndrome (PMS) characterized by psychological or behavioral symptoms that significantly impact a woman’s quality of life. Due to its recent recognition as a mental health disorder, many healthcare professionals remain unfamiliar with PMDD, complicating its diagnosis and management. Objective: To evaluate the perception of medical students in Curitiba, Paraná, regarding premenstrualdysphoric disorder. Methods: This descriptive cross-sectional study was approved by the Research Ethics Committee (CAAE: 47635921.4.0000.0093). Data were collected between August 2021 and April 2022 through an online questionnaire administered to 593 medical students from institutions in Curitiba, Paraná. The questionnaire assessed knowledge about PMDD, its teaching during medical training, differentiation from PMS, and the medical approach towards affected women. Results: Of the participants, 83.6% were women and 16.4% were men. A total of 51.9% had studied Gynecology and Obstetrics and/or Psychiatry. Regarding PMDD, 40.8% had never heard of it, and only 28.8% had acquired knowledge about it during their university education. Among those who had studied Gynecology and/or Psychiatry, 86.7% did not feel qualified to diagnose the disorder and were unaware of the differences between PMDD and PMS (52.4%), with a higher frequency of men (68.4%) compared to women (51%, p=0.017). While 55.2% of students correctly defined PMDD, the majority (53.2%) were unclear about its signs and symptoms. Among female students, 82.9% felt that the medical approach was superficial during consultations, while only 10.1% reported a thorough investigation of symptoms.Conclusions: PMDD is a condition that is poorly understood and inadequately addressed in the training of general practitioners. Increasing awareness and education on this subject in universities would better equip professionals to recognize and manage this disorder, ultimately improving women’s quality of life.

Language of primary medical qualification and differential MRCGP exam attainment: an observational study.

Background International Medical Graduates (IMGs) are more likely to fail postgraduate assessments and comprise over half of GP trainees. Aim This study assessed whether there is an association between language of primary medical qualification (PMQ) and Membership of the Royal College of General Practitioners (MRCGP) results and whether performance in previous pre-qualification assessments is correlated. Design and Setting We used the World Directory of Medical Schools Search and the UK Medical Education databases. Data were obtained for all candidates who sat the MRCGP exams between October 2013 and July 2021 (N=28,005). Method Cohort 1 included UK graduates, cohort 2 included IMGs with PMQ English who trained in countries with English (2a) or non-English (2b) as a first language, and cohort 3 included IMGs with PMQ non-English. Logistic and linear regression analyses were used to compare the odds of exam passing and the scores relative to pass. Associations with past MSRA scores, IELTS scores and PLAB scores were examined. Results IMGs who trained in countries with non-English as first language had statistically significantly lower odds of passing the exams and lower exam scores across all exam components. There were significant positive correlations between MSRA, IELTs and PLAB scores and MRCGP exam scores. Conclusion English PMQ language and undertaking medical training in a country with English as the native language seem to result in significantly better chances of passing the exams and better exam scores. Performance in pre-qualification assessments can help identify IMG trainees who may benefit from tailored support.

General practice trainee, supervisor and educator perspectives on the transitions in postgraduate training: a scoping review

Transitions are a period and a process, through which there is a longitudinal adaptation in response to changing circumstances in clinical practice and responsibilities. While the experience of the transition...

The hostile environment in primary care: Qualitative analysis of a cross sectional survey of health care professionals in primary care

BackgroundIn 2014 the UK government rolled out the then called hostile environment as a series of punitive policies designed to disenfranchise undocumented migrants from living in Britain. As part of these measures upfront charging was introduced in 2017 which saw patients being denied treatment without prior full payment based on their immigration status. AimAssess the knowledge of the charging regulations in a sample of primary care practitioners. Assess the impact of the regulations on both patients and practitioners in a primary care setting. MethodsBuilding on a previous survey by the RCPCH, a cross sectional survey was circulated through the RCGP faculties and GP training groups within England. Demographic information and likert responses were collected from over 300 responses. Thematic analysis of over 120 white space questions was undertaken to create themes and sub-themes. ResultsResults showed an overall poor knowledge of the regulations. Thematic analysis was split into two main categories, (i) human impact of the policies and (ii) the economic and political impact of the policies. Key points were (i) lack of knowledge and awareness of the regulations, (ii) evidence of patient harm through patients’ being denied care, avoiding care or having care delayed, (iii) evidence of clinician harm through burnout, stress, a loss of faith in practice and concerns over extra work and (iv) concerns over implicit bias and structural racism within primary care and (v) concerns over lack of economic analysis. ConclusionCharging of overseas visitors is poorly understood within primary care despite having an impact on both patients and practitioners within this setting. Recommendations to help tackle this issue and reduce harm include training of staff, systematic reporting of harm, and a system wide economic analysis.

Role of GP trainees in improving patient care.

Role of GP trainees in improving patient care.

Multidisciplinary team-based primary care: questions for general practice training

Multidisciplinary teams delivering person-centred care are a central feature of primary care reforms in Australia and North America. General Practice is a primary care service that prioritises clinical person-centred care. The recent Strengthening Medicare Taskforce Report recognised that a person-centred team care approach needs strengthened education and training programs to support multidisciplinary teams in general practice. While the premise of multidisciplinary care is well established, strengthening education and training programs in general practice offers opportunities at the vocational training level and for intra-practice education. This Education in Practice paper discusses the relevance to contemporary general practice of findings from Tasmanian research projects conducted over the past decade, addressing three questions for general practice training: How can approaches to team-based education be tailored to different general practice settings? What strategies are best for delivering interprofessional training in general practice? How can patients be involved in the process of training and education of collaborative healthcare teams? The challenges presented by these questions are addressed by drawing from a consensus project on best practice in interprofessional training for collaborative primary healthcare, and from projects using in-person and online education and training. We propose a model that uses the clinical training space as a way of promoting multidisciplinary general practice. The model incorporates online and face-to-face spaces, where primary health professionals, patients, practices/teaching organisations, educators and technology are aligned through facilitation and feedback channels in ways that promote collaborative practice. Tasmania, as an island state with close connections between its university, state public health service and GP training, is well placed to have the strategic conversations about coordinating general practice education and training to meet the need for an integrated primary care workforce.

Priority of competencies in the professional activities of general practitioners (family doctors)

The functional responsibilities of general practitioners (family doctors) (GPs) have changed significantly over the past decade. The number of GP functions has expanded. Despite the increasingly complex professional activities of GPs, there is no scientific evidence for the qualification characteristics of GPs expressed in knowledge, skills, abilities, and competencies in the theory and practice in training. In this regard, a study was conducted to determine the priority of GP competencies that make up the qualification characteristics of a specialist. Aim. To analyze, generalize and rationale the research results, as well as to develop preliminary guidelines for GP training. Material and methods. The information base for the study was the results of ranking competencies according to their importance in the professional activities of GPs in Russia. It was obtained during the ascertaining experiment, implemented using the Delphi method as a method of expert assessment and strategic planning of training specialists. Conclusion. The analysis of competencies developed and agreed upon by experts showed its compliance with the job functions of GPs, the requirements of the Federal State Educational Standard for the General Medical Practice (Family Medicine) and the WONCA guidelines. A summary of the study results to determine the priority of competence in GP activities showed the following: — all competencies (25) were defined as necessary and constitutive of GP qualification; — 21 competencies were considered significant and highly significant for GPs; — 4 competencies were considered as of moderate significance and below moderate significance. The analysis of the priority of competences revealed insufficient methodological support for GP training in accordance with the social order. The results obtained showed the need to continue the study within the project "Quality Management of Training of General Practitioners (Family Doctors)".

Evaluation of a multicomponent educational intervention to decrease general practice registrars’ prescribing of benzodiazepines and related drugs: the BENEFIT prospective controlled study

Background: Benzodiazepines and medicines (including Z-drugs) are associated with frequent and serious related adverse effects. Despite this, they are frequently prescribed by general practitioners (GPs). We aimed to evaluate the effectiveness of a multi-component educational intervention designed to decrease the prescribing and initiation of these drugs by GPs in training ('registrars'). Methods/design: A pragmatic non-randomised, non-equivalent control-group design nested within the Registrar Clinical Encounters in Training (ReCEnT) cohort study was used to assess an educational intervention delivered to registrars in Australia. The intervention was underpinned by the Behaviour Change Wheel framework and included face-to-face workshops with pre- and post-session readings, a webinar for supervisors, and facilitation of registrar-supervisor dyad interactions. Analyses employed univariable and multivariable logistic regression. The p-value of an interaction term in the multivariable regression was used to determine the statistical significance of intervention-related change. Results: Analyses included data of 1,088 intervention registrars and 1,003 control registrars. While some decrease in prescribing was seen, compared to the change from pre-post in controls, there were no statistically significant decreases in the ‘Intention to Treat’ (interaction aOR = 0.92, 95%CI: 0.70, 1.20, p = 0.52) or ‘On Treatment’ (interaction aOR = 0.87, 95%CI: 0.65, 1.16, p = 0.33) populations, and no statistically significant decrease in new prescriptions in the ‘Intention to Treat’ population (interaction aOR = 0.88, 95%CI: 0.58, 1.35, p = 0.57). Implications: Our study may have implications for further research aiming to identify effective strategies to promote appropriate benzodiazepine prescribing among GP registrars. Continued education for registrars around rational benzodiazepine prescribing is essential. This study is an initial step in evaluating the behaviour change intervention and further investigation and extended observation is warranted. This study highlights the educational challenges in improving rational benzodiazepine prescribing. Limitations: Randomization in the study design was not practicable. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12618000824268

Effect of Combination of Point-of-Care C-Reactive Protein Testing and General Practitioner Education and Long-Term Effect of Education on Reducing Antibiotic Prescribing for Children Presenting with Acute Infections in General Practice in Latvia: A Randomized Controlled Intervention Study.

Antibiotics are often overprescribed in children in general practice. We investigated whether the availability of C-reactive protein point-of-care testing (CRP POCT) in daily practice and general practitioner (GP) education reduces antibiotic prescribing for children with acute infections and whether GP education has a long-term effect on antibiotic prescribing. This was a randomized controlled intervention study with randomization at the GP practice level. Eligible patients were children aged 1 month to 17 years presenting to general practice with an acute infection. In the first study period, one GP group received combined interventions (CRP POCT was provided for daily use in combination with a live educational session), while the second GP group continued usual care. During the second study period, the GP groups were switched. During this period, the long-term education effect was evaluated in the GP group, which had previously received both interventions: the CRP POCT was no longer available in their practices in accordance with the study protocol, but education could have a lasting effect. Antibiotic prescribing at index consultation. GP with combined intervention enrolled 1784 patients, GP with usual care enrolled 886 patients, and GP with long-term education effect enrolled 647 patients. Most of the patients had upper (76.8%) and lower (18.8%) respiratory infections. In total, 29.3% of the study patients received antibiotic prescriptions. Adjusted binary logistic regression analysis showed no differences for the primary outcome between GPs with usual care and GPs with combined intervention (aOR 0.89 (0.74-1.07), p = 0.20), but significantly lower antibiotic prescribing was observed for GPs with long-term education in comparison with GPs with usual care (aOR 0.75 (0.59-0.96), p = 0.02); however, after multilevel analyses, any differences in the antibiotic prescription between intervention groups became non-significant. GPs widely used CRP POCT when it was available in practice (for 69.1% of patients in the combined intervention group), but rarely measured CRP in the laboratory in the usual care group (8.8% (n = 78)) or long-term education group (14.8% (n = 98)). The majority of the tested patients had low CRP levels (below 20 mg/L); despite this, up to 35.4% of them received antibiotic prescriptions. Our results show that the availability of CRP POCT and educational training for GPs together did not reduce antibiotic prescribing, and one-time education did not have a long-term effect on antibiotic prescribing.

The effects of physical activity prescription on mental health: Evidence from primary care

While the benefits of physical activity on health are well documented, in high-income countries 1 in 3 adults do not reach the recommended levels. Thus, policy makers have developed interventions to promote physical activity. The aim of this research is to evaluate the effectiveness of physical activity prescription on mental health outcomes, by studying an intervention that prescribes physical activity at the primary care level in Catalonia (PAFES). This intervention specifically targets the adult population with high cardiovascular risk. We use data from the Health Survey of Catalonia (2011–2016) and exploit the variation in the number of trained General Practitioners that prescribe physical activity. Our results show that physical activity prescription reduces the probability of suffering from poor mental health. This effect is mainly driven by females within the targeted population. We also explore the main effect (or the output) of the intervention. While PAFES increases the probability of patients undertaking high-level physical activity, it does not affect rates of sedentarism or minutes walked per day. Results are consistent when using alternative mental health outcome measures, including self-reported depression and anxiety. We conclude that the prescription of physical activity not only contributes to the improvement of physical health but is also a useful tool to help preserve mental wellbeing.