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Intervention research is rapidly evolving and the updated Medical Research Council's framework from 2021 recommends a number of elements to consider when developing, adapting and evaluating complex interventions. We aimed to introduce the framework into the Danish language, and it is now ready for use in the efforts to developing and evaluating interventions that can help closing the evidence-practice gap. Using the framework systematically is expected to optimise evidence-based decisions of implementing new or settle obsolete interventions targeted patients, providers or healthcare organisations. This review gives a brief summary of the updated recommendations.

Multimorbidity and polypharmacy increasingly challenge healthcare systems. In this review, we discuss the deprescribing of inappriopriate medication, which is essential for improved patient care and optimal use of healthcare resources. Barriers of deprescribing in primary care are multifaceted and exist not only at the general practitioner level or the patient level but also at the organizational, structural, and sociocultural levels. New approaches and tools are emerging. However, the complexity of this challenge calls for broad healthcare initiatives and policies to reduce inappropriate prescribing.

The aim of the study was to evaluate the impact of general practitioners (GPs) follow-up of unvaccinated girls in the Danish Human Papillomavirus catch-up vaccination programme. Telephone interviews were conducted with the GPs to explore their follow-up procedure. The girls were divided into two groups: 1) girls contacted by their GP and 2) girls not contacted by their GP. Ten months later 61% of the girls, who had been contacted, had started vaccination in the follow-up group compared to 53% of girls, who had not been contacted (p < 0.02). Follow-up by GPs increased the likelihood of subsequent vaccination in a group of unvaccinated girls.

About 85% of cancer patients present with symptoms to general practice. The health care system should be organised in a way that GPs are able to refer patients to timely and early cancer diagnosis. The GP works in an area where symptoms most often are benign and cancer is rare. Only a minority of the symptoms in the population are presented to the GP. The GP must refer many of these knowing that generally the positive predictive value is 2-10%. To be able to ensure the best primary cancer diagnostic pathway we need much more research on symptoms, use of diagnostics and the way to organise this in a health care system where every third citizen will get cancer.

Use of The Breakthrough Model is a complex intervention, which may support clinicians in implementing knowledge into clinical practice. It is targeted at small organisations and is based on a gradual change process in groups of clinical teams. Experts develop a change catalogue, which summarises previous experience, the clinical teams meet in three learning sessions to exchange experience and receive input from experts, and implementation is divided into smaller steps. Between learning sessions the teams conduct Plan-Do-Study-Act circles on small scale to test the feasibility of changes.

Background: Prostate cancer (PC) is the most frequent type of cancer among Danish men and its incidence is rising. PC is often asymptomatic, which makes it very difficult to diagnose clinically. The general practitioner can use prostate-specific antigen (PSA) testing as a diagnostic tool in PC. The use of PSA testing has been recommended by the Danish Urological Society since 1997. Our objective was to study the application and results of PSA testing in the former County of Aarhus, Denmark, in the period 1995-2006., Material and Methods: We extracted data from the laboratory database, LABKA, and the National Patient Registry (NPR) during the period 1995 to 2006. Data were merged by civil registration number, and the unit ordering PSA was identified as general practice or specialized healthcare system. Furthermore, we categorized samples as incident, repeated normal, repeated raised samples, or controls., Results: The use of PSA increased 43-fold in this period and the proportion of samples ordered by general practice increased from 38.6% (95% confidence interval: 36.4-40.8%) in 1998 to 66.1% (65.4-66.8%) in 2006. The proportion of incident samples ordered by general practice, with results below four mikromol/l increased rapidly, whereas it decreased in the specialized healthcare system. In this population, the PC incidence increased the same period, but remained stable from 2004 onwards. Furthermore, we found that the mean number of tests per man per year increased in general practice., Conclusion: PSA testing in general practice is conducted more frequently, a tendency which may be explained by more check-ups after PC treatment, watchful waiting and opportunistic screening.

The study shows that GPs perceive systematic reviews of patient cases as potential learning vehicles. This is in line with adult learning theories, which argue that professional capability is best enhanced by situating learning in real-life contexts. This paper argues that we should think pragmatically when developing learning methods, and strengthen future efforts to develop methods that ensure reliable learning based on reviews of patient cases.

Introduction: In about 10% of routine vaginal smears, pathologists recommend a repeat smear. The purpose of this paper is to describe the extent to which this recommendation is followed, reasons why this is not always the case, and possible ways of improvement., Materials and Methods: Data on follow-up rates were extracted from the cervical cancer screening database in Aarhus County. Through facilitator visits information was obtained about the routine procedures for informing women about the test results, reasons for lack of follow-up and suggestions for improvement of the follow-up rate., Results: One third of the recommended follow-up smears were not taken. Patients from single-handed practices were less likely to have a follow-up smear than those registered with group practices. The follow-up rate was independent of the organisation of the procedures for informing the women about the test results. Reasons at practice level for lack of follow-up included failure to convey the test results, unclear information to the women and lack of procedures to identify those who did not have the recommended test taken. To improve the follow-up rate, the general practitioners who were interviewed suggested a number of procedures to identify the women who did not receive the recommended follow-up smear., Conclusion: The follow-up rate is not acceptable, and a systematic follow-up procedure is necessary to ensure that the recommended follow-up tests are carried out. This is most efficiently done at a central level.

Based on a review of the literature, this article describes the most common causes of vaginal discharge including changes in the woman's perception of her vaginal secretion, disturbances in the vaginal microbiological environment (vulvovaginal candidiasis and bacterial vaginosis), and infection with Chlamydia trachomatis. The article attempts to answer a number of questions which this condition poses to the clinician. It is concluded that with the available diagnostic possibilities the general practitioner is in a good position to make a correct diagnosis and institute an effective treatment.