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ObjectivesTo investigate the usefulness of using automated appointment check-in screens to collect brief research data from patients, prior to their general practice consultation.DesignA descriptive, cross-sectional study.SettingNine general practices in the West Midlands, UK. Recruitment commenced in Autumn 2018 and was concluded by 31 March 2019.ParticipantsAll patients aged 18 years and above, self-completing an automated check-in screen prior to their general practice consultation, were invited to participate during a 3-week recruitment period.Primary and secondary outcome measuresThe response rate to the use of the automated check-in screen as a research data collection tool was the primary outcome measure. Secondary outcomes included responses to the two research questions and an assessment of impact of check-in completion on general practice operationalisationResultsOver 85% (n=9274) of patients self-completing an automated check-in screen participated in the Automated Check-in Data Collection Study (61.0% (n=5653) women, mean age 55.1 years (range 18–98 years, SD=18.5)). 96.2% (n=8922) of participants answered a ‘clinical’ research question, reporting the degree of bodily pain experienced during the past 4 weeks: 32.9% (n=2937) experienced no pain, 28.1% (n=2507) very mild or mild pain and 39.0% (n=3478) moderate, severe or very severe pain. 89.3% (n=8285) of participants answered a ‘non-clinical’ research question on contact regarding future research studies: 46.9% (n=3889) of participants responded ‘Yes, I’d be happy for you to contact me about research of relevance to me’.ConclusionsUsing automated check-in facilities to integrate research into routine general practice is a potentially useful way to collect brief research data from patients. With the COVID-19 pandemic initiating an extensive digital transformation in society, now is an ideal time to build on these opportunities and investigate alternative, innovative ways to collect research data.Trial registration numberISRCTN82531292.

Objectives To explore barriers and facilitators to COVID-19, influenza, and pneumococcal vaccine uptake in immunosuppressed adults with immune-mediated inflammatory diseases (IMIDs). Methods Recruiting through national patient charities and a local hospital, participants were invited to take part in an in-depth, one-to-one, semi-structured interview with a trained qualitative researcher between November 2021 and January 2022. Data were analysed thematically in NVivo, cross-validated by a second coder and mapped to the SAGE vaccine hesitancy matrix. Results Twenty participants (75% female, 20% non-white) were recruited. Barriers and facilitators spanned contextual, individual/group and vaccine/vaccination-specific factors. Key facilitators to all vaccines were higher perceived infection risk and belief that vaccination is beneficial. Key barriers to all vaccines were belief that vaccination could trigger IMID flare, and active IMID. Key facilitators specific to COVID-19 vaccines included media focus, high incidence, mass-vaccination programme with visible impact, social responsibility, and healthcare professionals’ (HCP) confirmation of the new vaccines’ suitability for their IMID. Novel vaccine technology was a concern, not a barrier. Key facilitators of influenza/pneumococcal vaccines were awareness of eligibility, direct invitation, and, clear recommendation from trusted HCP. Key barriers of influenza/pneumococcal vaccines were unaware of eligibility, no direct invitation or recommendation from HCP, low perceived infection risk, and no perceived benefit from vaccination. Conclusions Numerous barriers and facilitators to vaccination, varying by vaccine-type, exist for immunosuppressed-IMID patients. Addressing vaccine benefits and safety for IMID-patients in clinical practice, direct invitation, and public-health messaging highlighting immunosuppression as key vaccination-eligibility criteria may optimise uptake, although further research should assess this.

The COVID-19 pandemic disproportionately affected vulnerable populations’ access to health care. By proactively reaching out to them, general practices attempted to prevent the underutilization of their services. This paper examined the association between practice and country characteristics and the organization of outreach work in general practices during COVID-19. Linear mixed model analyses with practices nested in countries were performed on the data of 4982 practices from 38 countries. A 4-item scale on outreach work was constructed as the outcome variable with a reliability of 0.77 and 0.97 at the practice and country level. The results showed that many practices set up outreach work, including extracting at least one list of patients with chronic conditions from their electronic medical record (30.1%); and performing telephone outreach to patients with chronic conditions (62.8%), a psychological vulnerability (35.6%), or possible situation of domestic violence or a child-rearing situation (17.2%). Outreach work was positively related to the availability of an administrative assistant or practice manager (p < 0.05) or paramedical support staff (p < 0.01). Other practice and country characteristics were not significantly associated with undertaking outreach work. Policy and financial interventions supporting general practices to organize outreach work should focus on the range of personnel available to support such practice activities.

Contains fulltext : 285542.pdf (Publisher’s version ) (Open Access) The COVID-19 pandemic has had a large and varying impact on primary care. This paper studies changes in the tasks of general practitioners (GPs) and associated staff during the COVID-19 pandemic. Data from the PRICOV-19 study of 5093 GPs in 38 countries were used. We constructed a scale for task changes and performed multilevel analyses. The scale was reliable at both GP and country level. Clustering of task changes at country level was considerable (25%). During the pandemic, staff members were more involved in giving information and recommendations to patients contacting the practice by phone, and they were more involved in triage. GPs took on additional responsibilities and were more involved in reaching out to patients. Problems due to staff absence, when dealt with internally, were related to more task changes. Task changes were larger in practices employing a wider range of professional groups. Whilst GPs were happy with the task changes in practices with more changes, they also felt the need for further training. A higher-than-average proportion of elderly people and people with a chronic condition in the practice were related to task changes. The number of infections in a country during the first wave of the pandemic was related to task changes. Other characteristics at country level were not associated with task changes. Future research on the sustainability of task changes after the pandemic is needed. 20 p.

To estimate the prevalence of burnout among primary health-care professionals in low- and middle-income countries and to identify factors associated with burnout.We systematically searched nine databases up to February 2022 to identify studies investigating burnout in primary health-care professionals in low- and middle-income countries. There were no language limitations and we included observational studies. Two independent reviewers completed screening, study selection, data extraction and quality appraisal. Random-effects meta-analysis was used to estimate overall burnout prevalence as assessed using the Maslach Burnout Inventory subscales of emotional exhaustion, depersonalization and personal accomplishment. We narratively report factors associated with burnout.The search returned 1568 articles. After selection, 60 studies from 20 countries were included in the narrative review and 31 were included in the meta-analysis. Three studies collected data during the coronavirus disease 2019 pandemic but provided limited evidence on the impact of the disease on burnout. The overall single-point prevalence of burnout ranged from 2.5% to 87.9% (43 studies). In the meta-analysis (31 studies), the pooled prevalence of a high level of emotional exhaustion was 28.1% (95% confidence interval, CI: 21.5-33.5), a high level of depersonalization was 16.4% (95% CI: 10.1-22.9) and a high level of reduced personal accomplishment was 31.9% (95% CI: 21.7-39.1).The substantial prevalence of burnout among primary health-care professionals in low- and middle-income countries has implications for patient safety, care quality and workforce planning. Further cross-sectional studies are needed to help identify evidence-based solutions, particularly in Africa and South-East Asia.Estimer la prévalence de l’épuisement professionnel (burnout) chez les professionnels des soins de santé primaires dans les pays à revenu faible ou intermédiaire et identifier les facteurs associés à l’épuisement professionnel.Nous avons effectué une recherche systématique dans neuf bases de données jusqu’en février 2022 afin d’identifier les études portant sur l’épuisement chez les professionnels des soins de santé primaires dans les pays à revenu faible ou intermédiaire. Il n’y avait aucune limitation linguistique et nous avons inclus des études observationnelles. Deux examinateurs indépendants ont effectué le screening, la sélection des études, l’extraction des données et l’évaluation de la qualité. Une méta-analyse à effets aléatoires a été utilisée pour estimer la prévalence globale de l’épuisement professionnel, évaluée à l’aide des sous-échelles d’épuisement émotionnel, de dépersonnalisation et d’accomplissement personnel du Maslach Burnout Inventory. Voici un rapport narratif des facteurs associés à l’épuisement professionnel.Nos recherches ont permis d’identifier 1568 articles. Après sélection, 60 études provenant de 20 pays ont été incluses dans l’examen narratif, et 31 ont été incluses dans la méta-analyse. Trois études ont recueilli des données pendant la pandémie de Covid-19, mais ont fourni des preuves limitées de l’impact de cette maladie sur l’épuisement professionnel. La prévalence globale à point unique de l’épuisement professionnel variait de 2,5 à 87,9% (43 études). Dans la méta-analyse (31 études), la prévalence collective d’un niveau élevé d’épuisement émotionnel était de 28,1% (intervalle de confiance (IC) à 95%: 21,5–33,5), un niveau élevé de dépersonnalisation était de 16,4% (IC à 95%: 10,1–22,9) et un niveau élevé d’accomplissement personnel réduit était de 31,9% (IC à 95%: 21,7–39,1).La prévalence notable de l’épuisement professionnel chez les professionnels des soins de santé primaires dans les pays à revenu faible ou intermédiaire a des implications pour la sécurité des patients, la qualité des soins et la planification des effectifs. D’autres études transversales sont nécessaires pour aider à identifier des solutions empiriques, en particulier en Afrique et en Asie du Sud-Est.Estimar la prevalencia del desgaste profesional entre los profesionales de la atención primaria de salud en los países de ingresos bajos y medios e identificar los factores que se asocian a este síndrome.Se realizaron búsquedas sistemáticas en nueve bases de datos hasta febrero de 2022 para identificar estudios que investigaran el desgaste profesional en profesionales de la atención primaria de países de ingresos bajos y medios. No hubo limitaciones de idioma y se incluyeron estudios observacionales. Dos revisores independientes completaron el cribado, la selección de estudios, la extracción de datos y la evaluación de la calidad. Se utilizó el metanálisis de efectos aleatorios para estimar la prevalencia global del desgaste profesional, evaluada mediante las subescalas de agotamiento emocional, despersonalización y realización personal del Maslach Burnout Inventory. En este documento, se describen los factores asociados al síndrome de desgaste profesional.La búsqueda arrojó 1568 artículos. Tras la selección, se incluyeron 60 estudios de 20 países en la revisión narrativa y 31 en el metanálisis. Tres estudios recopilaron datos durante la pandemia de la enfermedad por coronavirus de 2019, pero proporcionaron pruebas limitadas sobre el impacto de la enfermedad en el desgaste profesional. La prevalencia global de un único punto sobre el desgaste profesional osciló entre el 2,5 y el 87,9 % (43 estudios). En el metanálisis (31 estudios), la prevalencia conjunta de un nivel alto de agotamiento emocional fue del 28,1 % (intervalo de confianza del 95 %, IC: 21,5-33,5), un nivel alto de despersonalización fue del 16,4 % (IC del 95 %: 10,1-22,9) y un nivel alto de disminución de la realización personal fue del 31,9 % (IC del 95 %: 21,7-39,1).La considerable prevalencia del desgaste profesional entre los profesionales de la atención primaria en los países de ingresos bajos y medios tiene implicaciones para la seguridad de los pacientes, la calidad de la atención y la planificación del personal. Se necesitan más estudios transversales para ayudar a identificar soluciones fundamentadas en la evidencia, en especial en África y Asia Sudoriental.تقدير مدى انتشار الإرهاق بين أخصائيي الرعاية الصحية الأولية في الدول ذات الدخل المنخفض والدخل المتوسط، وتحديد العوامل المرتبطة بالإرهاق. الطريقة قمنا بالبحث بشكل منهجي في تسع قواعد للبيانات حتى فبراير/شباط 2022، لتحديد الدراسات التي تقوم بالاستقصاء في الإنهاك لدى أخصائيي الرعاية الأولية في الدول ذات الدخل المنخفضة والدخل المتوسطة. لم تكن هناك قيود تتعلق باللغة، وقمنا بتضمين دراسات قائمة على الملاحظات. قام اثنان من المراجعين المستقلين بإكمال عمليات الفحص، وتحديد الدراسة، واستخراج البيانات، وتقييم الجودة. تم استخدام التحليل التلوي للتأثيرات العشوائية لتقدير مدى انتشار الإرهاق الكلي كما تم تقييمه باستخدام المقاييس الفرعية Maslach Burnout Inventory للإرهاق العاطفي، وفقدان الشخصية، والإنجاز الشخصي. نحن نقوم بالإبلاغ عن العوامل المرتبطة بالإرهاق عن طريق السرد. النتائج أسفر البحث عن 1568 مقالةً. بعد الاختيار، تم تضمين 60 دراسةً من 20 دولة في المراجعة السردية، وتضمين 31 دراسة في التحليل التلوي. جمعت ثلاث دراسات البيانات أثناء جائحة مرض فيروس كورونا 2019، ولكنها قدمت أدلة محدودة على تأثير المرض على الإرهاق. تراوح معدل الانتشار الكلي للإرهاق في نقطة واحدة من 2.5 إلى 87.9% (43 دراسة). في التحليل التلوي (31 دراسة)، كان معدل الانتشار المجمع لمستوى عالٍ من الإرهاق العاطفي هو 28.1% (بفاصل ثقة مقداره 95%: 21.5 إلى 33.5)، ومستوى عالٍ من فقدان الشخصية هو 16.4% (بفاصل ثقة مقداره 95%: 10.1 إلى 22.9)، ومستوى عالٍ من الإنجاز الشخصي هو 31.9% (بفاصل ثقة مقداره 95%: 21.7 إلى 39.1). الاستنتاج إن الانتشار الكبير للإرهاق بين أخصائيي الرعاية الصحية الأولية في الدول ذات الدخل المنخفض والدخل المتوسط، له آثار على سلامة المرضى، وجودة الرعاية، وتخطيط القوى العاملة. هناك حاجة إلى مزيد من الدراسات المقطعية للمساعدة في تحديد الحلول القائمة على الأدلة، وخاصة في أفريقيا وجنوب شرق آسيا.评估低收入和中等收入国家初级医疗护理工作者的职业倦怠率，并确定引起职业倦怠的相关因素。.我们系统地搜索了截至 2022 年 2 月的九个数据库，以确定调查低收入和中等收入国家初级医疗护理工作者职业倦怠情况的研究。搜集的研究没有语言限制，而且我们纳入了观察性研究。由两位独立评审员完成了筛查、研究选择、数据提取和质量评估。我们采用随机效应元分析法来评估整体职业倦怠率，并使用《马氏职业倦怠量表》作为子量表来评估情绪疲劳、人格解体和个人成就感的情况。我们对于职业倦怠相关的因素进行了叙述性报告。.搜索出 1568 篇论文。经过筛选，来自 20 个国家的 60 项研究被纳入叙述性回顾，31 项研究被纳入元分析。有三项研究收集了新型冠状病毒肺炎大流行期间的数据，但该疾病对职业倦怠的影响方面的证据有限。职业倦怠的总体单点流行率范围为 2.5% 至 87.9%（43 项研究）。在元分析（31 项研究）中，严重级别情绪疲劳的综合流行率为 28.1% （95% 置信区间，CI：21.5–33.5），严重级别人格解体的流行率为 16.4% (95% CI: 10.1-22.9），个人成就感严重缺失的流行率为 31.9% (95% CI: 21.7-39.1）。.低收入和中等收入国家初级医疗护理工作者的高职业倦怠率对患者安全、护理质量和人力规划会产生影响。需要开展进一步的横断面研究来帮助确定有证据支持的解决方案，特别是在非洲和东南亚地区。.Оценить распространенность профессионального выгорания среди специалистов первичной медико-санитарной помощи в странах с низким и средним уровнем дохода, а также выявить факторы, связанные с профессиональным выгоранием.Авторы провели систематический поиск по девяти базам данных, собранных до февраля 2022 года, и выявили исследования о профессиональном выгорании среди специалистов первичной медико-санитарной помощи в странах с низким и средним уровнем дохода. Языковых ограничений не было. Были включены обсервационные исследования. Два независимых эксперта провели скрининговое обследование, отбор исследований, извлечение данных и оценку качества. Для оценки общей распространенности профессионального выгорания использовался метаанализ случайных эффектов с помощью подшкал опросника выгорания Маслач для определения эмоционального истощения, деперсонализации и личных достижений. Авторы описательно сообщают о факторах, связанных с профессиональным выгоранием.В результате поиска обнаружено 1568 статей. После завершения отбора 60 исследований из 20 стран были включены в описательный анализ, а 31 – в метаанализ. Три исследования собрали данные во время пандемии коронавирусной инфекции 2019 года, но представили ограниченные данные о влиянии болезни на профессиональное выгорание. Общая распространенность профессионального выгорания колебалась от 2,5 до 87,9% (43 исследования). В метаанализе (31 исследование) общая распространенность высокого уровня эмоционального истощения составила 28,1% (95%-й ДИ: 21,5–33,5), высокий уровень деперсонализации составил 16,4% (95%-й ДИ: 10,1–22,9), а высокий уровень снижения личных достижений составил 31,9% (95%-й ДИ: 21,7–39,1).Значительная распространенность эмоционального выгорания среди специалистов первичной медико-санитарной помощи в странах с низким и средним уровнем дохода влияет на безопасность пациентов, качество медицинской помощи и планирование трудовых ресурсов. Необходимы дальнейшие поперечные исследования для поиска основанных на фактических данных решений, особенно в Африке и Юго-Восточной Азии.