Treatment decision-making in advanced kidney disease: an international collaborative workshop on future directions

By Dr Lucy Selman, Associate Professor in Palliative and End of Life Care, Centre for Academic Primary Care, University of Bristol

On Thursday 8 June 2023, an expert meeting was held at the University of Bristol, on treatment decision-making in advanced kidney disease. The meeting brought together renal and palliative care clinicians and researchers specialising in the area from across the UK with colleagues from Harvard University and Brigham and Women’s Hospital, with two guests from Boston coming to Bristol to attend in person.

The aim of the event was to share research and clinical practice models related to treatment decision-making in advanced kidney disease – an area in which the partnering teams have complementary expertise.

The event was led by Dr Lucy Selman, Associate Professor of Palliative and End-of-Life Care at the University of Bristol in collaboration with Professor James Tulsky, Professor of Medicine at … Read more

Why doing research with domestic abuse perpetrators is challenging

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by Dr Helen Cramer, Senior Research Fellow, Centre for Academic Primary Care, University of Bristol

The importance of providing support for victims and survivors of domestic abuse has long been established and a considerable body of research shows what effective support should look like. How to engage with perpetrators of domestic abuse is less well understood. There are a range of interventions of different lengths and purposes such as shorter ones to assess risk, and containment and disruption approaches for the highest risk perpetrators to try to manage that risk.

For lower risk perpetrators, longer (e.g. six month) group programmes aiming to reduce abusive behaviour and offering support to the partners and ex-partners alongside are recommended by Respect, a UK membership organisation that sets standards and accredits perpetrator programmes. However, the evidence for these group programmes is uncertain and there are extensive methodological challenges to … Read more

What do we know about how GPs are used in emergency medical services?

 

 

 

By Dr Alex Burrell, NIHR Academic Clinical Fellow in General Practice, Centre for Academic Primary Care, University of Bristol

CAPC researchers, Dr Alex Burrell, Dr Grace Scrimgeour and Dr Matthew Booker have conducted a systematic review and narrative synthesis to assess the evidence on how GPs are used in emergency medical services.

Emergency medical services in the UK are under significant pressure. A considerable proportion of their workload relates to problems that could be dealt with by a GP. Using GPs in emergency medical services, such as the ambulance service, might reduce the number of people being taken to Accident and Emergency (A&E) and may more appropriately meet these patients’ needs. This could also free up ambulances and paramedics to respond to life-threatening emergency calls.

Different roles

GPs have been used in emergency medical services in a number of countries. In some countries, … Read more

Festival of Teaching 2023

 

 

 

 

 

By Dr Simon Thornton, GP Engagement Lead, Centre for Academic Primary Care, University of Bristol (left) and Professor Trevor Thompson, GP and Head of Primary Care Teaching, Centre for Academic Primary Care, University of Bristol (right)

For the last two years the teaching arm of the Centre for Academic Primary Care (CAPC) have been doing something a little different when it comes to Continuing Professional Development (CPD): a Teaching Festival, a day of activities that aims to celebrate and entertain as well inform and train.

This year our destination was Clevedon Hall, a stone’s throw from the marine lake on the shore at Clevedon. On display throughout the day was a collection of artwork produced by our medical students as well as photography by a local GP, Dr Jon Rees. The grounds are an absolute delight as was our programme of … Read more

Arts and Sciences – researching the history of antibiotics in primary care

Dr Barbara Caddick
Dr Barbara Caddick

 

 

This article was originally published by the Elizabeth Blackwell Institute for Health Research. Reproduced here with kind permission.

 

The prevalence of antibiotic use in modern society is well established. Antibiotics have revolutionised medicine and how society sees – and deals with – disease. Along with concerns regarding the rise of antibiotic resistant bacteria, thought to be exacerbated by their over-use in many areas, there is a need to understand the history of their adoption and use, especially in primary care. Comprehending the many-tendrilled circumstances and behaviours that led to this point might help to inform future choices, and give some insight into future best practice.

Dr Barbara Caddick, Senior Research Associate at the Centre for Academic Primary Care (CAPC) at the University of Bristol, is well qualified for such an undertaking, with a PhD in History and extensive experience in research in Read more

Contraception: what women (over 40) want

Dr Jo Burgin

 

 

 

by Dr Jo Burgin, Centre for Academic Primary Care, University of Bristol

Over a third of all pregnancies in women over 40 result in therapeutic abortion. This is one of the highest rates of abortion compared to live births in any age group. This suggests an unmet need for contraception. I interviewed women over 40 about their views and experience with contraception to find out more.

“I couldn’t do another child”

Previous studies have attributed the relatively low use of reliable contraception in women over 40 to women’s perceptions of themselves as low risk of pregnancy. However, participants in this study felt pregnancy was a real possibility and that an unplanned pregnancy would have a significant negative impact on their lives. Some had completed their families or had other caring responsibilities. While others knew they did not want any children and did not want to … Read more

Improving consultations for patients and GPs: The Consultation Open and Close Study

Dr Mairead Murphy

 

 

 

by Dr Mairead Murphy, Honorary Research Fellow, Centre for Academic Primary Care, University of Bristol and Evaluation Lead, South West Academic Health Science Network

“I think everyone’s been in the situation where they go to a doctor to talk about something that they find hard to talk about or they might find it difficult to voice their concerns.”

“I just couldn’t get a word in edgewise, sometimes you find you’ve just arrived and the GP is writing the prescription you know?”

These are some of the things patients said to us when we interviewed them for the Consultation Open and Close (COAC) study. Patients felt that, in the 10-minute consultation, particularly when it was by telephone, the GP did not always have time to get to the root of their problems.

This is not new or surprising. The 10-minute GP consultation is the shortest in EuropeRead more