By Christie Cabral, Senior Lecturer, Centre for Academic Primary Care , University of Bristol
As a social anthropologist, I’ve been investigating why antibiotics are overused for over a decade and using the insights gained to develop antibiotic stewardship interventions. For World Antimicrobial Resistance (AMR) Awareness Week, I am writing about three key insights from my research.
1. The role of ‘Explanatory Models’ for illness and treatment: the influence on consulting and prescribing behaviours
Explanatory models are the set of linked ideas or theories that we each have in our minds about an illness and the possible treatments. These inform what we do as a patient, deciding whether to consult, or as a clinician deciding whether to prescribe.
The (simplified) biomedical model for the infections is of two types: viral or bacterial. Antibiotics treat bacterial infections but are ineffective for viral infections. So, it’s simple, no one … Read more
By Dr Ola Abdellatif, Primary Care Academic Collaborative (PACT) and Dr Jessica Watson, Centre for Academic Primary Care, University of Bristol
Rates of blood testing in general practice have increased over the past two decades in the UK. The reasons why are not entirely clear. Researchers from the University of Bristol, led by Dr Jessica Watson, joined forces with PACT – a collaborative of GP clinicians interested in research – to investigate who requests tests and why, and what the outcomes are. Why Test? Is their first study, which benefited from the unique access to clinical records facilitated by PACT. In this blog, Dr Ola Abdellatif, a GP trainee at the time of the study (now a salaried GP) and PACT member, together with Dr Jessica Watson, a GP and NIHR Clinical Lecturer in General Practice at the Centre for Academic Primary Care, University of Bristol and … Read more
by Dr Denize Atan, Associate Professor in Neuro-opthalmology, Neuroscience and Genetics, University of Bristol
Papilloedema is nerve swelling at the back of the eyes. It is caused by increased pressure inside the head and can be the first sign of a brain tumour or other serious health problems.
As half the people with a brain tumour have no symptoms, optometrists (trained eye care professionals who work at optician practices) may be the first to notice nerve swelling in someone during a routine eye test.
The importance of detecting papilloedema has been highlighted by recent high profile cases in the media.
The ‘Improving the Diagnostic accuracy of referrals for Papilloedema’ (DIPP) Study is funded by the National Institute for Health and Care Research (NIHR) to develop a set of guidelines and educational materials for optometrists and GPs that will help them to diagnose papilloedema more accurately … Read more
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.
GPs have been used in emergency medical services in a number of countries. In some countries, … Read more
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
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 Europe… Read more
By Dr Tanuka Palit, NIHR Academic Clinical Fellow in Primary Care, Centre for Academic Primary Care, University of Bristol
“You matter because you are you, and you matter to the end of your life. We will do all we can not only to help you die peacefully, but also to live until you die.” Dame Cicely Saunders
Many people express a wish to die at home. The proportion of deaths that occurred in the community (including private homes and care homes) rose significantly during the pandemic and has been sustained. As a consequence, the need to fund and improve our community palliative care services has never been more important. Earlier this year, this was recognised by a change in the Health and Social Care Bill to fund palliative care services in all areas. This will hopefully remove the postcode lottery that currently exists in the UK for … Read more
by Dr Simon Thornton, GP and GP Engagement Lead, Centre for Academic Primary Care, University of Bristol and Professor Trevor Thompson, GP and Head of Primary Care Teaching, Centre for Academic Primary Care, University of Bristol
The Centre for Academic Primary Care (CAPC) at the University of Bristol is a leading centre for primary care teaching and research based in Bristol Medical School. In April 2022, we held an inaugural Festival of Teaching at Bristol Zoo, to celebrate the skill and commitment of GP teachers, who are helping develop the primary care workforce of the future.
The day started with an introduction to teaching for the coming (2022/23) academic year from the teaching team. If you’re interested in teaching medical students and haven’t seen it already, do take a look at our Teaching Brochure that gives you all the information you need about teaching … Read more
by Dr Jessica Watson, NIHR Clinical Lecturer in General Practice, Centre for Academic Primary Care, University of Bristol
Have you ever found yourself looking at blood test results and wondered why the test was done in the first place?
Why Test? – It seems like a simple question. Yet despite increasing access to research databases such as Clinical Practice Research Datalink (CPRD), which contain millions of test results, there is no easy way to find out why these tests are being performed in the first place. How many are for monitoring, screening or diagnosis? Which symptoms trigger testing? To explore this, we are launching the Why Test study using the Primary Care Academic CollaboraTive (PACT).
Currently, only a tiny proportion of primary care clinicians have a formal academic contract with a University. PACT aims to open up opportunities for non-academic primary care clinicians to get … Read more
by Alastair Hay, Professor of Primary Care, Centre for Academic Primary Care, University of Bristol
I became a GP in 1997 and was appointed professor of primary care at the University of Bristol in 2013.
As a child, I was an avid Lego® player and reader of ‘how things work’ books. I was state-educated and did not enjoy school until my ‘A’ levels. I enjoyed the conceptual challenge of mathematics and, in 1985, was offered a place at Birmingham University to study maths and psychology. My results were better than I expected, so I withdrew and applied for medicine, securing a place at Sheffield.
I was initially disappointed by the course because of the lack of conceptual challenges. I was expected just to absorb lots of knowledge. Later, as I took responsibility for patient care, the application of knowledge became the interest. I did not intercalate … Read more