by Chris Salisbury, Mairead Murphy and Polly Duncan, Centre for Academic Primary Care, University of Bristol
Because of the COVID-19 pandemic, general practices have rapidly shifted to offering consultations remotely by telephone, video or online messaging rather than face-to-face. Many general practices are considering whether they should continue these new ways of working into the future and some commentators are arguing that general practice will be changed forever. Remote consultations could be more convenient for patients and reduce workload pressures on general practices.
Just before the COVID-19 pandemic we wrote a paper which modelled how an increasing use of online, video and telephone consultations would affect GPs’ workload. Our conclusion was that a reduction in workload should not be assumed, and remote consulting could instead lead to an increase in GP workload over time. It all depends on how remote consultations are used.
The paper … Read more
by Dr Sophie Turnbull, Senior Research Associate, Centre for Academic Primary Care, University of Bristol
Digital interventions have become increasingly popular due to their potential to increase access to healthcare for people with chronic conditions and reduce the burden on a stretched healthcare system.
This has been amplified during the COVID-19 crisis, where much face-to-face support has been reduced or is no longer available. However, there are concerns that digital health provision may exacerbate existing health inequalities.
Chronic or long-term conditions, such as diabetes, are estimated to account for 87% of deaths and have a significant impact on an individual’s quality of life. Even in high-income countries, people with lower socioeconomic status experience chronic illness more commonly and with greater severity than average for the rest of the population.
We also know that people with existing health conditions, in low paid or insecure work and … Read more
by Dr Rupert Payne
Consultant Senior Lecturer in Primary Health Care
Centre for Academic Primary Care
The seventieth anniversary of the NHS has made me reflect on how proud I am to have contributed to its work for over the past twenty-odd years. Founded on 5 July 1948, the service continues to this day to operate to the same three core principles – meeting the needs of everyone, free at the point of delivery, and based on clinical need.
Aside from providing comprehensive, high-quality healthcare services to virtually the entire UK population, the other thing that the NHS is known for is the constant political bickering that carries on in the background, with criticisms about chronic under-funding and stealth privatisation. However, these are not new issues, with medicines an important reason for the challenges the NHS now faces.
In a response to concerns about rising costs, perhaps the first … Read more
Unveiling the results of the 3D trial for patients with multimorbidity in general practice
by Chris Salibsury, Peter Bower, Stewart Mercer and Bruce Guthrie
There is good agreement about the sort of care that people with multimorbidity need. But can it be delivered in the busy setting of general practice, and does it improve outcomes? In this blog we discuss the results of the 3D trial, the largest study of an intervention for multimorbidity published to date.
Managing multimorbidity is a litmus test for modern health care systems. Patients with many long-term conditions face major challenges in managing their conditions and need significant support, which means that these patients are often associated with high costs.
Despite the complexity of caring for these patients, there is also significant agreement about what sort of care they need. Many authors have highlighted that patient-centred care is crucial, with a … Read more
By Dr Polly Duncan
Professor Chris Salisbury
Centre for Academic Primary Care
We have developed a new, simply-worded, concise questionnaire – the Multimorbidity Treatment Burden Questionnaire (MTBQ) – to measure treatment burden in patients with multimorbidity (multiple long-term conditions).
Treatment burden is the perceived effort of looking after one’s health and the impact this has on day-to-day life. It includes everything that the patient has to do to look after their health including: ordering, collecting and taking medicines; coordinating and arranging transport for, and attending, health appointments with multiple health professionals; monitoring blood sugar or blood pressure levels; learning about own health conditions; and taking on lifestyle advice.
To understand how new health care interventions impact on treatment burden, we need to be able to measure it. A recent study published in the Annals of Family Medicine highlighted treatment burden as one of the core outcome measures … Read more