Artwork for podcast BJGP Interviews
The impact of continuity on mortality in four common and chronic diseases in general practice
Episode 16223rd April 2024 • BJGP Interviews • The British Journal of General Practice
00:00:00 00:13:01

Share Episode

Shownotes

In this episode, we talk to Dr Sahar Pahlavanyali, a doctor and PhD candidate based at the Department of Global Public Health and Primary Care at the University of Bergen in Norway. 

Title of paper: Continuity and breaches in GP care and their associations with mortality for patients with chronic disease: an observational study using Norwegian registry data

Available at: https://doi.org/10.3399/BJGP.2023.0211

There is a growing body of evidence on advantages of continuity, and a GP personal list is believed to be one of the positive measures to improve continuity, though not much researched. In a Norwegian setting with GP personal lists, we investigated the associations between GP continuity and mortality for patients with different chronic diseases. Our results showed that lower GP continuity was associated with increased risk of death, but the association was not significantly different for patients with the same RGP compared with those with different RGPs. This study suggests that high informational and management continuity provided by a GP personal list might lower and compensate for the adverse effects when changing GP.

Chapters

More Episodes
162. The impact of continuity on mortality in four common and chronic diseases in general practice
00:13:01
161. The challenges and impacts of the Additional Roles Reimbursement Scheme (ARRS) in general practice
00:17:06
160. Improving access to general practice for people with multiple disadvantage
00:15:16
159. BJGP Easter break
00:00:38
158. Addressing child weight issues in the consultation – what could we be doing better in general practice?
00:16:30
157. The shift to online consultations – what is the patient perspective?
00:15:52
156. How can we provide better care for older patients with multiple disadvantage?
00:15:29
155. How can we better manage patients after a hospital admission for asthma?
00:14:00
154. Joining the dots – how do patients and clinicians experience continuity in extended access clinics?
00:15:58
153. What prescription medicines patients share and why
00:11:52
152. Signals before a diagnosis of bipolar disorder and opportunities for earlier diagnosis by GPs
00:15:05
151. BJGP’s top 10 most read papers of 2023
00:32:10
150. Satisfaction with remote consultations and why education matters
00:13:41
149. A paradox of access and how we can address the increasing demand in general practice
00:15:43
148. Providing proactive and holistic palliative care in general practice – exploring the patient perspective
00:12:08
147. Coeliac disease and its diagnosis in primary care – what is the patient experience?
00:14:30
The BJGP Christmas stocking filler podcast
00:45:54
Christmas break
00:01:00
146. Investigating the signals in primary care prescribing before a diagnosis of bladder or renal cancer
00:11:29
145. Strategies for better diagnosis of COPD in primary care – patient coordinators and the GOLD questions
00:13:08
144. How to safely taper off antidepressants – developing resources for patient use
00:14:28
143. What are the trends around private prescribing of opioids in England and why does it matter?
00:13:52
142. Moral distress in family physicians – the impact of societal inequities on doctors
00:14:19
141. Raising awareness of interconception care: what can we be doing to help women between pregnancies?
00:12:44
140. Disparities in Faecal Immunochemical Test (FIT) uptake – ethnicity and deprivation matter
00:14:41
139. Does continuity of care matter? A view from the BJGP and Sir Denis Pereira Gray from the RCGP conference
00:15:46
138. A focus on young people with ulcerative colitis – do they take their treatment and what can GPs do to help?
00:14:20
137. Domestic abuse during the Covid pandemic – patient experiences and how GPs can help
00:15:04
136. Hearing the voice of primary care – what are women’s health needs in practice?
00:15:12
135. Bloods tests in primary care – Why test and what can we learn from looking at current practice?
00:15:53
134. How can we integrate brief conversations about alcohol reduction into practice? Lessons from an Australian intervention
00:16:10
133. A look at how musculoskeletal consultations and prescribing changed during the Covid pandemic
00:11:29
132. Patients and gut feelings, and how to take these into account in the general practice consultation
00:12:48
BJGP podcasts on summer break - and a pitch for the BJGP Research Conference
00:01:33
BJGP podcasts on summer break - and a pitch for the BJGP Research Conference
00:01:33
131. It’s not all about the money – exploring the motivations of Danish GPs
00:15:18
130. Micro-teams in primary care – opportunities and implications for continuity and for patients
00:12:57
129. How to follow-up younger patients with atrial fibrillation and reassess stroke risk in general practice
00:10:29
128. Are there opportunities for earlier diagnosis of non-cancer diseases?
00:15:26
127. Celebrating the work of Dr Sarah Bailey and Dr Ben Brown, winners of the RCGP/SAPC Early Career Researcher Awards
00:14:29
126. Gender differences in pay and uptake of partnership roles – what can we do differently?
00:15:32
125. Results from two national cancer audits – what’s changed in referrals and early diagnosis for cancer between 2014 and 2018?
00:12:56
124. The association between burnout and the increasing prescribing of opioids and antibiotics in practice – what can we do differently?
00:14:05
123. Thinking about the best ways to integrate pharmacists into general practice – views of GPs and pharmacists
00:14:29
122. How the RCGP is supporting research – and how you can get involved
00:10:36
121. Looking at what happens when a GP surgery closes – what are the wider impacts on patients and other practices?
00:14:26
120. Clinical factors and characteristics of men who see their GP before death by suicide
00:11:45
119. Who’s at risk of acute kidney injury? Developing a score to use in general practice amongst patients with hypertension
00:13:34
118. How can GPs better manage breathlessness symptoms and what is the impact of diagnostic delays?
00:14:48
117. How can we improve our care for ethnic minority women through the menopause?
00:14:09
116. The consequences of online access to patient records – what are the views of practice staff?
00:14:30
115. Better colorectal cancer screening - lessons from the CRISP RCT
00:17:20
114. Continuity in the remote age – what is the impact on patients and GPs?
00:17:22
113. Primary care was overlooked in the pandemic - here's how we can do better next time
00:18:19
112. What constitutes good end of life care, and what is the role of general practice?
00:18:10
111. Discussing increasing trends in the diagnosis and treatment of anxiety in Belgium
00:13:54
110. Academic performance in clinical components of the MRCGP – does ethnicity matter?
00:15:36
109. Listening to women’s experiences of heavy menstrual bleeding – what are the implications for GPs?
00:17:55
108. What do GPs think about prescribing aspirin to prevent colorectal cancer in Lynch syndrome?
00:15:39
107. Looking at interventions to reduce antibiotic prescribing in general practice – results from a mixed-methods study
00:19:04
106. Managing patients with acute exacerbations of COPD in primary care – the Australian perspective
00:11:55
105. Home pulse oximetry amongst patients with Covid-19: patient perceptions and GP workload
00:13:13
104. Considering non-drug treatments for people with common mental health issues and socioeconomic disadvantage
00:15:35
103. Adverse drug reactions– how common are these in general practice and what are the implications for practice?
00:16:23
102. Combining vague cancer symptoms to improve referrals for suspected cancer
00:15:38
101. Diagnosing heart failure in primary care – what cut offs should GPs be using for referral based on natriuretic peptide levels?
00:15:22
100. BJGP’s top 10 most read papers of 2022
00:43:37
99. Exploring the reasons why general practice staff are reluctant to register undocumented people
00:18:25
98. Should we prescribe antibiotics to children with uncomplicated chest infections in primary care?
00:14:06
97. Preconception care – what GPs need to know to optimise pregnancy outcomes
00:15:13
96. Examining disparities in continuity of care in some ethnic groups and implications for practice
00:13:33
95. Should we measure blood pressure at night to diagnose hypertension?
00:14:42
94. 'Think gynae’: help seeking behaviour in women with gynaecological cancer
00:14:54
93. Survivorship care for colorectal cancer: pathways for GP led follow up
00:14:37
92. Consequences of patient access to online medical records
00:13:25
91. Common blood tests before cancer diagnosis and implications for primary care
00:14:22
90. Opportunities for earlier diagnosis of psoriasis in general practice
00:14:12
89. Newspapers on the ‘warpath’: portrayal of GPs in the UK media
00:18:18
88. B12 deficiency, patient safety and self-injection
00:14:03
87. Considering symptom appraisal and help seeking for cancer symptoms in older adults
00:17:30
86. When are proton pump inhibitors being inappropriately prescribed?
00:11:22
85. Considering treatment burden in our patients with multimorbidity
00:14:13
84. The golden thread of continuity of care
00:15:13
83. Summer 2022 - a quick update from the editor
00:03:07
82. Perspectives of GPs on diagnosing childhood urinary tract infections
00:12:58
81. Inflammatory marker blood tests suggest a diagnostic window to help earlier Hodgkin lymphoma diagnosis
00:09:59
80. Improving prescribing through feedback at individual patient level
00:15:45
79. Communication of blood test results to patients is often complex and confusing
00:11:59
78. Non-speculum clinician-taken sampling is comparable to self-sampling in cervical screening
00:09:51
77. How significant is abdominal pain when diagnosing intra-abdominal cancers?
00:15:09
76. People with colorectal cancer can show clinical features and abnormal bloods as early as 9-10 months before diagnosis
00:14:01
75. Primary care contacts with children and young people in the first Covid lockdown
00:10:03
74. Type 2 diabetes sub-groups could guide future treatment approaches in primary care
00:13:38
73. Developing a pathway to treat hepatitis C in primary care
00:13:35
72. The NICE traffic light system to assess sick children is not suitable for use as a clinical tool in general practice
00:15:03
71. The GP workforce crisis - how are outcomes associated with different professionals?
00:12:25
70. PRINCIPLE trial findings on the use of colchicine for COVID-19 in the community
00:13:29
69. The rise in prescribing for anxiety in primary care
00:13:30
68. GP wellbeing during the COVID-19 pandemic
00:15:39
67. Austin O'Carroll talks about the Triple F**k Syndrome
00:18:42
66. Do we need greater stratification of routine blood test monitoring in people on DMARDs?
00:13:35
65. Why do GPs rarely do video consultations?
00:17:40
64. Burnout among general practitioners across the world is often at high levels
00:14:22
63. Large prospective cohort study shows no association between breast pain alone and breast cancer
00:13:29
62. Managing emotional distress in people of South Asian origin with long-term conditions
00:15:22
61. Continuity of care for people with dementia is linked to significant clinical benefits
00:12:22
60. The unintended consequences of online consultations
00:10:55
59. Using urine collection devices to reduce urine sample contamination - results from a single-blind randomised controlled trial
00:11:40
58. The use of CXRs varies significantly between practices and addressing this could help with early detection of lung cancer
00:14:56
57. Locum use in England has remained stable in recent years
00:12:26
56. Non-speculum sampling with a clinician boosts cervical screening uptake in older women
00:13:32
55. Iona Heath on rewilding general practice
00:19:01
54. Identifying how GPs spend their time and the everyday obstacles they face
00:19:20
53. How patients feel about GPs using gut feelings
00:13:45
52. Exploring why emergency admission risk prediction software increased admissions in Wales
00:17:48
51. Developing resilience - just another work task for GPs?
00:13:40
50. The challenges of trials to promote physical activity in people with multimorbidity
00:11:57
49. The clinical coding of long Covid is low and variable
00:10:43
48. Continuity of care with a named GP reduces deaths
00:13:44
47. Recommendations for the recognition and management of long Covid
00:16:11
46. Urgent cancer referrals in primary care have more than doubled
00:14:29
45. Social prescribing and link workers in Deep End practices in Glasgow
00:19:13
44. Insights into safety-netting advice in general practice
00:15:24
43. Ondansetron for vomiting in paediatric gastroenteritis
00:10:47
42. Managing lower urinary tract symptoms in primary care
00:14:08
41. The complexity of diagnosing endometriosis in primary care
00:17:05
40. What is the experience of general practice for young people who self-harm?
00:11:39
39. What are the benefits and limitations of a continuous consultation peer-review system?
00:12:40
38. Episode 038: Summer 2021 Update
00:03:50
37. Talking to patients with long-term conditions about benefits and harms of treatment
00:16:28
36. The primary care experience in eight European countries during the first peak of COVID-19
00:14:57
35. Highlights from the July 2021 issue
00:23:57
34. Supporting patients to discontinue benzodiazepines
00:15:43
33. The impact of COVID-19 on migrants and how they access primary care
00:11:45
32. The role of GP outreach settings to help people experiencing homelessness
00:13:17
31. What factors are associated with potentially missed acute deterioration?
00:13:17
30. Remote consultations for people living with dementia and their carers
00:12:20
29. Cervical screening for trans men and non-binary people
00:13:15
28. Highlights from the May 2021 issue
00:31:38
27. Which patients miss appointments in general practice?
00:12:59
26. Targeting hard-to-reach groups to attend for possible cancer symptoms
00:19:30
25. The GP perspective on discontinuing long-term antidepressants
00:15:04
24. Highlights from the April 2021 issue of the BJGP
00:31:36
23. Professor Sir Michael Marmot on Julian Tudor Hart
00:14:14
22. Exploring the role of gut feelings in how GPs diagnose cancer
00:12:36
21. Group consultations in general practice
00:13:41
20. Domestic abuse among female doctors
00:14:19
19. Chronic kidney disease and the high burden of co-morbidity
00:15:06
18. Highlights from the February 2021 issue of the BJGP
00:37:57
17. Getting the right treatment to people in primary care with depression
00:15:57
16. How quickly are people with symptomatic lung cancer getting a pre-diagnostic chest X-ray?
00:10:32
15. Identifying patients at risk of psychosis
00:12:54
14. Remote consulting and the media during COVID-19
00:15:42
13. Approaches to help address missed appointments in general practice
00:13:10
12. High platelet counts and diagnosis in primary care
00:10:40
11. Testing for respiratory tract infection before and after COVID
00:18:02
10. Understanding the management of heart failure with preserved ejection fraction
00:11:13
9. Managing older people's perception of alcohol-related risk
00:12:08
8. End-of-life recognition in primary care in older people
00:13:11
7. Using the National Early Warning Scores (NEWS) in care homes
00:15:04
6. Excess mortality in the first COVID peak
00:11:20
5. Protecting pregnancies from the harmful effects of ACE inhibitors
00:13:47
4. Operational failures in primary care: the real world stresses of being a GP
00:11:41
3. What happens if we don't treat uncomplicated UTIs with antibiotics?
00:10:37
2. Supporting women with female genital mutilation in primary care
00:15:34
1. Impact of COVID-19 on the mental health of older adults
00:11:38