SCANDINAVIAN JOURNAL OF PRIMARY HEALTH CARE

'You would rather not fill your body with pills'-patient perspectives on polypharmacy and medication reviews by pharmacists in general practice
Als JG, Thomsen JL, Sørensen SS, Johnsen SP and Merrild CH
Polypharmacy is widespread. The demographic shift toward older patients receiving multiple medications increases risk and drug-related problems in these patients.
Cognitive dysfunction in diabetes - the 'forgotten' diabetes complication: a narrative review
Sjöholm Å, Bennet L and Nilsson PM
In addition to peripheral neuropathy of various kinds, diabetes can also cause central neuropathy, which among other things can manifest itself as premature cognitive dysfunction, often linked to vascular dysfunction. Although the link between diabetes and cognitive dysfunction was discovered more than 100 years ago and has important clinical implications, this diabetes complication remains relatively unknown. Recent years have seen research that has clarified cerebral insulin resistance and defective insulin signaling as examples of pathogenic factors behind this cognitive impairment in diabetes.
Considerations and experiences with healthcare-seeking during the first COVID-19 lockdown in Denmark
Raasthøj Holst I, Sætre LMS, Lauridsen GB, Balasubramaniam K, Haastrup P, Wehberg S and Jarbøl DE
To (1) examine considerations before and experiences with GP contact during the first COronaVIrus Disease 2019 (COVID-19) lockdown among Danish citizens; (2) analyse the associations with sex, age, chronic disease, and socioeconomic factors; and (3) explore changes in healthcare-seeking behaviour post-pandemic.
Health-related quality of life, lifestyle habits and chronic pain in individuals with knee pain - a 2-year follow-up study
Sylwander C, Haglund E, Larsson I and Andersson MLE
Knee pain increases the risk of developing chronic widespread pain (CWP) and knee osteoarthritis (KOA). The prevalence of CWP and KOA has increased, and there is a need for early prevention. Therefore, the aim was to examine the associations of health-related quality of life (HRQoL) and lifestyle habits with chronic pain at a two-year follow-up in individuals with knee pain.
General practitioners' clinical decision-making in patients that could have cancer: a vignette study comparing the Baltic states with four Nordic countries
Rosendahl A, Vanaveski A, Pilv-Toom L, Blumfelds J, Siliņa V, Brekke M, Koskela T, Rapalavičius A, Thulesius H, Vedsted P and Harris M
Relative one-year cancer survival rates in the Baltic states are lower than the European mean; in the Nordic countries they are higher than the mean. This study investigated the likelihood of General Practitioners (GPs) investigating or referring patients with a low but significant risk of cancer in these two regions, and how this was affected by GP demographics.
Exercise capacity after long-term physical activity on prescription provided by physiotherapists
Karsberg Zotterman D, Cider Å and Lundqvist S
Research has shown that physical activity on prescription (PAP), used in Swedish healthcare, increases patients' physical activity, but data are lacking regarding the long-term effects of PAP on exercise capacity. Therefor exercise capacity was evaluated in patients with metabolic risk factors, after 4.5 years of PAP treatment provided by physiotherapists in primary healthcare. This study included 98 patients (49% women; mean age, 56 years) with metabolic risk factors, who were still physically inactive after a previous 6-month PAP treatment. The patients received physiotherapist-provided PAP treatment for 4.5 years, including 11 follow-ups and 6 exercise capacity tests. After 4.5 years, 41 patients completed the final exercise capacity test (58% drop-out rate). Compared to baseline, the whole cohort exhibited a significantly increased exercise capacity (9.1 W,  = 0.014) with a small effect size ( = 0.27), with no significant differences associated with age or gender. The increased exercise capacity may indicate positive effects on longevity, and consolidates previous findings that long-term behavior change is possible among physically inactive patients. It also demonstrates the feasibility of continuous exercise capacity testing with physiotherapist support in an ordinary primary care setting. The drop-out rate and lack of control group complicate the interpretation of the effects of PAP treatment on the increased exercise capacity. Further research should strive for an RCT study design.
Systematic Coronary Risk Evaluation 2 (SCORE2), arterial stiffness, and subclinical coronary atherosclerosis in a population-based study
Strömberg S, Stomby A, Engvall J and Östgren CJ
To investigate the association between Systematic Coronary Risk Evaluation 2 (SCORE2) and subclinical damage in two vascular beds: atherosclerosis in the coronary arteries and aortic arterial stiffness, in a large population-based cohort without cardiovascular disease or diabetes.
B-phosphatidylethanol testing to identify hazardous alcohol use in primary health care-a game changer and a challenge for general practitioners: a qualitative study
Steensland Å, Segernäs A, Larsson M, Johansson Capusan A and Kastbom L
Alcohol use disorder (AUD) and hazardous alcohol use are common but underdiagnosed in primary health care (PHC). This study aimed to explore general practitioners' (GPs') experiences and perceptions of using B-Phosphatidylethanol (PEth), a specific quantitative biomarker for alcohol use, in their clinical work with patient consultations and treatment follow-up in Swedish PHC.
A systems perspective on gaps in the person-centered sick leave and rehabilitation process: a Swedish interview study
Löfgren M, Törnbom K, Gyllenhammar D, Nordeman L, Rembeck G, Björkelund C, Svenningsson I and Hange D
Consensus on priorities to optimize the sick leave and rehabilitation process (SRP) is lacking.
Care in the era of digital health: experiences from Norwegian general practitioners
Nassehi D and Ramvi E
This study explores the experiences of General Practitioners (GPs) in Norway, examining the role of care in their practice and the impact of digital health technologies on their caregiving approach.
General practitioners' barriers to cross-sectoral collaboration on pregnant women with vulnerabilities: a cross-sectional survey in Danish general practice
Brygger Venø L, Pedersen LB, Søndergaard J, Ertmann RK and Jarbøl DE
Pregnancy vulnerability contributes to poor perinatal mental health. Proper cross-sectoral collaboration may mitigate perinatal mental health problems. General practitioners (GPs) often face barriers when assessing pregnancy vulnerability, but little is known about GPs' perceived barriers to the cross-sectoral collaboration on vulnerable pregnant women.
A 'normal' life: a qualitative study exploring parents' experiences of everyday life with a child diagnosed with atopic dermatitis and atopic comorbidities
Færk G, Søndergaard E, Skov L, Hansen KS and Reventlow S
Atopic dermatitis (AD) and related atopic diseases are among the chronic health conditions that are becoming more common in children. Children with AD may develop atopic comorbidities, which makes it more difficult to manage treatment and necessitates more precautions in the child's everyday life. The parents of chronically ill children play a key role as the children's primary carers. This article explores the experiences of parents with the everyday tasks related to their children's illnesses.
They paid attention to the whole of me in some way, both physically, mentally, and everything in between: a qualitative study of patients' experiences of interdisciplinary rehabilitation (PREVSAM) in primary care for musculoskeletal disorders
Ekhammar A, Fridén S and Larsson MEH
To explore and describe patients' experiences and perceptions of rehabilitation according to the rehabilitation model 'Prevention of sickness absence through early identification and rehabilitation of at-risk patients with musculoskeletal pain' (PREVSAM).
Evaluating general practitioners' focused lung ultrasound competence and findings in patients with suspected community-acquired pneumonia in general practice
Strøm JJ, Andersen CA, Jensen MB, Thomsen JL, Laursen CB, Skaarup SH, Schultz HHL and Hansen MP
To evaluate general practitioners' (GPs') ability to perform focused lung ultrasound (FLUS) following a training program and assess FLUS feasibility in general practice. Also, to describe FLUS findings and evaluate GPs' ability to interpret these in adults with acute lower respiratory tract infection (LRTI) when pneumonia is suspected and assess GPs' perception of FLUS impact.
Effects on HbA1c of referral of type 2 diabetes patients to secondary care
Nøkleby K, Jenum AK, Buhl ES, Claudi T, Cooper JG, Flottorp S, Løvaas KF, Sandberg S and Berg TJ
To study trajectories of HbA1c in type 2 diabetes (T2D) patients referred to diabetes outpatient clinics (DOCs), and to explore characteristics of referrals and patient pathways in patients treated in DOCs.
Intervention description of pharmacist-facilitated medication reviews in Nordic primary care settings: a scoping review
Bø KE, Halvorsen KH and Lehnbom EC
Multicomponent interventions are increasingly utilized to tackle the complexity of aging and co-morbid patients. However, descriptions of interventions are generally poor, making it difficult for healthcare providers to implement successful programs.
Validation of point-of-care tests used at in-home assessments among older adults in primary care
Smedemark SA, Jepsen DB, Andersen-Ranberg K and Nybo M
Diagnosing acute disease in older adults is challenged by vague and atypical symptoms. Point-of-care tests (POCTs) at home may improve diagnostics and clinical decision-making. We compared various POCT devices to routine testing in acutely ill older adults to assess their clinical reliability.
Exploring participants' characteristics and self-assessed readiness to conduct clinical trials in general practice - baseline analysis of the RaPHaeL practice-based research network
Bauer A, Virnau L, Kroeber ES, Lingner H, Bleckwenn M, Frese T, Denny K, Braesigk A and Deutsch T
Primary care is integral to healthcare systems extending beyond traditional illness management to include preventive care, chronic disease management, and health promotion. Practice-based research networks (PBRNs) have emerged as essential infrastructures for conducting clinical research in primary care. This study explores the establishment of the 'Research-Practices Halle-Leipzig' (RaPHaeL) PBRN in Germany, evaluating the characteristics and research readiness of participating practices.
Medical encounters with young unaccompanied refugees: a qualitative study among general practitioners and physicians in migrant health clinics in Norway and Denmark
Moe G, Mjølstad BP, Getz LO, Sodemann M and Ytterhus B
This study examines the experiences of clinical encounters with young unaccompanied refugees in Norway and Denmark among both general practitioners (GPs) and physicians in migrant health clinics (MHC physicians), and it identifies important aspects that should be taken into consideration for improving the quality of healthcare for these patients.
How to support researchers in the primary care setting?
Gyllenberg F, Wasenius N and Laine MK
Exploring colorectal cancer patients' diagnostic pathways and general practitioners' assessment of the diagnostic processes: a Danish survey study
Jarbøl DE, Rasmussen S, Balasubramaniam K, Lykkegaard J, Ahrenfeldt LJ, Lauridsen GB and Haastrup P
Colorectal cancer (CRC) is among the most common cancers and the prognosis of CRC is highly dependent on stage at diagnosis. Although many cases are diagnosed swiftly, there is still room for improvement.