Yonder: a diverse selection of primary care relevant research stories from beyond the mainstream biomedical literature
COVID non-compliance
Throughout the world, adolescents and young people have consistently been characterised as being reluctant to comply with public health measures aimed at curbing the spread of COVID-19, especially with social distancing measures. Researchers from Switzerland recently sought to describe patterns of non-compliance with these measures in young adults.1 They found that non-compliance, particularly with hygiene-related measures, was more prevalent in males, and in individuals with higher education, higher socioeconomic status, and a non-migrant background. The authors suggest that public health campaigns should implement strategies that foster moral obligation and trust in authorities, or leverage trustworthy individuals in the community to disseminate information. More controversially, they also recommend long-term investments into ‘integrating youth with antisocial potential into society’, which they suggest may decrease rule-breaking behaviours in general.
Antidepressant withdrawal
Antidepressant use has been increasing rapidly over the past decade, and the mental health impacts of COVID-19 lockdowns are likely to have increased them further. Ideally, as conditions improve, patients should be supported to withdraw these medications. A recent study in Cornwall used questionnaires to ask GPs and psychiatrists about withdrawal symptoms and management.2 Psychiatrists thought that withdrawal symptoms were more severe than GPs did. Interestingly, about three-quarters of responders claimed they usually or always informed patients of potential withdrawal symptoms when they started a patient on antidepressants, but patient surveys say only 1% are warned. The authors suggest community pharmacists should be more widely used to support GP-managed antidepressant withdrawal.
Probiotics
A recent survey of European GPs that included telephone interviews with a remarkable 1318 doctors sought to examine their perceptions of probiotics.3 It found that 80% of GPs recommend probiotics in their practice at least sometimes, primarily for antibiotic-associated diarrhoea, infectious diarrhoea, and abdominal pain. Perhaps unsurprisingly, GPs that are familiar with the mode of action of probiotics, and/or who perceive them to be safe or efficacious, are more likely to recommend probiotics. The authors feel they need ‘better insight into which products, strains and indications are the main cause of GPs being hesitant to recommend probiotics’, which makes more sense when you see the study was funded by Yakult.
GPs in China
Healthy China 2030 is one of the most ambitious public health reform plans in history, and has a clear focus on strengthening primary care, including plans to train more than half a million more GPs. There has, however, been little study of existing GPs working in China, prompting a primary care research team from across China to investigate the job satisfaction of GPs.4 Their questionnaire was completed by 3236 doctors with a remarkable 99.8% response rate. They found job satisfaction among Chinese GPs is overall at a moderate level. Region, sex, professional title, education level, working overtime, income level, emotional exhaustion, depersonalisation, personal accomplishment, work stress, and occupational development opportunities were all significant predictors of job satisfaction. The authors conclude that as well as focussing on the 2030 agenda of expanding primary care, policymakers should also be improving working conditions, pay, and career development opportunities for existing GPs.
Podcast of the month
It’s hard not to be drawn in by Louis Theroux’s distinctive interviewing style, and his Grounded podcast series (recorded during lockdown) is typically engrossing (https://www.bbc.co.uk/programmes/p089sfrz/episodes/downloads).
REFERENCES
- 1.Nivette A, Ribeaud D, Murray A, et al. Non-compliance with COVID-19-related public health measures among young adults in Switzerland: insights from a longitudinal cohort study. Soc Sci Med. 2020;268:113370. doi: 10.1016/j.socscimed.2020.113370. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.McCabe J, Wilcock M, Atkinson K, et al. General practitioners’ and psychiatrists’ attitudes towards antidepressant withdrawal. BJPsych Open. 2020;6(4):e64. doi: 10.1192/bjo.2020.48. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.van der Geest AM, Flach J, Claassen E, et al. European general practitioners perceptions on probiotics: results of a multinational survey. PharmaNutrition. 2020 doi: 10.1016/j.phanu.2020.100178. [DOI]
- 4.Li L, Gan Y, Jiang H, et al. Job satisfaction and its associated factors among general practitioners in China. J Am Board Fam Med. 2020;33(3):456–459. doi: 10.3122/jabfm.2020.03.190126. [DOI] [PubMed] [Google Scholar]