Academic general practice/family medicine in times of COVID-19 – Perspective of WONCA Europe

Windak, Adam; Frese, Thomas; Hummers, Eva; Klemenc–Ketiš, Zalika; Tsukagoshi, Sonia; Vilaseca, Josep; Vinker, Shlomo; Ungan, Mehmet

doi:10.1080/13814788.2020.1855136

Cited by 31 publications

(34 citation statements)

References 25 publications

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“…The World Organization of Family Doctors (WONCA) Europe has identified a lack of evidence regarding the management of non-COVID-19 patients in primary care during the pandemic [ 13 ]. To fill this gap, we first need to know the reasons why patients seek primary care, and how this may have changed during the COVID-19 pandemic.…”

Section: Introductionmentioning

confidence: 99%

Changes in the top 25 reasons for primary care visits during the COVID-19 pandemic in a high-COVID region of Canada

et al. 2021

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Purpose We aimed to determine the degree to which reasons for primary care visits changed during the COVID-19 pandemic. Methods We used data from the University of Toronto Practice Based Research Network (UTOPIAN) to compare the most common reasons for primary care visits before and after the onset of the COVID-19 pandemic, focusing on the number of visits and the number of patients seen for each of the 25 most common diagnostic codes. The proportion of visits involving virtual care was assessed as a secondary outcome. Results UTOPIAN family physicians (N = 379) conducted 702,093 visits, involving 264,942 patients between March 14 and December 31, 2019 (pre-pandemic period), and 667,612 visits, involving 218,335 patients between March 14 and December 31, 2020 (pandemic period). Anxiety was the most common reason for visit, accounting for 9.2% of the total visit volume during the pandemic compared to 6.5% the year before. Diabetes and hypertension remained among the top 5 reasons for visit during the pandemic, but there were 23.7% and 26.2% fewer visits and 19.5% and 28.8% fewer individual patients accessing care for diabetes and hypertension, respectively. Preventive care visits were substantially reduced, with 89.0% fewer periodic health exams and 16.2% fewer well-baby visits. During the pandemic, virtual care became the dominant care format (77.5% virtual visits). Visits for anxiety and depression were the most common reasons for a virtual visit (90.6% virtual visits). Conclusion The decrease in primary care visit volumes during the COVID-19 pandemic varied based on the reason for the visit, with increases in visits for anxiety and decreases for preventive care and visits for chronic diseases. Implications of increased demands for mental health services and gaps in preventive care and chronic disease management may require focused efforts in primary care.

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Section: Introductionmentioning

confidence: 99%

Changes in the top 25 reasons for primary care visits during the COVID-19 pandemic in a high-COVID region of Canada

et al. 2021

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“…Nonetheless, they experience many challenges to fulfill this role. The PRICOV-19 study fills the gap in the current knowledge and meets the need for in-depth research on the organization of PHC during the COVID-19 pandemic [ 2 , 3 , 11 , 16 , 26 , 72 , 73 ]. The involvement of GPs in pandemic preparedness plans is widely recognized [ 74 ].…”

Section: Discussionmentioning

confidence: 99%

“…When available, primary health care (PHC) plays a vital role in the fight against the SARS-CoV-2 virus. It is the first point of contact for possibly infected patients [ 11 – 17 ], and the level of care on which the short and long-term follow-up care for the majority of the patients are organized. In addition, PHC workers are gatekeepers to authorize access to hospital care and diagnostic tests [ 18 ], and by doing so they limit the risk of overwhelmed hospitals and delayed specialist treatment [ 19 – 21 ].…”

Section: Introductionmentioning

confidence: 99%

“…During the COVID-19 pandemic, the measures taken by the government to prevent the spread of COVID-19, such as lockdown, social distancing, and quarantine, formed on itself an additional risk factor in the context of many patients leading to a decline in physical, mental, and social wellbeing of patients [ 29 ]. GPs expressed their concerns about the health and possible collateral damage of these measures on the health of their patients, especially those already living in vulnerable situations: for instance, frail elderly living at home, victims of family violence, people with insecure housing or with limited knowledge of the local language, limited health literacy, or other incriminating social determinants of health [ 5 , 11 , 30 ]. Thus, GPs are uniquely positioned to identify the patients at risk for increased COVID-19 impact [ 22 , 31 ].…”

Section: Introductionmentioning

confidence: 99%

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How did general practices organize care during the COVID-19 pandemic: the protocol of the cross-sectional PRICOV-19 study in 38 countries

et al. 2022

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Background General practitioners (GPs) play a crucial role in the fight against the COVID-19 pandemic as the first point of contact for possibly infected patients and are responsible for short and long-term follow-up care of the majority of COVID-19 patients. Nonetheless, they experience many barriers to fulfilling this role. The PRICOV-19 study investigates how GP practices in 38 countries are organized during the COVID-19 pandemic to guarantee safe, effective, patient-centered, and equitable care. Also, the shift in roles and tasks and the wellbeing of staff members is researched. Finally, PRICOV-19 aims to study the association with practice- and health care system characteristics. It is expected that both characteristics of the GP practice and health care system features are associated with how GP practices can cope with these challenges. This paper describes the protocol of the study. Methods Using a cross-sectional design, data are collected through an online questionnaire sent to GP practices in 37 European countries and Israel. The questionnaire is developed in multiple phases, including a pilot study in Belgium. The final version includes 53 items divided into six sections: patient flow (including appointments, triage, and management for routine care); infection prevention; information processing; communication; collaboration and self-care; and practice and participant characteristics. In the countries where data collection is already finished, between 13 and 636 GP practices per country participated in the study. Questionnaire data are linked with OECD and HSMR data regarding national policy responses to the pandemic and analyzed using multilevel models considering the system- and practice-level. Discussion To the best of our knowledge, the PRICOV-19 study is the largest and most comprehensive study that examines how GP practices function during the COVID-19 pandemic. Its results can significantly contribute to better preparedness of primary health care systems across Europe for future major outbreaks of infectious diseases.

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“…In Europe, rotations and outpatient clinics were cancelled, limiting residents from gaining knowledge and competencies through direct patient care. 22 The change to virtual didactics also raised concerns about the quality of education the residents received.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 disruption to family medicine residency curriculum: results from a 2020 US programme directors survey

2021

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ObjectiveThis research project examined the effects of the COVID-19 pandemic on the required curriculum in graduate medical education for family medicine residencies.DesignOur questions were part of a larger omnibus survey conducted by the Council of Academic Family Medicine Educational Research Alliance. Data were collected from 23 September to 16 October 2020.SettingThis study was set in the USA.ParticipantsEmails were sent to 664 family medicine programme directors in the USA. Of the 312 surveys returned, 35 did not answer our questions and were excluded, a total of 277 responses (44%) were analysed.ResultsThe level of disruption varied by discipline and region. Geriatrics had the highest reported disruption (median=4 on a 5-point scale) and intensive care unit had the lowest (median=1 on a 5-point scale). There were no significant differences for disruption by type of programme or community size.ConclusionProgramme directors reported moderate disruption in family medicine resident education in geriatrics, gynaecology, surgery, musculoskeletal medicine, paediatrics and family medicine site during the pandemic. We are limited in generalisations about how region, type of programme, community size or number of residents influenced the level of disruption, as less than 50% of programme directors completed the survey.

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Academic general practice/family medicine in times of COVID-19 – Perspective of WONCA Europe

Cited by 31 publications

References 25 publications

Changes in the top 25 reasons for primary care visits during the COVID-19 pandemic in a high-COVID region of Canada

Changes in the top 25 reasons for primary care visits during the COVID-19 pandemic in a high-COVID region of Canada

How did general practices organize care during the COVID-19 pandemic: the protocol of the cross-sectional PRICOV-19 study in 38 countries

COVID-19 disruption to family medicine residency curriculum: results from a 2020 US programme directors survey

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