General practitioners' barriers to cross-sectoral collaboration on pregnant women with vulnerabilities: a cross-sectional survey in Danish general practice.

Background: 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.

Is development and persistence of multiple physical symptoms associated with coping? A longitudinal study over a decade.

Objective: To examine the development and persistence of multiple physical symptoms (MPS) over a decade including the associations with sociodemographics and coping strategies.

Method: A longitudinal study of 16,405 individuals aged 20-64 years participating in the Danish Symptom Cohort (DaSC) was conducted in 2012 with follow-up data in 2022 (DaSC II). MPS were assessed according to the unifying diagnostic construct of bodily distress syndrome, and coping was measured with the Brief Approach/Avoidance Coping Questionnaire.

Examining health literacy in the Danish general population: a cross-sectional study on the associations between individual factors and healthcare-seeking behaviour.

Knowledge about health literacy challenges among the general population is valuable for initiatives targeting social inequity in health. We investigated health literacy in various population groups and the impact of healthcare-seeking behaviour by analysing the associations between (i) lifestyle, socioeconomics, self-rated health, chronic disease, and health literacy and (ii) symptom burden, contact to general practitioner (GP), and health literacy. In total, 27 488 individuals participated in a population-based survey.

General practice variation in peptic ulcer prophylaxis: a nationwide register-based study.

Background: Incidence of peptic ulcer bleeding can be substantially reduced by prophylactic use of proton pump inhibitors (PPIs) in patients at risk, but use of PPI varies among risk patients, and substantial under-prescribing may exist. The variation in prophylactic prescribing among general practices remains unknown.

Methods: A nationwide register-based cross-sectional study analyzing the proportion of patients at risk of ulcer bleeding receiving PPI treatment within Danish general practices.

Multiple physical symptoms and coping strategies over the last decade - Knowledge from two Danish population-based cross-sectional studies in 2012 and 2022.

Objective: To compare the prevalence of multiple physical symptoms, coping scores, and associations between multiple physical symptoms and coping in two population-based surveys within a 10-year interval.

Methods: A nationwide study on symptoms and healthcare-seeking, the Danish Symptom Cohort, was carried out in 2012 and repeated in 2022. For each survey, 100,000 randomly selected individuals were invited, and individuals aged 20-64 years were eligible for inclusion.

Introducing Point-of-Care PCR technology in general practice: Ambiguities, experiences, and perceptions among health care professionals.

In this paper we present findings from a qualitative ethnographic study investigating the experiences and perceptions of general practitioners and other practice staff when introducing a new point of care diagnostic test technology (point of care polymerase chain reaction (POC PCR)) in general practice in Denmark. The ethnographic study was conducted in five general practice clinics, involving observations in four of the clinics and interviews with general practitioners and practice staff in all five clinics. Following an initial analytic phase in which barriers and facilitators in the implementation process of the Point-of-Care test were identified, we developed theoretically informed themes, drawing upon Hartmut Rosa's social theory of technological acceleration.

Revisiting the symptom iceberg based on the Danish symptom cohort - Symptom experiences and healthcare-seeking behaviour in the general Danish population in 2022.

Introduction: Healthcare-seeking behaviour may change over time, and some groups are more likely to avoid relevant help seeking, which possibly contributes to social inequity in health. Thus, we developed an expansion of and follow-up to the Danish Symptom Cohort (DaSC) from 2012 and formed the DaSC II, which encompassed a population-based questionnaire study investigating symptoms and healthcare-seeking behaviour. In this paper, we describe the conceptual framework, development and content validity of the questionnaire and a responder analysis of the participants in the DaSC II.

Improving diagnostics using extended point-of-care testing during in-home assessments of older adults with signs of emerging acute disease: a prospective observational non-randomised pilot and feasibility study.

Background: Delayed recognition of acute disease among older adults hinders timely management and increases the risk of hospital admission. Point-of-Care testing, including Focused Lung Ultrasound (FLUS) and in-home analysis of biological material, may support clinical decision-making in suspected acute respiratory disease. The aim of this study was to pilot test the study design for a planned randomised trial, investigate whether in-home extended use of point-of-care testing is feasible, and explore its' potential clinical impact.

Follow-up cancer care in Danish general practice: a questionnaire study.

Background: The number of patients who have survived cancer has increased substantially owing to improved cancer treatment. This has reinforced the need for effective strategies for follow-up cancer care in general practice.

Aim: To investigate the organisation of follow-up cancer care in Danish general practice and to analyse GPs' self-assessment of competences regarding patients who have survived cancer and late effects.

Extended use of point-of-care technology versus usual care for in-home assessment by acute community nurses in older adults with signs of potential acute respiratory disease: an open-label randomised controlled trial protocol.

Background: Due to ageing-related physiological changes, diagnosing older adults is challenging. Delayed disease recognition may lead to adverse health outcomes and increased hospitalisation, necessitating the development of new initiatives for timely diagnosis and treatment of older adults. Point-of-care technology, such as focused lung ultrasound scan and bedside analysis of blood samples (leucocytes with differential count, electrolytes, and creatinine) conducted in the patients' home, may support clinical decision-making, and potentially reduce acute hospital admissions.

The durability of previous examinations for cancer: Danish nationwide cohort study.

Objective: Patients previously examined for cancer with a negative result may present in general practice with ongoing or new symptoms or signs suggestive of cancer. This paper explores the potential existence of a relatively safe period for cancer occurrence after receiving negative examination results for specific types of cancer, including lung (CT thorax), upper gastrointestinal (gastroscopy), colorectal (colonoscopy), bladder (cystoscopy), and breast (clinical mammography).

Design: Register-based time-to-event analyses.

Exploring GPs' assessments of their patients' cancer diagnostic processes: a questionnaire study.

Background: Most cancer diagnostic pathways start from primary care and several factors affect the diagnostic processes.

Aim: To analyse the associations between patient characteristics, symptom presentation, and cancer type and the GP's assessment of the diagnostic processes.

Design And Setting: General practices in the North, Central, and Southern regions of Denmark were invited to participate in a questionnaire survey.

Coping strategies among individuals with multiple physical symptoms: A general population-based cross-sectional study.

Objective: Coping has been suggested as a perpetuating factor for physical symptoms. The aim of this study was to examine the use of the coping strategies approach, resignation, and diversion in individuals with multiple physical symptoms according to the construct of Bodily Distress Syndrome (BDS).

Methods: This cross-sectional study was part of the nationwide web-based survey Danish Symptom Cohort (DaSC).

Associations between smoking status and involvement of personal and professional relations among individuals reporting symptoms related to a diagnosis of lung cancer: a population-based study.

Background: Smoking is the leading cause of lung cancer, but individuals who currently smoke seek healthcare less frequently. This study of individuals reporting symptoms related to diagnosis of lung cancer has the following aims: 1) to explore the involvement of personal and professional relations; 2) to analyse whether age, sex and smoking status are associated with involving personal and professional relations; and 3) to analyse whether involving a personal relation is associated with healthcare-seeking.

Methods: Data was extracted from a Danish population-based survey from 2012 with 100,000 randomly selected invitees 20 years or older.

Barriers to assessing vulnerability in pregnant women. A cross-sectional survey in Danish general practice.

Background: Undetected vulnerability in pregnancy contributes to inequality in maternal and perinatal health and is associated with negative birth outcomes and adverse child outcomes. Nationwide reports indicate important barriers to assessing vulnerability among Danish general practitioners.

Objective: To explore general practitioners perceived barriers to vulnerability assessment in pregnant women and whether the barriers are associated with practice organization of antenatal care, general practitioner, and practice characteristics.

A population-based study on social inequality and barriers to healthcare-seeking with lung cancer symptoms.

Healthcare-seeking with lung cancer symptoms is a prerequisite for improving timely diagnosis of lung cancer. In this study we aimed to explore barriers towards contacting the general practitioner (GP) with lung cancer symptoms, and to analyse the impact of social inequality. The study is based on a nationwide survey with 69,060 individuals aged ≥40 years, randomly selected from the Danish population.

Variation in suspected cancer referral pathways in primary care: comparative analysis across the International Benchmarking Cancer Partnership.

Background: International variations in cancer outcomes persist and may be influenced by differences in the accessibility and organisation of cancer patient pathways. More evidence is needed to understand to what extent variations in the structure of primary care referral pathways for cancer investigation contribute to differences in the timeliness of diagnoses and cancer outcomes in different countries.

Aim: To explore the variation in primary care referral pathways for the management of suspected cancer across different countries.

Prescribing antibiotics: Factors driving decision-making in general practice. A discrete choice experiment.

Background: Antimicrobial resistance is a threat to human health. We need to strive for a rational use of antibiotics to reduce the selection of resistant bacteria. Most antibiotics are prescribed in general practice, but little is known about factors influencing general practitioners' (GPs) decision-making when prescribing antibiotics.

Involvement of personal and professional relations when experiencing colorectal cancer symptoms - a cross sectional study.

Objective: As part of improving early diagnosis of colorectal cancer (CRC), knowledge about involvement of personal and professional relations, when experiencing CRC symptoms, is important. This study aimed to analyse involvement of personal and professional relations and whether age, sex, number of symptoms and available social network are associated with involving family, non-family and professional relations amongst individuals experiencing CRC symptoms.

Methods: Some, 100 000 Danes over 20 years were randomly selected and invited to a cross sectional survey comprising questions about involvement of relations regarding four predefined CRC symptoms (abdominal pain, rectal bleeding and change in stool texture and frequency).

Healthcare costs of patients with chronic obstructive pulmonary disease in Denmark - specialist care versus GP care only.

Background: Many patients with chronic obstructive pulmonary disease (COPD) are treated in general practice only and have never received specialist care for COPD. They are seldom included in COPD cost studies but may account for a substantial proportion of the total costs.

Objective: To estimate and specify the total healthcare costs of patients who are treated for COPD in Denmark comparing those who have- and have not had specialist care for COPD.

Quality clusters in general practice: associations between cluster organization and general practitioners' self-reported benefits.

Background: Quality clusters were introduced as a quality improvement concept in Danish general practice in 2018. This new concept anchored quality improvement in local clusters managed by general practitioners (GPs).

Objectives: To describe the cluster organization and GPs' self-reported benefits of participating in them and explore the associations between cluster organization and self-reported benefits.

Healthcare practices that increase the quality of care in cancer trajectories from a general practice perspective: a scoping review.

Objective: General practice plays an important role in cancer trajectories, and cancer patients request the continuous involvement of general practice. The objective of this scoping review was to identify healthcare practices that increase the quality of care in cancer trajectories from a general practice perspective.

Design, Setting, And Subjects: A scoping review of the literature published in Danish or English from 2010 to 2020 was conducted.

Factors associated with C-reactive protein testing when prescribing antibiotics in general practice: a register-based study.

Background: The use of C-reactive protein (CRP) tests has been shown to safely reduce antibiotic prescribing for acute respiratory tract infections (RTIs). The aim of this study was to explore patient and clinical factors associated with the use of CRP testing when prescribing antibiotics recommended for RTIs.

Methods: A nation-wide retrospective cross-sectional register-based study based on first redeemed antibiotic prescriptions issued to adults in Danish general practice between July 2015 and June 2017.

Is concern for gynaecological alarm symptoms associated with healthcare-seeking? A Danish population-based cross-sectional study.

Background: Diagnosing cancer at an early stage increases survival, and for most gynaecological cancers the diagnostic pathway is initiated, when women seek medical attention with symptoms. As many factors influence healthcare-seeking, knowledge about these factors is important. Concern can act as a barrier or a trigger for women experiencing gynaecological alarm symptoms.

Statin Discontinuation and Cardiovascular Events Among Older People in Denmark.

Importance: Statin use is common in older persons. Given uncertainties in ongoing benefit, changes in health status, and shifting goals of care and preferences, statin discontinuation may be considered in some older persons, although there is currently little evidence to guide this decision.

Objective: To evaluate the association between statin discontinuation and the rate of major adverse cardiovascular events (MACE) among people aged 75 years or older who receive long-term statin treatment.