Background: Persistent somatic symptoms and functional disorders (PSS/FD) are complex conditions requiring collaboration between healthcare professionals. This is especially true at the interface between primary and secondary care interface. The current fragmentation of care is a major barrier to this, leading to poor experiences and outcomes and high costs for healthcare and society.
Objectives: The aim is to identify barriers and possible solutions for collaboration between primary and secondary care in patients with PSS/FD.
Methods: In two sessions, using the nominal group technique, a mix of primary and secondary care professionals identified barriers and possible solutions to collaboration between primary and secondary care in PSS/FD care. Barriers to collaboration were identified during session one, with potential solutions identified during session two in response to the top eight barriers. Each session ended with a voting round ranking the barriers and solutions.
Results: A total of 102 healthcare professionals participated in two sessions. In the first session, 55 participants provided a list of 22 barriers, while in the second session, 47 participants provided 18 possible solutions. The top barriers related to shared language and protocols, referral quality, expectations and responsibilities between healthcare professionals and patients, and time pressure. The top solutions identified related to general practitioners using electronic consultations with specialists and shared terminology with patients.
Conclusion: The identified barriers and possible solutions for collaboration between primary and secondary care need attention when considering collaboration in PSS/FD care and related settings, both in new and ongoing collaborations.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485729 | PMC |
http://dx.doi.org/10.1080/13814788.2024.2413090 | DOI Listing |
Lung Cancer
December 2024
State Key Laboratory of Oncology in South China, Guangzhou, China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China; Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China. Electronic address:
Background: Primary pulmonary lymphoepithelioma-like carcinoma (PLELC) is a rare subtype of non-small-cell lung cancer. This study aims to compare the efficacy and safety of perioperative PD-1/PD-L1 inhibitor plus chemotherapy versus chemotherapy alone in stage II-IIIB PLELC patients.
Patients And Methods: This retrospective study included stage II-IIIB PLELC patients.
J Intern Med
December 2024
Division of Cardiology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea.
Otolaryngol Head Neck Surg
December 2024
Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, USA.
Objective: This study aimed to examine differences in postoperative outcomes between patients requiring postactivation adjustment and those who do not, within a cohort of patients undergoing hypoglossal nerve stimulation (HGNS) for obstructive sleep apnea (OSA).
Study Design: Retrospective database analysis.
Setting: Single-institution, academic center.
Prostate
December 2024
Department of Oncology, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland, USA.
Introduction: Non-castrating therapies are an unmet clinical need for patients with advanced prostate cancer. To maximize quality of life and prioritize cardiovascular health, we investigated SGLT2 inhibitors as a non-castrating therapy in patients with prostate cancer.
Materials And Methods: We conducted a retrospective analysis of patients with either local or biochemically recurrent prostate cancer who initiated therapy with an SGLT2 inhibitor without concurrent androgen deprivation therapy.
Knee Surg Sports Traumatol Arthrosc
December 2024
Department of Orthopedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Purpose: To explore if recentering the humeral head could improve shoulder abduction in shoulders with irreparable massive rotator cuff tears (IMRCTs).
Methods: Nine fresh-frozen cadaveric shoulders were used to simulate the intact condition and IMRCTs as controls. Four 'recenter' interventions were then sequentially applied: subacromial interposition (SI) using 4- and 8-mm spacers and superior capsule reconstruction (SCR) using two- and four-layer fascia lata grafts.
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