The British Journal of General Practice is a leading international primary care journal, publishing high-quality research with clinical impact worldwide. Here we highlight some recent papers and their clinical impact.
1. Detecting multiple myeloma
Koshiaris et al. Universities of Oxford and Exeter, UK. For unexplained back, rib, and chest pain, fatigue, and recurrent chest infection, simple blood tests of plasma viscosity and ESR can rule out myeloma or indicate urgent testing.
IMPACT ON PRACTICE: Faster diagnosis, faster treatment
2. Avoiding unnecessary thyroid tests
Roberts et al. Universities of Warwick, Bristol, Birmingham, and Oxford, UK. Patients over 65 with a normal thyroid function test in the last 5 years are not recommended for routine repeat thyroid testing unless clinically indicated.
IMPACT ON HEALTH CARE: Reduced workload, patient convenience, cost savings
3. Recognising testicular cancer
Shephard and Hamilton, University of Exeter, UK. Additional risk symptoms for testicular cancer include testicular pain associated with groin pain and blood tests showing inflammation.
IMPACT ON PRACTICE: Lower thresholds for urgent referral and earlier diagnosis
4. Detecting atrial fibrillation
Cole et al. Barts and the London School of Medicine, UK. More than 2000 strokes could be prevented each year in the UK with simple routine pulse checks for AF.
IMPACT ON PRACTICE: Minimal investment with life-saving results
5. Cancer safety netting
Nicholson et al. Universities of Oxford, UK; Aarhus, Denmark; and Lund, Sweden. Systematic follow up and ‘double safety netting’ are needed to prevent cancer patients from slipping through the net.
IMPACT ON PRACTICE: Unrecognised cancers will not be missed
6. Extending prescription length
King et al. RAND Europe, Cambridge, UK. Prescriptions longer than 28 days for patients with stable chronic conditions can improve adherence.
IMPACT ON PRACTICE: Drug effectiveness, patient convenience, reduced workload
7. Investigating weight loss
Nicholson et al. Universities of Oxford and Exeter, UK. Weight loss is a red flag for cancer, and is the second highest risk factor for colorectal, lung, pancreatic, and renal cancers.
IMPACT ON DIAGNOSIS: Increased awareness should lead to faster diagnosis
8. Responding to maternal non-attendance
Lyngsøe et al. Aarhus University, Denmark. Non-attendance at child health checks may signal maternal depression.
IMPACT ON HEALTH: Potential for earlier detection of mental health problems
9. Shortening antibiotic treatment for sore throat
Moore et al. University of Southampton, UK. A 5-day course of antibiotics appears to be as effective as a 10-day course for suspected streptococcal sore throat.
IMPACT ON PRACTICE: Reduced costs and reduced antibiotic resistance
10. Prescribing exercise for postnatal depression
Pritchett et al, University of Birmingham, UK. Exercise is effective in reducing postpartum depressive symptoms. It is also a potential preventive measure in postpartum women.
IMPACT ON PRACTICE: Non-pharmacologic treatment, with additional health benefits
11. C-reactive protein and acute cough
Cals and Ebell, Universities of Maastricht, The Netherlands, and Georgia, US. C-reactive protein testing in primary care helps to guide prescribing decisions for acute cough in adults.
IMPACT ON PRACTICE: More accurate diagnosis, fewer antibiotic prescriptions