ArticleBMC family practice2019
Challenges and strategies for general practitioners diagnosing serious infections in older adults: a UK qualitative interview study.
Article in BMC family practice, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Diagnostic uncertainty in primary care: what is known about its communication, and what are the associated ethical issues?Family practice · 2021Pooled it
- Exploration of Physiotherapists' Understanding and Application of Safety Netting Procedures in France-A Qualitative Study.Musculoskeletal care · 2026Article
- Continuity of care in UK primary care: a scoping review of measures, challenges, and future interventions.Primary health care research & development · 2026Article
- Application of artificial intelligence in geriatric infection: recent advances and prospects.Frontiers in cellular and infection microbiology · 2026Review
- Hospital-treated infectious diseases and the risk of epilepsy in older age.Nature aging · 2025Article
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- Maintaining physical activity in people with long-term conditions following engagement in physical activity referral schemes: barriers, enablers, and intervention strategies.The international journal of behavioral nutrition and physical activity · 2025Article
- Exploring the use of health technology in community-based midwifery care - an interview study.BMC pregnancy and childbirth · 2025Article
- Diagnostic Challenges and Patient Safety: The Critical Role of Accuracy - A Systematic Review.Journal of multidisciplinary healthcare · 2025Review
- Role of communicating diagnostic uncertainty in the safety-netting process: insights from a vignette study.BMJ quality & safety · 2024Article
- Article
- Nurses' Anxiety Mediates the Relationship between Clinical Tolerance to Uncertainty and Antibiotic Initiation Decisions in Residential Aged-Care Facilities.Medical decision making : an international journal of the Society for Medical Decision Making · 2024Article
- What influences antibiotic initiation? Developing a scale to measure nursing behaviour in residential aged-care facilities.Nursing open · 2024Article
- Optimising GPs' communication of advice to facilitate patients' self-care and prompt follow-up when the diagnosis is uncertain: a realist review of 'safety-netting' in primary care.BMJ quality & safety · 2022Review
- A qualitative approach to identify clinical uncertainty in practicing physicians and clinical residents.Journal of education and health promotion · 2022Article
- Urgent assessment and ongoing care for infection in community-dwelling older people: a qualitative study of patient experience.BMJ open · 2021Article
- An interview study to determine the experiences of cellulitis diagnosis amongst health care professionals in the UK.BMJ open · 2020Article
- Infection in older adults: a qualitative study of patient experience.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSerious infections in older people are associated with unplanned hospital admissions and high mortality. Recognising the presence of a serious infection and making an accurate diagnosis are important challenges for General Practice. This study aimed to explore the issues UK GPs face when diagnosing serious infections in older patients.
methodsQualitative study using semi-structured interviews. 28 GPs from 27 practices were purposively sampled from across the UK to achieve maximum variation in terms of GP role, experience and practice population. Interviews began by asking participants to describe recent or memorable cases where they had assessed older patients with suspected serious infections. Additional questions from the topic guide were used to explore the challenges further. Interview transcripts were coded and analysed using a modified framework approach.
resultsDiagnosing serious infection in older adults was perceived to be challenging by participating GPs and the diagnosis was often uncertain. Contributing factors included patient complexity, atypical presentations, as well as a lack of knowledge of patients due to a loss in continuity. Diagnostic challenges were present at each stage of the patient assessment. Scoring systems were mainly used as communication tools. Investigations were sometimes used to resolve diagnostic uncertainty, but availability and speed of result limited their practical use. Clear safety-net plans shared with patients and their families helped GPs manage ongoing uncertainty.
conclusionsDiagnostic challenges are present throughout the assessment of an older adult with a serious infection in primary care. Supporting GPs to provide continuity of care may improve the recognition and developing point of care testing for use in community settings may reduce diagnostic uncertainty.
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