Evidence map›Paper›PMID 35781333›Full record

ReviewFamily practice2023

General practitioners' role in improving health care in care homes: a realist review.

Neil H Chadborn, Reena Devi, Claire Goodman, Christopher D Williams, Kate Sartain, Adam L Gordon

Abstract readReview
In one paragraph

Review in Family practice, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Neil H ChadbornUnit of Injury, Inflammation and Recovery Sciences, University of Nottingham, Derby, United Kingdom.ORCID 0000-0003-1368-7983
Reena DeviSchool of Healthcare, University of Leeds, Leeds, United Kingdom.ORCID 0000-0003-2834-8597
Claire GoodmanCentre for Research in Public Health and Community Care, University of Hertfordshire, Hatfield, United Kingdom.ORCID 0000-0002-8938-4893
Christopher D WilliamsDepartment of Health Sciences, University of Leicester, Leicester, United Kingdom.ORCID 0000-0001-6036-5157
Kate SartainSchool of Medicine, University of Nottingham, Nottingham, United Kingdom.ORCID 0000-0002-5080-7190
Adam L GordonUnit of Injury, Inflammation and Recovery Sciences, University of Nottingham, Derby, United Kingdom.ORCID 0000-0003-1676-9853

Funding

Department of Health 127257
6 · The paper itself

Abstract

backgroundDespite recent focus on improving health care in care homes, it is unclear what role general practitioners (GPs) should play. To provide evidence for future practice we set out to explore how GPs have been involved in such improvements.

methodsRealist review incorporated theory-driven literature searches and stakeholder interviews, supplemented by focussed searches on GP-led medication reviews and end-of-life care. Medline, Embase, CINAHL, PsycInfo, Web of Science, and the Cochrane library were searched. Grey literature was identified through internet searches and professional networks. Studies were included based upon relevance. Data were coded to develop and test contexts, mechanisms, and outcomes for improvements involving GPs.

resultsEvidence was synthesized from 30 articles. Programme theories described: (i) "negotiated working with GPs," where other professionals led improvement and GPs provided expertise; and (ii) "GP involvement in national/regional improvement programmes." The expertise of GPs was vital to many improvement programmes, with their medical expertise or role as coordinators of primary care proving pivotal. GPs had limited training in quality improvement (QI) and care home improvement work had to be negotiated in the context of wider primary care commitments.

conclusionsGPs are central to QI in health care in care homes. Their contributions relate to their specialist expertise and recognition as leaders of primary care but are challenged by available time and resources to develop this role.

Indexed as

General PractitionersTerminal CareAgedDelivery of Health CareHomes for the AgedHumansQuality Improvementend-of-life caregeneral practicelong-term care facilitiesmedication review and optimizationnursing homesquality improvement

Identifiers

PMID35781333
PMCPMC9909664

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.