Evidence map›Paper›PMID 39856560›Full record

SynthesisBMC primary care2025

Ten pressure points in primary care during COVID-19: findings from an international narrative review.

Sally Hall Dykgraaf, Anne Parkinson, Michael Wright, William C W Wong, Jane Desborough, Lauren Ball, Elizabeth Sturgiss, Garang M Dut, Katelyn Barnes, Danielle Butler and 9 more

Abstract readSystematic Review
In one paragraph

Synthesis in BMC primary care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

4 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. 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

19 authors.

Sally Hall DykgraafSchool of Medicine & Psychology, College of Health & Medicine, Australian National University, Canberra, Australia. sally.hall@anu.edu.au.ORCID 0000-0002-8532-1086
Anne ParkinsonNational Centre for Epidemiology & Population Health, College of Health & Medicine, Australian National University, Canberra, Australia.ORCID 0000-0001-9053-0707
Michael WrightCentre for Health Economics Research and Evaluation, University of Technology, Ultimo, Australia.ORCID 0000-0003-2708-4753
William C W WongDepartment of Family Medicine and Primary Care Ap Lei Chau Clinic, University of Hong Kong, Hong Kong, China.ORCID 0000-0003-2540-4055
Jane DesboroughNational Centre for Epidemiology & Population Health, College of Health & Medicine, Australian National University, Canberra, Australia.ORCID 0000-0003-1406-4593
Lauren BallCentre for Community Health and Wellbeing, The University of Queensland, Brisbane, Australia.ORCID 0000-0002-5394-0931
Elizabeth SturgissSchool of Primary and Allied Health Care, Monash University (Peninsula Campus), Frankston, Australia.ORCID 0000-0003-4428-4060
Garang M DutCollege of Health & Medicine, Australian National University, Canberra, Australia.
Katelyn BarnesSchool of Medicine & Psychology, College of Health & Medicine, Australian National University, Canberra, Australia.ORCID 0000-0001-5891-1331
Danielle ButlerNational Centre for Epidemiology & Population Health, College of Health & Medicine, Australian National University, Canberra, Australia.ORCID 0000-0003-4870-4544
Steph DavisNational Centre for Epidemiology & Population Health, College of Health & Medicine, Australian National University, Canberra, Australia.ORCID 0000-0001-6057-9382
Kirsty DouglasSchool of Medicine & Psychology, College of Health & Medicine, Australian National University, Canberra, Australia.ORCID 0000-0003-0174-782X
Candan KendirOrganisation for Economic Co-operation and Development, Paris, France.ORCID 0000-0001-6877-4836
Danielle MartinDepartment of Family and Community Medicine, University of Toronto, Toronto, Canada.ORCID 0000-0003-2517-2602
Robert MartenAlliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland.ORCID 0000-0002-2416-2309
Katherine RouleauDepartment of Family and Community Medicine, University of Toronto, Toronto, Canada.ORCID 0000-0001-6970-7539
Shannon BarkleySpecial Programme on Primary Health Care, World Health Organization, Geneva, Switzerland.
Lucas de TocaAustralian Government Department of Health and Aged Care, Canberra, Australia.
Michael KiddCollege of Health & Medicine, Australian National University, Canberra, Australia.ORCID 0000-0002-0221-1245

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundStrong primary care (PC) services are the foundation of high-performing health care systems and can support effective responses to public health emergencies. Primary care practitioners (PCPs) and PC services played crucial roles in supporting global health system responses to the COVID-19 pandemic. However, these contributions have come at a cost, impacting on PC services and affecting patient care. This secondary analysis of data from an integrative systematic review across international PC settings aimed to identify and describe burdens and challenges experienced by PCPs and PC services in the context of their contributions to COVID-19 pandemic responses.

methodsWe conducted an integrative systematic review and narrative analysis, searching PubMed/Medline, Scopus, Proquest Central and Cochrane Database of Systematic Reviews, plus reference lists of key publications. Included studies were published in peer-reviewed English or Chinese language journals, and described collective responses to COVID-19 undertaken in PC settings or by PCPs. Narrative data regarding impacts on PC services and challenges experienced by PCPs were extracted and analysed using inductive coding and thematic analysis.

resultsFrom 1745 screened papers 108, representing 90 countries, were included. Seventy-eight contained data on negative impacts, challenges or issues encountered in PC. Ten 'pressure points' affecting PC during COVID-19 were identified, clustered in four themes: demand to adopt new ways of working; pressure to respond to fluctuating community needs; strain on PC resources and systems; and ambiguity in interactions with the broader health and social care system.

conclusionsPCPs and PC services made critical functional contributions to health system responsiveness during the COVID-19 pandemic. However, both practitioners and PC settings were individually and collectively impacted during this period as a result of changing demands in the PC environment and the operational burden of additional requirements imposed on the sector, offering lessons for future pandemics. This study articulates ten empirically derived 'pressure points' that provide an initial understanding of burdens and demands imposed on the international primary care sector during the COVID-19 pandemic. The impact of these contributions should inform future pandemic planning, guided by involvement of PCPs in public health preparedness and policy design.

Indexed as

COVID-19Primary Health CareGlobal HealthHumansPandemicsSARS-CoV-2COVID-19 pandemicDisaster planningFamily practiceGeneral practicePrimary carePrimary health care

Identifiers

PMID39856560
PMCPMC11759439

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.