Safety-netting advice 

GPs frequently do not document safety-netting advice they have discussed with patients which may have medico-legal implications. This is the first study to undertake a detailed analysis of documented safety-netting advice and make comparisons with what was spoken in recorded consultations. Two-thirds of routine GP consultations contained spoken safety-netting advice which was only documented in one-third. GPs were less likely to discuss or document safety-netting advice for problems raised in consultations where multiple problems were assessed. Although there are pressures on both patients and GPs to discuss multiple problems in a single visit, sharing these risks with patients may help to manage expectations of what can be safely achieved in a GP consultation.

Ondansetron for paediatric gastroenteritis

Ondansetron is found to be effective in reducing vomiting in secondary care, but this effect had not previously been evaluated in primary care. This study examined ondansetron for gastroenteritis in children and found that it is effective in reducing vomiting, seems safe, and is positively evaluated by parents. An additional cost-effectiveness evaluation showed that a single dose of oral ondansetron at out-of-hours primary care services also decreases the social and medical costs of managing acute gastroenteritis in these children. These studies show that ondansetron could be considered by GPs as an additional treatment in the management of dehydration due to acute gastroenteritis, when the child predominantly experiences vomiting.

Managing lower urinary tract symptoms 

Lower urinary tract symptoms (LUTS) in men can usually be treated effectively in primary care; however, referrals to urology services are increasing. This study explores the experiences of GPs and patients, including the key challenges of difficulty establishing causes and differentiating symptoms. Treatment for LUTS by GPs is often a process of trial and error, due to challenges such as symptoms having multiple causes and patients presenting with mixed symptoms. A diagnostic tool for use by GPs, together with greater exploration of non-pharmacological treatment approaches, could help to support effective management of LUTS in primary care settings.