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Research

Role of the GP in the management of patients with self-harm behaviour: a systematic review

Faraz Mughal, M Isabela Troya, Lisa Dikomitis, Carolyn A Chew-Graham, Nadia Corp and Opeyemi O Babatunde
British Journal of General Practice 2020; 70 (694): e364-e373. DOI: https://doi.org/10.3399/bjgp20X708257
Faraz Mughal
School of Primary, Community and Social Care, Keele University, Keele, UK; honorary clinical research fellow, Unit of Academic Primary Care, University of Warwick, Coventry, UK.
Roles: National Institute for Health Research in-practice fellow
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M Isabela Troya
National Suicide Research Foundation, University College Cork, Cork, Republic of Ireland.
Roles: Postdoctoral researcher
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Lisa Dikomitis
Centre for Prognosis Research, School of Primary, Community and Social Care, Keele University, Keele, UK.
Roles: Professor of anthropology and sociology of health
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Carolyn A Chew-Graham
School of Primary, Community and Social Care, Keele University, Keele, UK; honorary professor of primary care mental health, Midlands Partnership NHS Foundation Trust, St George’s Hospital, Stafford, UK.
Roles: Professor of general practice research
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Nadia Corp
Centre for Prognosis Research, School of Primary, Community and Social Care, Keele University, Keele, UK.
Roles: Postdoctoral research fellow in systematic reviews
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Opeyemi O Babatunde
Centre for Prognosis Research, School of Primary, Community and Social Care, Keele University, Keele, UK.
Roles: Lecturer in evidence synthesis
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Abstract

Background Self-harm is a serious risk factor for suicide, a major public health concern, and a significant burden on the NHS. Rates of self-harm presentation in primary care are rising and GPs interact with patients both before and after they have self-harmed. There is significant public and political interest in reducing rates of self-harm, but there has been no robust synthesis of the existing literature on the role of GPs in the management of patients who self-harm.

Aim This study aimed to explore the role of the GP in the management of patients with self-harm behaviour.

Design and setting A systematic review and narrative synthesis of primary care literature.

Method This systematic review was conducted and is reported in line with PRISMA guidance. Electronic databases systematically searched were MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science, and AMED. Two independent reviewers conducted study screening and selection, data extraction, and quality appraisal of all included studies. Thematic analysis was conducted.

Results From 6976 unique citations, 12 studies met eligibility criteria and were included. These 12 studies, published from 1997–2016, of 789 GPs/family medicine physicians from Europe, the US, and Australia were of good methodological quality. Five themes were identified for facilitating GP management of self-harm: GP training, improved communication, service provision, clinical guidelines, and young people. Four barriers for GP management of self-harm were identified: assessment, service provision, local, and systemic factors.

Conclusion GPs recognise self-harm as a serious risk factor for suicide, but some feel unprepared for managing self-harm. The role of the GP is multidimensional and includes frontline assessment and treatment, referral to specialist care, and the provision of ongoing support.

  • general practice
  • primary health care
  • self-harm
  • suicide
  • systematic review
  • Received June 4, 2019.
  • Revision requested August 1, 2019.
  • Accepted August 16, 2019.
  • © British Journal of General Practice 2020
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British Journal of General Practice: 70 (694)
British Journal of General Practice
Vol. 70, Issue 694
May 2020
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Role of the GP in the management of patients with self-harm behaviour: a systematic review
Faraz Mughal, M Isabela Troya, Lisa Dikomitis, Carolyn A Chew-Graham, Nadia Corp, Opeyemi O Babatunde
British Journal of General Practice 2020; 70 (694): e364-e373. DOI: 10.3399/bjgp20X708257

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Role of the GP in the management of patients with self-harm behaviour: a systematic review
Faraz Mughal, M Isabela Troya, Lisa Dikomitis, Carolyn A Chew-Graham, Nadia Corp, Opeyemi O Babatunde
British Journal of General Practice 2020; 70 (694): e364-e373. DOI: 10.3399/bjgp20X708257
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Keywords

  • general practice
  • primary health care
  • self-harm
  • suicide
  • systematic review

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