Yonder: a diverse selection of primary care relevant research stories from beyond the mainstream biomedical literature
New normal
The COVID-19 pandemic has forced organisations into rapid ‘big bang’ adoption of tech-driven practices under severe time pressure. Not least, of course, primary care practices, who have transformed their operating models and radically changed their use of telephone and video consulting almost overnight. A recent paper from Ireland argues that there is a need for a more reflective ‘normalisation’ of work practices and the role technology plays.1 It suggests that planning for, implementing, embedding, and integrating technology to facilitate new norms is incredibly challenging. This is further exacerbated, the authors argue, by a lack of any guidance from governments or policymakers on how to best facilitate these unprecedented changes to work practices.
Dental risk
The filmmaker Adam Curtis often talks about how the word ‘risk’ was rarely used in public discourse in any field until it’s use dramatically increased in the early 1980s. It is now a dominant idea across all sectors, not least in health care, where it has propelled the current focus on preventive health. In keeping with the rest of the NHS, policies in dentistry have recently started to place greater emphasis on personal responsibility, with contracts encouraging dentists to inform patients about oral health risks. A recent ethnographic study in the North of England examined how risk is acted on in primary care dental settings.2 They found that the everyday nature of risk work in NHS dental practices is often implicit, defensive, and focused on social interaction rather than explicit discussions of individual lifestyle risks that policymakers assume. Sounds familiar.
Shared decision making in China
In Western healthcare systems, shared decision making is a widely accepted model that encourages person-centred care. It is not clear, though, whether this model is useful in different cultural settings. A recent Australian study examined preferences for decision making in severe mental illness in China and Europe.3 They found that although both Chinese and European groups had some preference for shared involvement, Chinese participants preferred less involvement. They also found significant discrepancies between the opinions of patients and mental health professionals on the level of involvement for specific differences. Female clinicians and mental health nurses preferred more involvement than other groups. The authors conclude that there is clearly a complex interplay of cultural, contextual, and individual factors when it comes to patient involvement in decision making. As ever in medicine, one size most certainly does not fit all.
Antidepressants on Instagram
Global use of social media continues to rise rapidly, and Instagram is one of the fastest growing platforms of all, especially among young people. As individuals with mental illness regularly use social media to share treatment experiences and anecdotal information, a recent US study looked at public sentiments and content posted on Instagram regarding the use of antidepressants.4 They found that Instagram posts describing antidepressants have increased exponentially from 2010. Among these posts, 58% expressed negative sentiments towards antidepressant usage, citing adverse effects and lack of improvement. The authors suggest that mental health professionals should be cognisant of content trends related to mental illness and antidepressants on social media so that they can tailor their communication strategies when consulting with patients. They also recommend that clinicians could potentially develop the persona of ‘influencers’ by actively posting supportive messages that detail the challenges faced by individuals with mental illness, addressing misinformation, discussing medication adverse effects, and allowing for an exchange of mental illness-related information. Any takers?
Podcast of the month
LSE Public Lectures podcasts are always worth a listen. Recent episodes on globalisation in the context of the pandemic have been especially interesting.
- © British Journal of General Practice 2020
