Yonder: a diverse selection of primary care relevant research stories from beyond the mainstream biomedical literature
Long Covid
Long Covid is a term describing long-term symptoms that persist after initially contracting COVID-19, and those affected with this condition have been described as ‘Long Haulers’. A UK study sought to identify competing definitions of Long Covid through quantitative and qualitative analyses of online narratives.1 They found 7099 social media users who posted 144 637 posts, and identified four main areas that need urgent attention to improve support for affected individuals: the time-frames assigned to COVID-19; the range of symptoms, which affects testing and diagnoses; the emotional and intellectual impact of Long Covid; and lack of resources and information. Despite the promising increase in the number of studies and research on Long Covid and improved Long Covid patient care in the UK, the authors highlight that there is still a way to go in closing the gap between official definitions of COVID-19 and those articulated by ‘Long Haulers’ themselves.
Mental health video consultations
In many countries around the world, access to mental health services is precarious, particularly in remote and rural areas. Technology-based care models, mostly based on remote consultations, have been proposed as a solution and have been widely adopted in 2020 due to restrictions caused by the COVID-19 pandemic. A recent German study investigated patients’ experiences of video consultations for mental health problems in primary care, although they collected data prior to the onset of the pandemic.2 Participants mostly welcomed the use of video consultations, and particularly valued shorter waiting times and greater flexibility of access. The two main challenges were the impacts of a lack of face-to-face contact on building a trusting therapeutic relationship, and technical issues. The authors conclude that the goal of future development work should be to ‘ensure optimal resemblance to face-to-face settings’.
Overactive bladder syndrome
Although treatment can be very effective, overactive bladder syndrome (OAB) is significantly under-recognised and undertreated. This is concerning because of the significant impact it can have on quality of life, mental health, and personal relationships at home and work. A recent US study evaluated the impact of a virtual live-streamed education programme on OAB for primary care clinicians.3 They identified four key themes: taking OAB seriously; variations in therapy; patient motivation; and education value. Participants were proactive about screening for and managing OAB and recognised urgency as a key symptom, although some used diagnostic tests that are not considered necessary in the workup of uncomplicated OAB in patients with OAB. The authors note that narratives that frame patients as either embarrassed or unmotivated potentially close down the potential for discussion and should be actively avoided.
Haematological malignancies
The success and uptake of several treatments has transformed the management of haematological malignancies in recent years, and patients are surviving for much longer. This shift prompted researchers from England and Wales to study the impact of a wide range of haematological malignancies and their treatments on patients’ quality of life and symptoms.4 Their multi-centre qualitative study involved 129 patient interviews. They found that eating and drinking, physical activity, sleep, and psychological wellbeing were the key quality of life issues, and breathlessness, lack of energy, and back pain were the key disease-related symptoms. Of note, a significant number of patients had symptoms of anxiety and depression, and yet not a single patient mentioned being offered any psychosocial screening and/or rehabilitation.
Podcast of the month
The team at Serial are the masters of podcast storytelling and S-Town (https://stownpodcast.org) is one of their very best series. Ideal for a winter walk.
- © British Journal of General Practice 2020
