Prevention of Psychiatric Disorders in General Practice: 1981. Royal College of General Practitioners.  3

1981 ◽  
Vol 5 (8) ◽  
pp. 150-151
Author(s):  
P. Williams
Keyword(s):  
General Practice ◽  
Psychiatric Disorders ◽  
General Practitioners ◽  
Royal College

scholarly journals The Oxford Royal College of General Practitioners Clinical Informatics Digital Hub: Protocol to Develop Extended COVID-19 Surveillance and Trial Platforms (Preprint)

2020 ◽  
Author(s):  
Simon de Lusignan ◽  
Nicholas Jones ◽  
Jienchi Dorward ◽  
Rachel Byford ◽  
Harshana Liyanage ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Trials ◽  
General Practice ◽  
General Practitioners ◽  
Royal College ◽  
Digital Health ◽  
Health Data ◽  
Clinical Informatics ◽  
Data Sets ◽  
The United Kingdom

BACKGROUND Routinely recorded primary care data have been used for many years by sentinel networks for surveillance. More recently, real world data have been used for a wider range of research projects to support rapid, inexpensive clinical trials. Because the partial national lockdown in the United Kingdom due to the coronavirus disease (COVID-19) pandemic has resulted in decreasing community disease incidence, much larger numbers of general practices are needed to deliver effective COVID-19 surveillance and contribute to in-pandemic clinical trials. OBJECTIVE The aim of this protocol is to describe the rapid design and development of the Oxford Royal College of General Practitioners Clinical Informatics Digital Hub (ORCHID) and its first two platforms. The Surveillance Platform will provide extended primary care surveillance, while the Trials Platform is a streamlined clinical trials platform that will be integrated into routine primary care practice. METHODS We will apply the FAIR (Findable, Accessible, Interoperable, and Reusable) metadata principles to a new, integrated digital health hub that will extract routinely collected general practice electronic health data for use in clinical trials and provide enhanced communicable disease surveillance. The hub will be findable through membership in Health Data Research UK and European metadata repositories. Accessibility through an online application system will provide access to study-ready data sets or developed custom data sets. Interoperability will be facilitated by fixed linkage to other key sources such as Hospital Episodes Statistics and the Office of National Statistics using pseudonymized data. All semantic descriptors (ie, ontologies) and code used for analysis will be made available to accelerate analyses. We will also make data available using common data models, starting with the US Food and Drug Administration Sentinel and Observational Medical Outcomes Partnership approaches, to facilitate international studies. The Surveillance Platform will provide access to data for health protection and promotion work as authorized through agreements between Oxford, the Royal College of General Practitioners, and Public Health England. All studies using the Trials Platform will go through appropriate ethical and other regulatory approval processes. RESULTS The hub will be a bottom-up, professionally led network that will provide benefits for member practices, our health service, and the population served. Data will only be used for SQUIRE (surveillance, quality improvement, research, and education) purposes. We have already received positive responses from practices, and the number of practices in the network has doubled to over 1150 since February 2020. COVID-19 surveillance has resulted in tripling of the number of virology sites to 293 (target 300), which has aided the collection of the largest ever weekly total of surveillance swabs in the United Kingdom as well as over 3000 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serology samples. Practices are recruiting to the PRINCIPLE (Platform Randomised trial of INterventions against COVID-19 In older PeopLE) trial, and these participants will be followed up through ORCHID. These initial outputs demonstrate the feasibility of ORCHID to provide an extended national digital health hub. CONCLUSIONS ORCHID will provide equitable and innovative use of big data through a professionally led national primary care network and the application of FAIR principles. The secure data hub will host routinely collected general practice data linked to other key health care repositories for clinical trials and support enhanced in situ surveillance without always requiring large volume data extracts. ORCHID will support rapid data extraction, analysis, and dissemination with the aim of improving future research and development in general practice to positively impact patient care. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/19773

A Study of the Use of Antidepressant Medication in General Practice

1974 ◽  
Vol 125 (585) ◽  
pp. 186-192 ◽  
Author(s):  
D. A. W. Johnson
Keyword(s):  
General Practice ◽  
Psychiatric Disorders ◽  
General Practitioners ◽  
Present Author ◽  
Antidepressant Medication ◽  
Undergraduate Teaching ◽  
Specific Information ◽  
Clinical Expertise ◽  
Prescribing Habits ◽  
Treatment Of Depression

Several surveys (Carstairs and Bruhn, 1962; Shepherd et al., 1966; and Johnson, 1973a) have demonstrated that the treatment of psychiatric disorders in general practice consists principally of prescribing drugs, with relatively little use of social agencies and psychotherapy. Although Shepherd et al. (1966) comment that the treatment is often haphazard and inadequate, the published surveys of general practice give little specific information about the prescribing habits of doctors. The present author surveyed the prescribing habits of general practitioners in the treatment of depression in the belief that it is necessary to have this information in order to evaluate the need for education in this clinical expertise, and also to act as a comparison for other surveys which will undoubtedly be carried out in the future to test the effectiveness of the current expansion of undergraduate teaching in psychiatry.

scholarly journals Emergence of a Novel Coronavirus (COVID-19): Protocol for Extending Surveillance Used by the Royal College of General Practitioners Research and Surveillance Centre and Public Health England (Preprint)

2020 ◽  
Author(s):  
Simon de Lusignan ◽  
Jamie Lopez Bernal ◽  
Maria Zambon ◽  
Oluwafunmi Akinyemi ◽  
Gayatri Amirthalingam ◽  
...  
Keyword(s):  
Public Health ◽  
General Practice ◽  
General Practitioners ◽  
Royal College ◽  
Medical Records ◽  
Influenza Surveillance ◽  
General Practices ◽  
New Codes ◽  
Containment Policy ◽  
Tract Infections

BACKGROUND The Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) and Public Health England (PHE) have successfully worked together on the surveillance of influenza and other infectious diseases for over 50 years, including three previous pandemics. With the emergence of the international outbreak of the coronavirus infection (COVID-19), a UK national approach to containment has been established to test people suspected of exposure to COVID-19. At the same time and separately, the RCGP RSC’s surveillance has been extended to monitor the temporal and geographical distribution of COVID-19 infection in the community as well as assess the effectiveness of the containment strategy. OBJECTIVE The aim of this study is the surveillance of COVID-19 in both asymptomatic populations and ambulatory cases with respiratory infections to ascertain both the rate and pattern of COVID-19 spread and to assess the effectiveness of the containment policy. METHODS The RCGP RSC, a network of over 500 general practices in England, extract pseudonymized data weekly. This extended surveillance comprises of five components: (1) Recording in medical records of anyone suspected to have or who has been exposed to COVID-19. Computerized medical records suppliers have within a week of request created new codes to support this. (2) Extension of current virological surveillance and testing people with influenza-like illness or lower respiratory tract infections (LRTI)—with the caveat that people suspected to have or who have been exposed to COVID-19 should be referred to the national containment pathway and not seen in primary care. (3) Serology sample collection across all age groups. This will be an extra blood sample taken from people who are attending their general practice for a scheduled blood test. The 100 general practices currently undertaking annual influenza virology surveillance will be involved in the extended virological and serological surveillance. (4) Collecting convalescent serum samples. (5) Data curation. We have the opportunity to escalate the data extraction to twice weekly if needed. Swabs and sera will be analyzed in PHE reference laboratories. RESULTS General practice clinical system providers have introduced an emergency new set of clinical codes to support COVID-19 surveillance. Additionally, practices participating in current virology surveillance are now taking samples for COVID-19 surveillance from low-risk patients presenting with LRTIs. Within the first 2 weeks of setup of this surveillance, we have identified 3 cases: 1 through the new coding system, the other 2 through the extended virology sampling. CONCLUSIONS We have rapidly converted the established national RCGP RSC influenza surveillance system into one that can test the effectiveness of the COVID-19 containment policy. The extended surveillance has already seen the use of new codes with 3 cases reported. Rapid sharing of this protocol should enable scientific critique and shared learning. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/18606

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