We would like to thank everyone who participated in the EGPRN Vilnius meeting: general practitioners from 25 countries attended, and it provided an excellent opportunity to discuss the future of European family medicine.
In the pre-conference workshop on “collaborative studies”, participants had the opportunity to hear about quantitative and qualitative research methodologies and to discuss such matters with other workshop attendees. The other workshop dealt with “clinical trial results and general practice”, and focused on the discussion of evidence resulting from clinical trials.
Many interesting studies were presented at the Vilnius conference. Magdalena Esteva presented one of the most recent EGPRN collaborative research projects on behalf of co-authors Jean Karl Soler and Hakan Yaman. This cross-sectional exploratory study determined the prevalence of burnout among family doctors (FDs) in European countries. According to the study results, burnout seems to be a common problem among FDs across Europe, and is associated with personal and workload indicators, job satisfaction, intention to change job, and the (ab)use of alcohol, tobacco, and psychotropic medication. A British general practice network (STaRNeT) has developed the psychological outcome profiles (PSYCHLOPS) questionnaire, which was presented to the conference. Harm W. J. van Marwijk (the Netherlands) presented a cluster-randomized controlled educational trial, which found that PSYCHLOPS is a highly useful tool in evaluating a primary mental-health care intervention, both in the consulting room and in research.
The Rouen University research team study, presented by Jean-Yves Le Reste, was concerned with French GPs’ management of depressive patients, and had compared results with a similar study previously performed in the UK. The study found that nearly 50% of French GPs encountered obstacles when referring a depressive patient, mainly due to a lack of services to refer to and difficulties in accessing such services.
Another French study presented by Laurence Coblentz-Bauman explored GPs’ difficulties coping with a patient with suicidal ideation, and options to get through this difficult situation. The study's results confirmed the complexity of taking care of these patients in primary care. Research concluded that such consultations are emotional, and difficulties seem to arise more as a result of patient requests and physician profile rather than place of practice and nearness of hospital emergency units.
Joanna Skorupka from the Medical University of Silesia (Poland) presented a study on the relationship between depression and metabolic control. Erik Stolper from Maastricht University reported on “Consensus about gut feelings in general practice”. This qualitative research included a Delphi consensus procedure with a heterogeneous sample of 27 Dutch and Belgian GPs or ex-GPs involved in university educational or research programmes. Gut feelings in general practice seem to play a substantial role in diagnosing.
In a parallel session, Jouke van der Zee (the Netherlands) discussed the conditions necessary to develop research in general practice and the current situation in various European countries. Sandrine Huge concluded that a multiplicity of initiatives are not coherent and pertinent in trying to help doctors establish their practice. Most of the initiatives are financial, but young practitioners’ initial problems are most of all sociological.
Jochen Gensichen from Germany's Goethe University presented qualitative research on how to improve depression care by involving nurses using the PHQ (patient's health questioner). Nicole Boffin from Belgium presented a pilot descriptive study about the surveillance of new cases of depression.
Domestic violence was a distressing but interesting part of our conference. Anastasia Lygera (Greece) concluded that violence in families is common, and GPs have to be prepared to recognize abuse and to provide support for victims. Yvonne Winants (the Netherlands) and colleagues used qualitative and quantitative methods (pre-/post-patient controlled evaluation study design) to evaluate the effects of domestic violence in terms of psychopathology, level of post-traumatic stress, self-confidence, and social support. The study participants—women survivors—had a low level of education, un- or low-paid jobs, and had mostly young children. The group-work intervention appeared to be effective in helping battered women to overcome their experiences of domestic violence and to move on with their lives.
Jean Yves Le Reste asked: “What kind of operative and pragmatic knowledge do French GPs develop for caring for patients with mental suffering?” An answer to this question was attempted in a qualitative study. GPs understand the causes of the mental suffering by identifying critical incidents in the patient's life. Rather than attaching a psychiatric diagnosis to mental suffering, they try to address it and control it. Support psychotherapy was their tool to do so. All this requires a strong connection between GPs and patients. Roger Ruiz-Moral (Spain) discussed patient involvement in clinical decisions. Sümer Mamakli (Turkey) and colleagues concluded that health-related quality of life is reduced among undiscovered coronary heart disease cases.
We are sorry that space considerations do not allow us to mention every study, since they were all interesting. There were quite a few posters with interesting ideas and attractive presentations. Every presentation stimulated long and rich discussions and ideas for future collaborations.
Until the next EGPRN meeting in Antalya!