NAPCRG ANNUAL MEETING DISTINGUISHED PAPERS

Jill Haught

doi:10.1370/afm.2483

NAPCRG’s Annual Meeting is a forum for primary care researchers from across the globe to gather and present their work, collaborate for new research, and foster growth for up-and-coming researchers. The 2019 Annual Meeting was held in Toronto, Ontario, November 16-20, 2019, and was attended by more than 1,000 researchers, clinicians, patients, and other stakeholder members from around the world.

Three papers from the 2019 Annual Meeting were selected and given the special designation of “distinguished paper” for excellence in research based on the following factors: overall excellence, quality of research methods, quality of writing, relevance to primary care clinical research, and overall impact of the research on primary care and/or clinical practice.

Below are brief summaries of this year’s distinguished papers; complete abstracts are available on the NAPCRG website (https://www.napcrg.org/).

Health in a Hostile Environment. Migration as a Structural Determinant of Health for Refugees and Asylum Seekers

Kate O’Donnell, PhD, BSc, MPH BSc (Hons), FHEA, FRCGP (Hon); Anna Isaacs, PhD; Anna Black, BSc, MBChB

Caring for asylum seekers and refugees (ASRs) is an important activity for primary care. However, the wider societal environment in which ASRs find themselves in destination countries can impact greatly on an individual’s ability to live healthily and to access care, especially preventive health care services for chronic diseases or screening. This study looked to understand the health-related experiences of ASRs living in Glasgow, Scotland. Specifically, to address: (a) perceptions of health, well-being, and illness causation, (b) experiences of accessing primary and preventive health care, and (c) the wider societal factors influencing these perceptions and experiences. Two studies were done, each using mixed methods approaches including: focused ethnography; semi-structured interviews; media analysis. Analysis used theories of candidacy, which focused on access to health care, and structural vulnerability, which focused on upstream determinants and influences on health, to deepen the understanding of ASR health and access. The results concluded that ASRs do not see themselves as “candidates” for preventive health care. While services can be adapted to improve accessibility, wider structural variables such as experience of discrimination or entitlement to health care also need to be addressed. FULL ABSTRACT: https://napcrg.org/conferences/2001/sessions/869.

An Innovative Pragmatic Trial of Group Transdiagnostic Cognitive-Behaviour Therapy for Anxiety Disorders

Pasquale Roberge, PhD; Martin Provencher, PhD; Peter Norton; Annie Benoit, MSc; Patrick Gosselin, PhD; Martin Antony, PhD; Helen-Maria Vasiliadis; Catherine Hudon, MD, PhD; Catherine Hudon, MD, PhD; Isabelle Gaboury, PhD; Alexandra Chapdelaine, MSc

Anxiety disorders are the most common mental disorders in community settings and are associated with significant distress and functional impairment. Although cognitive behavior therapy (CBT) is the most consistently efficacious psychological treatment for anxiety disorders, limited resources and expertise challenge its accessibility in primary care, and only a minority of anxiety disorder sufferers are therefore treated according to guidelines’ recommendations for evidence-based psychotherapy. Transdiagnostic group CBT (tCBT) could be a promising intervention to improve access to CBT in primary care, yet its effectiveness in real world conditions requires investigation. This study investigated the effectiveness of group tCBT in addition to treatment-as-usual (TAU), compared to TAU only. The study was set in community-based primary mental health care in Québec, Canada using a pragmatic randomized controlled trial with post-treatment assessment and follow-up at 4 months. The results concluded that transferability of the intervention from a specialized clinic to community settings. The results from this rigorous evaluation of tCBT will contribute to the large-scale dissemination and implementation of this intervention in primary care to promote a more equitable access to evidence-based CBT. FULL ABSTRACT: https://napcrg.org/conferences/2001/sessions/554.

Penicillin V for 5 versus 10 Days in Patients With Pharyngotonsillitis Caused by GAS – A Randomised Controlled Trial

Pär-Daniel Sundvall, MD, PhD; Mia Tyrstrup, MD, PhD; Charlotta Edlund, PhD; Gunilla Skoog Stahlgren, MSc Pharmacy; Karin Rystedt, MD; Katarina Hedin

It is noted that Pharyngotonsillitis is common in primary health care and the current recommendation of the ESCMID Sore Throat Guideline Group is to treat patients with 3-4 Centor criteria and the presence of group A streptococci (GAS) with penicillin V for 10 days. This study investigated whether the total exposure of penicillin V can be substantially reduced while maintaining adequate clinical efficacy. The study was set in 17 primary health care centres in Sweden, as a randomied controlled, open-label, non-inferiority trial. The results concluded that the 5-day regimen was non-inferior to 10 days regarding clinical cure but less effective regarding bacteriological eradication. There was no increased risk of relapses or complications associated with the shorter treatment. The risk of less frequent bacterial eradication should be weighed against the positive effects of shorter time to relief of throat symptoms, numerically fewer adverse events, better compliance, and reduced antibiotic consumption. FULL ABSTRACT: https://napcrg.org/conferences/2001/sessions/34.