Several patient feedback questionnaires are available, showing potential for supporting practitioners' development. Valid questionnaires should be used with appropriate practitioners in developing more evidence for the impact they may have on actual consultations.

Background Diabetes prevention programmes delay or prevent the onset of type 2 diabetes in people with pre-diabetes. To increase accessibility, national guidelines recommend delivering diabetes prevention programmes in primary care settings, including community pharmacy. This study aimed to explore the English community pharmacy setting as an option for delivering diabetes prevention services. Methods Two focus groups and nine semi-structured interviews were conducted with stakeholders including, community pharmacists, general practitioners and commissioners. The topic guide was framed using the COM-B theoretical model for behaviour change to elicit practitioners’ capability, opportunity and motivation to engage with providing or referring to community pharmacy diabetes prevention services. Data were analysed thematically, and barriers/facilitators mapped to the COM-B framework. Results Five themes were identified: ‘Pre-diabetes management and associated challenges’, ‘The community pharmacy setting’, ‘Awareness of community pharmacy services’, ‘Relationships and communication’ and ‘Delivery of community pharmacy services’. Community pharmacy was highlighted as an accessible setting for delivering screening and follow-on lifestyle interventions. Key factors for enhancing the capability of community pharmacy teams to deliver the interventions included training and appropriate use of skill mix. Delivering diabetes prevention services in collaboration with general practices was identified as key to the provision of integrated primary care services. Whilst financial incentives were identified as a motivating factor for delivery, service promotion to patients, public and healthcare professionals was perceived as crucial for enhancing engagement. Conclusions This research highlights a role for community pharmacy in diabetes prevention. New service models should seek to integrate community pharmacy services in primary care to facilitate patient engagement and better communication with general practices.

Long COVID, the post-acute sequelae of SARS-CoV-2 infection, is seen in growing numbers of people and has been highlighted as the only illness to be initially identified by individuals coming together on social media. 1 Each reports a constellation of symptoms that are debilitating, persistent, and unexplained, often limiting day-to-day activities. 2 These include headaches, fatigue, breathlessness, mood changes, dizziness, insomnia, joint aches, and pain. While some are reported as persistent and others may be more 'sporadic', triggered by, for example, exercise, all such symptomology is underpinned by feelings of fear, uncertainty, anxiety, and depression, especially when many patients identify that their 'quest to be seen and cared for' 1 by healthcare practitioners has failed.While searches for causes, mechanisms, and treatments are underway, it is crucial that the patient narrative is understood across the healthcare environment, with urgent attention paid to supporting those with long COVID to manage and mitigate their symptoms, moving towards recovery. This poses challenges because symptoms vary between individuals, many of whom are at increased risk of developing a psychiatric disorder. 3 In addition, our existing fragmented health and care environment, focused on symptoms and specialities, is not suitable for managing long COVID, 4 not least as the collection of respiratory, neurological, gastrointestinal, and cardiac symptomology demands a range of specialist, secondary care-based support. Such care is becoming increasingly unlikely owing to the currently estimated 5.6 million patients in England alone awaiting hospitalbased treatment. 5 Guidance by the NHS and National Institute for Health and Care Excellence however, emphasises that an integrated, coordinated, and multidisciplinary health and social care approach is needed to reduce the impact of long COVID on the health and health inequalities of patients, families, friends, and carers. This will entail a systematic, individualised assessment that will inform a tailored package of support, with ongoing monitoring, review, and referral to appropriate

Background Long COVID is a collection of symptoms that develop during or following a confirmed or suspected case of COVID-19, which continue for more than 12 weeks. Despite the negative impact of long COVID on people’s lives and functioning, there is no validated treatment or even rehabilitation guidance. What has been recommended thus far is the adoption of holistic management approaches. The Optimal Health Program (OHP) is a brief 5-session, plus booster, psychosocial program designed to support mental and physical well-being that has been used effectively for a range of chronic conditions. Objective This study examines the feasibility and acceptability of employing an especially customized version of OHP (long COVID OHP [LC-OHP]) to improve psychological and physical health of people with long COVID. Methods This is a feasibility randomized controlled trial that will be running from November 2021 to February 2023. Eligible participants aged 18 years or older who are experiencing symptoms of long COVID will be identified through their secondary practitioners with recruitment to be undertaken by the research team. A total of 60 participants will be randomized into a control (usual care) or an intervention (LC-OHP) group. Outcomes will be feasibility and acceptability of the program (primary); and efficacy of the LC-OHP in improving anxiety, depression, fatigue, self-efficacy, and quality of life (secondary). Up to 20 participants will be interviewed at the end of the trial to explore their experience with the program. Quantitative data will be analyzed using SPSS, and differences between groups will be compared using inferential tests where appropriate. Qualitative data will be transcribed and thematically analyzed to identify common emerging themes. Results This is an ongoing study, which began in November 2021. Conclusions Long COVID has a significant impact on an individual’s mental and physical functioning. The LC-OHP has a potential to provide people living with long COVID with additional support and to improve self-efficacy. The findings of this study would identify the feasibility of delivering this program to this population and will provide an indication for the program’s effectiveness. Trial Registration ISRCTN Registry ISRCTN38746119; https://www.isrctn.com/ISRCTN38746119 International Registered Report Identifier (IRRID) DERR1-10.2196/36673

BACKGROUND Long COVID is a collection of symptoms that develop during or following a confirmed or suspected case of COVID-19, that continue for more than 12 weeks. Despite the negative impact of long COVID on people’s lives and functioning, there is no validated treatment or even rehabilitation guidance. What has been recommended thus far, is adoption of holistic management approaches. The Optimal Health Programme (OHP) is a brief 5-session, plus booster, psychosocial programme designed to support mental and physical wellbeing that has been used effectively for a range of chronic conditions. OBJECTIVE This study examines the feasibility and acceptability of employing a specially customised version of OHP (long COVID OHP or LC-OHP) to improve psychological and physical health of people with long COVID. METHODS This is a feasibility randomised controlled trial. Eligible participants aged 18 years or older who are experiencing symptoms of long COVID will be identified through their secondary practitioners with recruitment to be undertaken by the research team. Sixty participants will be randomised into a control (usual care) or an intervention (LC-OHP) group. Outcomes will be feasibility and acceptability of the programme (primary); and efficacy of the LC-OHP in improving anxiety, depression, fatigue, self-efficacy and quality of life (secondary). Up to 20 participants will be interviewed at the end of the trial to explore their experience with the programme. Quantitative data will be analysed using SPSS and differences between groups will be compared using inferential tests where appropriate. Qualitative data will be transcribed and thematically analysed to identify common emerging themes. RESULTS This is an ongoing study which began in November 2021. The study received approval from the University of Suffolk Ethics committee (RETH21/004) and from the NHS Health Research Authority (IRAS no. 304234). CONCLUSIONS Long COVID has a significant impact on an individual’s mental and physical functioning. The LC-OHP offers a holistic approach that can aid people through recovery and improve self-efficacy. This would ultimately contribute to reducing the unprecedented and unsustainable demand on healthcare services including mental health seen during the pandemic. CLINICALTRIAL Trial registration number ISRCTN38746119.