How did general practices organize care during the COVID-19 pandemic: the protocol of the cross-sectional PRICOV-19 study in 38 countries

Abstract

Background General practitioners (GPs) play a crucial role in the fight against the COVID-19 pandemic as the first point of contact for possibly infected patients and are responsible for short and long-term follow-up care of the majority of COVID-19 patients. Nonetheless, they experience many barriers to fulfilling this role. The PRICOV-19 study investigates how GP practices in 38 countries are organized during the COVID-19 pandemic to guarantee safe, effective, patient-centered, and equitable care. Also, the shift in roles and tasks and the wellbeing of staff members is researched. Finally, PRICOV-19 aims to study the association with practice- and health care system characteristics. It is expected that both characteristics of the GP practice and health care system features are associated with how GP practices can cope with these challenges. This paper describes the protocol of the study. Methods Using a cross-sectional design, data are collected through an online questionnaire sent to GP practices in 37 European countries and Israel. The questionnaire is developed in multiple phases, including a pilot study in Belgium. The final version includes 53 items divided into six sections: patient flow (including appointments, triage, and management for routine care); infection prevention; information processing; communication; collaboration and self-care; and practice and participant characteristics. In the countries where data collection is already finished, between 13 and 636 GP practices per country participated in the study. Questionnaire data are linked with OECD and HSMR data regarding national policy responses to the pandemic and analyzed using multilevel models considering the system- and practice-level. Discussion To the best of our knowledge, the PRICOV-19 study is the largest and most comprehensive study that examines how GP practices function during the COVID-19 pandemic. Its results can significantly contribute to better preparedness of primary health care systems across Europe for future major outbreaks of infectious diseases.

Distress and Wellbeing among General Practitioners in 33 Countries during COVID-19: Results from the Cross-Sectional PRICOV-19 Study to Inform Health System Interventions

“…However, as the main focus of the study was on the organization of primary care and the reference to wellbeing was not immediately relevant at the outset, the potential impact on wellbeing scores may be less than for other aspects covered by the study/questionnaire. Given the potential volunteer bias and the cross-sectional survey design [10], direct assessment of causal relationships was not possible. We also did not collect information on the actual support measures implemented or the requirements placed on practices; thus, what we reported on was the respondent's perception of support/change.…”

“…The questionnaire was developed at Ghent University in multiple phases, including a pilot study among 159 general practices in Flanders (Belgium). More details are described in the protocol [10]. The questionnaire consists of 53 items divided into six topics: (a) infection prevention, (b) patient flow for COVID-19 and non-COVID-19 care, (c) dealing with new knowledge and protocols, (d) communication with patients, (e) collaboration, (f) wellbeing of the respondent, and (g) characteristics of the respondent and the practice.…”

“…The questionnaire consists of 53 items divided into six topics: (a) infection prevention, (b) patient flow for COVID-19 and non-COVID-19 care, (c) dealing with new knowledge and protocols, (d) communication with patients, (e) collaboration, (f) wellbeing of the respondent, and (g) characteristics of the respondent and the practice. Permission was granted to use the Mayo Clinic Wellbeing Index [10]; the expanded 9-item Wellbeing Index (eWBI) version was utilized [11]. The questionnaire was translated into 38 languages following a standard procedure.…”

“…Data collection varied between countries from 3 to 35 weeks. In each partner country, the consortium partner(s) recruited general/family practices following a predefined recruitment procedure [10], which is shown in the Supplementary Materials (Table S1). There was no funding for this study, and coordinators recruited practices out of goodwill; however, a randomized sample was requested where possible.…”

Practice and System Factors Impact on Infection Prevention and Control in General Practice during COVID-19 across 33 Countries: Results of the PRICOV Cross-Sectional Survey

“…The questionnaire was developed at Ghent University in multiple phases, including a pilot study among 159 practices in Flanders (Belgium). More details are described in the protocol [19]. The questionnaire consisted of 53 items divided into six topics: (a) infection prevention; (b) patient flow for COVID and non-COVID care; (c) dealing with new knowledge and protocols; (d) communication with patients; (e) collaboration; (f) wellbeing of the respondent; and (g) characteristics of the respondent and the practice.…”