RT Journal Article
SR Electronic
T1 Understanding and improving compound pressures in general practice: a realist review protocol
JF BJGP Open
JO BJGP Open
FD Royal College of General Practitioners
SP BJGPO.2025.0073
DO 10.3399/BJGPO.2025.0073
A1 Owen-Boukra, Emily
A1 Abrams, Ruth
A1 Cohen, Tanya
A1 Goodman, Claire
A1 Henry, Cecily
A1 Ingle, Laura
A1 Mahtani, Kamal
A1 Ogden, Margaret
A1 Roberts, Nia Wyn
A1 Shah, Rupesh
A1 Thomas, James
A1 Wong, Geoff
A1 Park, Sophie
YR 2025
UL http://bjgpopen.org/content/early/2025/09/29/BJGPO.2025.0073.abstract
AB Background Compound Pressures (CP) significantly impact the role of General Practice (GP) in supporting human health. These pressures include climate change, pandemics, and financial crises. CP can be predictable, pre-determined, or unpredictable in nature and scope. Strategies to address the demands arising from CP range from short-term initiatives to buffering existing GP systems to ensure flexible and agile resources. Interventions designed to prevent, identify, and manage CP may result in both intended and unintended outcomes.Aim To conduct a realist appreciative inquiry, realist review, and three embedded studies within a review (SWAR) about CP affecting GP and the delivery of effective, equitable patient care.Design & setting Realist appreciative inquiry, realist review, and three SWARS.Method We will conduct a realist appreciative inquiry facilitating patient and stakeholder input into the review scope, focus, and initial programme theory development. This approach emphasises the identification of assets, successes, hopes, and aspirations to enable positive change. Based on these insights, we will conduct a realist review of empirical and grey literature. This project includes three elements of methodological innovation (SWARs). First, evaluation of how appreciative inquiry can inform initial programme theory development. Two further SWARs will examine how artificial intelligence might a) support the identification of relevant resources at title and abstract, and full-text stages, and b) support data extraction and analysis in future realist reviews.Conclusion Our research aims to understand the effects of CP on GP, supporting preparation and solutions that can inform future policies, interventions, and support systems.