In this episode, we speak to Dr Diarmuid Quinlan, a GP and MD candidate based at the Department of General Practice at University College Cork.

Title of paper: Competencies and clinical guidelines for managing acne with isotretinoin in general practice: a scoping review

Available at: https://doi.org/10.3399/BJGP.2025.0135

There is evidence of inequitable access to the most effective treatment for severe acne, isotretinoin. This scoping review identified the clinical competencies to safely manage acne using isotretinoin. No global consensus exists among clinical practice guidelines (CGPs) on whether GPs are appropriate prescribers of isotretinoin. Appropriately resourced and CPG-guided patient access to isotretinoin in primary care may promote safe, timely, and equitable acne management for patients and improve antimicrobial stewardship.

Transcript:

This transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions.

Speaker A

00:00:01.440 - 00:01:07.850

Hello and welcome to BJGP Interviews. My name is Nada Khan and I'm one of the associate editors of the bjgp. And welcome to our autumn edition of the BJGP podcast.

We're kicking off with a new set of interviews for the next few months. So thanks again for joining us.

Today we're speaking to Dr. Dermod Quinlan, who is a practicing GP in Cork and is also an MD candidate at University College Cork in Ireland.

We're here today to discuss his paper, recently published in the BJGP titled Competency and Clinical Guidelines for Managing Acne with Isotretinoin in General Practice. A Scoping Review. So thanks very much, Dermid, for joining me here today to talk about this paper.

But yeah, I guess I just wanted to start by saying that this is a really interesting paper and I think it covers a very common condition that we see in general practice and covers treatment, which can be quite difficult as well for acne.

But I wonder if you could just start by telling us a little bit about why you wanted to do this research and just a bit about the treatment of it and why you focused down on this topic, really.

Speaker B

00:01:09.610 - 00:02:59.510

So lovely to meet you, Nada. I'm first and foremost a GP and I see patients three days a week, 20 hours a week.

And I did a diploma in dermatology over a decade ago and I still do some online tutoring. So I have a long standing interest in dermatology and have an extended role in dermatology.

I work in an urban practice with lots of young teenagers and young people in it.

Acne is a common chronic disorder and I would see a lot of young people with acne of all grades of severity, mild, moderate and severe, and very severe. And as a clinician, very clearly recognize that behind acne is a patient very commonly suffering profound distress.

And we know that the morbidity associated with acne and particularly severe acne, is very extensive.

There's the emotional morbidity, there's psychological morbidity, it impacts people's employment opportunities, their education achievements, and then more widely, because treating acne is resource intensive, it has an impact on the healthcare workforce. And then there are concerns about the very prolonged use of antibiotics in acne, raising real antimicrobial stewardship concerns.

So I have an interest in this. And then we decided that we would do research into it because we don't know the clinical competencies for safe use of isotretinoin.

So I was particularly interested in severe acne and the management of severe acne, and also it didn't clearly...

Today, we’re speaking to Professor Helen Atherton. Helen is Professor of Primary Care Research based at the University of Southampton.

Title of paper: What do patients want from access to UK general practice?

Available at: https://doi.org/10.3399/BJGP.2024.0582

Widely accepted as perpetuated by the media is that patients are unhappy with access to general practice and desire faster access to a general practitioner. This review sought to summarise the research evidence about reported patient wants from access to general practice. Patients wanted to easily make an appointment in a timely fashion, to have a positive relationship with the practice, to see a specific clinician and choose consultation modality according to individual circumstance. Communication and being kept informed about access throughout the process of making and having an appointment, was something patients wanted, and this could be addressed by general practice.

Transcript

This transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions.

Speaker A

00:00:00.480 - 00:01:00.150

Hello and welcome to BJGP Interviews. I'm Nada Khan and I'm one of the Associate Editors of the bjgp. Thanks for listening to this podcast today.

In today's episode, we're speaking to Professor Helen Atherton.

Helen is professor of Primary Care Research based at the University of Southampton, and we've only just speaking to her recently on this podcast about the increasing digitalization of general practice. This time we're speaking to her about her recent paper here in the BJDP titled what Do Patients Want from Access to UK General Practice?

So, hi, Helen.

It's really nice to speak again about this area of research and I guess I just wanted to start by saying that access is such a loaded word and really, when it comes to general practice, it's part of a fairly negative media campaign against general practice. But it seems that this negative narrative just keeps getting pushed, despite lots of attempts to fix it.

So I just wonder if you could reflect on that.

Speaker B

00:01:00.470 - 00:01:51.950

Yeah, absolutely. So that the negative media coverage was one of the reasons that I wanted to do this review.

So this review was a bit of a labour of love because I had a feeling from the work that I was doing on digital access and other research that actually the reality was probably quite different, what we were seeing in the headlines and having looked into it, although there's lots of research out there on patient experience and satisfaction, we have a national survey that looks at that. There wasn't anything about what patients actually want. And so that kind of.

I thought, actually, wouldn't it be really interesting to find out from the evidence what they actually want and see if it does fit with the narrative we see in the papers and on social media. So, yes. So completely agree. And that was kind of where the idea came from, really.

Speaker A

00:01:52.420 - 00:02:08.180

Yeah.

And I just want to unpick what you really mean by access in this paper, because I think for some people it means, you know, just getting an appointment to see their GP within a day, but it can mean lots of different things to other people. So what did you conceptualize that as?

Speaker B

00:02:08.740 - 00:02:49.840

Well, it was difficult.

And you're right, there are lots of different definitions of access, and particularly in the research context, for us, we were...

Today, we’re speaking to Dr Sara Noden, a GP with an extended role in ADHD, and Dr Nishi Yarger, Consultant Psychiatrist in adult ADHD services.

Title of paper: A guide for primary care clinicians managing ADHD medication side effects

Available at: https://doi.org/10.3399/bjgp25X742653

Transcript

This transcript was generated using AI and has not been reviewed for accuracy. Please be aware it may contain errors or omissions.

Speaker A

00:00:00.320 - 00:00:55.720

Hello and welcome to BJGP Interviews. I'm Nada Khan and I'm one of the associate editors at the bjgp. Thanks for listening to this podcast today. In today's episode, we're speaking to Dr.

Sara Noden, a GP with an extended role in ADHD, and Dr. Nishi Yarger, consultant psychiatrist in Adult ADHD Services.

We're talking about the recent Clinical Practice article here in the BJGP titled A Guide for Primary Care Clinicians Managing ADHD Medication Side Effects. So, thanks. It's great to meet you both Sara and Nishi.

This is a really topical area to highlight in the journal, and not least because it seems that every week there seems to be a new article in the media about the increasing diagnosis of adhd. So it's a really topical area to look at, but I guess, Sar, I just really wanted to start with what prompted you to write this article and why now?

Speaker B

00:00:56.620 - 00:01:39.320

Yeah, so I think coming from a GP perspective, before I specialized in adhd, I think these medications did create a bit of anxiety, especially as they're controlled drugs, their stimulants, their specialist medications, and there was a lot that I didn't know about them as I since developed a special interest and it sort of demystified some of these medications. And I just.

I think we wanted to pass on to primary care clinicians some of that knowledge that we've learned, some really basic things that they can look out for that may or may not be related to medications and some common things that they can advise and to know when to escalate secondary care and how to manage these patients, essentially.

Speaker A

00:01:39.560 - 00:01:54.040

Yeah. And Saura, I wonder if you could just tell us a bit more about your role as a GP with an extended role in adhd.

So you must be very much in demand at the moment, but talk us through what led you to sort of take that role and what your typical week is like.

Speaker B

00:01:54.320 - 00:02:58.810

Yeah, So I think my interest in ADHD stemmed during my training years and I currently am working as a salary GP, but also working at CNWL under Dr. Jaga. I'm doing diagnosis and medication titrations. And I think my interest stemmed because of how prevalent ADHD is becoming.

I was seeing such an increase in patients presenting to gp, suspecting they have ADHD and requesting referral, and reading about this treatment and what we can offer, I was really taken aback by not only how ADHD can impact a patient in terms of their symptoms and concentration of focus, but also the lifelong issues that can arise sometimes with adhd, like all the Research showing that it increases rates of depression, underachievement at school, even early death and accidental injuries. So I feel it's a really important, important condition for us to be able to pick up, to be able to refer promptly and start treatment.

And that's where the interest started.

Speaker A

00:02:59.050 - 00:03:14.570

And, Nishi, from your perspective, what's it like having a GP working with your team?

And from a secondary care perspective, I wonder if you...