To examine fertility and preconception health (PCH) knowledge and attitudes among final-year university students in non-health majors in Türkiye.

This cross-sectional analytical study included 749 final-year undergraduate students from non-health majors at Bartın University. Data were collected online between November and December 2024 using the Demographic Information Form, Fertility Health Knowledge Survey (FHKS), Preconception Health Knowledge Questionnaire (PCHKQ), and Fertility and Preconception Health Attitude Questionnaire (F-PCHAQ).

Mean FHKS, PCHKQ, and F-PCHAQ scores were 69.80 ± 30.60, 27.07 ± 8.90, and 38.38 ± 3.32, respectively. Female students demonstrated significantly higher fertility and PCH knowledge scores than male students (p < .05). Overall attitude scores did not differ significantly by gender (p = .075), although significant differences were observed in the fertility and PCH attitude subscales (p < .05). Effect sizes were generally small to moderate. Fertility knowledge was strongly correlated with PCH knowledge (r = .634, p < .001), whereas knowledge–attitude correlations were weakly positive.

Female students demonstrated greater fertility and PCH knowledge, while overall attitudes were comparable between genders. Positive knowledge–attitude associations suggest that improved reproductive health knowledge may support more favorable attitudes. These findings highlight the importance of providing evidence-based fertility and PCH education to university students outside health disciplines.

Food insecurity and limited maternal nutrition knowledge contribute to childhood iron deficiency anaemia (IDA) and stunting. This study evaluated community-based Dietary Intake Behaviour Education (DIBE) for improving iron status and linear growth among children aged 6–59 months in rural central Ethiopia.

A cluster-randomized controlled trial with 1:1 allocation was conducted across 16 community units from April 2021 to January 2023, enrolling 1,012 mother–child pairs. Structured assessments collected data on nutritional status, maternal nutrition knowledge, feeding practices, and related factors. IDA was defined as a haemoglobin concentration below 110 g/L, while stunting was defined as a height-for-age Z-score (HAZ) below −2 SD from the WHO child growth standards. Independent-samples t-tests and generalized estimating equations assessed intervention effects and associated factors.

Baseline IDA prevalence was 18.2%, higher in the intervention group (22.13%) than the control group (14.2%). At endline, IDA prevalence decreased to 6.5% in the intervention group but increased to 20.4% in controls. Baseline stunting prevalence was comparable between intervention (41.5%) and control (40.7%) groups. At endline, stunting decreased to 15.0% in the intervention group but increased to 51.8% in controls. DIBE was positively associated with HAZ (B = 0.744, p = 0.003). Maternal food-preparation practices (B = 0.242, p = 0.020) and IDA awareness (B = 0.237) were also positively associated with HAZ.

Community-based DIBE improved linear growth and coincided with reductions in IDA and stunting. Integrating practical nutrition education into routine child health services may improve nutritional outcomes in resource-limited settings.

Trial registration: ClinicalTrials.gov:NCT04846062.

Registered: 15 April 2021, View at: https://clinicaltrials.gov/ct2/show/NCT04846062

The Close-knit County-level Medical Community (CCMC) policy has been implemented to strengthen the health service capacity of the primary health care (PHC) system and optimize medical resource allocation to achieve the goal of health for all in China. The aim of this study was to evaluate the effect of the policy on health resource allocation efficiency in the PHC system.

This was a quasi-experimental study based on data of 183 county-level districts across Sichuan Province from 2013 to 2023. The super-efficiency slacks-based measure model was used to assess the health resource allocation efficiency. The difference-in-difference (DID) model was adopted to evaluate the policy effect of CCMC. The propensity score matching DID (PSM-DID) method was used to test the robustness of the policy effect.

The number of institutions, beds, and health workers of the PHC system in Sichuan Province showed a steady upward trend from 2013 to 2023. The medical resource allocation efficiency of the PHC system in almost all county-level districts in Sichuan Province was lower than one. The average efficiency of the PHC system in both pilot and non-pilot districts remained at a low level both before and after the implementation of the CCMC policy. The policy might have a negative impact on the efficiency of the PHC system, but this negative association was only demonstrated statistically in the PSM-DID weight model (β = −0.0499, P < 0.1). However, when excluding data during the COVID-19 pandemic, the significant negative effect in the PSM-DID weighted model disappeared, all the coefficients of the policy interaction in different models became non-significant while maintaining a negative direction.

The CCMC policy did not demonstrate a statistically significant positive effect on the efficiency of the PHC system during the current observation period. The Chinese government should comprehensively regulate and support the health resources of the medical alliance through policy guidance, medical insurance regulation, and financial support to integrate not only different levels of medical institutions, but also medical resource of these institutions, making the medical alliance a unified interest community. A reasonable remuneration strategy should be established to encourage health workers to work in the PHC system for improving the health service capability.

To evaluate the effect of a nurse-led, stage-tailored home-based self-management and follow-up programme on self-care behaviour in people with heart failure.

People with heart failure require ongoing education, symptom monitoring, and self-management support after specialist assessment. However, access to structured centre-based cardiac rehabilitation may be limited. A nurse-led home-based model may help bridge the gap between specialist cardiology care and community-based long-term support, particularly where rehabilitation services are unavailable.

In this parallel-group randomized controlled trial, adults aged 40–75 years with New York Heart Association class I–III heart failure and ejection fraction >30% were allocated to a 12-week home-based programme or usual care. The intervention was delivered through nurse-led home visits and telephone follow-up for clinically stable patients who could not access structured centre-based rehabilitation. The intervention group received home visits and telephone follow-up (n = 32), while the control group received usual care (n = 31). The primary outcome was self-care behaviour. Secondary outcomes were quality of life, self-efficacy, and physical capacity. Exploratory clinical outcomes were body composition, ejection fraction, and HbA1c level.

At 12 weeks, the intervention group had better self-care scores than the control group (17.78 ± 2.93 vs 40.00 ± 6.49). Secondary outcomes also favoured the intervention group, with better quality of life scores, higher self-efficacy scores, and greater 6-minute walk distance. Exploratory clinical outcomes showed changes in some parameters, including ejection fraction and body-fluid values. Most intervention participants reached the Transtheoretical Model action stage, and New York Heart Association class improved significantly. This primary health care-relevant home-based model was associated with improved self-care behaviour and may support continuity of care for people with heart failure after specialist cardiology assessment when centre-based rehabilitation is unavailable.

The programme improved self-care in people with heart failure and showed potential to support home-based self-management when centre-based cardiac rehabilitation was unavailable.

General practice (GP) training is central to the development of the primary care workforce but is often described as a bounded educational programme rather than a process shaped by clinical work, workplace culture, and wider service conditions.

To examine how GP training is represented in the literature and to develop a complexity-informed conceptual model of GP training.

Systematic review and complexity-informed synthesis of studies relating to GP training in primary care contexts.

Empirical and conceptual studies were identified through systematic searching and analyzed using thematic synthesis, informed by complex adaptive systems and Cohered Emergent Theory.

Three thematic areas were identified: GP–patient interactions, GP–professional interactions, and training intricacies. Four cross-cutting insights emerged: complexity in everyday training, the influence of power and hierarchy, the importance of diversity and adaptability, and the shaping role of wider system pressures. These informed the Cohered GP Training Model, which conceptualizes GP training as a dynamic system in which outcomes emerge from the degree of coherence between trainee formation, educational relationships, patient care encounters, workplace and team ecology, and the wider primary care system.

GP training is best understood as a relational and system-embedded process rather than a discrete educational intervention. The model may help explain variation in training quality across settings and offers a conceptual basis for improving training environments and workforce development.

Hybrid care is increasingly used for chronic disease management, yet how patients are allocated to these modalities in routine practice remains poorly understood.

To characterize baseline factors associated with physician-driven allocation to hybrid versus in-person care and examine three-year clinical outcomes.

This retrospective observational cohort included adults with hypertension, type 2 diabetes, and/or dyslipidemia enrolled in a programme in Alma Mater Hospital of Antioquia, Medellín, Colombia (2019–2025). Care modality was determined by treating physicians. Associations between baseline clinical, functional–behavioural, and psychosocial characteristics, care allocation, and follow-up outcomes were examined using logistic regression and interpreted as associational rather than causal.

Among 638 participants (319 hybrid; 319 in-person), higher baseline glycated haemoglobin (HbA1c) (adjusted odds ratio [aOR] 2.68 per 1% increase; 95% CI 2.17–3.31) and inadequate medication adherence (aOR 1.96; 95% CI 1.17–3.28) were associated with hybrid care allocation, whereas higher educational attainment was inversely associated (middle vs low: aOR 0.43; 95% CI 0.25–0.72; high vs low: aOR 0.19; 95% CI 0.10–0.33). A strong gradient was observed in the secondary complexity analysis. Hybrid care was associated with higher three-year therapeutic goal attainment (OR 7.34; 95% CI 4.96–10.86) and lower chronic disease-related emergency department utilization (OR 0.53; 95% CI 0.36–0.79).

Hybrid care allocation was systematically associated with baseline clinical and contextual characteristics. Outcome differences should be interpreted cautiously given clinician-driven allocation and baseline differences.

The rapid adoption of AI tools in academic research has created uncertainty about appropriate use in manuscript preparation, particularly in primary health care where clear guidance is essential for maintaining research integrity across diverse settings.

This review aimed to assess the availability and content of AI policies across primary health care journals and their publishers.

We identified primary health care journals through searches of SCImago Journal & Country Rank, Google Scholar, and a Google search. After screening for English language, functioning webpages, recent publications, and exclusion of predatory journals, 41 journals were included. Two reviewers independently reviewed journal homepages, author guidelines, submission policies, and editorial policies for AI-related statements at both journal and publisher levels between 18 and 21 July 2025.

Of 41 journals assessed, 33 (80.5%) had publicly available AI policies – 21 (51.2%) at journal level and 12 (29.3%) at publisher level. Eight journals (19.5%) had no identifiable public AI policy. All identified policies were permissive toward AI use but varied in requirements across five key areas: disclosure of AI use, acceptable AI tasks, AI authorship considerations, author responsibility, and peer review guidelines.

While most primary health care journals have established AI policies, significant gaps remain in accessibility and standardization. The fragmented governance landscape, characterized by inconsistent policy locations and requirements, creates confusion for authors and might compromise research integrity. Standardized, easily accessible AI policies are needed to enable researchers to harness AI’s potential while maintaining transparency and scientific rigour essential to primary health care research.

To map publication growth, collaboration, knowledge structure, and thematic change in artificial intelligence (AI) research in primary health care (PHC) and general practice and assess whether attention has expanded from model development to validation, implementation evaluation, and governance.

PHC AI research covers risk stratification, screening, diagnostic support, clinical decision support, and workflow optimization. However, publication growth and changing hotspots do not directly indicate clinical implementation or practical value.

Web of Science Core Collection was searched for AI- and PHC-related records published from 1 January 2015 to 19 October 2025. Of 1,481 records, 1,261 articles and review articles were screened using titles, abstracts, and author keywords, Python-developed term lexicons, weighted scoring, and manual adjudication. Records lacking a specific PHC application, focused on public or consumer health, or insufficiently relevant were excluded. The main sample included 1,123 papers for bibliometric, collaboration, thematic, citation, and bibliographic coupling analyses. A supplementary search identified 599 candidates to assess omissions due to terminological variation; 142 remained after 457 exclusions and were added to form a 1,265-paper sensitivity corpus used only for keyword-frequency, co-occurrence, and annual trend reruns. Annual output was assessed for 2015 to 2024; 2025 was retained as an incomplete-year observation but excluded from complete-year comparisons.

Annual output rose from 6 papers in 2015 to 220 in 2024 and increased continuously after 2018. Sensitivity analyses confirmed a stable thematic structure centred on AI, machine learning, PHC, electronic health records, screening and diagnosis, with overall increases in standardized AI- and PHC-term frequencies. Bibliographic coupling identified multiple application settings and model-evaluation topics. Model validation became more common; implementation/workflow remained visible, governance/regulation emerged after 2018, and fairness/bias and explainability were more prominent from 2022 to 2024. These findings indicate broader research attention, but do not demonstrate routine AI use or improved clinical outcomes.

To assess the association of the doctor–patient relationship with adherence to treatment (AT) and lifestyle recommendations in patients with multimorbidity.

Multicentre, descriptive, cross-sectional study.

Primary care.

202 patients diagnosed with two or more chronic pathologies, from 23 health centres.

Self-administered questionnaires validated in our setting: Therapeutic Adherence Scale (EAT, for its acronym in Spanish) and perception of doctor–patient relationship (PREMEPA questionnaire). Descriptive, bivariate analysis, and multivariate modelling (log-linear analysis).

Categorical adherence score according to the Therapeutic Adherence Scale (EAT) and categorical doctor–patient relationship score according to the Physician-Patient Relationship Perception Questionnaire (PREMEPA questionnaire).

56.1% of the patients were women and 67% were over 60 years of age. Adherence was high in 52.2%, with very high adherence in 42.8%. Adequate doctor–patient relationship was reported by 86.6% of patients. There was a statistically significant but weak association (Cramer’s V = 0.182) between doctor–patient relationship and adherence (p < 0.05), with a higher degree of relationship found in women and those over 60 years of age. Generalized linear statistical analysis showed a significant model with a positive association between AT and empathy, courtesy, patient participation in decision-making and return.

Adequate doctor–patient relationship was associated with greater adherence to treatment. Empathy was the component of doctor–patient relationship that showed the strongest association with adherence. Courtesy and patient participation are favourable factors for adequate adherence.

This study aimed to examine the associations among complication risk perception, gender role stress, and symptom management self-efficacy in patients with Type 2 diabetes mellitus and to identify factors associated with these constructs.

This analytical cross-sectional study was performed at the endocrinology outpatient clinic of a hospital. The sample consisted of 500 Type 2 DM patients (250 women, 250 men). Study data were gathered through the Individual Information Form (IIF), Risk Perception Survey–Diabetes Mellitus Scale (RPS-DM), Symptom Management Scale for Self-Efficacy (SMSSE), Feminine Gender Role Stress Scale (FGRSS), and Masculine Gender Role Stress Scale (MGRSS). The data were analyzed using the Mann–Whitney test, Kruskal–Wallis H test, Spearman correlation coefficients, and binary logistic regression.

It was determined that both in women and men, it was found that as gender role stress increased, composite and environmental risk perceptions increased, and symptom management self-efficacy decreased (p < 0.001). According to logistic regression analysis, when risk knowledge increases in women, self-efficacy will increase (OR: 0.595), and composite risk perception will decrease (OR: 7.377). When composite risk perception increases in men, self-efficacy will decrease (OR: 16.933).

Complication risk perception and gender role stress were associated with symptom management self-efficacy among patients with Type 2 DM, with these associations differing by sex. Future interventional studies are needed to determine whether addressing these factors improves symptom management for self-efficacy. The findings may also help nurses recognize sex-specific differences when planning individualized patient care.

To describe and understand areas of concordance and discordance between the perceptions and experiences of family physicians and policymakers regarding the implementation and use of virtual care within the Nova Scotian primary care system.

COVID-19 brought rapid change to primary care delivery and accessibility. Virtual care rapidly expanded, facilitating primary care access amidst public health restrictions. Health systems leaders facilitated access to virtual care, developed and implemented guidelines, and created new billing codes. Providers integrated virtual care and operation changes into practice.

Semi-structured interviews with family physicians (n = 20), policymakers (n = 9) and a family physician/policymaker (n = 1) were conducted to understand virtual care implementation and outcomes in Nova Scotia, Canada, identifying benefits and challenges.

All participants discussed patient confidentiality concerns, overreliance potential, and virtual care to promote patient care access. Family physicians discussed provider privacy and burnout. Policymakers discussed virtual care increasing capacity for accepting new patients and challenges evaluating virtual care billing codes. Providers and policymakers shared concerns and policy directions for development and expansion of virtual care. As there is little research from policymaker perspectives on virtual care, reconciling these viewpoints is crucial for effectiveness and sustainability.

Malnutrition is prevalent among community-dwelling older adults (OAs), particularly those using healthcare services, and the number of affected individuals is expected to increase with ongoing population ageing. Early and systematic identification of OAs at risk of malnutrition is recommended as a key first step in prevention and management. However, a significant gap exists between recommended nutritional practices and their implementation in routine care.

This article aims to describe the development process of a complex intervention for early detection of malnutrition risk among community-dwelling OAs (≥65 years) in a Danish homecare setting.

The development process was overall framed by the Medical Research Council (MRC) framework and guided by the IdentifyiNg and assessing different approaches to DEveloping compleX intervention framework. Eleven iterative actions were undertaken, including systematic consideration of contextual conditions, key uncertainties, stakeholder engagement, review of published evidence, and development of the intervention’s programme theory.

The development process resulted in an intervention comprising four activities:

1. A. An interprofessional workgroup.

2. B. Learning activities for homecare staff.

3. C. Conversations with OAs and their informal caregivers.

4. D. Systematic and continuous screening followed by an action guide.

Activities C and D covered the screening procedure, and activities A and B the implementation strategy for this procedure.

The developed intervention was designed to support nutritional self-care among OAs and facilitate early identification of malnutrition risk in homecare settings. Subsequent feasibility testing of the intervention was conducted between August 2024 and December 2025. It is reported elsewhere.

This qualitative study describes patient perspectives on early pregnancy loss (EPL), the medical term for miscarriage, care in one federally qualified health centre (FQHC) that initiated provision of a mifepristone plus misoprostol regimen.

EPL is a common pregnancy complication that can generally be treated by primary care providers (PCPs), yet many PCPs report barriers to providing the most effective medication regimen: mifepristone plus misoprostol. Limited data exist on patient experiences with EPL in the primary care setting.

Researchers conducted semi-structured interviews with a sample of patients who received EPL care from one Illinois FQHC between 2021 and 2022. Interview transcripts were coded and analysed to identify themes regarding how primary care can address patients’ needs when experiencing pregnancy loss.

Participants (n = 16) expressed satisfaction with EPL management at the FQHC, specifically that the option of medication management eased concerns about potential complications and provided clear expectations of the passage of the pregnancy. Medication management became a more accessible option for patients after the clinic began stocking mifepristone. Participant suggestions to improve EPL management in primary care included stronger and/or more timely analgesia, increased education, and mental health support. Participants identified barriers to EPL care including difficulty scheduling visits and perceived lack of urgency when triaged by clinic staff.

Patients report comfort with and interest in the option of medication management for EPL in the community-based primary care setting. Barriers in primary care clinic infrastructure and logistics must be considered and optimized to provide timely and safe EPL care.

This study aimed to examine the prevalence and predictors of immediate mother–newborn skin-to-skin contact (SSC) in Malawi and factors associated with missed SSC despite being delivered in health facilities.

SSC immediately after birth is an evidence-based essential newborn care intervention associated with improved thermoregulation, early breastfeeding initiation, maternal–infant bonding, and neonatal survival. Although facility delivery is expected to promote SSC, a substantial proportion of newborns in low- and middle-income countries still do not receive this recommended practice.

We analysed data from the Malawi Demographic and Health Survey 2024. After restricting to the most recent live birth per woman and applying a complete-case approach across the outcome and all explanatory variables, the final analytic sample comprised 6,065 mother–newborn pairs (weighted sample: 6,142). The outcome was maternal report of immediate SSC after birth. Weighted descriptive statistics, chi-square tests, and multilevel logistic regression were used to identify factors associated with SSC. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) are reported.

Overall, 77.3% of newborns experienced SSC. In the fully adjusted model, caesarean delivery (aOR = 0.13, 95% CI: 0.10–0.17) and multiple births (aOR = 0.47, 95% CI: 0.26–0.86) were associated with lower adjusted odds of receiving SSC. Institutional delivery (aOR = 5.20, 95% CI: 1.86–14.56) and antenatal care attendance were associated with higher adjusted odds of receiving SSC. Among institutional deliveries, caesarean delivery and multiple births (aOR = 0.44, 95% CI: 0.24–0.80) remained associated with lower odds of receiving SSC. Cluster-level variation was substantial (ICC = 0.172–0.173).

This study explored registered nurse (RN) prescribers’ perspectives on educational preparation and identified barriers and facilitators to successful role adoption.

Registered nurse (RN) prescribing was introduced in Ontario in 2023 to improve access to care and optimize the nursing scope of practice. While educational programmes were developed rapidly, little is known about RN prescribers’ experiences with role implementation and workplace integration.

This study explored RN prescribers’ perspectives on educational preparation and identified barriers and facilitators to successful role adoption.

A mixed-methods design was used. A cross-sectional survey of 52 RN prescribers who completed a College of Nurses of Ontario-approved prescribing programme captured demographic data and employment experiences. Quantitative analysis included descriptive statistics, bivariate tests, and hierarchical regression. Fifteen participants completed semi-structured interviews, which were analysed thematically.

Quantitative findings indicated generally positive employment experiences, with higher satisfaction associated with supportive colleagues and management. Unrealistic employer expectations and lack of familiarity with RN prescribing scope were identified as barriers. Qualitative analysis revealed four themes: (1) value of prior RN experience, with most participants recommending 2–5 years before prescribing; (2) mentorship as a catalyst for role transition, and physician mentorship was most common; (3) colleague support and organizational culture as critical facilitators; and (4) role clarity and system-level barriers. Participants emphasized that although education prepared them to prescribe, workplace readiness and clear role expectations were essential for building confidence and ensuring safe practice.

Successful implementation of RN prescribing requires more than education; structured mentorship, supportive organizational culture, and standardized policies are vital. These findings inform strategies to strengthen RN prescribing integration and improve access to care.

In 2020 the Irish Health Service Executive (HSE) shifted chronic disease management (CDM), including COPD and asthma, into primary care via a funded CDM programme. An Enhanced Community Care (ECC) initiative established local clinical specialist teams (CSTs) providing spirometry, nurse-led clinics and pulmonary rehabilitation to support primary care practitioners (PCPs). We explored early PCP experience, diagnostic access, and confidence, to identify improvement priorities.

We sought to evaluate PCPs experiences with the implementation of Ireland’s CDM and ECC programmes for COPD and asthma, focusing on diagnostic access, clinical confidence and priorities for service improvement and professional development.

A semi-structured survey was distributed nationally through PCP faculty meetings, mailing lists and messaging groups. Single- and multi-choice items, Likert scales (1–10) reported as median and interquartile range (IQR), and ranked options quantified satisfaction, access and educational needs; free-text responses underwent thematic analysis.

One-hundred-12 PCPs responded (62% urban; 65% >10 years in practice). Most practices (97%) had adopted CDM and 87% perceived better patient outcomes arising from this, yet only 33% reported a major change in their own practice. Integrated-care hubs were rated good–excellent by 87% and superior to hospital outpatient care by 84%, but limited diagnostics (52%), delayed two-way communication (45%) and inadequate specialist support (50%) persisted. Self-reported confidence in guideline knowledge was modest (asthma 7 (IQR 6–7); COPD 7 (IQR 6–7)) and very low for interpreting pulmonary-function tests and prescribing pulmonary rehabilitation (3 (IQR 2–5) and 5 (IQR 4–6) respectively). Priority topics for continuing-professional-development were: differentiating asthma from COPD, inhaler device choice and PFT interpretation.

Irish PCPs value the CDM/ECC model but highlight implementation gaps. Targeted CPD, faster digital feedback and decision-support tools are needed, alongside longitudinal evaluation against health-service benchmarks and sustainability frameworks.

Type 2 diabetes mellitus (T2DM) is associated with an increased risk of cognitive function through multiple metabolic and vascular mechanisms. Evidence on the association between diabetes self-management skills and cognitive function in individuals with T2DM remains limited.

This study aimed to investigate the relationship between diabetes self-management and cognitive function among individuals with T2DM and to identify factors associated with cognitive function.

A cross-sectional, correlational study was conducted with 170 adults with T2DM at a public hospital in Ankara, Türkiye. Data were collected between June 2024 and January 2025 using a Participant Information Form, the Type 2 Diabetes Self-Management Scale (T2DM-SMS), and the Mini-Mental State Examination (MMSE) to assess cognitive function. Data were analysed using descriptive statistics, correlation analysis, and multiple linear regression.

The mean T2DM-SMS score was 58.84 ± 12.58, and the mean MMSE score was 17.77 ± 5.13. Diabetes self-management was positively correlated with cognitive function (r = 0.50, p < 0.05). Multiple linear regression analysis demonstrated that diabetes self-management remained independently associated with MMSE scores after adjustment for age, gender, and diabetes-related complications (β = 0.12, p < 0.001). Older age was independently associated with lower MMSE scores (β = −0.17, p < 0.001), whereas male participants had significantly higher MMSE scores than female participants (β = 1.59, p = 0.006).

Better diabetes self-management was independently associated with better cognitive function among individuals with T2DM. Integrating cognitive assessment and individualised self-management education into diabetes care may support early identification and help preserve cognitive function and improve long-term outcomes.

We aimed to examine changes in antidiabetic drug utilization associated with implementation and subsequent easing of pandemic-related restrictions.

The COVID-19 pandemic and associated restrictions disrupted healthcare access and glycemic regulation, affecting diabetes management.

We collected nationwide outpatient antidiabetic drug sales and projected prescribing data from IQVIA Turkey between 01.03.2018 and 31.12.2022. We assessed average monthly consumption, expenditure, and quarterly prescribing trends across ‘before restrictions’ (BfR, 01.03.2018–31.03.2020), ‘during restrictions’ (DuR, 01.04.2020–31.03.2022), and ‘after restrictions’ (AfR, 01.04.2022–31.12.2022) periods. Consumption and prescribing levels were expressed as ‘defined daily doses/1,000 inhabitants/day’ (DID).

Antidiabetic consumption increased from 123.6 ± 12.2 DID in BfR to 156.3 ± 25.4 DID in DuR and remained elevated in AfR (151.2 ± 28.9 DID), paralleled by expenditure (€63.6 m ± 8.4 m, €85.1 m ± 14.8 m, and €83.9 m ± 19.1 m, respectively). Prescribing levels declined from BfR to DuR (56.4 ± 3.5 to 29.9 ± 3.6 DID, p < 0.001) and slightly recovered in AfR (46.0 ± 10.9 DID, p > 0.05 vs. earlier periods). Oral antidiabetic consumption rose from 71.2 ± 6.8 DID in BfR to 90.6 ± 17.2 DID in DuR (p < 0.001) and further to 96.9 ± 19.4 DID in AfR (p < 0.001 vs. BfR), while sodium-glucose cotransporter-2 inhibitor use increased across periods (p < 0.001). Injectable antidiabetic consumption, mainly insulins, increased from BfR to DuR (p < 0.001), and decreased in AfR (p < 0.01 vs. DuR).

We demonstrated a sustained increase in antidiabetic consumption following implementation of COVID-19-related restrictions, persisting beyond easing of most measures. Medication-access policies, panic stockpiling, improved glycemic adherence, and newer therapies might have contributed. These findings may inform strategies to strengthen family physician-community pharmacist coordination while maintaining treatment continuity and optimizing medication access during future public health emergencies.

This study aimed to evaluate the prevalence, types, and duration of diagnosed cancers among adult type 2 diabetes mellitus (T2DM) patients in a primary care setting in Türkiye and to examine associated clinical and demographic factors according to T2DM duration.

T2DM is a growing global health concern linked to increased risks of various cancers. Epidemiological data suggest a complex relationship involving shared risk factors and pathophysiological mechanisms such as hyperinsulinemia, inflammation, and obesity.

This descriptive, cross-sectional study was conducted at an education-family health centre (EFHC), analysing medical records and patient interviews. The sample included 442 patients with T2DM registered at Marmara University Tuzla EFHC, of whom 152 had a diagnosed cancer. Data collected encompassed cancer prevalence, types, sociodemographic characteristics, clinical features (including body mass index, T2DM duration, comorbidities), and cancer duration.

The prevalence of cancer among T2DM patients was 34.4%. The most common cancers were prostate in men and breast in women. No significant correlation was observed between T2DM duration and cancer duration; however, breast cancer was less frequent among women with longer T2DM duration compared to their cancer duration. A high rate of obesity and comorbidities was noted in the cohort. Cancer prevalence among Turkish T2DM patients in primary care is notably high, highlighting the importance of integrated screening and risk factor management. These findings underscore the need for targeted preventive strategies and personalized patient care to reduce cancer-related morbidity and mortality in diabetic populations.