OBJECTIVES: The provision of primary health care was not interrupted during the coronavirus disease 2019 (COVID-19) pandemic in Czechia, although the capacity and resources of providers changed. We examined how the pandemic affected individual general practices throughout 2017-2021, focusing on differences between urban and rural practices. METHODS: We analysed data from the largest health insurance company in Czechia, which provides care to 4.5 million people (60% of the population). We evaluated the prescription volume, diabetes care procedures, and faecal immunochemical test (FIT) in preventive care and new pandemic-related procedures (remote consultations, testing, and vaccinations). For the spatial distribution of practices, we adapted the Organisation for Economic Cooperation and Development typology. RESULTS: We observed minimal declines in 2020 in the rate of prescribing (-1.0%) and diabetes care (-5.1%), with a rapid resumption in 2021, but a substantial decline in FIT (-17.8% in 2020) with slow resumption. Remote consultations were used by 94% of all practices regardless of location, with testing and vaccinations more commonly performed by rural general practitioners (GPs). CONCLUSIONS: Primary care in Czechia rose to the challenge of the COVID-19 pandemic, as shown by the finding that the volume of healthcare services provided through primary care did not decrease across most of the monitored parameters. This study also confirmed that rural GPs provide more care in-house, both in terms of prescribing and procedures performed in their practices. Future studies will need to focus on preventive care, which the pandemic has dampened in GP practices in Czechia.

• Keywords
• COVID-19, Cancer screening tests, Diabetes mellitus, Prescriptions, Primary health care, Rural health,
• MeSH
• Early Detection of Cancer * statistics & numerical data   MeSH
• COVID-19 * epidemiology   prevention & control   MeSH
• Diabetes Mellitus * epidemiology   MeSH
• Colorectal Neoplasms * diagnosis   epidemiology   MeSH
• Practice Patterns, Physicians' * statistics & numerical data   MeSH
• Middle Aged MeSH
• Humans MeSH
• Professional Practice Location statistics & numerical data   MeSH
• Pandemics prevention & control   MeSH
• General Practitioners statistics & numerical data   MeSH
• Primary Health Care MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic epidemiology   MeSH

BACKGROUND: Cardiometabolic diseases (CMDs) are the number one cause of death. Selective prevention of CMDs by general practitioners (GPs) could help reduce the burden of CMDs. This measure would entail the identification of individuals at high risk of CMDs-but currently asymptomatic-followed by interventions to reduce their risk. No data were available on the attitude and the extent to which European GPs have incorporated selective CMD prevention into daily practice. METHODS: A survey among 575 GPs from the Czech Republic, Denmark, Greece, the Netherlands and Sweden was conducted between September 2016 and January 2017, within the framework of the SPIMEU-project. RESULTS: On average, 71% of GPs invited their patients to attend for CMD risk assessment. Some used an active approach (47%) while others used an opportunistic approach (53%), but these values differed between countries. Most GPs considered selective CMD prevention as useful (82%) and saw it as part of their normal duties (84%). GPs who did find selective prevention useful were more likely to actively invite individuals compared with their counterparts who did not find prevention useful. Most GPs had a disease management programme for individuals with risk factor(s) for cardiovascular disease (71%) or diabetes (86%). CONCLUSIONS: Although most GPs considered selective CMD prevention as useful, it was not universally implemented. The biggest challenge was the process of inviting individuals for risk assessment. It is important to tailor the implementation of selective CMD prevention in primary care to the national context, involving stakeholders at different levels.

• MeSH
• Adult MeSH
• Cardiovascular Diseases epidemiology   prevention & control   MeSH
• Practice Patterns, Physicians' statistics & numerical data   MeSH
• Middle Aged MeSH
• Humans MeSH
• Attitude of Health Personnel * MeSH
• General Practitioners psychology   statistics & numerical data   MeSH
• Primary Health Care statistics & numerical data   MeSH
• Surveys and Questionnaires MeSH
• Risk Factors MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic epidemiology   MeSH
• Denmark epidemiology   MeSH
• Netherlands epidemiology   MeSH
• Greece epidemiology   MeSH
• Sweden epidemiology   MeSH

The aim of this paper is to explore general practitioners' (GPs) prescribing intentions and patterns across different European regions using the Theory of Planned Behavior (TPB). A cross-sectional study was undertaken in selected geographically defined Primary Health Care areas in Cyprus, Czech Republic (CZ), France, Greece, Malta, Sweden and Turkey. Face-to-face interviews were conducted using a TPB-based questionnaire. The number of GP participants ranged from 39 to 145 per country. Possible associations between TPB direct measures (attitudes, subjective norms (SN) and perceived behavioral control (PBC)) and intention to prescribe were assessed by country. On average, GPs thought positively of, and claimed to be in control of, prescribing. Correlations between TPB explanatory measures and prescribing intention were weak, with TPB direct measures explaining about 25% of the variance in intention to prescribe in Malta and CZ but only between 3% and 5% in Greece, Sweden and Turkey. SN appeared influential in GPs from Malta; attitude and PBC were statistically significant in GPs from CZ. GPs' prescribing intentions and patterns differed across participating countries, indicating that country-specific interventions are likely to be appropriate. Irrational prescribing behaviors were more apparent in the countries where an integrated primary care system has still not been fully developed and policies promoting the rational use of medicines are lacking. Demand-side measures aimed at modifying GPs prescribing behavior are deemed necessary.

• Keywords
• General practitioner, Prescribing, Primary care, Theory of Planned Behavior,
• MeSH
• Adult MeSH
• Practice Patterns, Physicians' statistics & numerical data   MeSH
• Middle Aged MeSH
• Humans MeSH
• General Practitioners psychology   statistics & numerical data   MeSH
• Surveys and Questionnaires MeSH
• Intention MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Geographicals
• Czech Republic MeSH
• France MeSH
• Cyprus MeSH
• Malta MeSH
• Greece MeSH
• Sweden MeSH
• Turkey MeSH

• MeSH
• Anti-Bacterial Agents therapeutic use   MeSH
• Databases, Factual statistics & numerical data   MeSH
• Practice Patterns, Physicians' statistics & numerical data   MeSH
• Drug Prescriptions statistics & numerical data   MeSH
• Humans MeSH
• Penicillins therapeutic use   MeSH
• General Practitioners statistics & numerical data   MeSH
• Drug Utilization statistics & numerical data   MeSH
• Insurance, Health statistics & numerical data   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Letter MeSH
• Geographicals
• Czech Republic MeSH
• Names of Substances
• Anti-Bacterial Agents MeSH
• Penicillins MeSH