The pandemic has left many GPs worldwide feeling depressed, anxious and burned out, found a systematic review led by the University of York and published in the British Journal of General Practice. Women doctors in primary care reporting more psychological problems, and those who are older suffering greater stress and burnout.
Researchers reviewed research literature and identified 31 studies evaluating the impact of COVID-19 on the mental health and well-being of doctors in primary care.
Healthcare systems vary across countries and this review identified only three studies of GPs working in the UK. Studies used a wide variety of measures to assess psychological well-being and lacked measurements from before the pandemic, which makes comparisons difficult.
There were, though, common themes highlighting the difficulties faced by doctors working in primary care settings (similar to NHS GPs) around the world.
Sources of stress during the pandemic included changed working practices, exposure to COVID-19 and inadequate PPE, information overload, lack of preparedness for the pandemic and poor communication across health sectors.
The studies demonstrated an impact on primary care doctors’ psychological wellbeing, with some also experiencing a fear of COVID-19 and lower job satisfaction. A third of the studies also explored physical symptoms – with GPs reporting migraines and headaches, tiredness and exhaustion, sleep disorders and increased eating, drinking and smoking.
One UK study, which focused on GPs with symptoms of long COVID, found GPs felt ‘let down’ and expressed frustration at the lack of support and recognition for the condition.
Study author Dr Laura Jefferson from the Department of Health Sciences said: “Many GPs have reported stress and burnout over recent years, which is potentially damaging not just to doctors themselves, but also to patients and healthcare systems.
“The COVID-19 pandemic has presented additional challenges for GPs, including rapid change, risks of infection, remote working, pent-up demand and reductions in face-to-face patient care.
“While there has been a tendency for research like this to focus on hospital roles, there was a need to synthesise evidence and explore factors associated with GPs' mental health and wellbeing during the pandemic.
“This is the first systematic review exploring the psychological well-being of primary care doctors during the COVID-19 pandemic.”
Seven studies reported statistically significant differences in outcomes for women GPs, including higher stress levels, greater reporting of burden, burnout and anxiety. Older age was associated with higher stress levels in three studies.
The research concluded that policy and infrastructure are needed to support GPs and further research is needed to explore gender and age differences; identifying interventions targeted to these groups.
Study details
GP wellbeing during the COVID-19 pandemic: a systematic review
Laura Jefferson, Su Golder, Claire Heathcote, Ana Castro Avila, Veronica Dale, Holly Essex, Christina van der Feltz Cornelis, Elizabeth McHugh, Thirimon Moe-Byrne, Karen Bloor .
Published in British Journal of General Practice on 21 March 20222
Abstract
Background
Doctors’ organisations in the UK have reported worrying levels of work-related stress and burnout in the GP workforce for some time, and the COVID-19 pandemic has presented clear new challenges.
Aim
To synthesise international evidence exploring the impact of COVID-19 on primary care doctors’ mental health and wellbeing, and identify risk factors associated with their psychological well-being during this time.
Method
Six bibliographic databases, Google Scholar, and MedRxiv were searched on 19 November 2020 and 3 June 2021 to identify studies of GP psychological well-being during the pandemic. Reference checking was also conducted. Two reviewers selected studies, extracted data, and assessed the quality of studies using standardised tools. Heterogeneity in outcomes, setting, and design prohibited statistical pooling; studies were combined using a convergent integrated thematic synthesis.
Results
Thirty-one studies were included. Multiple sources of stress were identified including changed working practices; risk, exposure, and inadequate personal protective equipment (PPE); information overload; pandemic preparedness; and cohesion across sectors. Studies demonstrated an impact on psychological wellbeing, with some GPs experiencing stress, burnout, anxiety, depression, fear of COVID-19, lower job satisfaction, and physical symptoms. Studies reported gender and age differences: women GPs had poorer psychological outcomes across all domains, and older GPs reported greater stress and burnout. Use of outcome measures and reporting practice varied greatly.
Conclusion
This review of international evidence demonstrates that the COVID-19 pandemic has adversely affected GPs’ well-being around the world. Further research could explore gender and age differences, identifying interventions targeted to these groups.
See more from MedicalBrief archives:
GMC survey: COVID stress hammers Britain's trainee doctors
Global nursing crisis deepens as pandemic and staff shortages wreak havoc
Need For Recovery among UK emergency care doctors at highest level yet