{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T18:16:30Z","timestamp":1790792190448,"version":"4.1.0"},"reference-count":29,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2020,12,7]],"date-time":"2020-12-07T00:00:00Z","timestamp":1607299200000},"content-version":"unspecified","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"The Research Fund of the Icelandic College of Family Physicians","award":["No grant number"],"award-info":[{"award-number":["No grant number"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,11,23]]},"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe how the primary healthcare (PHC) in Iceland changed its strategy to handle the COVID-19 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Descriptive observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Reykjavik, the capital of Iceland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>The Reykjavik area has a total of 233 000 inhabitants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>The number and the mode of consultations carried out. Drug prescriptions and changes in the 10 most common diagnoses made in PHC. Laboratory tests including COVID-19 tests. Average numbers in March and April 2020 compared with the same months in 2018 and 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Pragmatic strategies and new tasks were rapidly applied to the clinical work to meet the foreseen healthcare needs caused by the pandemic. The number of daytime consultations increased by 35% or from 780 to 1051\/1000 inhabitants (p&lt;0.001) during the study period. Telephone and web-based consultations increased by 127% (p&lt;0.001). The same tendency was observed in out-of-hours services. The number of consultations in maternity and well-child care decreased only by 4% (p=0.003). Changes were seen in the 10 most common diagnoses. Most noteworthy, apart from a high number of COVID-19 suspected disease, was that immunisation, depression, hypothyroidism and lumbago were not among the top 10 diagnoses during the epidemic period. The number of drug prescriptions increased by 10.3% (from 494 to 545 per 1000 inhabitants, p&lt;0.001). The number of prescriptions from telephone and web-based consultations rose by 55.6%. No changes were observed in antibiotics prescriptions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>As the first point of contact in the COVID-19 pandemic, the PHC in Iceland managed to change its strategy swiftly while preserving traditional maternity and well-child care, indicating a very solid PHC with substantial flexibility in its organisation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-043151","type":"journal-article","created":{"date-parts":[[2020,12,8]],"date-time":"2020-12-08T01:03:36Z","timestamp":1607389416000},"page":"e043151","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":49,"title":["How primary healthcare in Iceland swiftly changed its strategy in response to the COVID-19 pandemic"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0796-565X","authenticated-orcid":false,"given":"Emil Larus","family":"Sigurdsson","sequence":"first","affiliation":[{"name":"Department of Family Medicine, Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland"},{"name":"Development Centre for Primary Healthcare in Iceland, Primary Health Care of the Capital Area, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Bryndis","family":"Blondal","sequence":"additional","affiliation":[{"name":"Development Centre for Primary Healthcare in Iceland, Primary Health Care of the Capital Area, Reykjavik, Iceland"},{"name":"Faculty of Pharmaceutical Sciences, University of Iceland, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon Steinar","family":"Jonsson","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland"},{"name":"Development Centre for Primary Healthcare in Iceland, Primary Health Care of the Capital Area, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margret Olafia","family":"Tomasdottir","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland"},{"name":"Development Centre for Primary Healthcare in Iceland, Primary Health Care of the Capital Area, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannes","family":"Hrafnkelsson","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Faculty of Medicine, University of Iceland School of Health Sciences, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0189-9519","authenticated-orcid":false,"given":"Kristjan","family":"Linnet","sequence":"additional","affiliation":[{"name":"Development Centre for Primary Healthcare in Iceland, Primary Health Care of the Capital Area, Reykjavik, Iceland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johann Agust","family":"Sigurdsson","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Public Health and Nursing\/General Practice Research Unit, Norwegian University of Science and Technology (NTNU), Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,12,7]]},"reference":[{"key":"2025121513130142000_10.12.e043151.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1437"},{"key":"2025121513130142000_10.12.e043151.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1260"},{"key":"2025121513130142000_10.12.e043151.3","doi-asserted-by":"crossref","first-page":"2181","DOI":"10.1056\/NEJMp2006376","article-title":"Ensuring and sustaining a pandemic workforce","volume":"382","author":"Fraher","year":"2020","journal-title":"N Engl J Med"},{"key":"2025121513130142000_10.12.e043151.4","doi-asserted-by":"crossref","DOI":"10.1016\/S0140-6736(18)32478-4","article-title":"The Astana declaration: the future of primary health care?","volume":"392","year":"2018","journal-title":"Lancet"},{"key":"2025121513130142000_10.12.e043151.5","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m800"},{"key":"2025121513130142000_10.12.e043151.6","doi-asserted-by":"crossref","unstructured":"Greenhalgh T , Koh GCH , Car J . 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