{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T06:09:21Z","timestamp":1789193361167,"version":"build-2803163510"},"reference-count":33,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"unspecified","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Region Stockholm","award":["2021-01287"],"award-info":[{"award-number":["2021-01287"]}]},{"name":"Region Stockholm","award":["FoUI-1024881"],"award-info":[{"award-number":["FoUI-1024881"]}]},{"name":"Region Stockholm","award":["FoUI-1026406"],"award-info":[{"award-number":["FoUI-1026406"]}]},{"name":"Region Stockholm","award":["FoUI-973021"],"award-info":[{"award-number":["FoUI-973021"]}]},{"DOI":"10.13039\/501100006636","name":"Swedish Research Council for Health, Working Life and Welfare","doi-asserted-by":"crossref","award":["2025-01941"],"award-info":[{"award-number":["2025-01941"]}],"id":[{"id":"10.13039\/501100006636","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Swedish research Council","award":["2023-06094"],"award-info":[{"award-number":["2023-06094"]}]},{"DOI":"10.13039\/501100018713","name":"Center for Innovative Medicine","doi-asserted-by":"publisher","award":["FoUI-1002830"],"award-info":[{"award-number":["FoUI-1002830"]}],"id":[{"id":"10.13039\/501100018713","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,8,28]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Home-based primary care has been suggested to reduce emergency department visits among vulnerable older adults but how it should be organised to achieve this effect is unclear. This study aimed to increase the understanding of how older adults receiving home-based primary care and their family caregivers\u2019 experience care during the period prior to an emergency department visit and to identify components of home-based primary care delivery that could help reduce such visits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Qualitative study using semi-structured interviews with older adults receiving home-based primary care who had recently visited the emergency department, along with their family caregivers. Interviews were analysed using inductive thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Interviews were conducted in the homes of informants receiving home-based primary care in Region Stockholm, Sweden, 2022\u20132023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Fourteen adults aged \u226565 years receiving home-based primary care who had visited an emergency department within the past 3\u2009months were interviewed; seven interviews also included a family member.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      An overarching theme,\n                      <jats:italic>Trust as a prerequisite for timely emergency assessments in home-based primary care<\/jats:italic>\n                      , describes how patient trust\u2013in home-based primary care in general and in specific individual healthcare professionals\u2013seems important in reducing emergency department visits, especially when patients experience symptoms of uncertain urgency or gradual onset. Four subthemes describe how primary care may build trust: through (1) access to care, (2) medical competence, (3) respect and relationship and (4) coordination and teamwork.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Trust in both home-based primary care in general and in individual healthcare professionals is crucial in reducing emergency department visits among older adults receiving home-based primary care. Trust may be strengthened by accessible and competent care, familiarity with both general practitioners and the responsible nurse and working as a collaborative team.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-118687","type":"journal-article","created":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T05:15:38Z","timestamp":1789190138000},"page":"e118687","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Qualitative study to explore which components of home-based primary care may reduce emergency department visits among older adults"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3665-9275","authenticated-orcid":false,"given":"Hanna","family":"Bring","sequence":"first","affiliation":[{"name":"Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Huddinge, Sweden"},{"name":"Academic Primary Care Centre, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Bergqvist","sequence":"additional","affiliation":[{"name":"Academic Primary Care Centre, Stockholm, Sweden"},{"name":"Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0063-552X","authenticated-orcid":false,"given":"Lars L","family":"Gustafsson","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5151-4867","authenticated-orcid":false,"given":"Karin","family":"Modig","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine, Unit of Epidemiology, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Bastholm-Rahmner","sequence":"additional","affiliation":[{"name":"Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Huddinge, Sweden"},{"name":"Academic Primary Care Centre, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0446-8930","authenticated-orcid":false,"given":"Katharina","family":"Schmidt-Mende","sequence":"additional","affiliation":[{"name":"Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Huddinge, Sweden"},{"name":"Academic Primary Care Centre, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"2026091122152184000_16.9.e118687.1","doi-asserted-by":"publisher","DOI":"10.1177\/1077558710379422"},{"key":"2026091122152184000_16.9.e118687.2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5430\/ijh.v3n2p1","article-title":"Defining potentially preventable emergency department visits for older adults","volume":"3","author":"Latham","year":"2017","journal-title":"IJH"},{"key":"2026091122152184000_16.9.e118687.3","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1017\/cem.2020.4","article-title":"Effectiveness of hospital avoidance interventions among elderly patients: A systematic review","volume":"22","author":"Pritchard","year":"2020","journal-title":"CJEM"},{"key":"2026091122152184000_16.9.e118687.4","doi-asserted-by":"crossref","first-page":"2963","DOI":"10.1111\/jgs.17365","article-title":"Home-based primary care: A systematic review of the literature, 2010-2020","volume":"69","author":"Zimbroff","year":"2021","journal-title":"J Am Geriatr Soc"},{"key":"2026091122152184000_16.9.e118687.5","unstructured":"Totten AM , White-Chu EF , Wasson N , et al . 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