Keywords: general practice, continuity of care, preventive care, nurse-led care, risk stratification, mixed-methods research

Background:

Continuity of care is essential in general practice, yet preventive care in several European systems — including Latvia — remains organised as uniform, episodic health checks with limited integration into longitudinal GP–patient relationships. This may weaken follow-up, fragment care and underuse primary care teams, particularly nurses. There is limited evidence on how preventive care models can be adapted in routine practice to strengthen continuity of care in specific national contexts.

Research questions:

How can risk-based, nurse-led preventive care be adapted in general practice to strengthen continuity of care for adult patients in Latvia?

Method:

This doctoral project uses mixed-methods design in Latvian general practice. It comprises four interconnected components: an evidence synthesis on risk-based and nurse-led preventive care and continuity of care; a situational analysis of preventive care organisation in a purposive sample of general practices; development of a context-adapted conceptual model of risk-based, nurse-led prevention; and a small-scale feasibility and qualitative evaluation exploring acceptability and implementation challenges among patients and primary care professionals. Continuity of care will be examined using established conceptual frameworks, encompassing organisational, relational and informational dimensions, with attention to digital tools supporting follow-up. Qualitative data will be analysed.

Results:

The study is expected to generate a context-sensitive preventive care model for general practice and clarify organisational, relational and informational mechanisms linking preventive care and continuity of care. It will provide insights into how nurse-led, risk-based prevention may support longitudinal GP–patient relationships and structured follow-up in routine practice, alongside methodological guidance for small-scale mixed-methods research.

Conclusions:

This study positions preventive care as an underexplored mechanism for strengthening continuity of care in general practice and provides a structured foundation for doctoral research and future implementation studies. By focusing on organisational adaptation and team-based delivery, the project may also inform comparative research and contribute to strengthening continuity-oriented primary care systems across different European contexts.

Points for discussion:

How can organisational, relational and informational continuity of care be operationalised and assessed within preventive care research in general practice?

What mixed-methods approaches are most appropriate for identifying mechanisms linking risk-based, nurse-led preventive care with continuity of care in small-scale general practice studies?

How can risk-based, nurse-led preventive care models be adapted across different national and organisational contexts while preserving continuity-oriented care?