Journal of primary health care最新文献

{"title":"Ka Ora Telecare, a national after-hours telehealth service for rural Aotearoa New Zealand: a descriptive cross-sectional evaluation with particular attention to equity of access and outcomes.","authors":"Steven Lillis, Lara Oertly","doi":"10.1071/HC26147","DOIUrl":"https://doi.org/10.1071/HC26147","url":null,"abstract":"<p><strong>Introduction: </strong>Rural communities in Aotearoa New Zealand have reduced access to primary care, particularly after hours, with greater impact on Māori, Pacific peoples and those in areas of higher deprivation. Ka Ora Telecare is a national after-hours telehealth service established to address these gaps without replacing local services.</p><p><strong>Aim: </strong>This study aims to describe service use and clinical outcomes for Ka Ora, with attention to rurality, ethnicity and socioeconomic position.</p><p><strong>Methods: </strong>A cross-sectional descriptive evaluation of routinely collected, de-identified, aggregated service data, with the consultation as the unit of analysis, was performed. Variables were ethnicity (prioritised), age band, Community Services Card status, deprivation quintile, rurality by the Geographical Classification for Health (GCH), provider type and clinical outcome. Analysis was descriptive.</p><p><strong>Results: </strong>Across the 24 month study period, 69,337 consultations carried a valid GCH code: 63.1% in R1 (rural, close to an urban centre), 27.1% in R2 and 5.6% in R3. Māori representation fell from 22.5% in R1 to 16.8% in R3, and Pacific from 3.8% to 1.1%. Of 16,369 clinician-led consultations, 88% were resolved or partially resolved via telehealth and 8% required same-day escalation. Outcomes were similar across ethnic groups, and Māori and Pacific use was concentrated in higher deprivation quintiles.</p><p><strong>Discussion: </strong>Ka Ora is functioning as a useful component of the rural primary care system, reaching higher-deprivation populations. Use is concentrated in less remote rural communities, and Māori and Pacific representation declines with remoteness even though Māori form a larger share of the population in more remote areas. Whether use is proportionate to need cannot be determined from service-level data.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing health coaching for people with long-term conditions: a scoping review.","authors":"Caroline Stretton, Antonia Rosedale, Angela C Davenport, Julie Pryor","doi":"10.1071/HC26082","DOIUrl":"https://doi.org/10.1071/HC26082","url":null,"abstract":"<p><strong>Introduction: </strong>The rising global burden of chronic diseases has compelled healthcare practitioners to bolster their role in supporting individuals with long-term conditions in managing their health and well-being. Demand for health coaching continues to grow, but a limited body of knowledge makes it challenging to develop fit-for-purpose practitioner training.</p><p><strong>Aim: </strong>This study aims to examine what is known about how to implement health coaching for people with long-term conditions.</p><p><strong>Methods: </strong>Health databases were searched to identify peer-reviewed research articles. Data extraction was undertaken using a tool developed by the authors, and findings were charted, summarised and synthesised.</p><p><strong>Results: </strong>Seventy-six studies were included. Health coaching interventions span 17 different long-term conditions, are delivered by various providers (55% dedicated health coaches, 28% nurses) and occur primarily in community and public health settings (78%). Fundamental implementation guidance remains absent. With 69% lacking any named theoretical basis and 62% of studies failing to report training duration, practitioners receive inconsistent preparation for coaching patients with complex needs.</p><p><strong>Discussion: </strong>We found conceptual confusion and ambiguity across studies. Advancing the field will require identification of key theories, transferable core components and competency-based training standards. Themes of theorising, tailoring and training recur throughout this review. We offer a conceptual framework that synthesises concepts and bridges theory and practice, thus supporting practitioners to deliver person-centred coaching.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How coronary artery disease is portrayed in images from educational websites and resources in Aotearoa New Zealand: a content analysis.","authors":"Seita Meneua, Siobhan Tu'akoi, Punipuao Mariner, Malakai 'Ofanoa, Felicity Goodyear-Smith, Samuela 'Ofanoa","doi":"10.1071/HC26162","DOIUrl":"https://doi.org/10.1071/HC26162","url":null,"abstract":"<p><strong>Introduction: </strong>Coronary artery disease (CAD) is a leading cause of global morbidity and disproportionately affects Māori and Pacific peoples in Aotearoa New Zealand (NZ). Poor understanding of symptoms and management contributes to delayed care. Yet visual health information can enhance patient comprehension, engagement, and long-term health outcomes.</p><p><strong>Aim: </strong>This content analysis aims to explore how CAD is portrayed in images within NZ-based online educational webpages and resources.</p><p><strong>Methods: </strong>A content analysis was conducted on publicly available CAD images from NZ-based health educational websites. Data were collected in January 2026 using a systematic Google search strategy. Images were coded using a pre-defined framework categorising content into themes, and descriptive frequencies and proportions were calculated.</p><p><strong>Results: </strong>Of the 279 webpages identified in the search, 105 met the inclusion criteria, yielding 257 images. Photographs (44.8%) and digital graphics (24.9%) were most common. Only 30% of images depicted people, with slightly more males with neutral expressions. Content primarily focused on prevention and healthy lifestyle choices (24.9%) and anatomical images (21.8%). Clinical aspects were significantly underrepresented, including depictions of screening and diagnoses (13.2%), consequences (9.0%), and medications (7.0%).</p><p><strong>Discussion: </strong>CAD images in NZ webpages and educational resources emphasise healthy lifestyles and diet, but are less focused on treatment and long-term management. The scarcity of images depicting CAD symptoms, screening, medications, disease pathophysiology, and long-term management represents a missed opportunity to support health literacy. Culturally appropriate and clinically balanced visual resources are needed to improve patient understanding and reduce health inequities in NZ.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current state and future directions of the discipline of rural medicine in Aotearoa New Zealand: a qualitative study.","authors":"Katharina Blattner, Lynne Clay, Rory Miller, Garry Nixon, Tim Stokes","doi":"10.1071/HC26151","DOIUrl":"https://doi.org/10.1071/HC26151","url":null,"abstract":"<p><strong>Introduction: </strong>Rural medicine is shaped by geographic distance from resources and specialist care, requiring broad generalist practice. International evidence supports rural-targeted postgraduate training, clinical-academic integration, and a dedicated evidence base. Progress in Aotearoa New Zealand (NZ) has been constrained by underinvestment, workforce shortages, and persistent inequities.</p><p><strong>Aim: </strong>This study aimed to explore postgraduate rural medicine stakeholder perspectives on the current status of rural medicine as a speciality in NZ and what is needed to strengthen it.</p><p><strong>Methods: </strong>We conducted a qualitative study using semi-structured interviews. Thematic analysis was undertaken using a framework-guided rapid analysis approach. Interviews explored key patterns relating to clinical practice, postgraduate training, academic capacity, and system-level influences.</p><p><strong>Results: </strong>Interviews with 31 participants (including trainees, clinicians, educators, academics, and institutional leaders) identified two themes. The first described postgraduate rural medicine development to date, including the importance of rural-targeted training, emerging career pathways, and ongoing invisibility. The second highlighted future priorities, including a rural-specific general practice pathway, stronger rural leadership, and greater collaboration and institutional investment.</p><p><strong>Discussion: </strong>Strengthening rural-specific postgraduate pathways, together with stronger support for rural educators and researchers, is essential for improving visibility and fostering clinical-academic career development. A coordinated, nationwide strategy is also needed to strengthen the academic standing of rural medicine, ensure its long-term sustainability, and advance rural health equity in NZ.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ordering Herpes simplex virus serology in asymptomatic, non-pregnant patients: a national survey of Australian General Practitioners' knowledge, attitudes and practices.","authors":"Nicholas Comninos, Mariyam Walls, Anju Devkota, Shailendra Sawleshwarkar, Iryna Zablotska-Manos","doi":"10.1071/HC26200","DOIUrl":"https://doi.org/10.1071/HC26200","url":null,"abstract":"<p><strong>Introduction: </strong>Diagnostic serology for Herpes simplex virus is not recommended among asymptomatic, non-pregnant patients.</p><p><strong>Aim: </strong>This study aimed to survey knowledge, attitudes and practices regarding herpes serology and management among general practitioners across Australia.</p><p><strong>Methods: </strong>Anonymous online surveys were conducted from 1 January 2023 to 31 December 2025. Chi-square tests explored associations with ordering serological tests for Herpes simplex (significance threshold: P = 0.05).</p><p><strong>Results: </strong>Of 106 surveys completed, 71% of respondents were female, 63% were aged <50 years, 71% had work-experience <20 years, and 54% were metropolitan Sydney or Melbourne-based. Overall, 57% reported never having ordered serology (most common main reasons: lack of clinically useful information (68%), guideline recommendations (12%) and patient anxiety/distress (10%)). Of the 43% reporting ever ordering serology, 47% had ordered within the past year, and 78% generally ordered serology 'rarely-less than yearly'. The most common main ordering reasons were patient request (44%), assessing risk to sexual partner (38%) and determining the cause of previous symptoms (7%). Overall, 23% reported colleague(s) ordering serology. With regard to diagnosing and managing genital herpes, 80% felt 'very confident or confident'; 17%, 3%, and 0% felt 'somewhat', 'slightly' or 'not-at-all confident', respectively. Interpreting serology, 50% felt 'very confident or confident'; 38%, 4%, and 8% felt 'somewhat', 'slightly' or 'not-at-all' confident, respectively. Additionally, 58% strongly or somewhat disagreed that 'serology should only be ordered by/in consultation with specialists'; 47% were 'strongly interested' or 'interested' in herpes education/training. A metropolitan Sydney or Melbourne postcode was associated with ever having ordered serology (72% versus 28%; P = 0.003).</p><p><strong>Discussion: </strong>General practitioner self-reported ordering of serology was relatively uncommon. Confidence interpreting serology was modest, despite confidence with genital herpes diagnosis and management. Despite guideline adherence, patient request may be driving ordering, highlighting roles for general practitioner education and training and patient resources in improving care. Future studies using mixed-methods or pathology data would enrich these findings.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-creating culturally safe primary care for whānau Māori with cancer: a qualitative case study of systems change in general practice.","authors":"Gillian Potaka-Osborne, Heather Gifford, Lynley Cvitanovic, John McMenamin, Pat M Neuwelt","doi":"10.1071/HC26154","DOIUrl":"https://doi.org/10.1071/HC26154","url":null,"abstract":"<p><strong>Introduction: </strong>Māori experience later cancer diagnosis and poorer cancer outcomes than non-Māori. Although consultation-level cultural safety frameworks exist, less is known about embedding cultural safety across general practice to improve outcomes, guided by whānau (family) voices.</p><p><strong>Aim: </strong>This study aimed to identify what culturally safe primary care looks like for whānau Māori with cancer, and to describe development of a whānau-led systems-change model within a single general practice.</p><p><strong>Methods: </strong>A qualitative Kaupapa Māori (Māori approach) and Appreciative Inquiry study design was used. Māori patients with cancer, their whānau (family), and general practice staff participated in iterative phases of interviews and group hui. Reflexive thematic analysis and mahi ā rōpū (group work) informed theme development. A companion methods paper details methodology, data collection, and analysis.</p><p><strong>Results: </strong>Whānau and staff described culturally safe care grounded in relationships, continuity, and environments that signal belonging. Through the research process, participants co-created a shared set of values and formed a whānau-staff working group that initiated practical changes in the clinic environment, access pathways, communication processes, and team culture. The project generated an actionable systems change model, demonstrating how cultural safety can potentially be embedded over time through sustained whānau involvement.</p><p><strong>Discussion: </strong>This case study offers a pathway for general practices seeking to embed cultural safety at the service level. Practical considerations - leadership, commitment, whānau partnership, and willingness to address system constraints - are highlighted, and transferable pointers for other primary care services are outlined.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital health access, engagement and trust: a survey of Pacific navigators in the DIGIFALE mobile health literacy programme.","authors":"Amio Matenga-Ikihele, Kalesita Pole, Dudley Gentles","doi":"10.1071/HC26205","DOIUrl":"https://doi.org/10.1071/HC26205","url":null,"abstract":"<p><strong>Introduction: </strong>The DIGIFALE programme aims to strengthen mobile health literacy among Pacific communities in Aotearoa New Zealand (NZ) who continue to experience inequities in both healthcare access and digital inclusion.</p><p><strong>Aim: </strong>The aim of this study was to explore access to digital health technology, digital health engagement, and trust in health information sources among Pacific navigators in the DIGIFALE programme.</p><p><strong>Methods: </strong>An online survey was distributed via email to former DIGIFALE navigators across NZ. The survey collected information on participant characteristics, mobile phone access, connectivity, digital skills, health care, and digital health use in the previous six months and trust in digital health information sources. Data were analysed descriptively.</p><p><strong>Results: </strong>Thirty navigators completed the survey. Almost all had a mobile phone and rated their mobile skills as excellent or good. Internet and email use were high, and respondents commonly used online health information, patient portals, and digital communication with healthcare providers. Despite high digital confidence, some navigators reported no phone credit, no mobile data, or difficulty charging their phone.</p><p><strong>Discussion: </strong>Pacific navigators in the DIGIFALE programme were confident and engaged users of digital health tools and continued to provide informal support within families, churches, and communities after programme completion. Navigators also reported greater trust in online peer support health forums and GPs than other sources of digital health information.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating dispensing patterns of Parkinson's medications from 2012 to 2024 in Australia: insights from the Pharmaceutical Benefits Scheme concessional database.","authors":"Saisha Shetty, Alex Park, Estie Kruger, Mario Siervo, Marc Tennant","doi":"10.1071/HC25112","DOIUrl":"10.1071/HC25112","url":null,"abstract":"<p><strong>Introduction: </strong>Parkinson's disease is a neurodegenerative disorder that affects patients' lives by deteriorating their motor and non-motor functions through the loss of dopaminergic neurons. Medications remain the preferred option to manage Parkinson's disease symptoms. In Australia, the Pharmaceutical Benefits Scheme (PBS) supports access to essential medicines by subsidising their cost, making long-term treatment more affordable.</p><p><strong>Aim: </strong>This study analyses the dispensing patterns of Parkinson's medications in Australia from 2012 to 2024, focusing on utilisation trends over time and shifts in prescribing practices.</p><p><strong>Methods: </strong>We conducted a quantitative analysis using concessional PBS data. Key variables included cumulative and annual prescription counts, defined daily dose (DDD), and DDD per 1000 concessional population per day, classified by medication type and Anatomical Therapeutic Chemical code. Time trends were examined using linear regression, and Pearson's correlation coefficients were assessed to understand the relationship between changes over the year and time.</p><p><strong>Results: </strong>A total of 14 medications were assessed, with an accumulated dispensing count of 11,493,423. Levodopa combined with Benserazide had the highest prescription count at 3,663,722 and a mean DDD per 1000 concessional population of 1.81, followed by Levodopa combined with Carbidopa. Linear regression showed strong correlations (r > 0.9) between prescription volume and time for the majority of medications assessed.</p><p><strong>Discussion: </strong>The findings highlighted a preference for Levodopa-based therapies, combined with Benserazide or Carbidopa, and suggest shifts in prescription patterns. By identifying the dispensing patterns of Parkinson's medication, the study contributes to developing treatment trends for further analysis of these medications' distribution and consumption.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"227-234"},"PeriodicalIF":1.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pacific women's pre-diagnostic experiences of endometrial cancer across the Auckland region: a qualitative study using talanoa.","authors":"Georgina S McPherson, Suneela Mehta, Sarah Herbert, Karen Bartholomew, Julea Dalley, Maryanne Heather, Sulu Samu, Karaponi Okesene-Gafa, Lois Eva, Rozlyn Ali, Puawai Enoka, Marisa Letoa Chu Ling, Taria Viliua, Wendy Burgess, Gwyneth Capes","doi":"10.1071/HC26095","DOIUrl":"https://doi.org/10.1071/HC26095","url":null,"abstract":"<p><strong>Introduction: </strong>Pacific women are disproportionally affected by endometrial cancer in Aotearoa New Zealand. Early detection of endometrial cancer is critical to enable timely treatment, provide treatment choices and improve patient outcomes.</p><p><strong>Aim: </strong>This study sought to understand the pre-diagnostic experiences of Pacific women treated for endometrial cancer in the Auckland region.</p><p><strong>Methods: </strong>We used a talanoa approach (Pacific methodology) with 13 Pacific women aged ≥18 years who had undergone treatment for endometrial cancer in the three Health New Zealand | Te Whatu Ora districts in the Auckland region. One-on-one semi-structured talanoa were undertaken to explore their pre-diagnostic experiences. Thematic analysis of the data according to Braun and Clarke's six-step approach was undertaken.</p><p><strong>Results: </strong>Pacific women had limited endometrial cancer-related awareness prior to their diagnosis. The majority of premenopausal women experienced unnecessary delays in diagnostic assessment and referral to gynaecology services (and consequently, increased morbidity and poorer prognosis) despite multiple medical appointments and failed medical management. Abnormal uterine bleeding had negative consequences regarding psychological wellbeing and quality of life for premenopausal participants.</p><p><strong>Discussion: </strong>Improved endometrial cancer-related awareness and knowledge is urgently required among Pacific women. Greater awareness of abnormal uterine bleeding health pathways among healthcare professionals would facilitate timely referral to diagnostic testing and gynaecology services. Equitable healthcare access for Pacific women with endometrial cancer symptoms is critical for timely diagnosis and to reduce negative consequences for endometrial cancer-related morbidity, prognosis and quality of life.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From continuity to emergence: a new conceptual framework for primary care.","authors":"Jonathan Edward Simon","doi":"10.1071/HC26190","DOIUrl":"10.1071/HC26190","url":null,"abstract":"","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"293-295"},"PeriodicalIF":1.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}