Journal of primary health care最新文献

{"title":"Comparing physical examination in face-to-face and remote External Clinical Teaching Visits in general practice vocational training.","authors":"Benjamin Mundy, Alison Fielding, Amanda Tapley, Sarah Gani, Rula Ali, Michael Bentley, Rachael Boland, Lina Zbaidi, Elizabeth Holliday, Jean Ball, Mieke van Driel, Linda Klein, Parker Magin","doi":"10.1071/HC25144","DOIUrl":"10.1071/HC25144","url":null,"abstract":"<p><strong>Introduction: </strong>External Clinical Teaching Visits (ECTVs) are formative workplace-based assessments involving experienced general practitioners (GPs), acting as external clinical teaching visitors (ECT visitors), observing trainees ('registrars') in practice. ECTVs are a core element of Australian GP vocational training. Remote modalities of ECTVs, introduced in response to the COVID-19 pandemic, have continued alongside face-to-face ECTVs post-pandemic.</p><p><strong>Aim: </strong>This study aimed to explore the characteristics and associations of ECTV content delivered by these different modalities.</p><p><strong>Methods: </strong>From 2020 to 2021, GP registrars of three geographically defined regional training organisations were invited to complete a questionnaire after completing ECTVs. Outcomes included: (1) the frequency registrars were observed performing physical examination by an ECT visitor and (2) the frequency a physical examination was observed and discussed by the ECT visitor. Analyses employed univariable and multivariable logistic regressions.</p><p><strong>Results: </strong>A total of 1394 questionnaires (for 44% of eligible ECTVs) were completed by 729 (58% of eligible) registrars. After exclusions, 1106 questionnaires were analysed. Eighty-two percent of visits were conducted by video. Overall, 87% of visits involved a registrar being observed performing a physical examination at least once, and 42% involved both observation and discussion of physical examination. On multivariable analysis, the odds of observation of physical examination were significantly less with video-conducted visits (OR: 0.16, 95% CI: 0.05-0.49, P = 0.001).</p><p><strong>Discussion: </strong>Remote ECTVs are an attractive option to reduce resource usage and logistical burden. However, key differences in the content of ECTVs delivered by remote modalities compared to those conducted face-to-face were found. A hybrid model ECTV program may be appropriate to ensure the educational integrity of ECTVs is maintained.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"218-226"},"PeriodicalIF":1.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534288","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":"What does the evidence tell us: are hearing aids worth recommending for mild to moderate hearing loss?","authors":"Vanessa Jordan","doi":"10.1071/HC26247","DOIUrl":"https://doi.org/10.1071/HC26247","url":null,"abstract":"","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"18 3","pages":"296-297"},"PeriodicalIF":1.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030555","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":"Carbon emissions of urban general practice and waste to landfill audit: a quantitative case-study in New Zealand.","authors":"Darla Stroud-Bennett, Lachlan White, Kiyomi Kitagawa","doi":"10.1071/HC25089","DOIUrl":"10.1071/HC25089","url":null,"abstract":"<p><strong>Introduction: </strong>The healthcare sector accounts for 4-5% of global greenhouse gas emissions. Data regarding the environmental impact of general practice are lacking. Toitū Envirocare produced a report for the Carefirst Limited's general practice centres in Taranaki, concluding solid waste disposal to be their primary source of greenhouse gas emissions.</p><p><strong>Aim: </strong>Considering the increasing need to address climate change, this study aimed to provide novel insight into waste and carbon emissions generated by general practice through audit data.</p><p><strong>Method: </strong>A waste to landfill audit was conducted at four Taranaki general practices. Waste to landfill was collected for 3 days, then sorted to determine the amount which could have been diverted to recycling and composting.</p><p><strong>Results: </strong>The potential diversion rate of audited landfilled rubbish ranged from 65 to 79.3%. Although Westown had a potential diversion rate of 68.3%, its existing recycling processes meant this equated to 25% of its total waste production. Of the other three practices, 59-65% of their total waste production could be diverted.</p><p><strong>Discussion: </strong>It was recommended that all practices have recycling and composting bins, and to collect bottle caps, soft plastics, and batteries to further landfill diversion. These bins must be more available and visible. Ideally, each practice would have a 'waste champion' to educate staff and dispose of these recyclables at designated facilities. Recycling in a general practice setting can produce significant waste diversions from landfill, producing meaningful progress towards sustainable practice.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"287-292"},"PeriodicalIF":1.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145482308","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":"Cefalexin prescribing appropriateness in general practice: an evaluation study.","authors":"Ibrahim S Al-Busaidi, Sarmad Qamar, Yao-Min Lin, Dee Mangin, Ben Hudson","doi":"10.1071/HC25086","DOIUrl":"10.1071/HC25086","url":null,"abstract":"<p><strong>Introduction: </strong>Antibiotic misuse and overuse, among other factors, are the main drivers of increased antimicrobial resistance. Although cefalexin is generally recommended as a second-line agent, recent trends in Aotearoa New Zealand (NZ) indicate increased community use, highlighting the need for closer scrutiny.</p><p><strong>Aim: </strong>This preliminary study aimed to assess the appropriateness and guideline compliance of cefalexin prescribing.</p><p><strong>Methods: </strong>We conducted a cross-sectional study reviewing all cefalexin prescriptions issued at a single urban medical centre in Ōtautahi Christchurch, NZ, during July-August 2023. Retrieved prescriptions were assessed for guideline compliance and clinical appropriateness using a modified audit survey based on national and regional guidelines.</p><p><strong>Results: </strong>We identified 27 cefalexin prescriptions provided to 25 patients (16 female, 20 NZ European; median age 48.9 years, IQR 49.7). Soft tissue (n = 11, 42.3%) and genito-urinary infections (n = 10, 38.5%) were the most common indications. Of the assessable prescriptions (n = 26), 14 (53.8%) were guideline compliant, and 15 (57.7%) were clinically appropriate. Indications were documented in 22 cases (84.6%) - 6 on the prescription and 19 in the clinical record.</p><p><strong>Discussion: </strong>This exploratory study identifies areas for targeted antimicrobial stewardship interventions in general practice to promote improved prescribing practices. A larger multicentre study is planned to further investigate prescribing patterns and appropriateness.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"204-210"},"PeriodicalIF":1.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355297","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":"It's more than just a good consultation: defining high quality primary (health) care.","authors":"Felicity Goodyear-Smith, Tim Stokes","doi":"10.1071/HC26226","DOIUrl":"https://doi.org/10.1071/HC26226","url":null,"abstract":"","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"18 3","pages":"201-203"},"PeriodicalIF":1.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030558","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":"Paracetamol-associated knowledge, attitudes and practices of the New Zealand public: an online survey.","authors":"Samantha Marsh, Eeva-Katri Kumpula, Sarah Hetrick, Sarah Fortune","doi":"10.1071/HC25060","DOIUrl":"10.1071/HC25060","url":null,"abstract":"<p><strong>Introduction: </strong>Although paracetamol is the most widely used prescription and over-the-counter drug globally, it also has a higher toxicity than other common non-opioid analgesics and is a leading preventable cause of acute liver failure and liver transplants. International evidence suggests that the public may have inadequate knowledge about paracetamol; however, in Aotearoa New Zealand (NZ), paracetamol is relatively cheap and readily available in large quantities at pharmacy and non-pharmacy outlets.</p><p><strong>Aim: </strong>To identify paracetamol-associated knowledge, attitudes and beliefs of the NZ public.</p><p><strong>Methods: </strong>Using Horizon Research Limited, a NZ-based research panel, we explored paracetamol-associated knowledge, attitudes and practices using an online survey.</p><p><strong>Results: </strong>A total of 1723 respondents completed the survey. High rates of unintentional misuse of paracetamol were identified, in addition to significant knowledge gaps, particularly those related to participants' ability to identify paracetamol-containing formulations. Participants were also supportive of introducing policies restricting the supply and sale of paracetamol, such as where paracetamol can be purchased.</p><p><strong>Discussion: </strong>There appears to be a need to increase the NZ public's knowledge of the safe use of paracetamol. Given the current lack of policies restricting access to paracetamol, the substantial proportion of the NZ adult population exceeding paracetamol dosing guidelines, and the public's apparent support for introducing policies, our findings may have important implications. However, research is required to understand the potential impact of tightening current regulatory policies, including restricting where you can purchase paracetamol or reducing the amount of paracetamol you can purchase at once, before they are introduced.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"211-217"},"PeriodicalIF":1.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355080","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":"Spatial access to CT scanners: a rural-urban comparison in the Southern and Te Manawa Taki regions of New Zealand.","authors":"Hannah Dawson, Jesse Whitehead, Rory Miller","doi":"10.1071/HC26149","DOIUrl":"https://doi.org/10.1071/HC26149","url":null,"abstract":"<p><strong>Introduction: </strong>Computed tomography (CT) is available to few rural communities in Aotearoa New Zealand (NZ). Obtaining CT imaging is a common reason rural patients are transferred to urban hospitals.</p><p><strong>Aim: </strong>This study aimed to quantify rural-urban differences in spatial access to CT in the Southern and Te Manawa Taki regions of NZ and examine the impact of a theoretical investment in rural CT scanners.</p><p><strong>Methods: </strong>The resident population of each region was estimated using 2023 census data. The population living within a 60 min drive to a CT scanner was estimated using a drive time matrix. Subgroup analyses were performed by rurality, ethnicity, and socioeconomic status. Investment scenarios placed CT scanners in selected rural hospitals, and the impact on population-level access was measured.</p><p><strong>Results: </strong>In both regions, 100% of urban residents (U1 and U2) lived within 60 min of a CT scanner; however, only 25.8 and 1.2% of residents in the most rural (R3) areas of Southern and Te Manawa Taki respectively were within this range. Theoretical investment in CT scanners in rural hospitals may extend timely access to an additional 9465 to 17,784 rural people per scanner.</p><p><strong>Discussion: </strong>In both regions, rural populations, as well as Māori and those living in areas of high socioeconomic deprivation in Te Manawa Taki, faced inequitable access to CT services. Investment in rural CT scanners may substantially reduce rural-urban disparities in CT accessibility and aligns with NZ's Rural Health Strategy of providing care 'closer to home.'</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":"149030592","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":"Methods for measuring comprehensiveness in primary care: a narrative review.","authors":"Derek Baughman, Rafay Nasir, Andrew Bazemore","doi":"10.1071/HC25101","DOIUrl":"10.1071/HC25101","url":null,"abstract":"<p><strong>Introduction: </strong>Comprehensiveness in primary care is defined as managing most medical needs in a population while integrating the context of patient's values, preferences, and beliefs. This study aims to synthesise validated measures for measuring comprehensiveness in primary care to facilitate its practical application.</p><p><strong>Aim: </strong>The objective of this study was to synthesise validated measures for measuring comprehensiveness in primary care, facilitating its practical application.</p><p><strong>Methods: </strong>A narrative-style literature review was employed to conduct a hierarchical review of relevant literature. The process involved several stages: initial term filtering, separation of primary care from specialist care using medical subject heading (MeSH) terms, incorporation of non-MeSH terminology, and a manual review of titles, abstracts, and full articles. Articles were included if they discussed the measurement, assessment, or application of comprehensiveness in primary care and were relevant to primary care and methodologically sound. A multistage PubMed search of 'comprehensiveness' (MeSH) with hierarchical sub-term filtering and snowball method gleaning of additional articles from literature-described terminology was conducted.</p><p><strong>Results: </strong>Thirteen studies met the inclusion criteria. Methodological strategies varied from claims-based approaches for cost and utilisation to surveys assessing the scope of clinical services and patient experience.</p><p><strong>Discussion: </strong>Thoroughly measuring comprehensiveness in primary care integrates methods that evaluate the effect of physician ranges of clinical services on the cost and utilisation of health care, and the impact on patient outcomes within the context of the patient experience. Implementing these methods pragmatically can assist communities and health systems in implementing, measuring, and capturing comprehensiveness in primary care.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"270-277"},"PeriodicalIF":1.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355248","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":"Rokoā (Rongoā) Māori in primary care: supporting safe use alongside prescribed medicines.","authors":"Brendon McIntosh, Jo Barnes","doi":"10.1071/HC26236","DOIUrl":"https://doi.org/10.1071/HC26236","url":null,"abstract":"","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"18 3","pages":"298-301"},"PeriodicalIF":1.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030650","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":"Assessing the applicability of the Model for Understanding Success in Quality (MUSIQ) for primary care: a multi-case mixed methods analysis.","authors":"Jane Cullen, Nihal Jayamaha, Paul Childerhouse, Lynn McBain","doi":"10.1071/HC25021","DOIUrl":"10.1071/HC25021","url":null,"abstract":"<p><strong>Introduction: </strong>Effective quality improvement (QI) is vital to improve healthcare quality and outcomes. The context surrounding QI has a dynamic relationship that impacts QI efforts over time. Developing an understanding of context may provide opportunities to address barriers to success. Most studies into contextual influences have been conducted in secondary care. Primary care is key to improving population health, equity and value. The Model for Understanding Success in Quality (MUSIQ) is a commonly used context assessment tool that was developed in large, mainly secondary care organisations, and questions have been raised as to its applicability in primary care.</p><p><strong>Aim: </strong>This study aims to assess the applicability of the MUSIQ in primary care settings and suggest adaptations for primary care.</p><p><strong>Methods: </strong>A multi-case mixed methods approach was followed with quantitative data from the MUSIQ survey tool, compared with qualitative data from Aotearoa New Zealand primary care interviews. The Consolidated Framework for Implementation Research (CFIR) guided qualitative data collection and analysis.</p><p><strong>Results: </strong>Scores were duplicated between common microsystem and organisational factors. External motivation created mixed reactions and scores depending on interpretation, but consistent themes of community responsibility and network relationships were identified as strengths. A lack of QI infrastructure and triggering events were consistent findings.</p><p><strong>Discussion: </strong>Total MUSIQ scores were impacted by scores given for factors at different MUSIQ levels that are combined in many primary care organisations. A primary care adaptation of MUSIQ is proposed that removes the duplicated levels and adds key primary care contextual factors not included in MUSIQ.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"235-246"},"PeriodicalIF":1.1,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355245","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}