Journal of primary health care最新文献_第3页

Contribution of the community pharmacist workforce to primary care through the lens of medicines classification: comparison of Aotearoa New Zealand and Australia. 从药物分类的角度看社区药师队伍对初级保健的贡献：新西兰和澳大利亚的比较。

IF 1.1

Journal of primary health care Pub Date : 2024-12-01 DOI: 10.1071/HC24050

Chloë Campbell, Caroline Morris, Bruce Sunderland, Lynn McBain, Petra Czarniak

{"title":"Contribution of the community pharmacist workforce to primary care through the lens of medicines classification: comparison of Aotearoa New Zealand and Australia.","authors":"Chloë Campbell, Caroline Morris, Bruce Sunderland, Lynn McBain, Petra Czarniak","doi":"10.1071/HC24050","DOIUrl":"https://doi.org/10.1071/HC24050","url":null,"abstract":"Introduction Optimal use of the workforce in primary care is critical due to increasing complexity and demand resulting from multi-morbidity in ageing populations. Improving public access to medicines by making them available via a pharmacist without prescription can support self-care while ensuring oversight by a health professional. Aim The aim of this paper was to identify and explore key differences between New Zealand and Australia in medicines classified nationally for pharmacist-only non-prescription supply. Methods Medicines legally classified to allow sale by a pharmacist without a prescription were identified and compared between the two countries as of 1 February 2024. Based on consensus among the research team, notable differences were subjected to qualitative consideration about how medicines classification may be used to extend the role of pharmacists in primary care. Results Overall, New Zealand has a less restrictive approach to classification than Australia providing New Zealanders increased access to medicines via a pharmacist in two key therapeutic areas: sexual and reproductive health and infection. Oral contraceptives, sildenafil, antibiotics for urinary tract infection and two COVID-19 antivirals were classified for supply without prescription via pharmacists in New Zealand but not nationally in Australia, although some alternative legislative mechanisms are emerging at state level. Discussion Medicines classification has an ongoing role in enabling pharmacist contribution to primary care. Medicines classification needs to be considered alongside commissioning of services and other policy to facilitate integration of community pharmacy-provided care within the wider primary care environment. Digital tools supporting information sharing, collaboration and communication are key.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 4","pages":"372-381"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864658","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}

引用次数: 0

Registered nurses' antimicrobial stewardship roles: a qualitative descriptive exploratory study. 注册护士抗菌药物管理角色：一项定性描述性探索性研究。

IF 1.1

Journal of primary health care Pub Date : 2024-12-01 DOI: 10.1071/HC24080

Anecita Gigi Lim, Jennifer Woods, Brenda Waite

{"title":"Registered nurses' antimicrobial stewardship roles: a qualitative descriptive exploratory study.","authors":"Anecita Gigi Lim, Jennifer Woods, Brenda Waite","doi":"10.1071/HC24080","DOIUrl":"https://doi.org/10.1071/HC24080","url":null,"abstract":"Introduction Antimicrobial stewardship (AMS) is a global initiative aimed at promoting the responsible use of antimicrobials to combat antimicrobial resistance (AMR), a critical global health threat. In New Zealand, over 95% of antibiotics are prescribed in the community, with estimates suggesting that half of these prescriptions are for self-limiting respiratory infections, contributing significantly to AMR. Registered nurses (RNs), especially nurse practitioners and designated nurse prescribers, are well-positioned to play a pivotal role in AMS efforts due to their accessibility and broad skill set. However, their potential remains underutilised in AMS programmes. Aim This study aimed to explore the role of New Zealand Māori and non-Māori registered nurses as antimicrobial stewards within the New Zealand health care system. Methods The current knowledge and involvement in activities that mitigate the risks of infectious diseases and AMR of registered nurses was assessed. The educational and organisational support needed to enhance their leadership and engagement in AMS initiatives were identified. Results Findings highlight the need for targeted AMS education, greater participation in stewardship activities, and clarity in RN roles in collaboration with other health care professionals. This research underscores the importance of empowering registered nurses through education and organisational support to strengthen AMS and mitigate the growing threat of AMR. Discussion This study provides key insights into the leadership potential of RNs in AMS and offers recommendations for future policy and education strategies to optimise their role in New Zealand's health care.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 4","pages":"382-389"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864734","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}

引用次数: 0

Managing medicines-related continuity of care: the views of a range of prescribers in New Zealand general practice. 管理与药物相关的护理连续性：新西兰全科医生的观点。

IF 1.1

Journal of primary health care Pub Date : 2024-12-01 DOI: 10.1071/HC24034

C Julie Wells, Lynn McBain, Lesley Gray

{"title":"Managing medicines-related continuity of care: the views of a range of prescribers in New Zealand general practice.","authors":"C Julie Wells, Lynn McBain, Lesley Gray","doi":"10.1071/HC24034","DOIUrl":"https://doi.org/10.1071/HC24034","url":null,"abstract":"Introduction Continuity of care is considered vital to achieving high-quality health care. Traditionally, general practitioners have played a key role in managing continuity of care and have largely been accountable for prescribing decision-making in primary care. Following prescribing legislation changes, a range of health disciplines make decisions regarding medicines in the general practice setting. To date, few studies have investigated how different prescribing disciplines view the management of medicines-related continuity of care. Understanding the views of these clinicians is important to achieving safe, effective and equitable outcomes from medicines. Aim The purpose of this study was to explore the views of general practitioners, nurse prescribers and pharmacist prescribers about their role in managing medicines-related continuity of care. Methods Qualitative, semi-structured in-depth interviews were undertaken with 16 prescribers based in eight North Island (New Zealand) general practices. Interviews were transcribed verbatim and analysed thematically using an inductive approach. Results Three key themes were identified from data analysis: a patient-focused approach; interdisciplinary teamwork; and optimising the medicine regimen. Discussion Prescribers in this study identify the important connection between continuity of care and achieving good outcomes from medicines. Good patient-prescriber relationships and ongoing interdisciplinary relationships across all health settings are considered essential to medicines-related continuity of care. Prescribers experience challenges associated with increasing multimorbidity, medicines complexities and fragmentation of clinical records.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 4","pages":"364-371"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864710","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}

引用次数: 0

Patient demographics and psychotropic medication prescribing in Australian general practices: pre- and during COVID-19 pandemic. 澳大利亚一般做法中的患者人口统计数据和精神药物处方：COVID-19大流行之前和期间。

IF 1.1

Journal of primary health care Pub Date : 2024-12-01 DOI: 10.1071/HC23168

Getiye Dejenu Kibret, Abbish Kamalakkannan, Judith Thomas, Gorkem Sezgin, Rae-Anne Hardie, Lisa Pont, Precious McGuire, Christopher Pearce, Andrew Georgiou

{"title":"Patient demographics and psychotropic medication prescribing in Australian general practices: pre- and during COVID-19 pandemic.","authors":"Getiye Dejenu Kibret, Abbish Kamalakkannan, Judith Thomas, Gorkem Sezgin, Rae-Anne Hardie, Lisa Pont, Precious McGuire, Christopher Pearce, Andrew Georgiou","doi":"10.1071/HC23168","DOIUrl":"https://doi.org/10.1071/HC23168","url":null,"abstract":"Introduction Mental health conditions, such as depression, anxiety, and psychological distress in the adult population significantly increased during the COVID-19 pandemic. However, the rates of prescribing psychotropic medications in adults during the COVID-19 period have not been well explored. Aim The aim of this study was to examine the association between demographic characteristics and rates of prescribing psychotropic medications to general practice patients during 2018-2022. Methods A total of 154 528 general practice patients aged 20 years and above were included in the study. A mixed effects negative binomial regression model was employed and incidence risk ratios (IRRs) with corresponding 95% confidence interval (CI) are presented to measure the association of demographic characteristics with rates of prescribing psychotropic medication. Results Over half (56.2%) of study subjects were female and 41.4% were aged between 20 and 39 years. Males had lower prescribing rates of antidepressants (IRR = 0.95; 95% CI: 0.94, 0.97) and hypnotics and sedatives (IRR = 0.97; 95% CI: 0.96, 0.99) than females. People in the age group 60+ years (compared with age group 20-39 years) and those in low and middle socio-economic status (SES) categories (compared with high SES) had higher rates of prescribing psychotropic medication. Conclusion Females, people aged 60+ years, and people with low and middle SES had higher prescribing rates of psychotropic medication. A consistent increase in prescribing rates over time, particularly during the COVID-19 pandemic, was observed. It is important that health care planners and policy makers monitor and account for population diversity and equity.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 4","pages":"325-331"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864712","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}

引用次数: 0

Struggling to afford medicines: a qualitative exploration of the experiences of participants in the FreeMeds study. 努力负担药物：对FreeMeds研究参与者经验的定性探索。

IF 1.1

Journal of primary health care Pub Date : 2024-12-01 DOI: 10.1071/HC23156

Leinasei Isno, Pauline Norris, Marianna Churchward

{"title":"Struggling to afford medicines: a qualitative exploration of the experiences of participants in the FreeMeds study.","authors":"Leinasei Isno, Pauline Norris, Marianna Churchward","doi":"10.1071/HC23156","DOIUrl":"10.1071/HC23156","url":null,"abstract":"Introduction Existing research has established that some people struggle with prescription charges. This paper reports on the experiences of a sub-sample of people who participated in the FreeMeds study (a randomised controlled trial of prescription charges) about their problems paying for medicines. Aim The aim of this study was to explore participants' previous experiences with paying for medicines, and the impact of receiving free medicines through the Free Meds study. Method Semi-structured interviews were carried out with 23 people (21 were available for analysis), purposefully selected from the 1061 participants in the FreeMeds trial. Trial participants had to live in an area of high socio-economic deprivation (NZDep 7-10), either take medicines for diabetes and/or take anti-psychotics and/or have chronic obstructive pulmonary disease. Transcripts were analysed thematically. Results Prior to being enrolled in the study, prescription charges were an important issue for many of the participants, who faced multiple health challenges. Some reported having to go without medicines until they could afford them, and many reported having to make hard choices, such as choosing which of their medicines to pick up, or choosing between medicines and other expenses like food. Echoing the quantitative results from the trial, some participants reported previous hospitalisations because of their inability to pay for and hence take, their medicines. Few participants had discussed the affordability of medicines with their doctor. Participants reported that being exempted (through the FreeMeds trial) had reduced their stress and allowed them to afford medicines they would normally have gone without. Discussion The study supports the government's decision to eliminate prescription charges, to remove one barrier to health and wellbeing for people facing significant disadvantages.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 4","pages":"341-346"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864738","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}

引用次数: 0

Conventional medication adherence and self-treatment practices among South Asian immigrants: a qualitative study. 南亚移民的传统药物依从性和自我治疗实践：一项定性研究。

IF 1.1

Journal of primary health care Pub Date : 2024-12-01 DOI: 10.1071/HC24084

Sumera Saeed Akhtar, Mudassir Anwar, Kirsten J Coppell, Sherly Mathew Parackal

{"title":"Conventional medication adherence and self-treatment practices among South Asian immigrants: a qualitative study.","authors":"Sumera Saeed Akhtar, Mudassir Anwar, Kirsten J Coppell, Sherly Mathew Parackal","doi":"10.1071/HC24084","DOIUrl":"10.1071/HC24084","url":null,"abstract":"Introduction Globally, cardiovascular disease (CVD) is a common cause of death. The highest CVD rate is among South Asian populations and South Asian immigrants have a higher risk of developing CVD than other ethnic groups. While treatment of established CVD risk factors is recommended, medication adherence may be poor. Aim This qualitative study aimed to explore medication adherence practices of New Zealand South Asians who are prescribed medications for type 2 diabetes, and/or hypertension, and/or dyslipidaemia, established risk factors for CVD. Method Twenty-one semi-structured telephone interviews were conducted with South Asians with type 2 diabetes, and/or hypertension, and/or dyslipidaemia. Data were transcribed, then analysed thematically using NVivo12. Codes and inductively derived themes were discussed. Results Five themes with 12 subthemes were identified. The five themes included daily routine and medication adherence practices, perceived necessity of medications and concerns about side effects, concern and hesitancy to start conventional medications, integration of herbal and alternative therapies, and the role of healthcare providers and communication. Discussion These findings highlight the importance of personalised approaches to medication management that consider patients' beliefs, daily routines, and cultural contexts to reduce CVD risk and improve health outcomes among South Asians.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 4","pages":"390-397"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864664","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}

引用次数: 0

Prescriptions and prescribers in primary health care. 初级卫生保健中的处方和开处方者。

IF 1.1

Journal of primary health care Pub Date : 2024-12-01 DOI: 10.1071/HC24181

Felicity Goodyear-Smith, Tim Stokes

引用次数: 0

Patient perceptions of barriers to effective migraine management in Aotearoa New Zealand. 在新西兰奥特罗阿，患者对偏头痛有效管理障碍的认知。

IF 1.1

Journal of primary health care Pub Date : 2024-12-01 DOI: 10.1071/HC24020

Blair McInnarney, Fiona Imlach, Jonathan Kennedy, Susan M Garrett

{"title":"Patient perceptions of barriers to effective migraine management in Aotearoa New Zealand.","authors":"Blair McInnarney, Fiona Imlach, Jonathan Kennedy, Susan M Garrett","doi":"10.1071/HC24020","DOIUrl":"https://doi.org/10.1071/HC24020","url":null,"abstract":"Introduction Migraine is a complex neurological condition which requires evidence based treatment, tailored to the individual. International evidence shows that treatment is often sub-optimal, but the experience of people with migraine in NZ is unknown. Aim This study aimed to describe the barriers people with migraine disease face when seeking care for their condition in Aotearoa New Zealand (NZ). Methods The Migraine in Aotearoa New Zealand Survey (MiANZ) was delivered online via SurveyMonkey from 22 August 2022 to 7 October 2022. Questions included: sociodemographics, the Migraine Disability Assessment Scale (MIDAS), ability to access health care, perception of health professionals' knowledge and open-ended questions. Analysis used a mixed method approach. Results Five hundred and thirty people from NZ responded, of whom 82% (433/530) were female and 77% (409/530) NZ European/other. Eighty-eight percent (467/530) had accessed primary care for migraine, with 36% (167/467) finding GPs' knowledge of migraine to be excellent or very good. Forty-two percent (222/530) reported at least one instance where they had felt judged because of migraine by a health professional. Themes from free-text data included patient perception of health professionals' knowledge of migraine, the presence of stigma within medical practice and systemic barriers to accessing effective health care. Discussion People with migraine in NZ report significant barriers when trying to access effective management. Barriers were in both primary and secondary care and impacted the ability of people with migraine to manage their condition. More current migraine continuing medical education for GPs and other health professionals, better development and communication of care plans between primary and secondary care and patients and measures to address stigma are required to improve management of this complex disease.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 4","pages":"347-356"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864714","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}

引用次数: 0

Taken out of context: academic rural health in Aotearoa New Zealand. 断章取义：新西兰奥特亚罗瓦的农村学术卫生。

IF 1.1

Journal of primary health care Pub Date : 2024-09-01 DOI: 10.1071/HC24133

Garry Nixon

引用次数: 0

Preferred format and strategies for seeking and trusting online health information: a survey of cardiology outpatient attendees across three New Zealand hospitals. 寻求和信任在线健康信息的首选格式和策略：对新西兰三家医院心脏科门诊病人的调查。

IF 1.1

Journal of primary health care Pub Date : 2024-09-01 DOI: 10.1071/HC23143

Susan Wells, Faith Mahony, Arier Lee, Andrew McLachlan, Jennie Dean, Jane Clarke, Siobhan Lehnhard, Robyn Whittaker, Matire Harwood, Jacqueline Cumming, Janine Bycroft

{"title":"Preferred format and strategies for seeking and trusting online health information: a survey of cardiology outpatient attendees across three New Zealand hospitals.","authors":"Susan Wells, Faith Mahony, Arier Lee, Andrew McLachlan, Jennie Dean, Jane Clarke, Siobhan Lehnhard, Robyn Whittaker, Matire Harwood, Jacqueline Cumming, Janine Bycroft","doi":"10.1071/HC23143","DOIUrl":"https://doi.org/10.1071/HC23143","url":null,"abstract":"Introduction The volume and quality of online health information requires consumers to be discerning. Aim This study aimed to explore consumer Internet use for health information, preferred format and what factors helped them to trust the source. Methods A cross-sectional study was conducted in 2016-2017 with adults attending three cardiology outpatient clinic sites using a short paper-based survey. The survey included questions regarding online health information use and perceived trustworthiness with opportunities for free text responses. Survey data were summarised with key questions adjusted by age group, gender and ethnicity using logistic regression. Results Of the 708 respondents (51% women, 66% aged 45-74 years, 16% Māori, 12% Pacific), 73% had sought health information online (64% in the previous 12 months), commonly for medication side effects, their health condition and self-help. Most (65%) were successful, although Pacific respondents reported a lower likelihood of search success compared to Europeans. Younger age groups were more concerned about information quality. Fact sheets (80%) were the most popular format and for all ethnic groups, followed by short videos (31%) and discussion groups (23%). Trusting online information required many strategies with 72% wanting health professionals to recommend websites. Discussion Online health information seeking is a norm for consumers, with simple fact sheets being the preferred format to build knowledge and skills. With the rising tide of misinformation, health portal providers need to offer accurate and easy-to-read fact sheets in their suite of formats and health professionals need to support consumers guiding them to trusted websites.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 3","pages":"270-277"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348930","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}

引用次数: 0