Journal of primary health care最新文献_第7页

Substitution of regulated health professionals, such as doctors and nurses, with unregulated health care workers, such as physician assistants, gives rise to concerns around patient safety and accountability issues: No. 用医生助理等不受监管的医护人员取代医生和护士等受监管的医护专业人员，会引起对患者安全和问责问题的担忧：没有。

IF 1.1

Journal of primary health care Pub Date : 2024-06-01 DOI: 10.1071/HC24077

Allan R Moffitt

引用次数: 0

Attention deficit and hyperactivity disorder and use of psychostimulants in Aotearoa, New Zealand: exploring the treatment gap. 新西兰奥特亚罗瓦的注意力缺陷和多动症与精神兴奋剂的使用：探索治疗差距。

IF 1.2

Journal of primary health care Pub Date : 2024-03-01 DOI: 10.1071/HC23126

Steven Lillis

{"title":"Attention deficit and hyperactivity disorder and use of psychostimulants in Aotearoa, New Zealand: exploring the treatment gap.","authors":"Steven Lillis","doi":"10.1071/HC23126","DOIUrl":"10.1071/HC23126","url":null,"abstract":"Introduction Attention deficit and hyperactivity disorder (ADHD) is a common neurodevelopmental disorder affecting about 7% of those aged up to 12 years, 5% of teenagers and 3% of adults. It is associated with poor academic performance, substance abuse, criminality, poor social functioning and other negative outcomes. Psychotherapeutic treatment is moderately successful, whereas pharmacotherapy with stimulant medication is more efficacious and is recommended in many international guidelines. Anecdotal evidence suggests underuse of these medications in Aotearoa, New Zealand. Aim To estimate how many patients with ADHD are prescribed psychostimulants in Aotearoa, New Zealand. Methods National prescribing data for dexamphetamine and methylphenidate in 2022 were obtained and matched against estimated prevalence of ADHD by age. Results There is a significant treatment gap for which inability to access first-line medication is likely to be the predominant explanation. Discussion The data suggest failure of our health system to provide reasonable health care for a significant number of people with ADHD, and results in inequity in outcomes. New approaches are needed that will increase access to first-line medication, yet maintain appropriateness of diagnosis and limit risk of medication diversion.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 1","pages":"27-32"},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318537","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

Improving access to dermatology specialist care: review of a dermatologist- and general practitioner-integrated clinic model. 改善皮肤科专科医疗服务：皮肤科医生和全科医生综合诊所模式回顾。

IF 1.2

Journal of primary health care Pub Date : 2024-03-01 DOI: 10.1071/HC23122

Neakiry Kivi, Louise Reiche, Tanira Kingi, Christina Elder, Alex Semprini

{"title":"Improving access to dermatology specialist care: review of a dermatologist- and general practitioner-integrated clinic model.","authors":"Neakiry Kivi, Louise Reiche, Tanira Kingi, Christina Elder, Alex Semprini","doi":"10.1071/HC23122","DOIUrl":"10.1071/HC23122","url":null,"abstract":"Introduction This study presents an innovative model of integrated dermatology service delivery. Kauri HealthCare (KHC) is a general practice serving around 19 000 patients in Palmerston North, New Zealand. A 'mini clinic' is provided by an on-site dermatologist that is available for patients of KHC. Referring practitioners are required to attend with the patient to present their case and seek dermatologist input. This allows for patients to receive a specialist opinion, as well as for the referrer to receive practical and academic teaching, record findings, and arrange any further investigations, follow-up, or management. Aim To describe the nature of patient presentations and clinical outcomes of a novel dermatologist-general practitioner integrated clinic based in a provincial healthcare practice. Methods Descriptive analysis of all referrals to the Kauri HealthCare dermatology mini clinic from April 2017 to December 2022. Results During the study period, 964 diagnoses were recorded across 806 patients booked into the mini clinic. The most common presenting conditions were: (1) eczema; (2) psoriasis; (3) actinic keratoses; (4) naevi; and (5) seborrheic keratosis. Practitioners sought dermatology opinion on the diagnosis and/or management of skin conditions. Further referral to secondary care was not required for 86% of patients. Discussion Improvements could be made to better serve those of Māori and Pacific ethnicity, or living in high socioeconomic deprivation. Results indicate where teaching could be prioritised for practitioners, postgraduates, and medical students. Overall, this is an innovative clinic model, which seeks to provide equitable care, medical education, and collaboration between primary and secondary services.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 1","pages":"21-26"},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318544","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

Exploring how a patient encounter tracking and learning tool is used within general practice training: a qualitative study. 探索如何在全科培训中使用病人就诊跟踪和学习工具：一项定性研究。

IF 1.2

Journal of primary health care Pub Date : 2024-03-01 DOI: 10.1071/HC23082

Michael Bentley, Jennifer Taylor, Alison Fielding, Andrew Davey, Dominica Moad, Mieke van Driel, Parker Magin, Linda Klein

{"title":"Exploring how a patient encounter tracking and learning tool is used within general practice training: a qualitative study.","authors":"Michael Bentley, Jennifer Taylor, Alison Fielding, Andrew Davey, Dominica Moad, Mieke van Driel, Parker Magin, Linda Klein","doi":"10.1071/HC23082","DOIUrl":"10.1071/HC23082","url":null,"abstract":"Introduction In Australian general practitioner (GP) training, feedback and reflection on in-practice experience is central to developing GP registrars' (trainees') clinical competencies. Patient encounter tracking and learning tools (PETALs) that encompass an audit of consecutive patient consultations, feedback, and reflection are used to determine registrars' in-practice exposure and have been suggested as a tool for learning within a programmatic assessment framework. However, there is limited qualitative literature on the utility of PETALs in GP training. Aim To provide greater understanding of how PETALs are used in GP training, using Registrars' Clinical Encounters in Training (ReCEnT) as a case study. Methods Medical educators, supervisors, and registrars from two Australian regional GP training organisations participated in focus groups and interviews, designed to explore participants' perceptions of ReCEnT's utility. Data were analysed using reflexive thematic analysis. Results Eight themes were identified that enhance our understanding of: how ReCEnT reports are used (reassuring registrars, facilitating self-reflection, identifying learning needs), what enables ReCEnT to reach its full potential (a culture of reflection, meaningful discussions with supervisors and medical educators, valuing objective data), and differences in understanding about ReCEnT's role in a programmatic assessment framework (as a tool for learning, as 'one piece of the puzzle'). Discussion The findings were used to develop a Structure-Process-Outcomes model to demonstrate how ReCEnT is currently used and explores how it can be used for learning, rather than of learning, in a programmatic assessment framework for GP training. ReCEnT's longitudinal format has potential for enhancing learning throughout training.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 1","pages":"41-52"},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318543","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 perceptions of barriers to attending annual diabetes review and foot assessment in general practice: a qualitative study. 患者对在全科医生处接受糖尿病年度复查和足部评估的障碍的看法：一项定性研究。

IF 1.2

Journal of primary health care Pub Date : 2024-03-01 DOI: 10.1071/HC23081

William Ju, Ibrahim S Al-Busaidi, Helen Lunt, Ben Hudson

{"title":"Patient perceptions of barriers to attending annual diabetes review and foot assessment in general practice: a qualitative study.","authors":"William Ju, Ibrahim S Al-Busaidi, Helen Lunt, Ben Hudson","doi":"10.1071/HC23081","DOIUrl":"10.1071/HC23081","url":null,"abstract":"Introduction Regular diabetic foot checks, at least annually, are important for early identification of risk factors and prevention of ulceration and amputation. To ensure this, most general practices in Aotearoa New Zealand (NZ) offer free annual diabetes reviews (ADRs) which include a comprehensive foot evaluation. However, attendance rates at these ADRs are low. Aim To explore patients' perspectives on the barriers to attending ADRs and foot checks. Methods Semi-structured interviews with people with type 2 diabetes who were overdue their ADR (n = 13; 7 women, 6 Māori) from two urban practices were conducted. Interviews were audio recorded and transcribed verbatim and then analysed using an inductive thematic analysis approach. Results We identified three key themes demonstrating barriers to attendance: healthcare-associated factors (suboptimal clinician-patient relationship, not having a consistent general practitioner (GP)); patient-related factors (co-morbid health conditions, issues surrounding identity, and logistical issues); and systemic factors (COVID-19 pandemic, travel distance to the practice, unawareness of available foot care services). Participants' feedback focused on patient-centred approaches for improvements to service delivery, for example using online educational materials, and utilising culturally appropriate models of health including Te Whare Tapa Whā and Whānau Ora approach. Discussion We identified several barriers to attendance, some of which are potentially modifiable. Addressing modifiable barriers and incorporating suggestions made by participants may improve access to the ADR and reduce non-attendance. Further participatory action research could explore these insights in ways that facilitate tino rangatiratanga (self-determination) and palpable action.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 1","pages":"53-60"},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318547","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

De-prescribing in primary care: the clinical, ethical and psychological considerations. 在初级保健中取消处方：临床、伦理和心理方面的考虑。

IF 1.2

Journal of primary health care Pub Date : 2024-03-01 DOI: 10.1071/HC23118

Waseem Jerjes, Daniel Harding

引用次数: 0

The impact of nurse prescribing on health care delivery for patients with diabetes: a rapid review. 护士处方对糖尿病患者医疗服务的影响：快速综述。

IF 1.2

Journal of primary health care Pub Date : 2024-03-01 DOI: 10.1071/HC23121

Kylie Short, Cathy Andrew, Wenting Yang, Isabel Jamieson

{"title":"The impact of nurse prescribing on health care delivery for patients with diabetes: a rapid review.","authors":"Kylie Short, Cathy Andrew, Wenting Yang, Isabel Jamieson","doi":"10.1071/HC23121","DOIUrl":"10.1071/HC23121","url":null,"abstract":"Introduction The global prevalence of diabetes is a pressing public health concern. Over 400 million individuals live with the effects of the disease, predominantly in low- and middle-income countries. In Aotearoa New Zealand (NZ), over 300 000 people have diabetes, resulting in a population rate of 43.1 per 1000. Enabling nurses to prescribe diabetes medications enhances accessibility and improves health outcomes for large sections of the population. Aim This rapid review was undertaken to investigate the influence of nurse prescribing on health care delivery for individuals with diabetes in NZ, Australia, the United Kingdom, and Canada, countries sharing comparable health care systems and multicultural backgrounds. Methods The review protocol was published on PROSPERO. In November 2022, a search was conducted across multiple databases to locate relevant literature and resources constrained to the last decade (from January 2012 to November 2022). Utilising the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework, data extraction was systematically structured, while rigorous appraisal processes upheld selection quality. Results Fifteen publications were identified as meeting predefined inclusion and exclusion criteria. The review of these articles revealed four main themes: the impact of nurse prescribing on clinical outcomes, levels of patient satisfaction, implications for health care service provisions, and identification of barriers and facilitators associated with nurse prescribing. Discussion This report identifies outcomes of nurse prescribing, concluding it provides a potential avenue for enhancing access to and alleviating the burden on health care systems.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"16 1","pages":"78-89"},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318550","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

Ashwagandha. Ashwagandha.

IF 1.2

Journal of primary health care Pub Date : 2024-03-01 DOI: 10.1071/HC23172

Xin Yi Lim, Joanne Barnes

引用次数: 0

Carbohydrate intake in T2DM. T2DM 的碳水化合物摄入量。

IF 1.2

Journal of primary health care Pub Date : 2024-03-01 DOI: 10.1071/HC24042

Rosemary M Hall

引用次数: 0

Do decision aids improve clinical practice? 决策辅助工具能否改善临床实践？