Jean Wignall, Wendy Bennett, Lily P H Yang, Phyu Sin Aye, Clair Shiuan Miao, Catherine Jackson, Karen Bartholomew, Joanna Hikaka, Edward J Gane
{"title":"Demographic profile of potential target populations in community laboratory and emergency department settings for consideration in expanding hepatitis C screening in Aotearoa New Zealand.","authors":"Jean Wignall, Wendy Bennett, Lily P H Yang, Phyu Sin Aye, Clair Shiuan Miao, Catherine Jackson, Karen Bartholomew, Joanna Hikaka, Edward J Gane","doi":"10.1071/HC26042","DOIUrl":"https://doi.org/10.1071/HC26042","url":null,"abstract":"<p><strong>Introduction: </strong>Elimination of hepatitis C virus (HCV) is possible with publicly funded, highly effective and well-tolerated oral treatment. However, most people with chronic HCV are asymptomatic and remain undiagnosed until complications develop. Furthermore, HCV testing and treatment inequities remain for Māori. The addition of HCV testing to blood sampling for other indications in widely accessed settings to augment current screening strategies warrants further investigation.</p><p><strong>Aim: </strong>We analysed national and regional data to compare attenders at community laboratories and hospital emergency departments (EDs), and Northern Region data from ED attenders to determine the proportion who had blood sampling.</p><p><strong>Methods: </strong>National data (July 2023-June 2024) and Northern Region data (November 2024) were extracted for people aged ≥20 years.</p><p><strong>Results: </strong>Among 2,586,051 adult attenders at either setting, most (75%) attended community laboratories only, 8% attended EDs only, and 17% attended both (dual attenders). Although Māori represented a higher proportion of ED attenders than community laboratory attenders (22% vs 11%), the number of Māori attenders was 4.4 times greater for community laboratories vs EDs (203,585 vs 46,009). Of community laboratory attenders, 53% (n = 1,013,690) were aged 40-69 years, the age group with the highest HCV prevalence. Among 28,396 ED attenders in the Northern Region, 77% had a blood test at that visit.</p><p><strong>Discussion: </strong>These findings suggest that HCV screening at community laboratories could test more people, including Māori, than screening at EDs. However, the ED setting could capture people who may not engage with other health services, an important group for targeted outreach.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774658","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":"Improving glycaemic control in primary care for Tongan adults with type 2 diabetes through the use of continuous glucose monitoring and holistic support: a pilot study.","authors":"Janina'ofa Galewski-Tangataevaha, Hamish Crocket, S 'Apo' Aporosa, Sione Vaka, Seong Hoon Yoon, Lynne Chepulis","doi":"10.1071/HC25177","DOIUrl":"https://doi.org/10.1071/HC25177","url":null,"abstract":"<p><strong>Introduction: </strong>In Aotearoa New Zealand, Pacific peoples, including Tongans, experience disproportionately higher rates of type 2 diabetes and related complications. There is an urgent need for innovative, culturally appropriate interventions to improve outcomes.</p><p><strong>Aim: </strong>This study aimed to determine the impact of continuous glucose monitoring devices with cultural wrap-around support on medium-term glycaemic control and other type 2 diabetes biomarkers in Tongan adults with high-risk type 2 diabetes.</p><p><strong>Methods: </strong>Twenty-two Tongan adults with HbA1c ≥60 mmol/mol were invited to participate in a 6-month pilot intervention study involving 4 weeks of continuous glucose monitoring wear at baseline and 2 weeks at 3-months, alongside wrap-around care delivered by a Tongan kaiāwhina (support health worker). The primary endpoint was 3-month HbA1c. Clinical (glycated haemoglobin, lipids, estimated glomerular filtration rate, urinary albumin to creatinine ratio) and psychosocial (Diabetes Self-Management Questionnaire, measured at baseline and 3 months) outcomes were measured at baseline, 3, and 6 months.</p><p><strong>Results: </strong>Nineteen participants completed the study through to 6 months. Mean HbA1c significantly decreased from 80.2 ± 19.4 mmol/mol at baseline to 68.6 ± 14.2 mmol/mol at 3 months, with reductions maintained at 6 months. No significant changes in lipids or renal function were observed. Diabetes Self-Management Questionnaire scores increased from 4.9 ± 0.8 to 6.0 ± 1.0 (P < 0.001).</p><p><strong>Discussion: </strong>Culturally tailored continuous glucose monitoring-based interventions have the potential to support Tongan adults with understanding, optimising, and managing type 2 diabetes.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774695","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":"'I want to stay connected with everyone; this is important' - a qualitative study of Māori expectations and aspirations for aged residential care.","authors":"Joanna Hikaka, Tuakana August, Nora Parore, Ngaire Kerse","doi":"10.1071/HC25225","DOIUrl":"https://doi.org/10.1071/HC25225","url":null,"abstract":"<p><strong>Introduction: </strong>As people age, some require care supports, and transition from home to aged residential care (ARC) is associated with improvement in some measures of physical and psychosocial wellbeing. Yet, Māori experience reduced access to ARC.</p><p><strong>Aim: </strong>To explore Māori experiences and expectations of health and social care within ARC.</p><p><strong>Methods: </strong>We undertook a qualitative study in Hawkes Bay, Aotearoa. We included participants who were Māori with professional or personal/whānau experience of providing care to pakeke and/or kaumātua (older Māori). We interviewed participants one-on-one or in focus groups and analysed data using general inductive thematic analysis informed by kaupapa Māori theory.</p><p><strong>Results: </strong>Thirty-five people participated in 13 focus groups or interviews held from October 2022 to September 2024. We identified three themes: Māori look after our own; expectations of a high-quality clinical care environment; and home environment aspirations.</p><p><strong>Discussion: </strong>Transitions into ARC are shaped by more than clinical need; they reflect cultural expectations, emotional responsibility, financial considerations, and whānau perceptions and experiences relating to the quality and cultural safety of the care environment. ARC needs to provide high-quality clinical and cultural care and support home-like environments to reduce whānau guilt and support successful transitions and living environments for older Māori.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729304","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}
Katharina Blattner, Lynne Clay, Jane George, Jesse Whitehead, Rory Miller
{"title":"Establishing research priorities for rural health in Aotearoa New Zealand - a modified Delphi study.","authors":"Katharina Blattner, Lynne Clay, Jane George, Jesse Whitehead, Rory Miller","doi":"10.1071/HC26032","DOIUrl":"https://doi.org/10.1071/HC26032","url":null,"abstract":"<p><strong>Introduction: </strong>People in rural Aotearoa New Zealand (NZ) face distinct health challenges, including limited access to health care, workforce shortages, and persistent disparities. Hauora Taiwhenua Rural Health Network NZ (HTRHN) is a collective organisation advocating for the health and well-being of rural New Zealanders. HTRHN aims to foster research that improves rural health and reduces inequities.</p><p><strong>Aim: </strong>This study aims to identify the research priorities for rural health in NZ from the perspectives of HTRHN members.</p><p><strong>Methods: </strong>A modified Delphi methodology was used with expert panellists from HTRHN. In Round 1, panellists were asked to list broad research areas and specific research topics. Thematic analysis identified six broad research categories with specific research topics assigned to each. In Rounds 2 and 3, panellists rated the importance of the specific research topics using Likert scales.</p><p><strong>Results: </strong>Round 1 was completed by 30 participants, Round 2 by 21, and Round 3 by 19. There was wide representation from HTRHN's membership. Six broad rural health research areas were identified, and consensus ratings prioritised 14 specific research topics. Top-rated research topics included 'Health of place effect' - how features of a place influence health outcomes; improving rural health data collection and analysis; and rural-focused acute palliative care management.</p><p><strong>Discussion: </strong>The broad rural health research categories identified are consistent with those reported in comparable international contexts. These categories also mirror the 2023 New Zealand Rural Health Strategy. Final prioritised topics create a platform for continued rural health research in NZ, providing guidance for researchers/funders in developing future research projects.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674519","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":"Consultation circumstances leading to skin cancer detection in Australian general practice.","authors":"Alex Li Majri, Lucy Gilkes, Diane E Arnold-Reed","doi":"10.1071/HC26002","DOIUrl":"https://doi.org/10.1071/HC26002","url":null,"abstract":"<p><strong>Introduction: </strong>General practitioners (GPs) diagnose and manage most skin cancers in Australia, often within time-limited consultations involving multimorbid patients. There is limited evidence describing the consultation circumstances in which skin cancers are detected.</p><p><strong>Aim: </strong>This study aims to describe the most common consultation circumstances associated with skin cancer detection in Australian general practice.</p><p><strong>Methods: </strong>We conducted a retrospective descriptive study across three general practices in Perth, Western Australia. In phase 1, we interviewed eight GPs to identify common consultation circumstances that lead to skin cancer detection and developed descriptive categories. In phase 2, we reviewed medical records of patients who had undergone skin cancer excision in the preceding 12 months, identified using Medicare item numbers. Consultation notes from the visit in which the lesion was identified were reviewed and classified using the phase 1 categories. We also recorded the number of problems managed per consultation.</p><p><strong>Results: </strong>We reviewed 103 patient records from 210 eligible records. Most patients were aged over 60 years, and 73% had a documented history of skin cancer. Skin cancers were most commonly detected during multi-issue consultations addressing other health concerns (74.8%). Detection also occurred during general skin checks (21.4%), presentations for a single lesion (15.5%), and incidental findings during unrelated consultations (10.7%). GPs managed a mean of 2.90 problems per consultation. Percentages exceed 100% because more than one consultation category could apply to a single consultation.</p><p><strong>Discussion: </strong>Skin cancer detection commonly occurs within complex consultations addressing multiple competing health issues, supporting opportunistic assessment and risk-based follow-up in general practice.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645845","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":"General practitioners' views on community pharmacists in supporting equitable cardiovascular health outcomes for Pacific peoples: a qualitative study.","authors":"Jessie Lagaluga Hutchings, Corina Grey, Karen Brewer, Trudi Aspden","doi":"10.1071/HC25157","DOIUrl":"10.1071/HC25157","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular disease (CVD) is the leading cause of mortality and morbidity globally and a significant contributor to health inequities for Pacific peoples in Aotearoa New Zealand. Addressing these inequities requires a multidisciplinary approach, where community pharmacists (CPs) have the potential to play a critical role. CPs' accessibility, medication expertise, and ability to engage with underserved populations position them uniquely within the healthcare system. However, their contribution to equitable heart health outcomes remains underexplored.</p><p><strong>Aim: </strong>The aim was to explore the experiences and views of general practitioners (GPs) on CPs' roles in supporting heart health equity for Pacific peoples and to examine how GPs currently work with CPs.</p><p><strong>Methods: </strong>This research employed interpretive description with Pacific principles, and semi-structured interviews with GPs were conducted. Analysis was conducted using template analysis and the Lili Health Model data interpretation tool.</p><p><strong>Results: </strong>Nine interviews were conducted, from which five themes were generated: (1) Optimising CPs' roles beyond supporting GPs, (2) GPs and Pacific peoples' ability to engage with CPs, (3) Increasing Pacific representation and cultural responsiveness, (4) (Mis)perceptions of pharmacy, and (5) Control in a constrained healthcare system.</p><p><strong>Discussion: </strong>Interviewed GPs believed that CPs play a pivotal role in addressing heart health equity for Pacific peoples. This role could be enhanced by expanding CPs' clinical responsibilities, enhancing cultural safety, increasing the number of Pacific pharmacy staff, and addressing systemic barriers.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"28-35"},"PeriodicalIF":1.1,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145810187","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}
John McMenamin, Susan Parry, Bronwyn Rendle, Cathy Whiteside
{"title":"Improving National Bowel Screening participation through primary care engagement: a quality improvement report.","authors":"John McMenamin, Susan Parry, Bronwyn Rendle, Cathy Whiteside","doi":"10.1071/HC25069","DOIUrl":"10.1071/HC25069","url":null,"abstract":"<p><strong>Background and context: </strong>The National Bowel Screening Programme (NBSP) in Aotearoa New Zealand aims to reduce bowel cancer mortality through early detection. Despite this, participation remains lower among Māori and Pacific peoples. In 2023 and 2024, primary care-led campaigns were introduced to support general practices to engage eligible patients in screening discussions.</p><p><strong>Assessment of the problem: </strong>General practices had varied levels of engagement with reminder systems and resources, and many lacked consistent processes for incorporating screening into routine consultations. To address this, tailored materials and practice support tools were provided.</p><p><strong>Results: </strong>Campaign participation included a substantial number of New Zealand practices, including engagement of Very Low-Cost Access (VLCA) clinics. Overall, the volume of faecal immunochemical test (FIT) kit requests more than doubled over 2 years; however, return rates remained modest, highlighting the need for additional follow-up strategies.</p><p><strong>Strategies for improvement: </strong>Future efforts should focus on expanding reminder systems, enhancing practice workflows, and incorporating outreach support to increase kit completion rates.</p><p><strong>Lessons learnt: </strong>Structured primary care interventions can boost screening uptake, particularly among equity priority groups. Sustained improvements in screening participation will depend on system integration and continued support for practices and communities.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"82-85"},"PeriodicalIF":1.1,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355299","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":"Providing over-the-counter vaginal oestrogen in New Zealand: a cross-sectional study of pharmacists' views.","authors":"Tylah Maniapoto, Amber Young, Alesha Smith","doi":"10.1071/HC25065","DOIUrl":"10.1071/HC25065","url":null,"abstract":"<p><strong>Introduction: </strong>Genitourinary symptoms of menopause (GSM) affect a large proportion of women and can worsen over time if left untreated. In New Zealand, effective treatment with low-dose vaginal oestrogen is available only by prescription, limiting timely access. Internationally, such treatments have been reclassified for supply by pharmacists, but there are no studies examining New Zealand pharmacists' perspectives on this.</p><p><strong>Aim: </strong>This study aimed to determine pharmacists' confidence in treating GSM and their perspectives on supplying an over-the-counter (OTC) vaginal oestrogen.</p><p><strong>Methods: </strong>A cross-sectional survey was distributed by the research team to 2762 registered pharmacists. The survey explored confidence in GSM management, opinions on OTC vaginal oestrogen supply, perceptions of patient preferences, and barriers and facilitators to service delivery. Quantitative data were analysed descriptively, and open-ended responses were reviewed using descriptive thematic analysis.</p><p><strong>Results: </strong>A total of 299 pharmacists responded (response rate 10.8%). While only 46.8% felt confident in recommending currently available OTC products for GSM, 61.2% reported they would be confident supplying low-dose vaginal oestrogen OTC. Pharmacists believed that supplying OTC oestrogen would improve accessibility, reduce the burden on general practice, and support patient-centred care. Key barriers included cost to patients, lack of specific knowledge of GSM, and limited time or resources in the pharmacy setting.</p><p><strong>Discussion: </strong>Pharmacists in New Zealand support expanding their role to supply low-dose OTC vaginal oestrogen for GSM, provided that appropriate tools and training are implemented. This service could improve access, address health disparities, and significantly enhance menopause care in New Zealand.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"45-52"},"PeriodicalIF":1.1,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355147","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":"Feasibility and outcomes of a collaborative pharmacy and general practice service for people with type 2 diabetes with high HbA1c: a mixed methods study.","authors":"N Gauld, J Faletau, M Bentley, S Tutty","doi":"10.1071/HC25123","DOIUrl":"10.1071/HC25123","url":null,"abstract":"<p><strong>Introduction: </strong>New approaches are needed to respond to increasing numbers of patients with type 2 diabetes and high HbA1c (glycated haemoglobin). This pilot supported additional care from five primary care nurses and community pharmacists for people with type 2 diabetes with high HbA1c.</p><p><strong>Aim: </strong>To describe uptake, outcomes and experiences of a collaborative pharmacy and general practice diabetes programme.</p><p><strong>Methods: </strong>Quantitative data from patients enrolled before 31 August 2022 included change in HbA1c and medication, and pharmacist activity. Interviews with seven patients, five pharmacists and four practice nurses were analysed thematically.</p><p><strong>Results: </strong>The evaluation included 26 people with an average baseline HbA1c of 97.6 mmol/mol (range 69-136 mmol/mol), of whom 84.6% were Māori or Pacific peoples. HbA1c reduced by an average 25.2 mmol/mol; 20.7 mmol/mol for Māori and Pacific peoples. HbA1c reduced by ≥5 mmol/mol in 84.6% of service users, and 81.8% of Māori and Pacific peoples. HbA1c reductions were sustained an average 7.5 months after programme completion. Pharmacists tailored their actions to the individual. The programme was highly acceptable to patients, pharmacists and nurses, with generally good communication and trust between them. Understanding about diabetes and medication, and medication adherence improved. New, effective medicines and insulin were often introduced. Some participants described increased blood glucose testing and lifestyle changes. Diabetes distress and denial, goal setting, client understanding of HbA1c and dropouts need further attention. COVID-19, staffing changes and staff shortages impacted enrolments. Pharmacist mentoring may help enrolments.</p><p><strong>Discussion: </strong>A collaborative pharmacy-general practice model has potential to improve HbA1c in patients with type 2 diabetes through relatively simple interventions.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"36-44"},"PeriodicalIF":1.1,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145401359","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":"Smarter referrals: why AI-assisted triage should begin in primary care.","authors":"Steven Lillis, Vithya Yogarajan","doi":"10.1071/HC25087","DOIUrl":"10.1071/HC25087","url":null,"abstract":"","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"89-91"},"PeriodicalIF":0.9,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355216","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}