Journal of primary health care最新文献_第8页

Physician and nurse practitioner perspectives of a modified Routine Opioid Outcome Monitoring (ROOM) Tool. 改良阿片类药物常规疗效监测（ROOM）工具的医生和执业护士观点。

IF 1.2

Journal of primary health care Pub Date : 2023-09-01 DOI: 10.1071/HC23022

Cynthia Lam, Patricia Marr, Kori Leblanc, Christine Papoushek, Debbie Kwan, Beth Sproule, Laura Murphy

{"title":"Physician and nurse practitioner perspectives of a modified Routine Opioid Outcome Monitoring (ROOM) Tool.","authors":"Cynthia Lam, Patricia Marr, Kori Leblanc, Christine Papoushek, Debbie Kwan, Beth Sproule, Laura Murphy","doi":"10.1071/HC23022","DOIUrl":"https://doi.org/10.1071/HC23022","url":null,"abstract":"Introduction The Routine Opioid Outcome Monitoring (ROOM) Tool was developed for use in community pharmacies in Australia. It facilitates pharmacists' screening and brief interventions regarding an individual's opioid use for chronic pain. At our academic teaching hospital, the ROOM Tool was adapted to incorporate a communication tool that includes a pharmacist's assessment and recommendations for primary care providers. This modified ROOM Tool was implemented as part of usual care in our outpatient pharmacies; however, the value to primary care providers is unknown. Aim The aim of this study was to determine primary care provider perspectives on the modified ROOM Tool. Methods Focus groups were conducted with primary care providers from an Academic Family Health Team. The focus group encompassed topics related to the positive and negative aspects of the modified ROOM Tool in supporting the care of patients using opioids for chronic pain. Qualitative content analysis of transcripts was performed to identify themes. Results Three focus groups were conducted with a total of six participants. Four themes emerged: (i) Facilitators to using the tool, (ii) Barriers to using the tool, (iii) Recommendations for improvement, (iv) Impact of the tool on patient care and safety. Discussion The ROOM Tool paired with the communication tool supports collaboration between pharmacists and primary care providers. The communication tool standardises the approach for communicating the pharmacist's assessment and recommendations. Recommendations to refine this modified ROOM Tool may increase its utility to primary care providers and enhance the impact on patient care and safety.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"15 3","pages":"246-252"},"PeriodicalIF":1.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41125549","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: 1

Patient representation in New Zealand general practice and rural health case-based teaching: a quality improvement exercise. 新西兰全科医学和农村卫生案例教学中的患者代表性：一项质量改进活动。

IF 1.2

Journal of primary health care Pub Date : 2023-09-01 DOI: 10.1071/HC23070

Jessica Gu, Jim Ross, Sharon Leitch

{"title":"Patient representation in New Zealand general practice and rural health case-based teaching: a quality improvement exercise.","authors":"Jessica Gu, Jim Ross, Sharon Leitch","doi":"10.1071/HC23070","DOIUrl":"https://doi.org/10.1071/HC23070","url":null,"abstract":"Introduction Healthcare inequity disproportionately affects minority populations in Aotearoa New Zealand. Healthcare providers may contribute to inequity due to their biases. Medical education can unintentionally promote biases by reinforcing stereotypes or limiting exposure to diversity. Teaching staff from the Department of General Practice and Rural Health suggested a need to review current teaching materials to ascertain if they have the potential to contribute to this bias. Aim The aim of this study was to review case-based teaching material to determine its representation of the New Zealand population, and whether there is potential to contribute to implicit bias. Methods Document analysis of 135 cases used to teach fourth- and fifth-year medical students in the Department of General Practice and Rural Health, Otago Medical School was performed. Demographic, clinical and social features of each case were recorded and analysed. Results Cases typically included patient age (129/135, 95.6%), sex (127/135, 94.1%) and occupation status (91/136, 66.9%). Ethnicity (31/135, 23.0%), living situation (55/135, 40.7%), relationship status (57/135, 42.2%) and sexual orientation (52/135, 40.0%) were less frequently defined. Cases typically represented the population majority norms. Discussion Case-based teaching materials require regular review and updating to match population demographics. There is potential to improve representation of diversity, and hence cultural safety, though review and revision of written teaching cases.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"15 3","pages":"281-287"},"PeriodicalIF":1.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41164590","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: 1

A new system. 一个新的系统。

IF 1.2

Journal of primary health care Pub Date : 2023-09-01 DOI: 10.1071/HC23099

Mason Durie

引用次数: 0

Factors associated with general practitioner visits for pain in people experiencing chronic pain. 慢性疼痛患者因疼痛就诊的全科医生相关因素。

IF 1.2

Journal of primary health care Pub Date : 2023-09-01 DOI: 10.1071/HC23004

Dinberu Shebeshi, Samuel Allingham, Janelle White, Hilarie Tardif, David Holloway

{"title":"Factors associated with general practitioner visits for pain in people experiencing chronic pain.","authors":"Dinberu Shebeshi, Samuel Allingham, Janelle White, Hilarie Tardif, David Holloway","doi":"10.1071/HC23004","DOIUrl":"https://doi.org/10.1071/HC23004","url":null,"abstract":"Introduction Patients with chronic pain (CP) are frequent users of general practitioners (GPs). Aim This study aimed to assess factors associated with the rate of GP visits related to pain in patients with CP. Methods This study used data collected by adult specialist pain management services (SPMS) that participated in the electronic Persistent Pain Outcomes Collaboration (ePPOC) in Australia. Adult patients (18 years or older) with CP (duration greater than 3 months) who were referred to SPMS from the calendar year 2015-2021 were included (N = 84 829). Results Patients who reported severe anxiety, stress, pain, pain interference, pain catastrophising and severely impaired pain self-efficacy were more likely to seek help from a GP. Patients with longer pain duration had a lower rate of GP visits. The rate of GP visits was 1.22 (IRR = 1.22, 95% CI: 1.19, 1.26) times higher in patients with severe pain severity, compared to patients with mild pain severity. Patients who used opioids were more likely to visit a GP (IRR = 1.32, 95% CI: 1.30, 1.34) than those who were not using opioids. Discussions More than half of the adult CP patients had greater than three GP visits in the 3 months before referral. This study would indicate that some patients may attend their GP to seek an opioid prescription. Given the rising use of opioids nationally, future study is required on opioid users' GP visitation practices. Additionally, the inverse association between pain duration and the rate of GP visits warrants further exploration.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"15 3","pages":"199-205"},"PeriodicalIF":1.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41134946","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: 1

Timeliness of diagnosis and treatment of cutaneous melanoma with dermatology, general practice, plastics surgery collaboration - are we meeting standards? 皮肤科、全科医学、整形外科合作诊断和治疗皮肤黑色素瘤的及时性——我们符合标准吗？

IF 1.2

Journal of primary health care Pub Date : 2023-09-01 DOI: 10.1071/HC23013

Haein Na, Amanda Oakley

{"title":"Timeliness of diagnosis and treatment of cutaneous melanoma with dermatology, general practice, plastics surgery collaboration - are we meeting standards?","authors":"Haein Na, Amanda Oakley","doi":"10.1071/HC23013","DOIUrl":"10.1071/HC23013","url":null,"abstract":"Introduction Melanoma is a serious type of skin cancer with a high burden in New Zealand. MelNet Quality Statements (2021) guide the timeliness of investigations and management for melanoma patients, who might experience long delays waiting for treatment. Aim To assess compliance of melanoma diagnosis and treatment timeliness with the MelNet Quality Statements at Waikato Hospital and in primary care for melanoma and melanoma in situ (MIS). Methods This is a retrospective clinical audit of patients referred via the Suspected Skin Cancer (SSC) teledermatology pathway between June 2020 and June 2022, and histologically confirmed as having melanoma or MIS. Time intervals between elements of service were analysed. Results For 43 melanomas and 105 MIS, compliance with MelNet Quality Statements across all melanoma services was poor, except for teledermatology response rates (100% compliance). From referral to first cancer treatment (Statement 2.1.1), compliance was 50% in general practice and 7.7% in Waikato Hospital. From teledermatologist response to biopsy (Statement 2.1.3), compliance was 65.2% in general practice and 7.7% in hospital plastics department. Histopathological reporting delays were also identified. Discussion Long delays for melanoma care in hospital likely reflect system failures (such as inadequate funding and human resources) and the increasing burden of skin cancer. In contrast, primary care provided quicker diagnostic biopsies and surgical treatments for melanoma.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"15 3","pages":"267-273"},"PeriodicalIF":1.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41120773","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: 1

Interventions to improve vaccine coverage of pregnant women in Aotearoa New Zealand. 为提高新西兰奥特亚孕妇的疫苗覆盖率而采取的干预措施。

IF 1.2

Journal of primary health care Pub Date : 2023-09-01 DOI: 10.1071/HC23041

Flynn Macredie, Esther Willing, Pauline Dawson, Anna Howe, Amber Young

{"title":"Interventions to improve vaccine coverage of pregnant women in Aotearoa New Zealand.","authors":"Flynn Macredie, Esther Willing, Pauline Dawson, Anna Howe, Amber Young","doi":"10.1071/HC23041","DOIUrl":"https://doi.org/10.1071/HC23041","url":null,"abstract":"Introduction Maternal vaccination against influenza and pertussis protects mothers and babies from severe disease and is recommended and funded in Aotearoa New Zealand. Despite this, maternal vaccination uptake is low, varies by region and is inequitable, with Māori and Pacific māmā (mothers) less likely to receive vaccination. Aim To determine what interventions currently exist to support and encourage maternal vaccination against influenza and pertussis and what changes and interventions could be implemented to improve coverage, with a focus on Māori and Pacific hapū māmā (pregnant mothers). Methods Interviews with six participants with diverse roles in the vaccination workforce were conducted. Participants were involved in education, certification and supporting vaccinators, high-level strategising, and vaccination. Interviews aimed to determine what interventions currently exist for hapū māmā, what changes need to be made to improve coverage and how Māori and Pacific people have been specifically engaged. Qualitative data analysis was used to determine themes. Results Participants identified that interventions must focus on prioritising and emphasising the importance of maternal vaccination, promoting collaboration and innovation, making interventions accessible, and empowering Māori- and Pacific-driven avenues to vaccination. To create positive foundations, participants identified the importance of building and maintaining trust and affording mothers' time and autonomy in vaccination. Discussion Healthcare professionals need to proactively engage hapū māmā about vaccination and collaborate in service delivery. Interventions must be suitably accessible and allow for the autonomy of hapū māmā over vaccination decisions. Equity should be considered at the foundation of vaccine interventions to improve the accessibility of vaccines to all communities.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"15 3","pages":"230-237"},"PeriodicalIF":1.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41099773","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: 1

New Zealanders with low back pain seeking health care: a retrospective descriptive analysis of Accident Compensation Corporation-funded low back pain healthcare service usage. 患有腰痛的新西兰人寻求医疗保健：对事故赔偿公司资助的腰痛医疗服务使用情况的回顾性描述性分析。

IF 1.2

Journal of primary health care Pub Date : 2023-09-01 DOI: 10.1071/HC23010

Julia Hill, Dylan Kay, Jacob Gordon, Imran Khan Niazi, Nicola Saywell

{"title":"New Zealanders with low back pain seeking health care: a retrospective descriptive analysis of Accident Compensation Corporation-funded low back pain healthcare service usage.","authors":"Julia Hill, Dylan Kay, Jacob Gordon, Imran Khan Niazi, Nicola Saywell","doi":"10.1071/HC23010","DOIUrl":"10.1071/HC23010","url":null,"abstract":"Introduction Most New Zealanders experience low back pain (LBP) at least once throughout their lifetime and many seek help from the large range of health providers in primary care. Accident Compensation Corporation (ACC) funds a significant proportion of those claims, but which services are they funding and what are the costs? Method This was a retrospective audit and descriptive analysis of ACC-funded, non-public hospital healthcare service use by people with LBP in New Zealand (NZ). Outcome measures were the healthcare services accessed by people with ACC-funded LBP,the claims (all occurrences for a service that has generated a payment/year), single contact (with a service), and costs (NZ$) for services between 2009 and 2020. Results The number of claims for services were 129 000 for physiotherapy, 105 000 for general practitioner and 59 000 for radiology services. Per single contact, elective surgery and radiology services were the most expensive. During 2009-2020, there were 3.3 million ACC claims for LBP with a total cost of NZ$4 billion. Over this time, there was an increase in claims, costs and single contacts. Costs decreased slightly during 2010 due to changes in healthcare funding and in 2020 due to the COVID-19 pandemic. Discussion Consumers have considerable choice in where they access health care for ACC-funded LBP services. This study shows the services they use most frequently and the cost to NZ for those services. These data can inform service planning for ACC-funded LBP health care in NZ.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"15 3","pages":"206-214"},"PeriodicalIF":1.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41128956","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: 1

Imaging incidence and type in primary care patients with low back pain: a cross-sectional study on new referrals to an Australian specialist spinal surgical centre. 腰痛初级保健患者的影像学发病率和类型：一项关于新转诊到澳大利亚脊柱外科专家中心的横断面研究。

IF 1.2

Journal of primary health care Pub Date : 2023-09-01 DOI: 10.1071/HC22127

Isaac J Tennant, Yun-Hom Yau, Derek Yull, Peter Murphy, Ian R Whittle

{"title":"Imaging incidence and type in primary care patients with low back pain: a cross-sectional study on new referrals to an Australian specialist spinal surgical centre.","authors":"Isaac J Tennant, Yun-Hom Yau, Derek Yull, Peter Murphy, Ian R Whittle","doi":"10.1071/HC22127","DOIUrl":"https://doi.org/10.1071/HC22127","url":null,"abstract":"Introduction Low back pain (LBP) is common and a significant cause of morbidity. Many patients receive inappropriate imaging for LBP in primary care. Aim To explore the incidence and type of spinal imaging conducted for LBP patients referred from general practice for specialist surgical opinion, and evaluate whether imaging conformed to clinical guidelines. Methods Audit of a sequential cohort (n = 100) of new LBP patients referred from primary care for specialist opinion at a suburban Australian capital city independent Spinal Centre. Results In the 6 months before referral, 90% (95% CI 83-95%) of patients underwent spinal imaging. Imaging was performed in 95% of those who did and 79% of those who did not meet guidelines for radiological investigation. 35% of patients were inappropriately imaged and 3% inappropriately not imaged. Spinal computed tomography (CT) imaging was used in 52% of patients, magnetic resonance imaging (MRI) in 42% and image-guided lumbar spinal interventional procedures in 28%. Discussion Most patients with LBP referred for surgical opinion have diagnostic radiological investigations whether or not it is indicated by clinical guidelines. The more frequent use of spinal CT compared to MRI may be due to idiosyncrasies of the Australian Medicare Benefits Schedule (MBS) rebate system. The findings of this pilot study provide support for the changes recommended by the 2016 MBS Review Taskforce on LBP that permit GP access to subsidised lumbar MRI, while constraining access to lumbar CT, and provide novel data about spinal imaging and practice in this cohort of patients.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"15 3","pages":"262-266"},"PeriodicalIF":1.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41128955","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: 1

Development and validation of PolyScan, an information technology triage tool for older adults with polypharmacy: a healthcare informatics study. PolyScan的开发和验证，这是一种用于老年人多药治疗的信息技术分诊工具：一项医疗信息学研究。

IF 1.2

Journal of primary health care Pub Date : 2023-09-01 DOI: 10.1071/HC23034

Lisheng Liu, Rashmi Alate, Jeff Harrison

{"title":"Development and validation of PolyScan, an information technology triage tool for older adults with polypharmacy: a healthcare informatics study.","authors":"Lisheng Liu, Rashmi Alate, Jeff Harrison","doi":"10.1071/HC23034","DOIUrl":"https://doi.org/10.1071/HC23034","url":null,"abstract":"Introduction Polypharmacy is associated with potentially inappropriate medicine prescribing and avoidable medicine-related harm. Polypharmacy should not be perceived as inherently harmful. Instead, priority should be placed on reducing inappropriate prescribing. Aim The study aimed to develop and validate PolyScan, a primary care information technology tool, to triage older adults with polypharmacy who are prescribed potentially inappropriate medicines. Methods Twenty-one indicators from a New Zealand criteria of potentially inappropriate medicines to correct for older adults with polypharmacy were developed into a set of implementable definitions. The definitions were applied as algorithmic logic statements used to interrogate hospital and emergency department records and pharmaceutical collection data to classify whether each indicator was present at an individual patient level, and then triage individuals based on the number of indicators met. Validity was evaluated by comparing PolyScan's accuracy against a manual review of healthcare records for 300 older adults. Results PolyScan was successfully implemented as a tool that can be used to identify potentially inappropriate prescribing in older adults with polypharmacy at different levels of aggregation. The tool has utility for individual practitioners delivering patient care, primary care organisations undertaking quality improvement programmes, and policymakers considering system-level interventions for medicines-related safety. During the validity assessment, PolyScan identified nine individuals (3%) with polypharmacy and indicators of potentially inappropriate medicine. Five unique indicators were detected. PolyScan achieved 100% sensitivity, specificity, and positive and negative predictive values. Discussion PolyScan can support clinicians, clinics, and policymakers with allocation of resources, rational medicine campaigns, and identifying individuals prescribed potentially inappropriate medicines for review.","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"15 3","pages":"215-223"},"PeriodicalIF":1.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41132545","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

Primary health care: walking backwards into the future? 初级保健：倒退走向未来？

IF 1.2

Journal of primary health care Pub Date : 2023-09-01 DOI: 10.1071/HC23113

Tim Stokes, Felicity Goodyear-Smith

引用次数: 0