Australian journal of primary health最新文献

{"title":"Lifestyle medicine integrated care models in primary care and factors that contribute to their effective implementation: a rapid scoping review.","authors":"Emma King, David Taniar, Sam Manger, Karen Carlisle","doi":"10.1071/PY25215","DOIUrl":"https://doi.org/10.1071/PY25215","url":null,"abstract":"<p><strong>Background: </strong>Globally, there has been a rise in chronic disease attributable to a change in lifestyle post-industrialisation. Lifestyle medicine has shown promise in preventing and managing these conditions, yet within the context of Australia it remains underutilised in general practice due to structural and systemic barriers. Lifestyle medicine focuses on behavioural interventions across modifiable lifestyle factors to prevent and treat noncommunicable disease. Additionally, it has been established that behavioural change is more likely when social and lifestyle needs are addressed as a whole system. This rapid scoping review evaluated implementation of lifestyle medicine in primary care and identified key enablers and barriers to inform its effective integration into the Australian primary healthcare system.</p><p><strong>Methods: </strong>Following an adapted Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for scoping reviews method for rapid scoping reviews, MEDLINE Ovid and CINAHL databases were searched for models of care utilising lifestyle medicine interventions in primary care. In total 28 studies were included for review.</p><p><strong>Results: </strong>Key enablers included embedding lifestyle medicine into standard care pathways, employing health coaches and social prescribers, offering group or digital interventions, and incorporating lifestyle medicine into medical education. Identified barriers included time constraints, fee-for-service funding models that discourage holistic care, limited practitioner training in health coaching, and poor integration with community services.</p><p><strong>Conclusions: </strong>Although lifestyle medicine holds significant promise, its success depends on integrated care models, team-based delivery, policy support, and further research using implementation science frameworks. We suggest using lifestyle medicine as a quality improvement framework to guide future system reform, practice innovation, and evidence generation in primary care in Australia.</p>","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":"32 2","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679319","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":"From referral to reality: utilisation of Medicare-funded allied health services among people with newly diagnosed diabetes.","authors":"Emma Cox, Joanne Gale, Pippy Walker, Gideon Meyerowitz-Katz, Evelyn B Parr, Stephen Colagiuri, Natasha Nassar, Alice A Gibson","doi":"10.1071/PY25240","DOIUrl":"https://doi.org/10.1071/PY25240","url":null,"abstract":"<p><strong>Background: </strong>To investigate how Medicare-funded chronic disease management services are utilised by people with newly diagnosed diabetes, and the patient characteristics associated with receiving multidisciplinary care.</p><p><strong>Methods: </strong>This prospective cohort study used baseline survey data from the 45 and Up Study, Australia, linked to administrative health records to identify individuals newly diagnosed with diabetes from 2011 to 2017. Medicare Benefits Schedule data were used to identify claims for general practitioner management plans (GPMPs), team care arrangements (TCAs) and allied health services within 24-months of diagnosis (follow up to 31 December 2019). Multivariable logistic regression models were used to identify patient characteristics associated with receiving multidisciplinary care.</p><p><strong>Results: </strong>Of 12,694 newly diagnosed diabetes cases, two-thirds (67.9%) received a GPMP, 61.0% received a GPMP and TCA, and 45.8% claimed for at least one allied health service within two years of diagnosis. Allied health service use was highest for podiatrists (26.3% with ≥1 claim) and lowest for diabetes educators (6.0%). Women, individuals aged ≥75 years, English-speakers, and those with obesity had higher odds of receiving a GPMP and progressing along the chronic disease management care pathway to allied health service use. In contrast, individuals from remote areas had lower odds of accessing allied health services (aOR 0.29, 95% CI: 0.20-0.43).</p><p><strong>Conclusions: </strong>The findings of this study reveal substantial underutilisation of Medicare-funded chronic disease management services, in particular allied health services, during the crucial period following diagnosis. Targeted strategies are needed to improve initiation of care planning by GPs, and to ensure equitable access to government-funded allied health services.</p>","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":"32 2","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640984","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 the experiences of young adults with the Australian healthcare system.","authors":"Katharine Keller, Barbara J Mintzes, Eliza J McEwin","doi":"10.1071/PY25046","DOIUrl":"10.1071/PY25046","url":null,"abstract":"<p><strong>Background: </strong>Young adults (18-25 years) are struggling with the transition to becoming autonomous users of healthcare services. Although barriers to healthcare accessibility for young adults, such as service cost and difficulty navigating the healthcare system, have been identified, the interactions and relationships between these barriers have not been explored in depth.</p><p><strong>Methods: </strong>A narrative literature review was conducted to determine the foundational knowledge and communication skills needed by young adults to effectively interact with the healthcare system. Semi-structured interviews were conducted with young adults from New South Wales and the Australian Capital Territory Australia to explore their experiences of healthcare and barriers to their care, and the potential for education based on the identified necessary knowledge and skills to improve their experiences.</p><p><strong>Results: </strong>Inductive thematic analysis of 11 interviews showed young adults' experiences of barriers across policy, institutional, community, interpersonal, and individual levels. These factors contributed to suboptimal healthcare experiences and impeded participants' ability to effectively communicate with healthcare providers, leading to eroding trust between providers and young adult patients. All participants supported the subsequent recommendations of education priorities for young adults, expecting increased confidence and ability to self-advocate if provided teaching based on the suggested content.</p><p><strong>Conclusions: </strong>This paper highlights specific targets and directions for future health policy and health education initiatives to improve the healthcare experiences of young adults.</p>","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727723","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":"Exploring Australian community pharmacists' perspectives, practices and use of emergency hormonal contraception guidelines: a qualitative study using the Theoretical Domains Framework.","authors":"Ruth A Nona, Robin A Ray, Selina M Taylor, Beverley D Glass","doi":"10.1071/PY25181","DOIUrl":"https://doi.org/10.1071/PY25181","url":null,"abstract":"<p><strong>Background: </strong>Emergency hormonal contraceptive pills (ECP), a safe and effective way to reduce the risk of unwanted pregnancy, are available without a prescription in community pharmacies in Australia, and >90 countries globally. Supply is informed by practice guidelines for pharmacists in several countries; however, use remains limited. This study aimed to explore the perspectives and practices of community pharmacists in Australia when providing ECP, to identify challenges and facilitators encountered when using ECP practice guidelines.</p><p><strong>Methods: </strong>Semi-structured interviews were undertaken with purposively sampled Australian community pharmacists who actively supplied ECP, from across a diversity of locations and years of practice. Interview questions were informed by the Theoretical Domains Framework. The interviews were audio-recorded, transcribed verbatim, thematically analysed inductively, then deductively mapped against the Theoretical Domains Framework and double coded.</p><p><strong>Results: </strong>Seventeen interviews were conducted. The four overarching themes - decision-making in ECP provision, geographic variation in practice, guideline use, and knowledge gaps and training needs - could be mapped against seven of the 10 relevant Theoretical Domains Framework domains. A lack of confidence and up-to-date knowledge among pharmacists was a challenge to optimal provision of ECP. Practice guidelines were acknowledged to contain valuable information, but were difficult to interpret, and use was limited.</p><p><strong>Conclusions: </strong>Australian pharmacists' perspective of their practice in providing ECP has highlighted the challenges and facilitators to the use of the ECP practice guidelines. Guidelines were seen as inaccessible, ambiguous and impractical, indicating the need for future research to optimise their use. Findings can inform targeted interventions to enhance ECP guideline uptake and improve patient outcomes.</p>","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":"32 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115245","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":"Understanding how culture shapes Chinese patients' mental health decision-making in Australian general practice.","authors":"Jia Shing See, Catherine Kaylor-Hughes, Caroline Johnson, Amy Coe","doi":"10.1071/PY25189","DOIUrl":"10.1071/PY25189","url":null,"abstract":"<p><strong>Background: </strong>Individuals of Chinese cultural background make up the second largest group within Australia's culturally and linguistically diverse population. However, there is limited understanding of the use of mental healthcare services in general practice by the Chinese community, particularly when considering the influence of cultural nuances. This study aimed to investigate how cultural factors shape the experiences of Chinese individuals in accessing mental health support through general practice.</p><p><strong>Methods: </strong>One-on-one semi-structured interviews were conducted with 12 Chinese participants who had consulted a general practitioner for mental health care in Australia.</p><p><strong>Results: </strong>Thematic analysis captured five themes: (1) attitudes or beliefs about mental ill-health, (2) barriers to seeking mental health care, (3) facilitators to seeking mental health care, (4) preferences in GP selection, and (5) experience in mental health recovery. These also encapsulated participant perceptions of GPs' roles in mental health care and patients' treatment preferences.</p><p><strong>Conclusions: </strong>This study suggests that cultural stigma surrounding mental illness is a potential cause of underdiagnosis and underutilisation of mental health services among Chinese individuals in Australia. Practical barriers, such as costs, perceived care effectiveness and GP availabilities, further complicate care usage. Nonetheless, self-motivation and support from family and friends encourage positive help-seeking behaviours. Overall, the evolving beliefs about mental illnesses emphasise the need for strengthened communication and trust between GPs and Chinese patients to enhance prioritisation of GPs' role in mental health care. Future investigations into the adequacy of current cultural competency trainings for GPs are needed.</p>","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919206","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":"Corrigendum to: Improving the experiences of young adults with the Australian healthcare system.","authors":"Katharine Keller, Barbara J Mintzes, Eliza J McEwin","doi":"10.1071/PY25046_CO","DOIUrl":"https://doi.org/10.1071/PY25046_CO","url":null,"abstract":"","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":"32 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146115257","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":"A multidisciplinary case conference model to conservatively manage hip and knee osteoarthritis: a pre-pilot feasibility and proof-of-concept study.","authors":"Timothy D Miller, Andrew D Bonney, Judy R Mullan, Christine Metusela, Deirdre E McGhee","doi":"10.1071/PY25207","DOIUrl":"10.1071/PY25207","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis (OA) is a prevalent, debilitating and costly chronic condition. National and international guidelines recommend the conservative treatment strategies of body mass reduction and exercise for the management of hip and knee OA because of the strong evidence to support the efficacy of these interventions. Despite this, these conservative management strategies are currently underutilised in Australia. Appropriately designed, novel models of care may play a role in improving the utilisation of appropriate conservative treatment strategies for hip and knee OA. Therefore, a qualitative study was conducted to investigate patient and clinician perspectives of a novel multidisciplinary case conference model to conservatively manage hip and knee OA within a primary care setting.</p><p><strong>Methods: </strong>Qualitative data were collected via telephone-based semi-structured one-on-one interviews with patients with OA (n = 11), general practitioners (n = 2), accredited exercise physiologists (n = 2), accredited practising dietitians (n = 2) and practice nurses (n = 2).</p><p><strong>Results: </strong>Thematic content analysis led to the generation of four major themes from the data: (i) potential benefits; (ii) foreseeable challenges; (iii) the benefit-engagement cycle and (iv) maintenance of lifestyle changes.</p><p><strong>Conclusion: </strong>The proposed multidisciplinary model of care to conservatively manage hip and knee OA was perceived by both patients and clinicians to have many benefits and a limited number of manageable challenges. The identified challenges provide guidance on how the model should be refined before it is implemented in clinical practice.</p>","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710481","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":"Implementation of a clinical trial patient recruitment tool and process in Australian general practice: A qualitative perspective.","authors":"Ruby Biezen, Kaleswari Somasundaram, Barbara Hunter, Lena Sanci, Jon Emery, Dougie Boyle, Craig Nelson, Jo-Anne Manski-Nankervis","doi":"10.1071/PY23232","DOIUrl":"https://doi.org/10.1071/PY23232","url":null,"abstract":"<p><strong>Background: </strong>Recruiting participants for clinical trials poses significant challenges, which can result in escalating costs, delay, and possible abandonment of the trial. Torch Recruit is a software tool that is developed to streamline recruitment process by identifying general practice patients who meet the recruitment criteria specific to a clinical trial by interrogating the patient electronic medical record (EMR) database, thereby optimizing trial recruitment. The aim of the study was to explore the use, acceptability and feasibility of Torch Recruit to support patient recruitment in Australian general practice.</p><p><strong>Methods: </strong>Twenty-three semi-structured interviews were completed with four practice staff, nine research staff and ten patients. between January to September 2023, to explore the use of Torch Recruit to recruit and manage patients in clinical trials. Data were thematically analysed and interpreted using the updated Consolidated Framework of Implementation Research.</p><p><strong>Results: </strong>Both practice and research staff expressed that Torch Recruit was a well-designed, intuitive tool, enabling accurate and automatic identification of eligible patients for clinical trials. Identifying eligible patients using trial inclusion and exclusion reduced time spent on otherwise traditional methods such as identifying patients through practice electronic medical records or through waiting room recruitment. Patient privacy was mentioned as a possible concern for participants. However, having patient related data stored within the practice, limiting patient information access, as well as having practice and research staff trained in patient recruitment using Torch Recruit, alleviated most concerns. Patients' trust in their GPs and their general practice were seen as a facilitator in patient trial recruitment.</p><p><strong>Conclusions: </strong>Patient recruitment into any clinical trial is often difficult. This study demonstrated that using an innovative tool such as Torch Recruit provides accurate identification of eligible participants, can streamline a time-consuming process that aligns with practice workflow.</p>","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145746273","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":"Corrigendum to: 'I'm sick of being called insane': experiences of Australian healthcare support for premenstrual distress.","authors":"Megan E Buys","doi":"10.1071/PY25133_CO","DOIUrl":"https://doi.org/10.1071/PY25133_CO","url":null,"abstract":"","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":"31 5","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357201","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":"Social movements and the Whitlam-initiated community health movement in Australia.","authors":"Fran Baum, Connie Musolino, Toby Freeman, Denise Fry, Paul Laris, Virginia Lewis, David Legge, Jenny Macmillan, Tony McBride","doi":"10.1071/PY24167","DOIUrl":"https://doi.org/10.1071/PY24167","url":null,"abstract":"<p><strong>Background: </strong>This paper examines the social movements that influenced the development and implementation of the original Whitlam Government Community Health Program, the community health movement that emerged, and the opportunities it created for people to develop and deliver health programs in new ways.</p><p><strong>Methods: </strong>Oral history interviews with 93 people involved in community health in South Australia, Victoria and New South Wales, and 212 community health policy and archival documents were collected as a part of an Australian Research Council study documenting the history of community health services in Australia since the 1970s.</p><p><strong>Results: </strong>Ideas about community health in Australia were influenced by several social movements that had overlapping, but distinctive, contributions: (1) left-wing movements: political parties, workers' health; trade unions, anti-war and anti-establishment; (2) international social medicine and community-oriented primary care; (3) Indigenous rights/Black Power; (4) feminist; and (5) community development/community power. These movements influenced Australian community health to embrace community management, advocacy and community development strategies in addition to multi-disciplinary care. However, these progressive elements were undermined by neo-liberal management reforms and medical opposition to elements of the Community Health Program.</p><p><strong>Conclusions: </strong>The early passion for community health in the 1970s and 1980s was fuelled by social movements, but the inconsistent support from the federal and most state governments limited progressive and innovative community health practice. The window of opportunity for the Community Health Program was supported by progressive social movements, but restricted from the 1990s onwards.</p>","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":"31 5","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357204","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}