Australian journal of primary health最新文献

{"title":"Factors influencing uptake and sustained utility of HealthPathways in Australian general practice: a qualitative study.","authors":"Susan Saldanha, Riki Lane, Sharon Clifford, Prisha Dadoo, Chris Barton, Grant Russell","doi":"10.1071/PY24142","DOIUrl":"10.1071/PY24142","url":null,"abstract":"<p><p>Background Formalised clinical pathways have become popular approaches to translate evidence into clinical recommendations, tailored for the local healthcare setting. In recent years, the HealthPathways platform has been used to implement a range of clinical and referral pathways in New Zealand and Australia. Despite widespread adoption, little is known of factors influencing the sustained use of HealthPathways in Australian general practice. Methods This qualitative study, conducted in three Melbourne Primary Health Network catchments, applied normalisation process theory to explore HealthPathways implementation. We conducted semi-structured interviews with 43 participants, including general practitioners (GPs), practice nurses, practice managers, Primary Health Network staff and key regional informants. Analysis combined inductive and deductive approaches. Results The findings suggest that although HealthPathways holds promise for enhancing clinical practice, its adoption and impact are currently limited due to low awareness and varied integration across Primary Health Network catchments. Recent medical graduates found it useful for helping patients access appropriate care. Adoption was influenced by peer recommendations and time constraints, although established GPs resisted change. Targeted education, effective promotion and improved monitoring systems were identified as crucial to facilitate wider and more effective use of HealthPathways, ultimately contributing to better patient care and streamlined clinical processes. Conclusion Although HealthPathways' relative normalisation is evident, challenges in integration persist, requiring targeted strategies. Comprehensive promotion to GPs, standardisation across Australia and enhancing technical interoperability between digital interfaces is essential. Strong partnerships and feedback mechanisms can optimise HealthPathways' impact on patient care, supporting the objectives of the Australian National Primary Health Care 10-year plan.</p>","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":"31 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733586","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":"Mental health consumers and primary care providers co-designing improvements and innovations: a scoping review.","authors":"Kathryn Thorburn, Bani Aadam, Shifra Waks, Brett Bellingham, Mark F Harris, Karen R Fisher, Catherine Spooner","doi":"10.1071/PY24104","DOIUrl":"10.1071/PY24104","url":null,"abstract":"<p><p>Co-design and co-production are increasingly used to improve and innovate healthcare practices and services to better address people's healthcare needs. Mental health consumers, especially people diagnosed with serious mental illness, experience considerable health disparities and barriers to primary care, while primary care providers experience barriers to addressing the healthcare needs of people diagnosed with serious mental illness. Both mental health consumers and primary care providers bring knowledge and expertise to improving mental health consumers' health care. This scoping review of the peer-reviewed and grey literature was undertaken to determine the extent and scope of co-design and co-production involving mental health consumers and primary care providers to address mental health consumers' healthcare needs. The review also sought to determine factors that enable or limit co-design and co-production involving mental health consumers and primary care providers. Twelve studies and reports of co-design and co-production involving mental health consumers and primary care providers were identified by the review. These studies showed that co-design and co-production were feasible and beneficial, and that there was significant scope for collaboration at the intersection of mental health and primary care services. Lessons learned from projects that have led the way include the need for (1) co-design/co-production practices that sustain equitable participation and address inevitable power imbalances when service users and service providers work together, (2) sufficient reporting on methods to ascertain claims of co-design/co-production and allow replication of these methods in similar healthcare improvement projects, and (3) co-design/co-production projects to be supported by other systems change strategies.</p>","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":"31 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574912","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 dementia service gaps and barriers in the Australian Capital Territory: a qualitative study.","authors":"Nathan M D'Cunha, Georgina Chelberg, Ian Huang, Hossein Tabatabaei-Jafari, Nasser Bagheri, Kasia Bail, Diane Gibson, Stephen Isbel, Lara Wiseman, Poulomi Chowdhury, Mary Anne Furst, Perminder S Sachdev, Luis Salvador-Carulla","doi":"10.1071/PY24174","DOIUrl":"10.1071/PY24174","url":null,"abstract":"<p><p>Background In recent years, there has been increased recognition of the importance of unmet needs of services for people with dementia regionally and nationally. This study aimed to explore the service gaps described by health and aged care providers in the Australian Capital Territory (ACT) to inform decisions regarding dementia care services. Methods Semi-structured interviews were conducted with 29 health and aged care service providers, managers, and stakeholders providing dementia services in the ACT in 2022 and 2023. Responses to two open-ended questions regarding the perception of service gaps in the region were examined using content analysis. Results Six themes were identified across the interviews: (1) concerns with existing dementia care services; (2) concerns with primary care; (3) a lack of dementia-appropriate services; (4) workforce shortages and limited training; (5) funding as a barrier to access and collaboration between services; and (6) lack of understanding of dementia. Several participants felt these issues were not unique to the ACT and indicative of systemic issues common across Australia. Conclusions The service gaps described in the ACT region indicate a need for improved access to high-quality, coordinated, dementia-specific services with appropriate staffing, potentially reducing pressure on the ACT health system and current and future associated costs.</p>","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":"31 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607483","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":"The role of general practitioners in the follow-up of positive results from the Australian National Bowel Cancer Screening Program - a scoping review.","authors":"Jane Gaspar, Caroline Bulsara, Diane Arnold-Reed, Karen Taylor, Anne Williams","doi":"10.1071/PY24090","DOIUrl":"10.1071/PY24090","url":null,"abstract":"<p><p>Background There are several studies investigating the effectiveness and participation rates of the Australian National Bowel Cancer Screening Program (NBCSP), but there is limited literature pertaining to the role and processes that general practitioners (GPs) follow after a positive immunochemical faecal occult blood test (iFOBT) result. The aim of this paper is to review evidence examining GP involvement in the follow-up of positive iFOBT results from the NBCSP and identify knowledge gaps. Methods A scoping review was undertaken involving the search of the Cochrane Library, Informit, PubMed and Scopus electronic databases. Inclusion criteria were the follow-up processes and practices by GPs subsequent to notification of a positive iFOBT from this program. Searches were limited to English and publication was from January 2006 to January 2024. A combination of keywords was used and adapted to each search engines' requirements: general practitioner AND bowel cancer AND screening AND Australia. Results Relevant sources of evidence were reviewed, and 24 records met inclusion criteria. Results are represented across three themes: (i) screening process and GP follow-up; (ii) follow-up rates and facilitation; and (iii) recommendations for improved follow-up. Conclusion This scoping review provides insight into the central role GPs play in the implementation of the NBCSP and highlights the lack of information regarding steps taken and systems employed in general practice to manage positive iFOBTs.</p>","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":"31 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560305","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":"Community health in Victoria: a history of challenges, adaptations and potential.","authors":"Virginia Lewis, Jennifer Macmillan, T McBride, David Legge","doi":"10.1071/PY24194","DOIUrl":"10.1071/PY24194","url":null,"abstract":"<p><p>Background The Whitlam Labor government established the Community Health Program (CHP) in Australia in 1973 to improve access to health and related welfare services nationally. States reacted differently to the program. Designated Australian Government funding for the program ended in 1981. In spite of fluctuating state government support and changing legislative frameworks over time, Victoria is the only state that continues to operate a generic community health centre (CHC) program reflecting the original CHP. Methods Data were collected from policy documents and archival material, as well as interviews with 29 key stake holders from Victoria. Transcripts from the interviews were reviewed by the interviewees and permission given to include identifiable quotes. The research is part of a larger Australian Research Council project looking at the history of community health in Australia. Results In Victoria the CHP broke new ground in several respects including creating a public primary health care (PHC) sector, promoting equitable access to PHC, introducing salaried GPs, creating multidisciplinary PHC teams, valuing community involvement (in planning, accountability, health promotion) and taking action on the social determinants of health. Key stakeholders described the challenges that the sector has faced in the decades from 1973 to the current day. The basis for the sector's survival ultimately rests with how it was initially established and the cultural environment in which it developed and continues to operate. In addition to the (albeit irregular) geographically wide distribution of CHCs, their high level of public recognition and sense of community ownership were seen as critical factors that aided their survival and worked against their closure or absorption into hospital networks. Conclusions Based on a synthesis of our findings and personal experiences, we propose five new directions for policy, management and practice that could support this model to have a greater contribution to the health system in Australia.</p>","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":"31 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660022","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":"Perceptions and willingness concerning the collection of sexual orientation and gender identity data in Australian healthcare services.","authors":"Daniel Demant, Paul Byron, Deborah Debono, Suneel Jethani, Beth Goldblatt, Michael Thomson, Jo River River","doi":"10.1071/PY24178","DOIUrl":"10.1071/PY24178","url":null,"abstract":"<p><p>Background Despite growing recognition of the importance of collecting sexual orientation and gender identity (SOGI) data to improve healthcare access and equity for LGBTQA+ populations, uncertainty remains around how these data are collected, their perceived importance and individuals' willingness to disclose such information in healthcare settings. The aim of this study was to understand perceptions of the collection of data on sexual orientation and gender identity in healthcare settings across Australia, and individuals' willingness to provide this data. Methods A cross-sectional online survey of 657 Australian residents was conducted to assess participants' attitudes towards SOGI data in healthcare settings, along with preferences for methods to collect these data. Statistical analyses included ANCOVA, Chi-squared tests and Wilcoxon signed-rank tests. Results Participants generally recognised the importance of the collection of basic demographic data to support the provision of health services. Willingness to share SOGI data varied, with significant differences noted across gender, sexual orientation and cultural backgrounds. LGBTQA+ participants expressed greater willingness to provide SOGI data, but only in contextually appropriate situations, and preferred more inclusive data collection methods. Conclusions The study shows a context-dependent willingness to provide SOGI data in health care, underscoring the need for sensitive data collection methods. Insights into SOGI data collection attitudes are vital for developing inclusive and respectful healthcare practices. Improved SOGI data collection can enrich healthcare outcomes for diverse groups, informing public health policies and practices tailored to LGBTQA+ needs.</p>","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":"31 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625878","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":"Health promotion activities in Ontario Community Health Centres: a descriptive report.","authors":"Sara Bhatti, Jennifer Rayner","doi":"10.1071/PY25009","DOIUrl":"10.1071/PY25009","url":null,"abstract":"<p><p>Background Community Health Centres (CHCs) in Ontario, Canada have been delivering health promotion programming as part of their model of comprehensive primary health care to communities for decades. The purpose of this paper is to describe how health promotion programming is delivered within the context of Ontario CHCs. Methods This report used both quantitative and qualitative methods. Electronic medical record data were used to describe the variety of health promotion programming offered, as well as target populations, funding sources, and evaluation. Six focus groups were conducted with 72 health promotion staff and managers across 42 CHCs between February and March of 2023 to provide greater context on how health promotion is delivered. Results In 2021-2022, 2452 programs were reported amongst 69 CHCs, with the top three priorities for programming being social support, food security and education, and physical activity. The most prevalent target populations reported were the general community (24%) and children and youth (15%). Focus group data revealed that priorities are identified through a variety of approaches to ensure programs are relevant, address the needs of their communities, and promote health equity. Programs provided by CHCs leverage community volunteers to support program development and delivery, reduce barriers to participating, and link participants to other programs and services offered by the CHC. Conclusion Health promotion as an upstream approach can relieve pressure on the healthcare system, reduce disease prevalence and health inequities all while being cost-effective. Greater investments in health promotion are needed if we want to support and sustain our healthcare systems.</p>","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":"31 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733599","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":"Investigating men's perspectives on preventive health care within general practice: a qualitative study.","authors":"Ruth Mursa, Gemma McErlean, Christopher Patterson, Elizabeth Halcomb","doi":"10.1071/PY24151","DOIUrl":"10.1071/PY24151","url":null,"abstract":"<p><p>Background Chronic conditions are a major health concern. Most Australian men are overweight or obese and half live with at least one chronic health condition. Many chronic conditions are preventable and treatable by reducing lifestyle risk factors. General practice delivers a range of services, including preventive health care; however, men have been noted to have low engagement with general practice. This study aimed to investigate men's perspectives on preventive health care within general practice. Methods Seventeen semi-structured interviews were conducted with a purposive sample of Australian men recruited from the NSW Rural Fire Service following an initial survey. Interviews sought to explore men's perspectives on engagement in preventive health care within general practice. Data were thematically analysed. Results Two sub-themes were identified relating to men's engagement in preventive health care within general practice. 'The scope of general practice services' highlighted diverse understandings among men's perceptions of the role and value of preventive health care. Whereas 'addressing lifestyle risk factors' revealed the nature of communication and advice provided within general practice concerning lifestyle risks and behavioural change. The findings indicated that when advice is provided, men want tangible and meaningful healthcare strategies that support them in making behavioural changes. Conclusions General practice clinicians need to prioritise preventive health care. Proactively addressing preventive health care with men and supporting them to make informed decisions about their lifestyle choices has the potential to enhance their health and reduce chronic health conditions.</p>","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":"31 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470131","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":"Oral COVID-19 antiviral prescribing in Australian general practice - a retrospective observational study.","authors":"Judith Thomas, Abbish Kamalakkannan, Mirela Prgomet, Karina Gardner, Precious McGuire, Geoffrey Campbell, Andrew Georgiou","doi":"10.1071/PY24170","DOIUrl":"10.1071/PY24170","url":null,"abstract":"<p><p>Background This study aimed to gain a comprehensive understanding of oral COVID-19 antiviral prescribing in Australian general practice. Methods The study was a retrospective observational cohort study. Routinely collected, de-identified, Australian general practice consultation and prescription data was used with permission from participating primary health networks, from 938 general practices between March 2022 and September 2023. Study cohorts were patients aged ≥15 encompassing (i) an 'antiviral cohort' comprising patient records with ≥1 oral COVID-19 antiviral prescription/s and (ii) a 'comparison cohort' of remaining records. Primary outcome measures were the frequency and type of oral COVID-19 antivirals prescribed, and sociodemographic and health characteristics of patients prescribed antivirals. Secondary measures were the frequency of antiviral repeat prescribing and consultation modality. Results Within the study population of 3,813,051 patients, oral COVID-19 antivirals were prescribed to 3.39% (129,267) of patients including 14.79% (82,215/555,757) of patients aged ≥70years. Molnupiravir prescribing exceeded nirmatrelvir-ritonavir across all study months. Proportionally, antiviral prescribing was higher in the female population (74,709/2,059,676: 3.63%), Victoria (81,184/2,222,837: 3.65%), residing in high socioeconomic advantage areas (87,530/2,224,501: 3.93%), and ages 80-84 years (16,419/100,911: 16.27%). Of patients prescribed COVID-19 antivirals, 7.27% (9402/129,267) had repeat prescribing. Cardiovascular and musculoskeletal conditions were the most prevalent chronic diagnoses, and telehealth (58,660/107,727: 54.45%) exceeded face-to-face consultations. Conclusions Oral COVID-19 antiviral prescribing volumes in general practice may serve as an indicator of periods of increased transmission of COVID-19, through increases in prescribing activity. Telehealth exceeding face-to-face for oral COVID-19 antiviral prescribing supports continued access to telehealth to reduce exposure to COVID-19 and provide time-critical access to treatment.</p>","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":"31 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401068","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":"Senior staff experiences of implementing a reablement model in community care.","authors":"Sarah J Prior, Hazel Maxwell, Marguerite Bramble, Annette Marlow, Douglass Doherty, Steven Campbell","doi":"10.1071/PY23214","DOIUrl":"10.1071/PY23214","url":null,"abstract":"<p><p>Background In 2018, a community care organisation in Northwest Tasmania collaborated with University of Tasmania researchers to develop and implement a strategy for incorporating a reablement-based model of care into their service delivery model as a core organisational approach to care. This study aimed to investigate the long-term outcomes from the initial reablement education to improve our understanding of the needs of staff and clients of community care organisations. Methods The research explored the impact of reablement on client outcomes and how reablement can be translated across organisations. A qualitative research method was utilised to explore experiences of senior staff 2years after the first reablement education sessions. Two focus groups were held 4weeks apart. Nine senior staff participated in focus group one and seven in focus group two. Results Three key themes emerged; reablement needs an appropriate governance and organisational strategy; reablement is a beneficial practice; and strong organisational culture supports reablement. Achieving long-term outcomes involves integrating reablement into working practices and this remains challenging due to organisational constraints. Conclusions This study contributes to the growing body of evidence that shifting underlying practices in community care from 'doing for' to 'doing with' involves a major change of behaviour and practice for individuals and organisations.</p>","PeriodicalId":93892,"journal":{"name":"Australian journal of primary health","volume":"31 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143417114","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}