HC24044 Full Text | HC24044PDF (655 KB) Open Access Article
Current Issue
Journal of Primary Health Care
Volume 16 Number 1 2024
HC23044Utilisation of in-consultation supervisor assistance in general practice training and personal cost to trainees: a cross-sectional study
What is already known: Within the ‘apprenticeship-like’ model of general practice training operating in many countries, the trainee’s in-consultation recourse to real-time supervisor assistance or advice is considered to be essential for both patient safety and trainee learning. Some trainees, however, may feel uncomfortable presenting their concerns or questions to the supervisor in the patient’s presence and/or believe that patient impressions of their competence will be adversely affected by calling on supervisory assistance. What this study adds: Contrary to predictions of utility-based models of behaviour, we found no association of trainees’ documented in-consultation help-seeking with either (i) their beliefs about the impact of help-seeking on patient impressions of their competence, or (ii) their levels of comfort/discomfort presenting within the patients’ hearing.
HC23044 Abstract | HC23044 Full Text | HC23044PDF (721 KB) | HC23044Supplementary Material (1.2 MB) Open Access Article
HC22158Perceptions of the effectiveness of using patient encounter data as an education and reflection tool in general practice training
What is already known: In-practice learning is central to GP registrars developing competencies within the apprenticeship-style model of GP training. Feedback followed by reflection is important for GP registrars’ in-practice learning. Patient encounter tools can provide clear in-practice feedback to registrars, yet little published evidence is available to support the use of such tools within general practice training. What this study adds: This study demonstrates that patient encounter tools, such as ReCEnT, can be useful for registrars’ self-reflection on their clinical practice and can lead to changes in practice and learning approaches. The relative lack of engagement between numerous registrars and their supervisors or MEs on ReCEnT feedback reports indicates a missed opportunity for supported reflection and suggests more work is needed on effective engagement for ReCEnT to be used as an assessment for learning in general practice training.
HC22158 Abstract | HC22158 Full Text | HC22158PDF (798 KB) | HC22158Supplementary Material (284 KB) Open Access Article
What is already known: There is a recognised shortage of dermatologists in New Zealand, thus innovative strategies are required to improve access to specialist care. Collaborative services between specialists and general practitioners already exist, but have not been widely utilised in the field of dermatology. What this study adds: This collaborative dermatologist and general practitioner clinic model is the only one of its kind in New Zealand. It acts as an effective triage service, as the majority of presenting patients do not require further referral to secondary care.
HC23122 Abstract | HC23122 Full Text | HC23122PDF (769 KB) Open Access Article
What is already known: Limited evidence suggests there are barriers to accessing psychostimulants for those with ADHD. This leaves many without the option to access and use the most effective medications. What this study adds: This research indicates that the use of psychostimulants is low. Although some fraction of the treatment gap might be explainable by other reasons, barriers to access remains significant.
HC23126 Abstract | HC23126 Full Text | HC23126PDF (719 KB) Open Access Article
What is known about the topic: There has been a general expectation internationally that GPs are to play a central role in the collection of family health history as part of precision medicine. However, for more than 20 years it has remained widely reported as being both poorly and infrequently undertaken. What this study adds: Family health history information was used to varying degrees – risk ascertainment, patient engagement with a diagnosis, social context and building relationships. Perceived low quality (unreliability) of family health history information and accessibility issues are potential indicators of current limits of family health history, especially as a part of precision medicine. An opportunity exists to establish specific roles to enable socio-culturally appropriate collection, storage and use of family health history information.
HC23055 Abstract | HC23055 Full Text | HC23055PDF (739 KB) | HC23055Supplementary Material (1.4 MB) Open Access Article
HC23082Exploring how a patient encounter tracking and learning tool is used within general practice training: a qualitative study
What is already known: In Australia’s apprenticeship-style model of GP training, in-practice learning and experience for GP registrars is central to the development of their confidence and clinical competencies. The Registrar Clinical Encounters in Training (ReCEnT) project is a patient encounter tracking and learning tool (PETAL) that has been shown to provide opportunities for GP registrars along with their supervisors and medical educators (MEs) to reflect on registrars’ clinical practice and identify their learning needs, leading to change in practice. There is limited qualitative literature on how registrars, supervisors and MEs describe the utility of workplace-based assessment tools such as PETALs, particularly within proposed programmatic assessment frameworks. What this study adds: This study builds on previous survey findings, providing greater depth of understanding from the perspective of GP registrars, supervisors and MEs regarding how ReCEnT can be useful as an educational and reflective PETAL tool for GP registrars during their training. Meaningful engagement between GP registrars and their supervisors and MEs enables ReCEnT to be more effective as a tool for learning in general practice training. More work needs to be done on how PETALs, such as ReCEnT, best fit within a programmatic assessment framework for general practice training.
HC23082 Abstract | HC23082 Full Text | HC23082PDF (814 KB) | HC23082Supplementary Material (441 KB) Open Access Article
What is already known: Diabetes-related foot problems affect around one-third of people with diabetes in New Zealand. Early identification of the at-risk patient is crucial in the prevention of diabetic foot ulcers. Annual diabetes reviews (ADRs) delivered by general practice teams that include a comprehensive foot evaluation and risk categorisation are recommended by local and international guidelines.
What this study adds: People with type 2 diabetes identified important barriers to attending ADRs several of which are amenable to change. Participants provided suggestions on how to improve the delivery of the ADR in primary care, including the utilisation of Māori tailored models of care such as the Te Whare Tapa Whā model and Māori support workers.
HC23081 Abstract | HC23081 Full Text | HC23081PDF (750 KB) | HC23081Supplementary Material (1 MB) Open Access Article
HC23141Are patients with type 2 diabetes in the Waikato District provided with adequate education and support in primary care to self-manage their condition? A qualitative study
What is already known?: Diagnosis of type 2 diabetes is a challenging time, where healthcare professionals must consider health literacy, previous medical history, whānau, finances, and psychosocial factors. Current research states the treatment in primary care is suboptimal, compounded by clinical inertia, and that appointment times of 15 min are typically not long enough for sufficient diagnosis and treatment. What this study adds: The current system of educating and supporting patients in primary care is viewed by patients as unsuitable in terms of appointment times, education, and communication. Graphic, conversational, or imagery-based education methods are preferred to pamphlets, and written sources of information that are tailored to the individual are needed, and must reflect cultural context. More support is required in terms of healthcare practitioners’ relationships and culturally safe and compassionate patient care.
HC23141 Abstract | HC23141 Full Text | HC23141PDF (902 KB) Open Access Article
HC23012Determinants of cancer screenings participation in Queensland: a scoping review
What is already known: Cancer screening programs (cervical, breast, and bowel) participation is generally low, especially in regional and rural areas in Queensland, Australia. What this study adds: This scoping review provides a suggested approach to understanding the known determinants of cancer screening participation to help influence the uptake among target populations.
HC23012 Abstract | HC23012 Full Text | HC23012PDF (985 KB) Open Access Article
What is known about the topic: This rapid review offers an evidence‐based synthesis of the existing literature concerning the evolving role of nurse prescribers. What this study adds: It provides valuable insights for the primary care interprofessional team, underscoring the potential of nurse prescribing as a solution to enhance diabetes care.
HC23121 Abstract | HC23121 Full Text | HC23121PDF (992 KB) Open Access Article
What is already known: Keratinocytic cancers are increasing worldwide. Teledermatology is a valuable tool for communication between general practitioners, dermatologists, and plastic surgeons. What this study adds: It describes the teledermatology diagnosis of 358 suspected keratinocytic cancers after e-referral, and pathways to excision by general practitioners, dermatologists, and plastic surgeons.
HC23098 Abstract | HC23098 Full Text | HC23098PDF (805 KB) | HC23098Supplementary Material (283 KB) Open Access Article
HC23118De-prescribing in primary care: the clinical, ethical and psychological considerations
HC23118 Full Text | HC23118PDF (663 KB) Open Access Article
HC23114 Full Text | HC23114PDF (641 KB) Open Access Article
HC24011New Zealand’s slow uptake of carbohydrate-reduction in type 2 diabetes management
HC24011 Full Text | HC24011PDF (638 KB) Open Access Article
HC24042 Full Text | HC24042PDF (630 KB) Open Access Article
HC24035Primary care clinicians should proactively take up latest AI-based technology: Yes
HC24035 Full Text | HC24035PDF (646 KB) Open Access Article
HC24033Primary care clinicians should proactively take up latest AI-based technology: No
HC24033 Full Text | HC24033PDF (626 KB) Open Access Article
HC24043 Full Text | HC24043PDF (627 KB) Open Access Article
HC23172 Full Text | HC23172PDF (716 KB) Open Access Article
Online Early
The peer-reviewed and edited version of record published online before inclusion in an issue
HC23142A community of practice intervention to increase education-focused mental health promotion actions among interdisciplinary professionals: a qualitative study
What is known about the topic: Mental health challenges pose a significant public health risk. There is a need to build workforce capacity to address the mental health needs of children and youth in order to promote positive outcomes in later life. What this study adds: All sectors must take responsibility for promoting mental health in children and youth. This participatory action research study presents communities of practice as providing a sustainable mechanism by which international evidence can be received, transformed and translated into practice.
HC23142 Abstract | HC23142 Full Text | HC23142PDF (705 KB) Open Access Article
HC23143Preferred format and strategies for seeking and trusting online health information: a survey of cardiology outpatient attendees across three New Zealand hospitals
What is already known: The COVID-19 pandemic and its sequelae served to reduce access to health care providers, exacerbated unmet preventive and diagnostic health needs and made online health information even more important for consumers to make decisions about self- and family-care. What this study adds: This survey asked an ethnically diverse group of patients attending cardiology outpatients what format of information was most valued and strategies they use to trust the information they find. Simple fact sheets were the most preferred online format followed by videos and discussion groups with the best ‘life-hack’ being to get their health professional’s advice on the most trusted website for their condition.
HC23143 Abstract | HC23143 Full Text | HC23143PDF (768 KB) | HC23143Supplementary Material (212 KB) Open Access Article
HC23131A supported primary health pathway for mild traumatic brain injury quality improvement report
What is already known: Some patients with mild traumatic brain injury (mTBI) can experience persistent symptoms for many years if not treated early. Early access to specialist services such as concussion services can significantly improve patient recovery. What this study adds: This study provides initial evidence that a supported health care pathway following mTBI is feasible to implement in primary care and can facilitate early access to concussion services for those who need it.
HC23131 Abstract | HC23131 Full Text | HC23131PDF (981 KB) | HC23131Supplementary Material (285 KB) Open Access Article
HC23171He Aroka Urutā. Rural health provider perspectives of the COVID-19 vaccination rollout in rural Aotearoa New Zealand with a focus on Māori and Pasifika communities: a qualitative study
Disparities between rural and urban COVID-19 vaccination coverage both in NZ and globally have been demonstrated. New Zealand rural health provider perspectives of the COVID-19 vaccination rollout provide insight into factors contributing to the urban–rural COVID-19 vaccination disparity. Findings emphasise the relevance of context in delivering health initiatives rurally, which should be geographically tailored, culturally anchored and locally driven.
HC23171 Abstract | HC23171 Full Text | HC23171PDF (774 KB) Open Access Article
HC23178Aotearoa New Zealand general practice workforce crisis: what are our solutions?
HC23178 Full Text | HC23178PDF (672 KB) Open Access Article
HC23170Priorities for data collection through a prospective cohort study on gender-affirming hormone therapy in Aotearoa New Zealand: community and clinical perspectives
What is already known: There is a shift towards general practitioners (GPs) prescribing gender-affirming hormone therapy (GAHT) in primary care settings using an informed consent model of care. There is a lack of long-term data on health and wellbeing outcomes for people taking GAHT in Aotearoa New Zealand. What this study adds: The insights from this study offer a blueprint for current and future survey design, to ensure data collection is responsive to the needs of transgender and non-binary (TNB) communities and health care providers. These findings will inform future research to equip health care professionals involved in prescribing GAHT with local, evidence-based data to support their delivery of quality health care to TNB people.
HC23170 Abstract | HC23170 Full Text | HC23170PDF (718 KB) | HC23170Supplementary Material (501 KB) Open Access Article
HC23168Patient demographics and psychotropic medication prescribing in Australian general practices: pre- and during COVID-19 pandemic
What is already known: The use of psychotropic medications in Australia has increased over the last two decades, with general practitioners being the primary prescribers. The COVID-19 pandemic exacerbated mental health issues in adults and the older population, leading to increased concerns about mental health and wellbeing. What this study adds: This study estimates prescribing rates of psychotropic medication by patient demographics and found higher rates of prescribing among females, older people, and those with low to moderate SES. There was a consistent increase in prescribing rates between 2018 and 2022, particularly during the COVID-19 pandemic.
HC23168 Abstract | HC23168 Full Text | HC23168PDF (1 MB) | HC23168Supplementary Material (379 KB) Open Access Article
HC23157An area-based analysis of general practice fees in Aotearoa New Zealand
What is already known: Aotearoa New Zealand prioritises the pursuit of health care equity as a central objective. The existence of patient co-payments in primary care poses obstacles to achieving this goal. To address these challenges, the government has implemented various schemes aimed at alleviating them. What this study adds: The sociodemographic characteristics of people in the areas where general practices are located are related to the amount charged for an appointment with a general practitioner. The strongest relationships are seen across ethnicity and socioeconomic deprivation levels with lower fees being associated with higher proportions of Māori and Pacific peoples in that area and among people who are more socioeconomically deprived. The Very-Low-Cost-Access scheme appears to reduce these associations indicating that general practices operating under the scheme appear to reach groups with greater need.
HC23157 Abstract | HC23157 Full Text | HC23157PDF (1.1 MB) Open Access Article
HC23150Private practice model of physiotherapy: professional challenges identified through an exploratory qualitative study
What is already known: Community-based primary care physiotherapy is provided in Aotearoa New Zealand through a private practice, fee-for-service model. The impact of this model on patient care, physiotherapists, and professional behaviour is unknown. What this study adds: This exploratory study suggests that competition can dominate communication and collaboration in private practice physiotherapy. Competitive business models and an aversion to scrutiny may reduce collegial interaction and professional behaviour.
HC23150 Abstract | HC23150 Full Text | HC23150PDF (728 KB) | HC23150Supplementary Material (877 KB) Open Access Article
HC23116The costs, barriers and enablers of providing PGY2 placements in general practice in Aotearoa New Zealand: a mixed-methods study
What is already known: Community-based attachments (CBAs) are mandatory in NZ for junior doctors in their first 2 years of study. Some research indicates that CBAs are a positive experience for the practice and the junior doctors. What this study adds: An estimated average cost for hosting PGY2s in general practice was $NZ4907 (range $890–$9183) per placement before consideration of space costs, over and above current funding provided by Health New Zealand |Te Whatu Ora (TWO) Health Workforce Directorate. The small business model of general practice is in tension with providing a positive experience for the PGY2s in a new learning environment, and better communication and cooperation between practices and TWO employing hospitals are needed.
HC23116 Abstract | HC23116 Full Text | HC23116PDF (796 KB) | HC23116Supplementary Material (195 KB) Open Access Article
HC23123Worldviews of hearing health for Pacific peoples in Aotearoa New Zealand: a mixed methods study
What is already known: Limited international research with Pacific Island communities has examined ear disease and hearing health knowledge and beliefs to inform health service delivery. What this study adds: This study is the first mixed-methods investigation using a Pacific methodological approach to examine Pacific peoples’ ear and hearing health worldviews, including knowledge, beliefs, and experiences of the hearing healthcare system in Aotearoa New Zealand. It will assist healthcare professionals in providing more responsive ear and hearing care services for Pacific peoples.
HC23123 Abstract | HC23123 Full Text | HC23123PDF (729 KB) | HC23123Supplementary Material (585 KB) Open Access Article
HC23102Who uses yoga and why? Who teaches yoga? Insights from a national survey in New Zealand
What is already known: While there is extensive global documentation on the sociodemographic attributes of yoga instructors and users, along with their motivations for engaging in yoga, the specifics of yoga instructors and users in New Zealand remain relatively unexplored. What this study adds: This study aims to fill this gap by investigating the distinctive traits and backgrounds of yoga instructors and users in New Zealand. Additionally, the study examines the rationale behind yoga use, the factors that shape participant involvement, participantr methods of seeking information, and how participants communicate with healthcare providers. The insights garnered from this research aim to provide valuable information to the healthcare sector in New Zealand.
HC23102 Abstract | HC23102 Full Text | HC23102PDF (2 MB) Open Access Article
HC23136Māori and Pacific young people’s perspectives on testing for sexually transmitted infections via an online service: a qualitative study
What is already known: Screening sexually active young people for asymptomatic chlamydia and gonorrhoea is important to detect infection, prevent transmission and reduce reproductive health risks. Free online postal self-sampling for sexually transmitted infection (STI) testing is an acceptable alternative to clinic-based testing in some countries, but accessibility and acceptability of online testing in Aotearoa New Zealand is unknown. What this study adds: Opinions about online STI testing among Māori and Pacific young people were mixed, but more concerns than potential advantages were identified. Equity in access to online STI testing by Māori and Pacific young people could be improved by reducing cost, improving awareness about STI testing, and addressing barriers identified in the online testing pathway.
HC23136 Abstract | HC23136 Full Text | HC23136PDF (912 KB) | HC23136Supplementary Material (993 KB) Open Access Article
HC23107Comfort with having sexual orientation recorded on official databases among a community and online sample of gay and bisexual men in Aotearoa New Zealand
What’s already known: Sexual orientation and gender identity (SOGI) minority populations face known and preventable health inequities. However, SOGI data are not collected in routine data collection such as administrative health data, and there are limited studies exploring whether these populations are comfortable with having their data stored in these datasets. What does this study add: The research offers estimates of comfort with having sexual identity data recorded in official datasets among the GBM population of NZ, contributing to a larger body of research that primarily focusses on disclosure in health care settings.
HC23107 Abstract | HC23107 Full Text | HC23107PDF (749 KB) Open Access Article
HC23134Exploring the role of physician associates in Aotearoa New Zealand primary health care
What is already known: In various countries, health care providers aim to diversify the health workforce by introducing new clinical roles such as physician associates/assistants (PAs) to tackle ongoing workforce shortages. Numerous studies highlight PAs as cost-effective contributors who enhance access to safe and effective care. Despite these benefits, the integration of PAs into health care systems has encountered considerable scrutiny from both the public and medical professionals. What this study adds: The Ministry of Health has recently proposed the regulation of the PA profession, allowing foreign-trained PAs to take on clinical responsibilities in both primary and secondary care settings. This article examines the feasibility and implications of introducing PAs into New Zealand’s primary care sector, particularly within the context of general practice.
HC23134 Abstract | HC23134 Full Text | HC23134PDF (682 KB) Open Access Article
Just Accepted
These articles have been peer reviewed and accepted for publication. They are still in production and have not been edited, so may differ from the final published form.
Struggling to afford medicines: A qualitative exploration of the experiences of participants in the FreeMeds study
Nurses’ and general practitioners’ perspectives on oral health in primary care: a qualitative study
Primary care clinicians should proactively take up latest AI-based technology: YES
Most Read
The Most Read ranking is based on the number of downloads in the last 60 days from papers published on the CSIRO PUBLISHING website within the last 12 months. Usage statistics are updated daily.
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Private practice model of physiotherapy: professional challenges identified through an exploratory qualitative study
Journal of Primary Health Care (Online Early) -
Exploring the role of physician associates in Aotearoa New Zealand primary health care
Journal of Primary Health Care (Online Early) -
Prompting lifestyle interventions to promote weight loss is safe, effective and patient-centred: No
Journal of Primary Health Care 15 (4) -
Eating behaviour, body image, and mental health: updated estimates of adolescent health, well-being, and positive functioning in Aotearoa New Zealand
Journal of Primary Health Care 15 (4) -
What are green prescriptions? A scoping review
Journal of Primary Health Care 15 (2) -
Holistic health for Pacific seniors from a weekly group gathering run by a Pacific health provider
Journal of Primary Health Care 15 (4) -
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Rural general practice and ethical issues. A rapid review of the literature
Journal of Primary Health Care 15 (4) -
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He Aroka Urutā. Rural health provider perspectives of the COVID-19 vaccination rollout in rural Aotearoa New Zealand with a focus on Māori and Pasifika communities: a qualitative study
Journal of Primary Health Care (Online Early) -
New Zealand’s slow uptake of carbohydrate-reduction in type 2 diabetes management
Journal of Primary Health Care 16 (1) -
New Zealand pharmacists’ views regarding the current prescribing courses: questionnaire survey
Journal of Primary Health Care 15 (4) -
The enrolment gap and the COVID-19 pandemic: an exploration of routinely collected primary care enrolment data from 2016 to 2023 in Aotearoa New Zealand
Journal of Primary Health Care 15 (4) -
Developing a model for primary care quality improvement success: a comparative case study in rural, urban and Kaupapa Māori organisations
Journal of Primary Health Care 15 (4) -
The impact of nurse prescribing on health care delivery for patients with diabetes: a rapid review
Journal of Primary Health Care 16 (1) -
Can cranberry products be used to prevent UTIs?
Journal of Primary Health Care 15 (4) -
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Defining comprehensiveness in primary care: a scoping review
Journal of Primary Health Care 15 (3) -
An area-based analysis of general practice fees in Aotearoa New Zealand
Journal of Primary Health Care (Online Early) -