首页 > 最新文献

Journal of primary health care最新文献

英文 中文
The impact of nurse prescribing on health care delivery for patients with diabetes: a rapid review. 护士处方对糖尿病患者医疗服务的影响:快速综述。
IF 1.2 Q2 Medicine Pub Date : 2024-03-01 DOI: 10.1071/HC23121
Kylie Short, Cathy Andrew, Wenting Yang, Isabel Jamieson

Introduction The global prevalence of diabetes is a pressing public health concern. Over 400 million individuals live with the effects of the disease, predominantly in low- and middle-income countries. In Aotearoa New Zealand (NZ), over 300 000 people have diabetes, resulting in a population rate of 43.1 per 1000. Enabling nurses to prescribe diabetes medications enhances accessibility and improves health outcomes for large sections of the population. Aim This rapid review was undertaken to investigate the influence of nurse prescribing on health care delivery for individuals with diabetes in NZ, Australia, the United Kingdom, and Canada, countries sharing comparable health care systems and multicultural backgrounds. Methods The review protocol was published on PROSPERO. In November 2022, a search was conducted across multiple databases to locate relevant literature and resources constrained to the last decade (from January 2012 to November 2022). Utilising the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework, data extraction was systematically structured, while rigorous appraisal processes upheld selection quality. Results Fifteen publications were identified as meeting predefined inclusion and exclusion criteria. The review of these articles revealed four main themes: the impact of nurse prescribing on clinical outcomes, levels of patient satisfaction, implications for health care service provisions, and identification of barriers and facilitators associated with nurse prescribing. Discussion This report identifies outcomes of nurse prescribing, concluding it provides a potential avenue for enhancing access to and alleviating the burden on health care systems.

导言 全球糖尿病发病率是一个紧迫的公共卫生问题。全球有超过 4 亿人患有糖尿病,主要集中在中低收入国家。在奥特亚罗瓦新西兰(NZ),有 30 多万人患有糖尿病,人口患病率为 43.1/1000。让护士能够开具糖尿病药物处方,可以提高糖尿病患者的可及性,并改善大部分人口的健康状况。目的 本快速综述旨在调查护士开具处方对新西兰、澳大利亚、英国和加拿大糖尿病患者医疗保健服务的影响,这些国家拥有相似的医疗保健系统和多元文化背景。方法 在 PROSPERO 上发布了综述方案。2022 年 11 月,我们在多个数据库中进行了搜索,以查找过去十年(2012 年 1 月至 2022 年 11 月)内的相关文献和资源。利用《系统综述和元分析首选报告项目》框架,对数据提取进行了系统化处理,同时采用严格的评估程序来保证选题质量。结果 确定了 15 篇符合预定义纳入和排除标准的出版物。对这些文章的综述揭示了四个主题:护士处方对临床结果的影响、患者满意度、对医疗保健服务提供的影响,以及确定与护士处方相关的障碍和促进因素。讨论 本报告确定了护士处方的结果,并得出结论,护士处方为提高医疗保健系统的可及性和减轻其负担提供了一个潜在的途径。
{"title":"The impact of nurse prescribing on health care delivery for patients with diabetes: a rapid review.","authors":"Kylie Short, Cathy Andrew, Wenting Yang, Isabel Jamieson","doi":"10.1071/HC23121","DOIUrl":"10.1071/HC23121","url":null,"abstract":"<p><p>Introduction The global prevalence of diabetes is a pressing public health concern. Over 400 million individuals live with the effects of the disease, predominantly in low- and middle-income countries. In Aotearoa New Zealand (NZ), over 300 000 people have diabetes, resulting in a population rate of 43.1 per 1000. Enabling nurses to prescribe diabetes medications enhances accessibility and improves health outcomes for large sections of the population. Aim This rapid review was undertaken to investigate the influence of nurse prescribing on health care delivery for individuals with diabetes in NZ, Australia, the United Kingdom, and Canada, countries sharing comparable health care systems and multicultural backgrounds. Methods The review protocol was published on PROSPERO. In November 2022, a search was conducted across multiple databases to locate relevant literature and resources constrained to the last decade (from January 2012 to November 2022). Utilising the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework, data extraction was systematically structured, while rigorous appraisal processes upheld selection quality. Results Fifteen publications were identified as meeting predefined inclusion and exclusion criteria. The review of these articles revealed four main themes: the impact of nurse prescribing on clinical outcomes, levels of patient satisfaction, implications for health care service provisions, and identification of barriers and facilitators associated with nurse prescribing. Discussion This report identifies outcomes of nurse prescribing, concluding it provides a potential avenue for enhancing access to and alleviating the burden on health care systems.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318550","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
Perceptions of the effectiveness of using patient encounter data as an education and reflection tool in general practice training. 对在全科医生培训中使用患者就诊数据作为教育和反思工具的有效性的看法。
IF 1.2 Q2 Medicine Pub Date : 2024-03-01 DOI: 10.1071/HC22158
Linda Klein, Michael Bentley, Dominica Moad, Alison Fielding, Amanda Tapley, Mieke van Driel, Andrew Davey, Ben Mundy, Kristen FitzGerald, Jennifer Taylor, Racheal Norris, Elizabeth Holliday, Parker Magin

Introduction Patient encounter tools provide feedback and potentially reflection on general practitioner (GP) registrars' in-practice learning and may contribute to the formative assessment of clinical competencies. However, little is known about the perceived utility of such tools. Aim To investigate the perceived utility of a patient encounter tool by GP registrars, their supervisors, and medical educators (MEs). Methods General practice registrars, supervisors and MEs from two Australian regional training organisations completed a cross-sectional questionnaire. Registrars rated how Registrar Clinical Encounters in Training (ReCEnT), a patient encounter tool, influenced their reflection on, and change in, clinical practice, learning and training. Supervisors' and MEs' perceptions provided contextual information about understanding their registrars' clinical practice, learning and training needs. Results Questionnaires were completed by 48% of registrars (n  = 90), 22% of supervisors (n  = 182), and 61% of MEs (n  = 62). Most registrars agreed that ReCEnT helped them reflect on their clinical practice (79%), learning needs (69%) and training needs (72%). Many registrars reported changing their clinical practice (54%) and learning approaches (51%). Fewer (37%) agreed that ReCEnT influenced them to change their training plans. Most supervisors (68%) and MEs (82%) agreed ReCEnT reports helped them better understand their registrars' clinical practice. Similarly, most supervisors (63%) and MEs (68%) agreed ReCEnT reports helped them better understand their registrars' learning and training needs. Discussion ReCEnT can prompt self-reflection among registrars, leading to changes in clinical practice, learning approaches and training plans. Reaching its potential as an assessment for learning (as opposed to an assessment of learning) requires effective engagement between registrars, their supervisors and MEs.

引言 患者见面工具为全科医生(GP)注册人员的实践学习提供反馈和可能的反思,并有助于对临床能力进行形成性评估。然而,人们对此类工具的实用性知之甚少。目的 调查全科医生注册医师、其导师和医学教育者(MEs)对患者见面工具实用性的看法。方法 来自澳大利亚两个地区培训机构的全科注册医师、导师和医学教育者填写了一份横向问卷。注册医师对注册医师培训中的临床相遇(ReCEnT)这一患者相遇工具如何影响他们对临床实践、学习和培训的反思和改变进行了评分。督导和医务人员的看法为了解注册医师的临床实践、学习和培训需求提供了背景信息。结果 48% 的注册医师(90 人)、22% 的督导(182 人)和 61% 的医务人员(62 人)填写了调查问卷。大多数注册医师都认为 ReCEnT 有助于他们反思自己的临床实践(79%)、学习需求(69%)和培训需求(72%)。许多注册医师表示他们改变了临床实践(54%)和学习方法(51%)。只有较少的人(37%)认为 ReCEnT 影响了他们改变培训计划。大多数督导(68%)和医务人员(82%)认为 ReCEnT 报告有助于他们更好地了解注册医师的临床实践。同样,大多数督导(63%)和教育硕士(68%)都认为 ReCEnT 报告有助于他们更好地了解注册医师的学习和培训需求。讨论 ReCEnT 可以促使注册医师进行自我反思,从而改变临床实践、学习方法和培训计划。要发挥 ReCEnT 作为学习评估(而非学习评估)的潜能,需要注册医师、其督导和 ME 的有效参与。
{"title":"Perceptions of the effectiveness of using patient encounter data as an education and reflection tool in general practice training.","authors":"Linda Klein, Michael Bentley, Dominica Moad, Alison Fielding, Amanda Tapley, Mieke van Driel, Andrew Davey, Ben Mundy, Kristen FitzGerald, Jennifer Taylor, Racheal Norris, Elizabeth Holliday, Parker Magin","doi":"10.1071/HC22158","DOIUrl":"10.1071/HC22158","url":null,"abstract":"<p><p>Introduction Patient encounter tools provide feedback and potentially reflection on general practitioner (GP) registrars' in-practice learning and may contribute to the formative assessment of clinical competencies. However, little is known about the perceived utility of such tools. Aim To investigate the perceived utility of a patient encounter tool by GP registrars, their supervisors, and medical educators (MEs). Methods General practice registrars, supervisors and MEs from two Australian regional training organisations completed a cross-sectional questionnaire. Registrars rated how Registrar Clinical Encounters in Training (ReCEnT), a patient encounter tool, influenced their reflection on, and change in, clinical practice, learning and training. Supervisors' and MEs' perceptions provided contextual information about understanding their registrars' clinical practice, learning and training needs. Results Questionnaires were completed by 48% of registrars (n  = 90), 22% of supervisors (n  = 182), and 61% of MEs (n  = 62). Most registrars agreed that ReCEnT helped them reflect on their clinical practice (79%), learning needs (69%) and training needs (72%). Many registrars reported changing their clinical practice (54%) and learning approaches (51%). Fewer (37%) agreed that ReCEnT influenced them to change their training plans. Most supervisors (68%) and MEs (82%) agreed ReCEnT reports helped them better understand their registrars' clinical practice. Similarly, most supervisors (63%) and MEs (68%) agreed ReCEnT reports helped them better understand their registrars' learning and training needs. Discussion ReCEnT can prompt self-reflection among registrars, leading to changes in clinical practice, learning approaches and training plans. Reaching its potential as an assessment for learning (as opposed to an assessment of learning) requires effective engagement between registrars, their supervisors and MEs.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82433396","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
Ashwagandha. Ashwagandha.
IF 1.2 Q2 Medicine Pub Date : 2024-03-01 DOI: 10.1071/HC23172
Xin Yi Lim, Joanne Barnes
{"title":"Ashwagandha.","authors":"Xin Yi Lim, Joanne Barnes","doi":"10.1071/HC23172","DOIUrl":"10.1071/HC23172","url":null,"abstract":"","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318536","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
Carbohydrate intake in T2DM. T2DM 的碳水化合物摄入量。
IF 1.2 Q2 Medicine Pub Date : 2024-03-01 DOI: 10.1071/HC24042
Rosemary M Hall
{"title":"Carbohydrate intake in T2DM.","authors":"Rosemary M Hall","doi":"10.1071/HC24042","DOIUrl":"10.1071/HC24042","url":null,"abstract":"","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318538","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
Do decision aids improve clinical practice? 决策辅助工具能否改善临床实践?
IF 1.2 Q2 Medicine Pub Date : 2024-03-01 DOI: 10.1071/HC24043
Vanessa Jordan
{"title":"Do decision aids improve clinical practice?","authors":"Vanessa Jordan","doi":"10.1071/HC24043","DOIUrl":"10.1071/HC24043","url":null,"abstract":"","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318540","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
Doing the 'bread and butter' of general practice well in uncertain times. 在不确定时期做好全科医生的 "面包和黄油"。
IF 1.2 Q2 Medicine Pub Date : 2024-03-01 DOI: 10.1071/HC24044
Tim Stokes, Felicity Goodyear-Smith
{"title":"Doing the 'bread and butter' of general practice well in uncertain times.","authors":"Tim Stokes, Felicity Goodyear-Smith","doi":"10.1071/HC24044","DOIUrl":"10.1071/HC24044","url":null,"abstract":"","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318541","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
Are 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. 怀卡托地区的 2 型糖尿病患者是否在初级保健中获得了足够的教育和支持,以自我管理病情?一项定性研究。
IF 1.2 Q2 Medicine Pub Date : 2024-03-01 DOI: 10.1071/HC23141
Rebekah Crosswell, Kimberley Norman, Shemana Cassim, Valentina Papa, Rawiri Keenan, Ryan Paul, Lynne Chepulis

Introduction In Aotearoa New Zealand (NZ), type 2 diabetes (T2D) is predominantly managed in primary care. Despite established guidelines, patients are often suboptimally managed, with inequitable health outcomes. To date, few NZ studies have evaluated the primary care management of T2D at the time of diagnosis. Aim This study aims to explore patients' the provision of education and delivery of care to patients at the time of diagnosis, which is a crucial time in the disease trajectory. Methods Participants were recruited from a Māori health provider in the Waikato District, and diagnosed with T2D after January 2020. Patients were texted a link to opt into a survey (larger study) and then registered interest by providing contact details for an interview (current study). Semi-structured interviews were conducted and were audio recorded, transcribed, and thematically analysed. Results In total, 11 participants aged 19-65 years completed the interviews (female n  = 9 and male n  = 20); the comprised Māori (n  = 5), NZ European (n  = 5) and Asian (n  = 1) participants. Three overarching themes were identified, including: (1) ineffective provision of resources and education methods; (2) poor communication from healthcare practitioners; and (3) health system barriers. Discussion Evidently, there are difficulties in primary care diabetes mellitus diagnosis and management. Improvements could include locally relevant resources tailored to patients' experiences and cultural identities. Utilising whānau support and a non-clinical workforce, such as health navigators/kaiāwhina, will drastically address current workforce issues and assist patient self-management. This will allow improved diagnosis experiences and better health outcomes for patients and whānau.

导言:在新西兰奥特亚罗瓦,2 型糖尿病(T2D)主要由初级医疗机构负责管理。尽管制定了相关指南,但患者往往得不到最佳管理,造成不公平的健康结果。迄今为止,新西兰很少有研究对 T2D 诊断时的初级医疗管理进行评估。目的 本研究旨在探讨患者在确诊时的教育和护理提供情况,这是疾病轨迹中的关键时期。方法 从怀卡托地区的一家毛利医疗机构招募参与者,并在 2020 年 1 月之后诊断出患有 T2D。患者会收到短信链接,选择参加调查(大型研究),然后通过提供详细联系信息来登记是否有兴趣参加访谈(当前研究)。研究人员进行了半结构式访谈,并对访谈内容进行了录音、转录和主题分析。结果 共有 11 名年龄在 19-65 岁之间的参与者完成了访谈(女性 9 人,男性 20 人);其中包括毛利人(5 人)、新西兰欧洲人(5 人)和亚洲人(1 人)。研究发现了三个重要主题,包括:(1)资源和教育方法的无效提供;(2)医疗从业人员的沟通不畅;以及(3)医疗系统的障碍。讨论 显然,基层医疗机构在糖尿病诊断和管理方面存在困难。改进措施可包括根据患者的经历和文化特性提供与当地相关的资源。利用whānau支持和非临床劳动力,如健康导航员/kaiāwhina,将极大地解决目前的劳动力问题,并帮助患者进行自我管理。这将改善诊断体验,为患者和土著居民带来更好的健康结果。
{"title":"Are 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.","authors":"Rebekah Crosswell, Kimberley Norman, Shemana Cassim, Valentina Papa, Rawiri Keenan, Ryan Paul, Lynne Chepulis","doi":"10.1071/HC23141","DOIUrl":"10.1071/HC23141","url":null,"abstract":"<p><p>Introduction In Aotearoa New Zealand (NZ), type 2 diabetes (T2D) is predominantly managed in primary care. Despite established guidelines, patients are often suboptimally managed, with inequitable health outcomes. To date, few NZ studies have evaluated the primary care management of T2D at the time of diagnosis. Aim This study aims to explore patients' the provision of education and delivery of care to patients at the time of diagnosis, which is a crucial time in the disease trajectory. Methods Participants were recruited from a Māori health provider in the Waikato District, and diagnosed with T2D after January 2020. Patients were texted a link to opt into a survey (larger study) and then registered interest by providing contact details for an interview (current study). Semi-structured interviews were conducted and were audio recorded, transcribed, and thematically analysed. Results In total, 11 participants aged 19-65 years completed the interviews (female n  = 9 and male n  = 20); the comprised Māori (n  = 5), NZ European (n  = 5) and Asian (n  = 1) participants. Three overarching themes were identified, including: (1) ineffective provision of resources and education methods; (2) poor communication from healthcare practitioners; and (3) health system barriers. Discussion Evidently, there are difficulties in primary care diabetes mellitus diagnosis and management. Improvements could include locally relevant resources tailored to patients' experiences and cultural identities. Utilising whānau support and a non-clinical workforce, such as health navigators/kaiāwhina, will drastically address current workforce issues and assist patient self-management. This will allow improved diagnosis experiences and better health outcomes for patients and whānau.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318535","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
New Zealand's slow uptake of carbohydrate-reduction in type 2 diabetes management. 新西兰在 2 型糖尿病管理中对减少碳水化合物摄入量的认识缓慢。
IF 1.2 Q2 Medicine Pub Date : 2024-03-01 DOI: 10.1071/HC24011
Marcus Hawkins, Caryn Zinn
{"title":"New Zealand's slow uptake of carbohydrate-reduction in type 2 diabetes management.","authors":"Marcus Hawkins, Caryn Zinn","doi":"10.1071/HC24011","DOIUrl":"10.1071/HC24011","url":null,"abstract":"","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318546","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
Inequities in medicines use are probably much worse than we thought. 药品使用的不公平现象可能比我们想象的要严重得多。
IF 1.2 Q2 Medicine Pub Date : 2024-03-01 DOI: 10.1071/HC23114
Pauline Norris, Simon Horsburgh, Gemma Waterhouse-Perry, Patti Napier
{"title":"Inequities in medicines use are probably much worse than we thought.","authors":"Pauline Norris, Simon Horsburgh, Gemma Waterhouse-Perry, Patti Napier","doi":"10.1071/HC23114","DOIUrl":"10.1071/HC23114","url":null,"abstract":"","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318545","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
Excision pathways for keratinocyte cancers diagnosed by teledermatology: a retrospective review. 通过远程皮肤学诊断的角质细胞癌的切除途径:回顾性研究。
IF 1.2 Q2 Medicine Pub Date : 2024-03-01 DOI: 10.1071/HC23098
J P Tirado-Perez, A Oakley, R Gansel

Introduction The New Zealand population has one of the highest incidences of skin cancer in the world. Hospital waiting lists for surgical excision of keratinocytic skin cancers (basal cell carcinoma and squamous cell carcinoma) are lengthy, and increasingly, excisions are undertaken in primary care. Teledermatology, in response to general practitioners' electronic referrals (e-referrals), can improve clinical communication between general practitioners and dermatologists. Aim The aim of this study was to evaluate an excision pathway for keratinocytic cancers diagnosed by teledermatology. Methods A retrospective observational descriptive review of a 3-month cohort of primary care e-referrals was undertaken. Results Three hundred and fifty eight suspected keratinocytic cancers (KCs) were diagnosed by teledermatology; histology reports confirmed KC in 201 of 267 excisions (75%). The majority (77.2%) were excised by general practitioners an average of 25 days after the dermatologist's recommendation. The rest were excised by plastic surgeons in private (3.4%) or at a public hospital (19.5%) after an average of 40 or 134 days, respectively. Discussion E-referral pathways are now widely implemented. However, the ideal workflow for skin cancer management is unknown. We have demonstrated in New Zealand that surgery can be undertaken in primary care within a month of a teledermatology diagnosis and excision recommendation. Conclusion This study reports prompt excision of KCs by general practitioners after an e-referral and a teledermatology response.

导言 新西兰是世界上皮肤癌发病率最高的国家之一。医院等待角化细胞皮肤癌(基底细胞癌和鳞状细胞癌)切除手术的时间很长,越来越多的切除手术在基层医疗机构进行。针对全科医生的电子转诊(电子转诊),远程皮肤病学可以改善全科医生和皮肤病医生之间的临床沟通。目的 本研究旨在评估通过远程皮肤科诊断的角化细胞癌的切除路径。方法 对为期 3 个月的初级医疗电子转诊进行回顾性观察描述。结果 远程皮肤科诊断出 358 例疑似角化细胞癌(KC);267 例切除术中有 201 例(75%)的组织学报告证实为角化细胞癌。大多数患者(77.2%)是在皮肤科医生建议后平均 25 天由普通医生进行切除的。其余患者分别在平均 40 天或 134 天后由私立整形外科医生(3.4%)或公立医院整形外科医生(19.5%)进行切除。讨论 目前,电子转诊途径已广泛应用。然而,皮肤癌治疗的理想工作流程仍是未知数。我们已在新西兰证明,在获得远程皮肤科诊断和切除建议后的一个月内,可在初级医疗机构进行手术。结论 本研究报告显示,全科医生在接到电子转诊和远程皮肤病学回复后可迅速对 KC 进行切除。
{"title":"Excision pathways for keratinocyte cancers diagnosed by teledermatology: a retrospective review.","authors":"J P Tirado-Perez, A Oakley, R Gansel","doi":"10.1071/HC23098","DOIUrl":"10.1071/HC23098","url":null,"abstract":"<p><p>Introduction The New Zealand population has one of the highest incidences of skin cancer in the world. Hospital waiting lists for surgical excision of keratinocytic skin cancers (basal cell carcinoma and squamous cell carcinoma) are lengthy, and increasingly, excisions are undertaken in primary care. Teledermatology, in response to general practitioners' electronic referrals (e-referrals), can improve clinical communication between general practitioners and dermatologists. Aim The aim of this study was to evaluate an excision pathway for keratinocytic cancers diagnosed by teledermatology. Methods A retrospective observational descriptive review of a 3-month cohort of primary care e-referrals was undertaken. Results Three hundred and fifty eight suspected keratinocytic cancers (KCs) were diagnosed by teledermatology; histology reports confirmed KC in 201 of 267 excisions (75%). The majority (77.2%) were excised by general practitioners an average of 25 days after the dermatologist's recommendation. The rest were excised by plastic surgeons in private (3.4%) or at a public hospital (19.5%) after an average of 40 or 134 days, respectively. Discussion E-referral pathways are now widely implemented. However, the ideal workflow for skin cancer management is unknown. We have demonstrated in New Zealand that surgery can be undertaken in primary care within a month of a teledermatology diagnosis and excision recommendation. Conclusion This study reports prompt excision of KCs by general practitioners after an e-referral and a teledermatology response.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140318542","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
期刊
Journal of primary health care
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1