Australian Journal of General Practice最新文献

Background and objectives: The Australian National Bowel Cancer Screening Program (NBCSP) targets early detection through immunochemical faecal occult blood test (iFOBT) screening of eligible individuals. This study examined Western Australian general practitioner (GP) follow-up processes of patients returning positive iFOBTs through the NBCSP.  METHOD: The study reports on qualitative descriptive findings from round one key informant interviews of a two-round Delphi study.  RESULTS: Sixteen GP interviews were undertaken for the study. Analysis indicated patient contact comprised a non-urgent appointment within two weeks. Three themes were identified. All consenting NBCSP participants with a positive screen were referred for colonoscopy unless comorbidities or procedural risk were present. Inefficiencies occurred in the interfaces between general practice-based clinical software, the NBCSP and the National Cancer Screening Register. The GP-patient relationship played a part in facilitating NBCSP participation. Conclusion GP participants regarded the NBCSP as beneficial but highlighted inefficiencies in tracking patients, referring them for colonoscopies and registering their screening data.

Background: General practitioners (GPs) have a key role in concussion diagnosis and management. Recent surveys have shown that GPs are competent in diagnosis but lack confidence in appropriate concussion management. Although some patients recover spontaneously, early education is valuable, and provision of evidence-informed, individualised management plans may facilitate recovery within typical recovery windows.  OBJECTIVE: The aim of this article is to provide GPs with contemporary recommendations on paediatric concussion diagnosis and management in the acute and subacute phases, and to highlight the benefit of a biopsychosocial approach and multidisciplinary management.

Discussion: Paediatric concussion management can be complex, requiring a biopsychosocial approach, including a thorough understanding of each individual paediatric patient's pre-concussion history. Given the relationship GPs have with their patients, they are well placed to coordinate multidisciplinary care. For paediatric patients who are at risk of a prolonged recovery or persisting symptoms, early identification and referral for multidisciplinary care are essential.

Background: Mild traumatic brain injury (mTBI) and concussion are important healthcare issues, with ongoing and persisting symptoms significantly affecting a person's quality of life. Management is often challenging.

Objective: Using a case study example, this article outlines key updates and practical guidance for assessment and management of mTBI/concussion, informed by the newly developed Australian and Aotearoa New Zealand (ANZ) mTBI and concussion clinical practice guideline.

Discussion: The 'Australian and Aotearoa New Zealand Clinical Practice Guideline for the management of mild traumatic brain injury/concussion and persisting post-concussion symptoms in adults and children' is the first guideline to address the full scope of mTBI/concussion management across diverse ANZ populations. It provides general practitioners and other clinicians with practical, evidence-based recommendations for assessing and managing mTBI and persisting symptoms across all ages. Developed through multidisciplinary and consumer collaboration, it aims to promote consistent, high-quality care and reduce practice variation across healthcare settings.

Background: Precision medicine tailors an individual's healthcare to their genetics, environment and behaviour. This has been driven by rapid advances in genomics, where an individual's entire genetic code can now be sequenced. General practitioners (GPs) are increasingly involved in genomics throughout the lifespan, including performing prenatal screening during pregnancy, requesting reproductive genetic carrier screening and arranging genetic referrals for cancer and other conditions. Patients are relying on their GPs to appropriately counsel, test, refer and manage genetic conditions, and provide genomic healthcare.

Objective: This article provides an overview of the GP's expanding role in genomic medicine, some tools to assist GPs to navigate this landscape, and barriers to genomic uptake.

Discussion: GPs are integral to supporting patients and families in the genomics and precision medicine era. Resources specifically aimed at, and codesigned with, GPs are required to enable broader and equitable access for the benefit of all Australians.