Australian Journal of General Practice最新文献

Background: An estimated one in five Australians aged 60 years and older have sarcopenia, marked by progressive and accelerated loss in muscle mass, strength and function. Sarcopenia is associated with considerable healthcare costs and a myriad of adverse health outcomes, including increased risk of death. Despite its clinical importance, muscle health is often overlooked in routine clinical practice, hindering diagnosis and treatment.

Objective: In July 2023, eight representatives from Australia's primary care and research communities convened to discuss barriers to sarcopenia screening, assessment and management within routine clinical practice. Solutions were proposed to improve the implementation of muscle health assessment and management in general practice. This article summarises the key discussions and outcomes from this meeting.

Discussion: Strategies to improve the implementation of muscle health assessment and management in general practice include (1) improving public awareness; (2) professional education; (3) provision of tools and resources; (4) advocacy and policy; and (5) increasing collaborative efforts between healthcare professionals, professional societies, universities, electronic medical record software vendors and the government.

Background and objectives: Patients with prolonged symptoms following COVID-19 infection(s) will increasingly present to general practice. Our research objective was to understand the general practice experience of diagnosing and managing long COVID and to explore recommendations for contributing to the safety and quality of the long COVID response.

Method: A two-hour qualitative session involving 11 project stakeholders was held in March 2023. The stakeholders included general practitioners as well as representatives from four Primary Health Networks, Outcome Health and the funding body. Transcripts were analysed using qualitative content analysis.

Results: Key challenges and practical recommendations emerged relating to diagnosing long COVID, documentation of COVID-19 infections, ongoing management, screening tools and the need for public health messaging.

Discussion: General practices need more accurate definitions and information about the diagnosis of long COVID. Supporting general practitioners with information to diagnose and manage patients with long COVID is essential. General practice voices need to be heard to enhance our understanding of long COVID and inform policy decisions.

Background: The age of puberty and sexual maturation has been decreasing, highlighting the importance of providing appropriate contraception to girls and adolescents. However, challenges remain, including legal implications and understanding the effects of hormonal methods on pubertal development.

Objective: This article aims to equip general practitioners with the knowledge of options, as well as their use and limitations, in young people seeking contraception.

Discussion: No one-size-fits-all approach exists for adolescent contraception. Long-acting reversible contraceptives offer superior contraceptive efficacy, with subdermal implants being the most acceptable regarding the insertion procedure. Condoms should be recommended for protection against sexually transmissible infections. Bone health and mood disorders should be considered when prescribing hormonal contraceptives. Despite the lack of robust evidence regarding harm caused by contraception in adolescents, preventing unintended pregnancies should take precedence, with theoretical risks guiding tailored options for individuals.

Background and objectives: Tuberculosis infection (TBI) screening and treatment delivered from primary care could hold the key to achieving tuberculosis (TB) elimination in low TB burden countries. This scoping review was undertaken to understand how elements of the cascade of care for TBI screening and treatment have been implemented in primary care settings globally.

Method: For this review, eight databases were searched, including PubMed, Embase, CINAHL, Global Index Medicus, Scopus, Web of Science, ProQuest Dissertations & Theses Global and the Cochrane Library, to examine models of care for TBI screening and treatment in primary care.

Results: Eight articles were included from the 7207 articles screened. These eight articles describe models of care that are varied in their aim, design and focus and elements of the TBI cascade of care.

Discussion: Although primary care is well placed to offer TBI screening and treatment, robust referral, community mobilisation and systems support are critical. Further research is necessary for Australia to deliver on the elimination target of the World Health Organization.