Australian Journal of General Practice最新文献

Background and objectives: Highlighting the complexity of general practice is essential for capturing the comprehensive nature of whole-person care. Our aim is to highlight complexity in the general practitioner consultation by identifying the number of items mentioned or discussed.

Method: Secondary analysis of video-recorded consultations was undertaken. Two researchers coded items using the body systems in International Classification of Primary Care, Version 2 (ICPC-2) codes. Items were categorised as 'mentioned' or 'discussed'.

Results: In the 54 consultations, most patients were aged over 45 years and were women (51.9%). On average, consultations lasted 19 minutes (range 03:35-39:59 minutes), five items were discussed (range 1-14), and three were mentioned (range 0-8). Half of consultations included cardiovascular items, half included musculoskeletal items and one-third included psychological items.

Discussion: Recordings are a useful research method for capturing the complexity of general practice. Highlighting this complexity might be useful for discussions with policymakers and funders to describe the comprehensiveness of general practice care.

Background: Immunoglobulin A nephropathy (IgAN) is the most common primary glomerulonephritis and a leading cause of chronic kidney disease globally. IgAN often presents with varied symptoms, and general practitioners (GPs) play a key role in its early detection and management.

Objective: This review aims to provide GPs with an overview of IgAN, focusing on clinical presentations that warrant referral to nephrology and highlighting common pitfalls in primary care management with a case example.

Discussion: Recognising high-risk features of IgAN through symptoms such as haematuria or proteinuria, addressing modifiable factors and understanding recent advances in management are vital for improving patient outcomes. New therapies targeting pathogenic pathways underscore the importance of collaborative care.

Background: Most patients who seek travel health advice do so from their general practitioners (GPs). Travel medicine is recognised as a fundamental skill of Australian general practice, as reflected in The Royal Australian College of General Practitioners (RACGP) curriculum and syllabus.

Objective: The aim of this article is to show the natural fit of travel medicine within general practice, briefly outline the pre-travel consultation and suggest strategies for improving delivery of travel medicine in the context of general practice.

Discussion: 'Oh, by the way, Doc, I'm going to Bali next week.' GPs are familiar with a passing comment that requires clinical assessment and advice. As with any other information presented during the consultation, the GP must decide how to discharge their professional responsibility to their patient.

Background: Presentations of unwell patients after travel can be challenging, as assessment and management requires consideration of a range of unfamiliar conditions.

Objective: The objective of this article is to provide general practitioners (GPs) with a framework they can use when faced with an unwell returned traveller. This enables the GP to go through a process to reach a differential diagnosis, and ultimately a diagnosis, of the illness or illnesses that may be present.

Discussion: There are many causes of illness in the returned traveller; these range from very common and potentially self-limiting to severe and potentially life-threatening.  It is important that GPs are aware of the epidemiology and incubation periods of diseases overseas to help provide a diagnosis or diagnoses. The process will help GPs identify life-threatening diseases or those that may be a public health threat. A detailed history of travel itinerary and the presenting symptoms, combined with a thorough examination and relevant investigations, are required. The treating GP requires an awareness of when extra help or referral are required.

Background: Injuries are a common cause of harm to travellers, many of which can be prevented with some simple strategies and prior preparation. While general practitioners (GPs) often focus on immunisation and infectious disease prevention in travel consultations, they are also well-positioned to provide injury prevention advice.  OBJECTIVE: This article aims to describe common injury categories among travellers. These include road injuries, water (and water safety), selfies, drugs and alcohol, and children and older adults. It also offers practical advice for GPs to share with patients to help reduce injury risk.

Discussion: This article outlines common injury risks faced by travellers and highlights the importance of tailored safety advice based on destination, activities and individual health status. The article also emphasises the value of a well-prepared first aid kit and the role of GPs in reinforcing safety behaviours. By incorporating injury prevention into pre-travel consultations, GPs can help reduce harm and potentially save lives.