Australian Journal of General Practice最新文献

Background: Focal therapy is an emerging treatment modality for prostate cancer that aims to spare patients treatment-related side effects including erectile dysfunction and urinary incontinence associated with surgery and radiotherapy, which are the current standards of care.

Objective: In this narrative review, the authors aim to provide a focused summary of prostate cancer focal therapies for general practice including an overview of key underlying oncological principles, existing treatment modalities, their functional and oncological outcomes, and follow-up after treatment.

Discussion: Focal therapy is being increasingly established in the management of localised prostate cancer and is a promising alternative to surgery and radiotherapy in carefully selected patients. With a growing body of evidence in support of focal therapy, its potential in the future of prostate cancer management is clear.

Background: Parotitis, inflammation of the parotid glands, is a clinically significant presentation with a wide range of aetiologies that can result in systemically unwell patients.

Objective: The aim of this article is to: (1) outline the assessment of parotitis and distinguish features relevant to determining the aetiology; (2) discuss the role of imaging in parotitis and other serological tests; (3) provide treatment principles and management approaches in treating parotitis in the general practice setting; and (4) identify key features that necessitate referral to an ear, nose and throat service or escalation in treatment.

Discussion: When encountering parotitis in the primary care setting, a comprehensive history and examination is necessary to evaluate the patient, direct further ancillary investigations and to plan treatment. Differentiating between the well and unwell patient with parotitis is essential in determining whether investigation and treatment can be performed in the primary care setting versus the hospital setting.

Background: Australians with life-limiting conditions can, with appropriate support, have a home death, if that is their choice. General practitioners (GPs) are essential for coordinating care and managing symptoms. Necessary medicines must be quickly available to provide responsive symptom management in the terminal phase. GPs can facilitate prompt availability of medicines by working collaboratively with pharmacists who have a shared understanding of the required medicines.

Objective: This article explains the development of, and provides information about, the National Core Community Palliative Care Medicines List.

Discussion: A group of healthcare professionals with community palliative care expertise (Expert Group) compared the medicines to manage terminal phase symptoms against a set of criteria, choosing four core medicines based on their ability to manage symptoms, cost and ease of use. Creating a standardised National Core Community Palliative Care Medicines List supports clinical communication by providing an accepted baseline for symptom management; however, it should not replace communication between prescribers and pharmacists; rather, it should support collaborative practices.

Background and objectives: Although general practitioners (GPs) are the first-line treatment providers for chronic non-cancer pain (CNCP) in Australia, the experience of patients in this context is not well documented. This study explored patients' experiences with GPs managing their CNCP.

Method: Qualitative responses to two open-ended questions about GP care from adult respondents (n=200) to Chronic Pain Australia's 2021 National Pain Survey were thematically analysed.

Results: Five themes emerged regarding valued GP skills and attributes: effective treatment; communication with patients; common therapeutic factors; shared expertise; and the importance of mental health. Five themes regarding patients' needs emerged: access to services; access to medication treatment options; the importance of GPs staying up to date; communication; and common therapeutic factors.

Discussion: A critical need exists to raise GPs' awareness about the expectations and unmet needs of people living with CNCP. Addressing patients' needs early in their journey might result in better GP-patient relationships and cooperation, and more effective treatment.