Australian Journal of General Practice最新文献

Background and objectives: General practitioner (GP) recruitment strategies have been explored in previous research and are vital to workforce development. This study explores factors that influence engagement with Tasmanian GP training pathways and hence GP workforce recruitment and supply.

Method: Eighteen interviews investigated the experiences of Tasmanian GP trainees, supervisors and trainee support personnel to explore enablers and barriers to training engagement.

Results: Factors influencing training engagement included aspects of trainees' personal lives, professional career-related factors and elements of training support. Personal aspects included family dynamics, health and finances. Professional factors included perceptions of GP careers, remuneration and stigma. Training support factors related to complex interactions between the trainee and the training organisation, supervisors, medical educators, practices and peers.

Discussion: Personal aspects are non-modifiable; however, professional factors and training support features can be targeted to foster engagement with GP training pathways. Considering training as a complex system is helpful in translating this evidence into practice.

Background and objectives: Oral antiviral therapies are recommended for treatment of COVID-19 in people vulnerable to severe outcomes. This study examined COVID-19 antiviral dispensation and incidence of severe outcomes among eligible Victorians by socioeconomic status and cultural and linguistic diversity.

Method: A retrospective analysis was conducted using linked population data. Dispensation of COVID-19 antiviral treatment (molnupiravir or nirmatrelvir/ritonavir) is described, stratified by socioeconomic and culturally and linguistically diverse (CALD) status between 1 January and 30 June 2023 in Victorian residents aged ≥70 years. Rates of severe COVID-19 outcomes (hospitalisation or death) were also calculated from 1 November 2022 to 30 April 2023.

Results: Victorians living in areas of increasing socioeconomic disadvantage had steadily reduced COVID-19 antiviral dispensation in both CALD and non-CALD groups, with lower rates in CALD groups across all socioeconomic levels. The rate of severe COVID-19 outcomes showed the opposite trend.

Discussion: This analysis suggests that treatment access and outcomes are inequitable in Victorians eligible for COVID-19 antivirals. Increasing equity is a public health imperative.

Background and objectives: Since 2019, numerous urgent care clinic (UCC) models have been introduced to Australia. This study investigates concerns raised by medical doctors working in UCC models.

Method: A convenience sample of medical doctors working in UCC models in Australia since 1 July 2023 were invited to participate in a custom-designed 22-item online survey. This was advertised through The Royal Australian College of General Practitioners (RACGP), The Royal New Zealand College of Urgent Care (RNZCUC), corporate general practices, UCC peer groups and on LinkedIn.

Results: Overall, 52 responses were received. Descriptive statistics and qualitative descriptive content analysis was used to identify concerns raised by participants, which included: capacity, accreditation standard, qualifications and experience of medical doctors and nurse practitioners, training, funding, public education and UCCs taking work general practitioners (GPs) could do if appropriately funded.

Discussion: Four practical solutions to the seven concerns were: (1) adoption of Medicare Benefits Schedule UCC item numbers for UCCs and general practices; (2) introducing recognition of extended skills for UCC medical doctors through the RACGP; (3) developing an Australian UCC standard; and (4) increased public health campaigns.

Background and objectives: General practitioners (GPs) need postgraduate training pathways specific to their needs and integrated into local health environments. This scoping review investigates components of integrated GP training pathways including the barriers and enablers of effective pathways for GP recruitment and retention.

Method: This review was guided by methodological framework of Arksey and O'Malley and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews Checklist. MEDLINE, EMBASE, CINAHL and Scopus databases were searched for articles published between 2013 and March 2024. Included articles were analysed and categorised by thematic analysis.

Results: Twenty-seven articles were included, resulting in six key themes: (1) place-based training; (2) trainee background and connections; (3) support structures; (4) professional identity; (5) trainee demographics; and (6) family factors.

Discussion: The components, barriers and enablers of GP training pathways identified will guide development and evaluation of improved integrated training pathway options for GP trainees in Australia.

Background and objectives: Australian Red Cross Lifeblood (Lifeblood) provides therapeutic venesection for patients who meet evidence-based eligibility criteria. Many of these patients have iron overload due to hereditary haemochromatosis (HHC). This study aimed to gain knowledge into the demographic characteristics of donors with haemochromatosis and to investigate their knowledge, compliance and experiences with their condition.

Method: An online survey was sent to therapeutic donors who had provided at least one donation in the five years prior to December 2022. Data were analysed using descriptive statistics.

Results: HHC donors self-reported high compliance with their prescribed venesection schedules. They reported being very knowledgeable about HHC, with most attending Lifeblood as they know their blood will be used. Further, they reported their doctor had little difficulty referring them to Lifeblood.

Discussion: These findings will enable the development of more tailored communications with therapeutic donors to enhance their donation experience and potentially improve treatment compliance.