An extraordinary year

Welcome to the final issue of the Australian Journal of Primary Health for 2020. December is the month when it is customary to reflect on the past year, our achievements, and our challenges. No one could have predicted the challenges confronting Australian health care, academics, and researchers; no wonder 2020 has been dubbed by many the most extraordinary year in recent history.

The impact of the pandemic on research productivity has been diverse. Discussions among our peers, on social media and in journal articles portray two dichotomous groups. First, there are those who felt solace and embraced having time away from the office and face-to-face teaching and data collection to submit some (or in some cases, many) of those ‘bottom draw papers’. Others have not had the same opportunities. Those with childcare, household management and other carer responsibilities, as well as in the workplace, extra teaching duties, were less likely to submit manuscripts to journals during the months of lockdown and physical distancing restrictions (Frederickson 2020; Gabster et al. 2020; Viglione 2020).

Everyone recognises that all researchers have had their challenges: working at home from a kitchen table or in a shared home office an arm’s length away from a partner; the agony and the ecstasy of home schooling (for me this meant no school lunches or school drop off, but ‘rediscovering’ year 8 maths and year 11 biology); and the profound pain of not seeing friends and families. Many of us have also embraced this time to put aside the computer, to put down the phone and constant stream of social media, and to take up long-forgotten hobbies. We have found joy in the mundane, everyday duties of making the best banana bread or bonding over board games, or the bliss of a long walk with a pet who is also feeling ‘cabin fever’.

Whichever group you are in, or maybe you are inbetween, we would like to take this opportunity to thank all those who have submitted, reviewed, and read papers in our journal in what has indeed been an extraordinary time. This issue reflects the diversity and adaptability of primary health care (PHC) as a discipline, and the resilience of our community. The strength and contribution of PHC to population health and wellbeing is reflected in our final issue for 2020.

In this issue, there are two interesting meta-analyses focusing on patient self-management of diabetes. Hosseinzadeh et al. (2020) found that patient activation can be a useful tool to drive self-management decision-making and improve T2D clinical outcomes. Guo et al. (2020) evaluated the nature and role of health literacy in the self-management of diabetes. In a novel systematic review, O’Donnell et al. (2020) describe the types of community-based mental health care programs delivered and evaluated in Australia over the past 20 years and explores their contribution to outcomes for those with serious mental illness.

Having been part of the Primary Health Care Research Evaluation and Development (PHCRED) program I am always keen to learn how PHC practitioners fit research into their busy practice (Brown and McIntyre 2014). Monaghan et al.’s (2020) exploration of the attitudes and beliefs of General Practice teams around sharing de-identified electronic medical record (EMR) patient information will be of interest to both novice and more experienced PHC researchers.

This demanding year has also brought the global community closer together and sparked interest in other health systems. The AJPH encourages submissions from around the world. Two studies give our readers insight into PHC innovations in different settings. Hertanti et al. (2020) unpack Indonesian providers’ knowledge about and comfort to providing palliative care. From Canada, Pang et al. (2020) describe the impact of providing healthcare providers with an information sheet on laboratory testing for children infected by Shiga toxin-producing Escherichia coli (STEC) to increase follow-up rates.

Innovation across the spectrum of PHC services and disciplines is also evident in this issue. Three papers explore initiatives to improve integration and coordination of care pathways across the health system in Australia. Recognising that more integrated health services could address gaps and promote continuity of care in refugee health, Sackey et al. (2020) present the Co-location Model, arguing it has the potential to deliver benefits for patients, health professionals and the health system. Borg et al.’s (2020) paper outlines the positive impact of the Primary Care Practice Improvement Tool (PC-PIT), supported by a Primary Health Network practice support team, in building practice quality and performance. Hains et al.’s (2020) paper presents a comprehensive account of the delivery and evaluation of a national education program for over 8000 Australian GPs to optimise the use of statins. They demonstrate that providing GPs with an Australian-developed statin-associated muscle symptoms (SAMS) management algorithm supported assessment and management of suspected SAMS.

Interprofessional aspects of research and practice are always relevant in PHC settings and Seaton et al.’s (2020) paper describes the characteristics of private physiotherapy practitioners’ interprofessional interactions, including their experiences and perceptions regarding interprofessional collaboration (IPC). I have recently mentored a group of radiographers in qualitative research methods and therefore found Makanjee et al.’s (2020) discussion on the patients’ journey through diagnostic imaging referring very relevant.

This issue also presents two fascinating studies on questions that we often ponder in PHC: patients’ choices of practitioners and practitioners’ choices of area of practice. Cosgriff et al. (2020) aimed to understand the barriers or choices made by patients who access regular care for long-term health issues from multiple general practitioners. Seal et al. (2020) considered whether there were differences between International Medical Graduates and Australian Medical Graduates in terms of their backgrounds and experiences of rural practice.

Here in Queensland, where we have felt some distance from the extremes of lockdown experienced in other states and countries (and perhaps a bit of survivor’s guilt), we know the year’s work is winding down when we smell the mangoes in the air and hear the fruit bats overhead at night. We hope you will take this wind down time to rest, refresh and reflect on all you have achieved this year, and stop to smell the mangoes (and avoid the fruit bats).

The author declares no conflicts of interest.