HC24078 Full Text | HC24078PDF (652 KB) Open Access Article
Current Issue
Journal of Primary Health Care
Volume 16 Number 2 2024
HC24063 Full Text | HC24063PDF (652 KB) Open Access Article
What is already known: Aotearoa New Zealand prioritises the pursuit of health care equity as a central objective. The existence of patient co-payments in primary care poses obstacles to achieving this goal. To address these challenges, the government has implemented various schemes aimed at alleviating them. What this study adds: The sociodemographic characteristics of people in the areas where general practices are located are related to the amount charged for an appointment with a general practitioner. The strongest relationships are seen across ethnicity and socioeconomic deprivation levels with lower fees being associated with higher proportions of Māori and Pacific peoples in that area and among people who are more socioeconomically deprived. The Very-Low-Cost-Access scheme appears to reduce these associations indicating that general practices operating under the scheme appear to reach groups with greater need.
HC23157 Abstract | HC23157 Full Text | HC23157PDF (1.1 MB) Open Access Article
What is already known: In 2022/23, 13% of the population aged 15 and over did not have a GP consultation when needed because of cost; this percentage differs by age group, sex, ethnicity and the New Zealand Deprivation Index. What this study adds: This paper explores the sociodemographic differences in those with met and unmet need for a GP consultation because of cost, their subsequent admissions to hospital and the characteristics of those admissions.
HC24018 Abstract | HC24018 Full Text | HC24018PDF (725 KB) | HC24018Supplementary Material (1.4 MB) Open Access Article
What is already known: Around 5% of the population were not enrolled in a general practice in 2023. This has been found to differ by age, ethnicity and deprivation; with Māori and Pacific peoples (compared to non-Māori/non-Pacific people), young people and those who live in more socioeconomically deprived areas having lower enrolment rates. What this study adds: Those not enrolled generally use fewer health services in general practice than the enrolled. They are less likely to use and take longer to access an emergency department compared to the enrolled but are more likely to use it for conditions that could be treated at a general practice.
HC24023 Abstract | HC24023 Full Text | HC24023PDF (741 KB) | HC24023Supplementary Material (1.4 MB) Open Access Article
What is already known: Community-based primary care physiotherapy is provided in Aotearoa New Zealand through a private practice, fee-for-service model. The impact of this model on patient care, physiotherapists, and professional behaviour is unknown. What this study adds: This exploratory study suggests that competition can dominate communication and collaboration in private practice physiotherapy. Competitive business models and an aversion to scrutiny may reduce collegial interaction and professional behaviour.
HC23150 Abstract | HC23150 Full Text | HC23150PDF (721 KB) | HC23150Supplementary Material (877 KB) Open Access Article
What is already known: Community-based attachments (CBAs) are mandatory in NZ for junior doctors in their first 2 years of study. Some research indicates that CBAs are a positive experience for the practice and the junior doctors. What this study adds: An estimated average cost for hosting PGY2s in general practice was $NZ4907 (range $890–$9183) per placement before consideration of space costs, over and above current funding provided by Health New Zealand |Te Whatu Ora (TWO) Health Workforce Directorate. The small business model of general practice is in tension with providing a positive experience for the PGY2s in a new learning environment, and better communication and cooperation between practices and TWO employing hospitals are needed.
HC23116 Abstract | HC23116 Full Text | HC23116PDF (774 KB) | HC23116Supplementary Material (195 KB) Open Access Article
What is already known: The Physiotherapy Board has recently introduced an Advanced Physiotherapy Practitioner scope of practice. Little is known about how stakeholders perceive this scope of practice. What this study adds: Primary health care stakeholders are broadly supportive of the Advanced Physiotherapy Practitioner scope of practice. It may improve patient pathways, health care delivery and health outcomes for those with musculoskeletal conditions, and the clinical career pathway for physiotherapists.
HC24029 Abstract | HC24029 Full Text | HC24029PDF (735 KB) | HC24029Supplementary Material (403 KB) Open Access Article
HC23171He Aroka Urutā. Rural health provider perspectives of the COVID-19 vaccination rollout in rural Aotearoa New Zealand with a focus on Māori and Pasifika communities: a qualitative study
Disparities between rural and urban COVID-19 vaccination coverage both in NZ and globally have been demonstrated. New Zealand rural health provider perspectives of the COVID-19 vaccination rollout provide insight into factors contributing to the urban–rural COVID-19 vaccination disparity. Findings emphasise the relevance of context in delivering health initiatives rurally, which should be geographically tailored, culturally anchored and locally driven.
HC23171 Abstract | HC23171 Full Text | HC23171PDF (765 KB) Open Access Article
What we already know: Culturally unsafe care negatively impacts health outcomes and further health care utilisation for Māori. Inequities exist in access to and quality of pre-hospital cardiovascular care for Māori. The reasons for such inequities in pre-hospital care are not well understood. What this study adds: This study provides an insight into pre-hospital care from the perspectives of Māori and whānau who utilised the ambulance service for chest pain or cardiac symptoms. A culturally appropriate research approach, using Kaupapa Māori Research, identified interpersonal interactions between Māori and paramedics and systemic and structural barriers as key drivers of poor experiences while highlighting areas where improvements could occur.
HC24010 Abstract | HC24010 Full Text | HC24010PDF (790 KB) Open Access Article
What is already known: The first university-based pharmacy clinic in Australasia provides a unique setting for pharmacy care and education in New Zealand. Little is understood about the experiences of healthcare providers who have referred their patient for a consultation at the Clinic or how well the service is meeting their needs. What this study adds: Healthcare providers valued the opportunities for interprofessional collaborative practice and continuing professional education presented by the Clinic. Perceived benefits to patients and the broader healthcare system support the rationale for ongoing service development.
HC24022 Abstract | HC24022 Full Text | HC24022PDF (717 KB) Open Access Article
HC24026Implementing new forms of collaboration and participation in primary health care: leveraging past learnings to inform future initiatives
What is already known: Primary health care is expected to be a part of a wide diversity of activity providing a more seamless and coordinated patient centred experience. Shifting general practices to take on more care coordination roles can be problematic. Some providers have a starting philosophy as well as the resources and capacity to be very good at this, while others need substantial support to make those transitions. What this study adds: Providing explanation for what has caused variable progress helps identify the type of support that has the most chance of success. Familiar themes of trust and power are examined in different contexts, alongside insights into what helps complex collaborative initiatives gain traction.
HC24026 Abstract | HC24026 Full Text | HC24026PDF (971 KB) Open Access Article
What is known about the topic: Mental health challenges pose a significant public health risk. There is a need to build workforce capacity to address the mental health needs of children and youth in order to promote positive outcomes in later life. What this study adds: All sectors must take responsibility for promoting mental health in children and youth. This participatory action research study presents communities of practice as providing a sustainable mechanism by which international evidence can be received, transformed and translated into practice.
HC23142 Abstract | HC23142 Full Text | HC23142PDF (688 KB) Open Access Article
HC23134Exploring the role of physician associates in Aotearoa New Zealand primary health care
What is already known: In various countries, health care providers aim to diversify the health workforce by introducing new clinical roles such as physician associates/assistants (PAs) to tackle ongoing workforce shortages. Numerous studies highlight PAs as cost-effective contributors who enhance access to safe and effective care. Despite these benefits, the integration of PAs into health care systems has encountered considerable scrutiny from both the public and medical professionals. What this study adds: The Ministry of Health has recently proposed the regulation of the PA profession, allowing foreign-trained PAs to take on clinical responsibilities in both primary and secondary care settings. This article examines the feasibility and implications of introducing PAs into New Zealand’s primary care sector, particularly within the context of general practice.
HC23134 Abstract | HC23134 Full Text | HC23134PDF (682 KB) Open Access Article
HC23178 Full Text | HC23178PDF (673 KB) Open Access Article
Online Early
The peer-reviewed and edited version of record published online before inclusion in an issue
HC24027Ethical assessment of virtual consultation services: scoping review and development of a practical ethical checklist
What is already known: Telephone and video consultations are widely used in general practice. Evaluating these virtual services from an ethical perspective is challenging yet essential to ensure good quality of care. What this study adds: We developed a practical ethical checklist for direct-to-consumer telemedicine services that should make ethical assessment more accessible for all stakeholders.
HC24027 Abstract | HC24027 Full Text | HC24027PDF (814 KB) | HC24027Supplementary Material (1 MB) Open Access Article
HC24030Ethical assessment of virtual consultation services: application of a practical ethical checklist to direct-to-consumer services in Aotearoa New Zealand
What is already known: We have developed a practical ethical checklist comprising 25 questions to assess direct-to-consumer virtual consultation services from an ethical perspective. What this study adds: This study applies the practical ethical checklist to six direct-to-consumer virtual consultation services in Aotearoa New Zealand. It identifies their strengths and weaknesses in this area and raises fundamental questions on what we deem important in virtual care.
HC24030 Abstract | HC24030 Full Text | HC24030PDF (769 KB) | HC24030Supplementary Material (544 KB) Open Access Article
HC24046Establishing the research priorities of a national primary care research network in New Zealand: a Delphi exercise
What is known about the topic: Routinely collected administrative and health data have potential to be used for research that provides real-world health insights that can inform policy and improve clinical practice and population health. Engaging stakeholders to establish priorities can help ensure research is fit for purpose, provides important health benefits, and has the greatest potential to improve health equity. What this study adds: Primary care clinicians and academics identified the top research areas to improve health equity in primary care as the health workforce, health services, mental health, and models of primary health care. The top research questions include evaluating the impacts of annual health checks for people with intellectual disability, the role of allied health as front-line primary health care providers, and the role of an embedded social worker in a general practice clinic setting.
HC24046 Abstract | HC24046 Full Text | HC24046PDF (753 KB) | HC24046Supplementary Material (760 KB) Open Access Article
HC23169Prescribing deprescribing for polypharmacy in Aotearoa New Zealand; experiences of a medication review activity in final year medical students on a general practice module
What is already known: Polypharmacy is increasing as the population ages and causes harm. Deprescribing takes time and requires thoughtful consideration and patient interaction. What this study adds: Focused deprescribing is a significant reflective learning and quality improvement opportunity for medical students and general practitioner supervisors. This student-led activity adds benefit to the student, their supervisor, and the patient of a comprehensive medications review leading to improved knowledge, appropriate deprescribing, and reduced drug interactions.
HC23169 Abstract | HC23169 Full Text | HC23169PDF (751 KB) | HC23169Supplementary Material (1.4 MB) Open Access Article
HC24005Impact of emergency simulation training in primary care: a rapid review
What is known about this topic: There is a current paucity of research in emergency simulation training in primary care. Although there is literature on the use that emergency simulation education has in secondary care services such as emergency medicine (EM) or for intensive care unit (ICU) staff, it is not well established or validated in primary care. What this study adds: To the best of the author's knowledge, this is the first literature review of studies that evaluate the use of emergency care simulations for primary care clinicians. The findings from this review can help inform and guide the appropriate education and training of primary care clinicians.
HC24005 Abstract | HC24005 Full Text | HC24005PDF (797 KB) Open Access Article
HC24040Use of a smartphone-based, non-mydriatic fundus camera for patients with red flag ophthalmic presentations in a rural general practice
What is already known: General practitioners find examining the retina with direct ophthalmoscopy challenging and have low confidence in interpreting findings. What this study adds: General practitioners using smart-phone non-mydriatic fundus photography achieved more adequate views and positive findings of the optic nerve and fundus compared to direct ophthalmoscopy and had close agreement for management referral with the reviewing ophthalmologist.
HC24040 Abstract | HC24040 Full Text | HC24040PDF (802 KB) | HC24040Supplementary Material (290 KB) Open Access Article
HC24020Patient perceptions of barriers to effective migraine management in Aotearoa New Zealand
What is already known: International research shows that people with migraine face significant barriers to accessing effective management. Known barriers include expense of health care and treatments, lack of or misdiagnosis and inadequate access to and communication of effective treatment strategies. What this study adds: This is the first study in Aotearoa New Zealand to document barriers to effective migraine management. Findings are taken from the perspective of people with migraine. Issues were identified in a range of areas including health professional knowledge and training, poor interface between primary and secondary care, inadequately communicated care plans and patients feeling stigmatised by health professionals. We offer recommendations to improve access to effective migraine management.
HC24020 Abstract | HC24020 Full Text | HC24020PDF (786 KB) | HC24020Supplementary Material (1 MB) Open Access Article
HC24038Medicines use and polypharmacy in retirement village residents in Aotearoa New Zealand: a point prevalence observational study
What is already known: Older people commonly take medicines to improve their health, however medicines can also be harmful. Little is known about medicines use in retirement village residents in Aotearoa New Zealand. What this study adds:Our findings, along with new information about medicine use in ‘oldest’ age, suggest that retirement village residents may benefit from talking to their health professional about their medicines to see if they are still the right medicines for them.
HC24038 Abstract | HC24038 Full Text | HC24038PDF (709 KB) | HC24038Supplementary Material (704 KB) Open Access Article
HC23156Struggling to afford medicines: a qualitative exploration of the experiences of participants in the FreeMeds study
What is known about the topic: Even small prescription charges can prevent people from accessing medicines they need, leading to increased use of other health services. The FreeMeds randomised controlled trial found that eliminating $5 prescription charges led to a reduction in hospital use. What this research adds: This paper provides some of the human stories of participants in the FreeMeds study. Many reported having to make changes to how they took their medicines or making choices between obtaining their medicines or other essentials. Some reported hospitalisations due to inability to afford medicines. Few participants had discussed their inability to afford medicines with their general practitioners.
HC23156 Abstract | HC23156 Full Text | HC23156PDF (688 KB) Open Access Article
HC23066Respiratory research with Māori and Pacific children living in Aotearoa, New Zealand: a systematic review and narrative synthesis
What is already known: Respiratory conditions are a major public health concern in Aotearoa New Zealand, and are responsible for a large proportion of the morbidity and mortality experienced by Māori and Pacific children. What this study adds: This paper provides an important overview of respiratory research that involve Māori and Pacific children living in Aotearoa New Zealand. It emphasises that more studies focusing on the needs of Māori and Pacific whānau and communities, and the use of culturally responsive approaches, are essential, ensuring that aspirations are whānau centred and tailored to their needs.
HC23066 Abstract | HC23066 Full Text | HC23066PDF (917 KB) Open Access Article
HC23153Nurses’ and general practitioners’ perspectives on oral health in primary care: a qualitative study
What is already known: Primary healthcare teams are well positioned to promote and protect patients’ oral health, and it is likely that more people at risk of oral disease or needing oral health care will present at primary healthcare practices. Primary healthcare teams need to have sufficient knowledge and confidence to address patients’ oral health complaints. What this study adds: Doctors and nurses appear open to incorporating oral health in their day-to-day practice. Integrating oral health in primary health care in Aotearoa New Zealand will require changes at the individual, professional and systems levels.
HC23153 Abstract | HC23153 Full Text | HC23153PDF (728 KB) | HC23153Supplementary Material (2.5 MB) Open Access Article
HC23131A supported primary health pathway for mild traumatic brain injury quality improvement report
What is already known: Some patients with mild traumatic brain injury (mTBI) can experience persistent symptoms for many years if not treated early. Early access to specialist services such as concussion services can significantly improve patient recovery. What this study adds: This study provides initial evidence that a supported health care pathway following mTBI is feasible to implement in primary care and can facilitate early access to concussion services for those who need it.
HC23131 Abstract | HC23131 Full Text | HC23131PDF (981 KB) | HC23131Supplementary Material (285 KB) Open Access Article
HC23143Preferred format and strategies for seeking and trusting online health information: a survey of cardiology outpatient attendees across three New Zealand hospitals
What is already known: The COVID-19 pandemic and its sequelae served to reduce access to health care providers, exacerbated unmet preventive and diagnostic health needs and made online health information even more important for consumers to make decisions about self- and family-care. What this study adds: This survey asked an ethnically diverse group of patients attending cardiology outpatients what format of information was most valued and strategies they use to trust the information they find. Simple fact sheets were the most preferred online format followed by videos and discussion groups with the best ‘life-hack’ being to get their health professional’s advice on the most trusted website for their condition.
HC23143 Abstract | HC23143 Full Text | HC23143PDF (768 KB) | HC23143Supplementary Material (212 KB) Open Access Article
HC23170Priorities for data collection through a prospective cohort study on gender-affirming hormone therapy in Aotearoa New Zealand: community and clinical perspectives
What is already known: There is a shift towards general practitioners (GPs) prescribing gender-affirming hormone therapy (GAHT) in primary care settings using an informed consent model of care. There is a lack of long-term data on health and wellbeing outcomes for people taking GAHT in Aotearoa New Zealand. What this study adds: The insights from this study offer a blueprint for current and future survey design, to ensure data collection is responsive to the needs of transgender and non-binary (TNB) communities and health care providers. These findings will inform future research to equip health care professionals involved in prescribing GAHT with local, evidence-based data to support their delivery of quality health care to TNB people.
HC23170 Abstract | HC23170 Full Text | HC23170PDF (718 KB) | HC23170Supplementary Material (501 KB) Open Access Article
HC23168Patient demographics and psychotropic medication prescribing in Australian general practices: pre- and during COVID-19 pandemic
What is already known: The use of psychotropic medications in Australia has increased over the last two decades, with general practitioners being the primary prescribers. The COVID-19 pandemic exacerbated mental health issues in adults and the older population, leading to increased concerns about mental health and wellbeing. What this study adds: This study estimates prescribing rates of psychotropic medication by patient demographics and found higher rates of prescribing among females, older people, and those with low to moderate SES. There was a consistent increase in prescribing rates between 2018 and 2022, particularly during the COVID-19 pandemic.
HC23168 Abstract | HC23168 Full Text | HC23168PDF (1 MB) | HC23168Supplementary Material (379 KB) Open Access Article
HC23123Worldviews of hearing health for Pacific peoples in Aotearoa New Zealand: a mixed methods study
What is already known: Limited international research with Pacific Island communities has examined ear disease and hearing health knowledge and beliefs to inform health service delivery. What this study adds: This study is the first mixed-methods investigation using a Pacific methodological approach to examine Pacific peoples’ ear and hearing health worldviews, including knowledge, beliefs, and experiences of the hearing healthcare system in Aotearoa New Zealand. It will assist healthcare professionals in providing more responsive ear and hearing care services for Pacific peoples.
HC23123 Abstract | HC23123 Full Text | HC23123PDF (729 KB) | HC23123Supplementary Material (585 KB) Open Access Article
HC23102Who uses yoga and why? Who teaches yoga? Insights from a national survey in New Zealand
What is already known: While there is extensive global documentation on the sociodemographic attributes of yoga instructors and users, along with their motivations for engaging in yoga, the specifics of yoga instructors and users in New Zealand remain relatively unexplored. What this study adds: This study aims to fill this gap by investigating the distinctive traits and backgrounds of yoga instructors and users in New Zealand. Additionally, the study examines the rationale behind yoga use, the factors that shape participant involvement, participantr methods of seeking information, and how participants communicate with healthcare providers. The insights garnered from this research aim to provide valuable information to the healthcare sector in New Zealand.
HC23102 Abstract | HC23102 Full Text | HC23102PDF (2 MB) Open Access Article
HC23136Māori and Pacific young people’s perspectives on testing for sexually transmitted infections via an online service: a qualitative study
What is already known: Screening sexually active young people for asymptomatic chlamydia and gonorrhoea is important to detect infection, prevent transmission and reduce reproductive health risks. Free online postal self-sampling for sexually transmitted infection (STI) testing is an acceptable alternative to clinic-based testing in some countries, but accessibility and acceptability of online testing in Aotearoa New Zealand is unknown. What this study adds: Opinions about online STI testing among Māori and Pacific young people were mixed, but more concerns than potential advantages were identified. Equity in access to online STI testing by Māori and Pacific young people could be improved by reducing cost, improving awareness about STI testing, and addressing barriers identified in the online testing pathway.
HC23136 Abstract | HC23136 Full Text | HC23136PDF (912 KB) | HC23136Supplementary Material (993 KB) Open Access Article
HC23107Comfort with having sexual orientation recorded on official databases among a community and online sample of gay and bisexual men in Aotearoa New Zealand
What’s already known: Sexual orientation and gender identity (SOGI) minority populations face known and preventable health inequities. However, SOGI data are not collected in routine data collection such as administrative health data, and there are limited studies exploring whether these populations are comfortable with having their data stored in these datasets. What does this study add: The research offers estimates of comfort with having sexual identity data recorded in official datasets among the GBM population of NZ, contributing to a larger body of research that primarily focusses on disclosure in health care settings.
HC23107 Abstract | HC23107 Full Text | HC23107PDF (749 KB) Open Access Article
Just Accepted
These articles have been peer reviewed and accepted for publication. They are still in production and have not been edited, so may differ from the final published form.
Towards new forms of communication and surveillance: A mixed methods study of rapid respiratory virus assessment in general practice during the SARS-CoV-2 pandemic.
Student-run falls prevention programmes for older adult community members: a pilot study
Tertiary institution’s duty of care for the health and well-being of Pacific students during Covid-19: a cross sectional survey
Practice pharmacists in the primary health care team in Aotearoa New Zealand: A national survey
Expert patient and general practitioners’ perspectives on the clinical attributes needed to deal with uncertainty: A qualitative study.
The primary care workforce crisis: defining the problems and finding solutions
Most Read
The Most Read ranking is based on the number of downloads in the last 60 days from papers published on the CSIRO PUBLISHING website within the last 12 months. Usage statistics are updated daily.
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Exploring the role of physician associates in Aotearoa New Zealand primary health care
Journal of Primary Health Care (Online Early) -
Attention deficit and hyperactivity disorder and use of psychostimulants in Aotearoa, New Zealand: exploring the treatment gap
Journal of Primary Health Care 16 (1) -
Patient perceptions of barriers to attending annual diabetes review and foot assessment in general practice: a qualitative study
Journal of Primary Health Care 16 (1) -
Eating behaviour, body image, and mental health: updated estimates of adolescent health, well-being, and positive functioning in Aotearoa New Zealand
Journal of Primary Health Care 15 (4) -
The impact of nurse prescribing on health care delivery for patients with diabetes: a rapid review
Journal of Primary Health Care 16 (1) -
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Respiratory research with Māori and Pacific children living in Aotearoa, New Zealand: a systematic review and narrative synthesis
Journal of Primary Health Care (Online Early) -
Determinants of cancer screenings participation in Queensland: a scoping review
Journal of Primary Health Care 16 (1) -
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Rural general practice and ethical issues. A rapid review of the literature
Journal of Primary Health Care 15 (4) -
Utilisation of in-consultation supervisor assistance in general practice training and personal cost to trainees: a cross-sectional study
Journal of Primary Health Care 16 (1) -
Advanced practice physiotherapists in primary health care: stakeholders’ views of a new scope of practice
Journal of Primary Health Care (Online Early) -
Private practice model of physiotherapy: professional challenges identified through an exploratory qualitative study
Journal of Primary Health Care (Online Early) -
Holistic health for Pacific seniors from a weekly group gathering run by a Pacific health provider
Journal of Primary Health Care 15 (4) -
Defining comprehensiveness in primary care: a scoping review
Journal of Primary Health Care 15 (3) -
Improving access to dermatology specialist care: review of a dermatologist- and general practitioner-integrated clinic model
Journal of Primary Health Care 16 (1) -
Prompting lifestyle interventions to promote weight loss is safe, effective and patient-centred: No
Journal of Primary Health Care 15 (4) -
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Inequities in medicines use are probably much worse than we thought
Journal of Primary Health Care 16 (1) -
New Zealand pharmacists’ views regarding the current prescribing courses: questionnaire survey
Journal of Primary Health Care 15 (4)