Register      Login
Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care

Australian Journal of Primary Health Top Downloads 2024

The Australian Journal of Primary Health (AJPH) presents the 2024 most downloaded papers from across all issues and special issues. These highly accessed papers reflect the scope of the AJPH to be a leading voice highlighting the key innovations and new knowledge across primary health care (PHC). This list of 20 papers emphasises the PHC communities focus on comprehensive, whole-person care that is responsive to the needs of the community.

A leading topic in this series includes First Nations healthcare. The AJPH receives and publishes a large number of manuscripts that report Aboriginal and Torres Strait Islander health. Our top downloaded papers include a review on pelvic health care for Aboriginal Torres Strait Islander people (Wise et al. 2024), diagnosis and treatment of cancer pathways (Ivers et al. 2024), a co-design paper on culturally safe health care (Cormick et al. 2024) and another on communication (Ghamrawi et al. 2024). It is pleasing to see a dental paper in the top downloads that focuses on the role of Aboriginal Health Practitioners and fluoride varnish (Ummer-Christian et al. 2024).

Four of the top downloaded papers focus on mental health which reflects the high level of mental health care delivered in PHC. Antidepressant deprescribing (Coe et al. 2024; Wallis et al. 2024), youth mental health (Savaglio et al. 2024), and preventive health care for people who experience severe mental illnesses (Spooner et al. 2024) were the focus of these papers.

Multidisciplinary team care and how professions can work together was the focus of three papers in the top downloads. Interprofessional collaborative practice (Seaton et al. 2024), chronic disease management (Pearson et al. 2024), and the role of the general practice nurse (Willis et al. 2024) featured in this series.

Primary health care for older people was also a highly accessed set of papers with eye care for people with dementia (Piano et al. 2024), nutrition and frailty (Rattray and Roberts), and Advanced Care Directives (Manandi et al. 2024) featuring in this series.

The evaluation of new innovations included a gambling harm screening model (Reid et al. 2024), Plan–Do–Study–Act cycles (Manandi et al. 2024), nurse-led clinic for chronic wounds (Dhar et al. 2024), a community-based family education and resourcing program (Latham et al. 2024), and e-prescriptions (Lau et al. 2024). These papers demonstrate the wide array of methods that are used in PHC research to demonstrate effectiveness and impact of new interventions.

We congratulate our colleagues on their inclusion in the top 20 most downloaded papers in 2024.

Virginia Lewis (La Trobe University)
Liz Sturgiss (Bond University)

Last Updated: 28 Apr 2025

Deprescribing of antidepressants is not routinely occurring in clinical practice, leading patients to seek help via other methods. Little is known about what role social media support groups play in a patient’s journey when ceasing antidepressant medication. This is one of the first studies to gain insight from antidepressant users who are also members of two Facebook groups providing support for antidepressant deprescribing. Lack of clinical knowledge by clinicians is a big driver for patients help seeking from their peers.

PY23074Mapping community-based youth mental health services in Tasmania, Australia

Melissa Savaglio, Marie Yap, Ash Vincent and Helen Skouteris

Standard descriptions of mental healthcare provision are needed to inform evidence-based mental healthcare policy, planning and implementation. Systematic service scoping and mapping of community-based youth mental health services in Tasmania, Australia highlighted the limited availability and accessibility of supports available for young people (aged under 25 years) experiencing mental illness. These findings may inform the (re)design, (re)development and implementation of community-based youth mental health services, including a focus on integrated models of youth mental healthcare.

The rate of antidepressant use in Australia is among the highest in the world (one in seven adults) and increasing, while the rate in the Netherlands is about half that of Australia and remained steady over 2013–2021. The Netherlands achieved this through a multifaceted approach including improved access to non-pharmacological alternatives, initiatives targeting safer antidepressant prescribing and deprescribing, and tight regulation of pharmaceutical company influence on prescribers. Australia may learn from the Netherlands’ approach to redress increasing antidepressant use.

PY23195Access to general practice for preventive health care for people who experience severe mental illness in Sydney, Australia: a qualitative study

Catherine Spooner 0000-0002-6741-5644, Peri O’Shea 0009-0008-1393-2516, Karen R. Fisher 0000-0002-0828-6395, Ben Harris-Roxas 0000-0003-1716-2009, Jane Taggart 0000-0001-7283-6710, Patrick Bolton 0000-0002-3401-553X and Mark F. Harris 0000-0002-0705-8913

People with lived experience of severe mental illness (PWLE) experience poorer physical health and worse access to preventive care than the general population. This paper provides information from a lived experience perspective on how PWLE in Sydney, Australia have been able to access preventive care from a GP. These results highlight the importance of supporting PWLE to access effective preventive care across their journey and suggest specific areas for improvement in GP capabilities and care coordination/shared care.

This article belongs to the Collection Access to Primary Health Care.

PY23172Co-designing a Health Journey Mapping resource for culturally safe health care with and for First Nations people

Alyssa Cormick, Amy Graham, Tahlee Stevenson, Kelli Owen, Kim O’Donnell and Janet Kelly

We have co-designed Health Journey Mapping tools and resources with First Nations patients and families and with First Nations and non-First Nations healthcare professionals to address current gaps in care. These pragmatic, strengths-based tools and resources enhance and incorporate cultural safety, continuous quality and improvement and comprehensive care and can be used collaboratively by healthcare consumers and professionals to assess and improve the quality, access, experiences and outcomes of care.

PY23167A systematic search and narrative review of Aboriginal and Torres Strait Islander women and men pelvic health care: demonstrated need for improvement

Emma M. Wise 0000-0003-1810-9525, Marilyn A. Morgan, Emily D. Biggs, Bronte H. Ellis, Marissa C. Joseph, Melanie L. Say, Lea T. Yanitsas, Jonathan C. Bullen 0000-0003-0437-2541, Brooke R. Conley 0000-0002-1677-4540, Ivan B. Lin 0000-0001-6901-2569, Leo Ng 0000-0002-9814-0495 and Darren J. Beales 0000-0002-7176-4644

Warning:This article contains terms, descriptions and opinions that may be culturally sensitive for Aboriginal and Torres Strait Islander peoples.

Pelvic health conditions are under-recognised and under-reported by Aboriginal and Torres Strait Islander peoples. Access to effective conservative (non-surgical) management options provided in a culturally safe manner appear to be lacking. We provide strategies to improve pelvic health care of Aboriginal and Torres Strait Islander women and men by highlighting considerations that facilitate culturally safe pelvic health care at the systems, health service and clinician levels.

Communicating health information can be a challenging skill to clinicians especially when working in Aboriginal health. Despite Aboriginal Health Community Controlled Health Organisations having enriched the experience of Aboriginal patients, there is limited research on the approaches adopted by general practitioners (GPs) working in these clinics. Our research combines thoughts from experienced and novice GPs who worked in Aboriginal Health, and shares some of their experiences related to communicating medical information with Aboriginal patients in this highly complex field.

Self-determination informed policies are key to improved outcomes for Aboriginal health. The paper presents work on an oral health policy, undertaken under Loddon Mallee Aboriginal Reference Group’s leadership on an Australian state (Victoria) regulation – The Drugs, Poisons and Controlled Substances Amendment (Registered Aboriginal and Torres Strait Islander Health Practitioners) Regulations 2022, as an exemplar of a self-determination informed change. The amendment translates to a culturally appropriate integrated oral health promotion model that addresses dental access barriers experienced by Aboriginal people.

This article belongs to the Collection Access to Primary Health Care.

PY22181Barriers and facilitators to adherence to Optimal Care Pathways for diagnosis and treatment of cancer for Aboriginal and Torres Strait Islander people

Rowena Ivers, Michelle Dickson, Kathleen Taylor, Trish Levett, Kyla Wynn, Janelle Trees, Emma Webster, Gail Garvey, Joan Cunningham, Lisa Whop and Abbey Diaz

This qualitative project involves Yarns with 30 health professionals in Aboriginal community-controlled services and other services, and addresses barriers and facilitators to adherence to Optimal Care Pathways for diagnosis and treatment of cancer for Aboriginal people.

Physiotherapists working in primary care are becoming increasingly important members of interprofessional healthcare teams. This research outlines key strategies from the perspective of Queensland physiotherapy private practitioners, including reforming funding structures, leveraging digital communication and improving education and training initiatives, to promote effective interprofessional collaborative practice. The insights from this study underscore the broader complexities within Australia’s healthcare system and emphasise the need for strategic changes to achieve collaboration in ensuring optimal patient care.

PY23124Supporting best practice in the management of chronic diseases in primary health care settings: a scoping review of training programs for Indigenous Health Workers and Practitioners

Odette Pearson, Shwikar Othman, Kate Colmer, Sana Ishaque, Gloria Mejia, Sarah Crossing, David Jesudason, Gary Wittert, Paul Zimmet, Sophia Zoungas, Natalie Wischer, Kim Morey, Jane Giles, Sara Jones, Alex Brown and Saravana Kumar

Limited studies have sought to implement and evaluate novel workforce approaches to reducing differential diabetes-related outcomes in the Aboriginal and Torres Strait Islander peoples populations. This review described the characteristics of the chronic disease management training programs and their effectiveness for Aboriginal Health Workers and Practitioners. Most included studies reported satisfaction with the training content, whereas some reported improved knowledge, confidence, and clinical and non-clinical skills of the participants. However, few studies reported knowledge transfer into clinical practice and client-related outcomes.

PY23127An integrative review of missed nursing care and the general practice nurse

Eileen Willis, Claire Verrall 0000-0001-5557-7067, Susan McInnes and Elyce Pate

Identifying missed nursing care is an important avenue to achieving improvements in patient care. Predominantly undertaken in the acute sector, there is a need to expand missed care research to the primary healthcare sector. We conducted an integrative review to determine missed care and the general practice nurse. Some commonalities between the primary health and acute sectors were identified such as issues with communication and resource availability. Recent calls for general practice nurses to work to the top of their scope involve a more nuanced understanding of the role, and what is being missed.

Access to allied health services offers significant benefits for people living with dementia, yet access is currently fragmented and inconsistent. People living with dementia are at greater risk of experiencing vision impairment, preventable through regular eye examinations usually provided by community-based optometrists in a primary care capacity. We encourage all primary care practitioners to ‘think vision’ when consulting with people living with dementia, and advocate for a schedule of regular eye tests post-diagnosis.

This article belongs to the Collection Access to Primary Health Care.

Malnutrition and frailty are common in Australian and New Zealand communities, burdening individuals, health systems and the economy. This paper describes the process by which an evidence-informed guide for identifying and managing these conditions in the community was developed. The guide is now freely available online and can be used by all healthcare professionals across several settings, and our description of the process might be informative to others who are developing such tools to guide practice in their healthcare environment.

The law supports good end-of-life clinical practice by facilitating health care that aligns with the values and goals of patients, including those residing in residential aged care facilities. GPs and nurses here reported broad-ranging legal concerns relevant to providing end-of-life care within aged care, including substitute decision makers/family members wanting to overrule Advance Care Directives, requests for futile or non-beneficial treatment and conflict about decision-making. Participants’ concerns can inform end-of-life legal training for aged care GPs and nurses.

PY23208Exploring the feasibility of a gambling harm screening model in general practice and community service settings in Fairfield: a pilot study

Andrew Reid 0000-0001-8173-2710, Nick McGhie 0000-0003-0827-9539, Thi Huyen Linh Nguyen 0000-0002-2815-0241, Uday Yadav 0000-0002-6626-1604, Patricia Cullen 0000-0003-4652-0936, Leon Booth 0000-0002-6326-1908 and Amy Bestman 0000-0003-1269-2123

Primary healthcare and community services are important settings for gambling harm screening, and more broadly can contribute to the prevention and treatment of gambling harm in communities. However, there has been limited research on how screening can be embedded into routine practice. This pilot research identifies the enablers and barriers to implementing a co-designed screening model in local primary care settings.

PY23123The evaluation of the Plan–Do–Study–Act cycles for a healthcare quality improvement intervention in primary care

Deborah Manandi 0000-0002-7532-0477, Qiang Tu, Nashid Hafiz, Rebecca Raeside, Julie Redfern and Karice Hyun

Plan–Do–Study–Act (PDSA) cycles are increasingly used as a framework for improving quality of health care, yet its utility in primary care practices have remained largely understudied. PDSA cycles reported by general practices were high in completion, successful and achieved improvement, but low in content quality. Completion, success and content quality of PDSA cycles were likely influenced by human or capital resources availability and training provided to general practices.

PY23081The client and family experience of attending a nurse-led clinic for chronic wounds

Anusuya Dhar 0000-0002-0311-9563, Judith Needham, Michelle Gibb and Elisabeth Coyne

Nurse-led wound care has been shown to improve client outcomes, but there is minimal research on the lived experience of attending a nurse-led wound clinic. The findings demonstrate that clients and family members were satisfied with their experience in the nurse-led clinic, and highly regarded the expert advice they received and the physical accessibility of the location. To improve the client and family experience of the nurse-led clinic, there needs to be a greater focus on pain management, improving social support, providing client education and enabling cost-effective care.

Home visiting programs can improve outcomes for infants and families at risk of suboptimal health and developmental outcomes. However, there is limited evidence regarding the efficacy of current programs in use in Queensland. This study analyses Child Health Nurse perceptions of one such program, with findings confirming the need for active monitoring of program outcomes against their stated objectives.

PY22240E-prescription: views and acceptance of general practitioners and pharmacists in Greater Sydney

Phyllis Lau 0000-0002-0665-6348, Minh Thuan Tran 0000-0002-0857-8785, Ricky Yong Kim, Alsayed Hashem Alrefae, Sangwoo Ryu and Jim Chyuan Teh

It is inevitable that electronic prescriptions will one day supersede paper prescriptions, but there is resistance to their implementation at the practitioner and patient levels. This paper explored GPs and pharmacists’ experience and views, and found that while e-prescription improves the quality of patient care, there are several challenges to its effective use. Findings may inform the future promotion of e-prescription, particularly post-COVID-19 pandemic, and guide future research in exploring consumer perspectives.