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Background and objective Tuberculosis infection (TBI) screening and treatment delivered from primary care could hold the key to achieving tuberculosis (TB) elimination in lowTB burden countries. This scoping review was undertaken to understand how elements of the cascade of care for TBI screening and treatment have been implemented in primary care settings globally. Methods For this review, eight databases were searched, including PubMed, Embase, CINAHL, Global Index Medicus, Scopus, Web of Science, ProQuest Dissertations & Theses Global and the Cochrane Library, to examine models of care for TBI screening and treatment in primary care. Results Eight articles were included from the 7207 articles screened. These eight articles describe models of care that are varied in their aim, design and focus and elements of the TBI cascade of care. Discussion Although primary care is well placed to offer TBI screening and treatment, robust referral, community mobilisation and systems support are critical. Further research is necessary for Australia to deliver on the elimination target of the World Health Organization. [ABSTRACT FROM AUTHOR]

Objective: To establish prevalence and associations of provision of nursing home visits (NHV) and home visits (HV) by early‐career specialist GPs. Of particular interest were associations of rurality with performing NHVs and HVs. Methods: A cross‐sectional study. Design: A questionnaire‐based study. Setting: Australian general practice. Participants: Early‐career specialist GPs, practising in Australia, who attained Fellowship between January 2016 and July 2018, inclusive, having completed GP training in NSW, the ACT, Eastern Victoria or Tasmania. Main Outcome Measures: Current provision of NHV and HV. Results: NHV were provided by 34% of participants (59% in rural areas) and HV by 41% of participants (60% in rural areas). Remote, rural or regional practice location, as compared to major‐city practice, was strongly associated with performing NHV as an early‐career specialist GP; multivariable OR 5.87 (95% CI: 2.73, 12.6), p < 0.001, and with the provision of HV; multivariable OR 3.64 (95% CI: 1.63, 8.11), p = 0.002. Rurality of GP training (prior to attaining Fellowship) was significantly univariably associated with providing NHV and with providing HV as an early‐career specialist GP. On multivariable analyses, these were no longer statistically significant. Conclusion: Early‐career specialist GPs located in regional/remote areas are more likely than their urban colleagues to provide NHV and HV. [ABSTRACT FROM AUTHOR]

Background: The use of telehealth has increased dramatically since the beginning of the COVID-19 pandemic. Little is known about how GPs manage acute infections during telehealth, and the potential impact on antimicrobial stewardship. Aim: To explore the experiences and perceptions of GP trainees' and supervisors' use of telehealth, and how it influences their management of acute infections. Design & setting: Australian GP registrars (trainees) and supervisors were recruited via email through their training organisations. Semi-structured interviews with 18 participants were conducted between July and August 2022. Method: Interviews were transcribed verbatim and analysed using a reflexive thematic approach. Results: We identified six overall themes. 1. Participants experienced impaired diagnostic capacity during telehealth consultations. 2. Attempts to improve diagnostic acuity included various methods, such as having patients self-examine. 3. The management of clinical uncertainty frequently entailed referring patients for in-person assessment, overinvestigating, or overtreating. 4. Antibiotic prescribing decisions during telehealth were informed by less information than were in-person consults, with varying impact. 5. Participants believed that other GPs improperly prescribed antibiotics during telehealth. 6. Supervisors believed that registrars hadn't developed the knowledge or skills to determine when conditions could be managed appropriately via telehealth. Conclusion: Telehealth has potential for reducing transmission of acute infections and increasing access to healthcare. However, the implications of GPs, especially less experienced GPs, making diagnoses with less certainty, and consequently compromising antimicrobial stewardship, are a concern. Patient self-assessment tools may improve outcomes of telehealth consultations for acute infections. [ABSTRACT FROM AUTHOR]

Background: The vast health inequities experienced by people with intellectual disability remain indisputable. Persistent and contemporary challenges exist for primary healthcare providers and researchers working to contribute to improvements to the health and well-being of people with intellectual disability. Over two decades after the only review of supports for primary healthcare providers was published, this paper contributes to an evolving research agenda that aims to make meaningful gains in health-related outcomes for this group. Methods: The present authors updated the existing review by searching the international literature for developments and evaluations of multinational models of care. Results: Based on our review, we present three strategies to support primary healthcare providers: (i) effectively using what we know, (ii) considering other strategies that offer support to primary healthcare professionals and (iii) researching primary health care at the system level. Conclusions: Strengthening primary care by supporting equitable provision of health-related care for people with intellectual disability is a much needed step towards improving health outcomes among people with intellectual disability. More descriptive quantitative and qualitative research, as well as intervention-based research underpinned by rigorous mixed-methods evaluating these strategies at the primary care level, which is sensitive to the needs of people with intellectual disability will assist primary care providers to provide better care and achieve better health outcomes.

Introduction: Access to after‐hours care (AHC) is an important aspect of general practice service provision. Objective: To establish the prevalence and associations of early‐career GPs' provision of AHC. Design: An analysis of data from the New alumni Experiences of Training and independent Unsupervised Practice (NEXT‐UP) cross‐sectional questionnaire‐based study. Participants were early‐career GPs (6‐month to 2‐year post‐Fellowship) following the completion of GP vocational training in NSW, the ACT, Victoria or Tasmania. The outcome factor was 'current provision of after‐hours care'. Associations of the outcome were established using multivariable logistic regression. Findings: Three hundred and fifty‐four early‐career GPs participated (response rate 28%). Of these, 322 had responses available for analysis of currently performing AHC. Of these observations, 128 (40%) reported current provision of AHC (55% of rural participants and 32% of urban participants). On multivariable analysis, participants who provided any AHC during training were more likely to be providing AHC (odds ratio (OR) 5.51, [95% confidence interval (CI) 2.80–10.80], p < 0.001). Current rural location and in‐training rural experience were strongly associated with currently providing AHC in univariable but not multivariable analysis. Discussion: Early‐career GPs who provided AHC during training, compared with those who did not, were more than five times more likely to provide after‐hours care in their first 2 years after gaining Fellowship, suggesting participation in AHC during training may have a role in preparing registrars to provide AHC as independent practitioners. Conclusion: These findings may inform future GP vocational training policy and practice concerning registrars' provision of AHC during training. [ABSTRACT FROM AUTHOR]