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Primary care (PC) is a unique clinical specialty and research discipline with its own perspectives and methods. Research in this field uses varied research methods and study designs to investigate myriad topics. The diversity of PC presents challenges for reporting, and despite the proliferation of reporting guidelines, none focuses specifically on the needs of PC. The Consensus Reporting Items for Studies in Primary Care (CRISP) Checklist guides reporting of PC research to include the information needed by the diverse PC community, including practitioners, patients, and communities. CRISP complements current guidelines to enhance the reporting, dissemination, and application of PC research findings and results. Prior CRISP studies documented opportunities to improve research reporting in this field. Our surveys of the international, interdisciplinary, and interprofessional PC community identified essential items to include in PC research reports. A 2-round Delphi study identified a consensus list of items considered necessary. The CRISP Checklist contains 24 items that describe the research team, patients, study participants, health conditions, clinical encounters, care teams, interventions, study measures, settings of care, and implementation of findings/results in PC. Not every item applies to every study design or topic. The CRISP guidelines inform the design and reporting of (1) studies done by PC researchers, (2) studies done by other investigators in PC populations and settings, and (3) studies intended for application in PC practice. Improved reporting of the context of the clinical services and the process of research is critical to interpreting study findings/results and applying them to diverse populations and varied settings in PC. Key words: guidelines; research report; checklist; primary care; research; consensus; stakeholder participation; Delphi studies; research impact; research design; surveys and questionnaires; authors; editors; reviewers; article; publishing; journals, INTRODUCTION Researchers, journals, and research users across many fields recognize the need to improve research reporting (1,2) and have developed research reporting guidelines to assist researchers. Many guidelines have been [...]

Context: There is a global movement to advance the use of data to inform and improve health service delivery. Despite extensive and long term computerisation of Australian general practice, aggregated data has rarely been used to improve the quality of primary care. This project arose from an increasing interest from a large Academic Health Science Centre (AHSC) in data-led health care improvement in primary care. The AHSC, Monash Partners, commissioned this work to inform future data initiatives. Objective: Identify contextual influences, key challenges and approaches required to embed data-led primary health care improvement in the Monash Partners' region. Study Design and Analysis: Our qualitative design used semi-structured interviews. We used purposive and snowball sampling to recruit 24 clinicians, researchers and policy makers between October and November 2021. Interviews were conducted via Zoom video-conferencing and recorded. Analysis was iterative, with thematic coding developed using deductive and inductive processes and refined during analysis, reflection and investigator discussions. Setting: The AHSC's catchment, South East and East Melbourne, Australia, between October and November 2021. Population Studied: Regional data custodians and data users. Results: We found an uncoordinated system that mirrored Australia's difficulties in using health data to benefit society. Nearly all participants were passionate about the potential for data-led health care improvement, yet cautious about the practicalities of change. General practitioner (GP) academics stressed how difficult it was for GPs to see a 'value add' from primary care data, and whether data initiatives met GP and community needs. Nevertheless, participants saw potential in creation of an accessible high quality data asset linking GP clinical data with state and federal health datasets. This resource would require a regional data strategy and formalised partnerships between regional primary care organisations, data custodians and academics. Conclusions: Our findings suggest that a region-wide strategy involving creative individual and organisational capacity building could achieve success in sustainable primary care data-led improvement. This should focus on the needs of diverse communities, and the priorities of primary care clinicians and their teams. The AHSC appears to be the only regional organisation with the mandate and capacity to promote such an approach., Presenters Grant Russell, MD, PhD, MBBS, FRACGP MFM, Sharon Clifford, Maryanne Li, Sanne Peters, Riki Lane, PhD, BA, [...]

Context: Chronic pain has been long recognised as a defining feature among the wide range of health-related problems exhibited in women belonging to refugee backgrounds. Insights into the health and socio-cultural experiences of refugee women seeking care for chronic pain may help inform practice protocols and reduce health inequalities in populations that are systematically marginalised. Objective: To explore the health-seeking narratives of Assyrian refugee women and the factors that influence their care for chronic pain in Australia. Study Design and Analysis: A qualitative study using a phenomenological perspective to understand the lived experience of Assyrian refugee women seeking care for chronic pain. Analysis involved reflexive thematic analysis based in identifying meaningful patterns and organising these into themes. Setting: The study was set in Melbourne, Victoria where recruitment began by approaching Iraqi Assyrian refugee community leaders, acting as key informants, through pre-existing partnerships with settlement services. Purposive sampling and a snowballing approach was used to identify eligible participants. Population Studied: Ten Assyrian refugee women who identified as having chronic pain. Women were aged between 19 to 85 years and had lived in Australia for four years or longer. Instrument: Semi-structured, in-depth interviews lasting between 30 to 90 minutes were conducted in English or in Arabic with an interpreter present. Outcome Measured: The lived experience of refugee women receiving care for chronic pain in Australia. Results: Overall, experiences such as their culture and family caregiver role in their homeland heavily influenced their experiences seeking healthcare in Australia. Five key themes emerged from this, including 1) Trust in health care systems 2) Accessibility to care 3) Perceptions of pain 4) Support seeking mechanisms and 5) Health knowledge. These themes played a significant role on shaping and forming their models of thought around accessing health care and living life with chronic pain. Conclusions: Refugee women arriving in Australia were confronted with social and cultural conditions and health systems that were radically different to their past experiences. This study provides rich insights into the health needs of refugee women, and highlights a need for an evidence base for better patient advocacy around chronic pain management and practice protocols to support refugee women resettling in Australia., Presenters Areni Altun, Helen Brown, Liz Sturgiss, MD, PhD, BMed, MPH, FRACGP, Grant Russell, MD, PhD, MBBS, FRACGP [...]

BACKGROUND: Primary aldosteronism (PA) is a common but underdiagnosed cause of hypertension. Many patients experience preventable end-organ injury due to delayed or missed diagnosis but data on the experience of patients are limited. METHODS: We evaluated the lived experience of PA and determines factors associated with diagnostic delay through an international anonymous online cross-sectional survey, codesigned by researchers and PA consumers. We distributed the survey through academic medical centers, Amazon Mechanical Turk, Twitter, PA patient advocacy groups, and hypertension support groups on Facebook between March 21 and June 5, 2022. RESULTS: Of 684 eligible respondents, 66.5% were women. Diagnostic delay (defined as ≥5 years between the diagnosis of hypertension and PA) was reported in 35.6%. Delay was more likely in women than in men (odds ratio, 1.55 [95% CI, 1.10-2.20]) and respondents with ≥3 comorbidities versus none (odds ratio, 1.77 [95% CI, 1.05-3.02]), ≥10 symptoms versus none (odds ratio, 2.73 [95% CI, 1.74-4.44]), and on ≥4 antihypertensive medications versus none (odds ratio, 18.23 [95% CI, 6.24-77.72]). Three-quarters of patients (74.4%) experienced reduced symptom burden following targeted PA treatment. Quality of life improved in 62.3% of patients, and greater improvement was associated with being a woman (odds ratio, 1.42, [95% CI, 1.02-1.97]), receiving adrenalectomy (odds ratio, 2.36 [95% CI, 1.67-3.35]), and taking fewer antihypertensive medications following diagnosis (odds ratio, 5.28 [95% CI, 3.55-7.90]). CONCLUSIONS: One-third of patients with PA experienced prolonged diagnostic delays. Targeted treatment led to reduced symptom burden and improved quality of life. Gender differences in diagnostic delay and symptom burden are prominent. These findings suggest that routine screening for PA at the onset of hypertension may reduce diagnostic delay and facilitate timely diagnosis. [ABSTRACT FROM AUTHOR]

Alzheimer’s disease (AD) is one of the looming health crises of the near future. Increasing lifespans and better medical treatment for other conditions mean that the prevalence of this disease is expected to triple by 2050. The impact of AD includes both the large toll on individuals and their families as well as a large financial cost to society. So far, we have no way to prevent, slow, or cure the disease. Current medications can only alleviate some of the symptoms temporarily. Many animal models of AD have been created, with the first transgenic mouse model in 1995. Mouse models have been beset by challenges, and no mouse model fully captures the symptomatology of AD without multiple genetic mutations and/or transgenes, some of which have never been implicated in human AD. Over 25 years later, many mouse models have been given an AD-like disease and then ‘cured’ in the lab, only for the treatments to fail in clinical trials. This review argues that small animal models are insufficient for modelling complex disorders such as AD. In order to find effective treatments for AD, we need to create large animal models with brains and lifespan that are closer to humans, and underlying genetics that already predispose them to AD-like phenotypes.