Australian general practice and pandemic influenza: models of clinical practice in an established pandemic

Phillips, Christine; Patel, Mahomed; Glasgow, Nicholas; Pearce, Christopher; Dugdale, Paul; Davies, Alison; Hall, Sally; Kljakovic, Marjan

doi:10.5694/j.1326-5377.2007.tb00937.x

Cited by 12 publications

(24 citation statements)

References 6 publications

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“…1 : PRISMA Search). These were comprised of 20 research studies ( 11–30 ), one thesis ( 31 ), five reports ( 32–36 ) and five commentaries ( 37–41 ). Table 1 summarizes included studies and Table 2 presents countries and epidemics examined.…”

Section: Resultsmentioning

confidence: 99%

Lessons for the global primary care response to COVID-19: a rapid review of evidence from past epidemics

et al. 2021

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Background COVID-19 is the fifth and most significant infectious disease epidemic this century. Primary health care providers, which include those working in primary care and public health roles, have critical responsibilities in the management of health emergencies. Objective To synthesize accounts of primary care lessons learnt from past epidemics and their relevance to COVID-19. Methods We conducted a review of lessons learnt from previous infectious disease epidemics for primary care, and their relevance to COVID-19. We searched PubMed/MEDLINE, PROQUEST and Google Scholar, hand-searched reference lists of included studies, and included research identified through professional contacts. Results Of 173 publications identified, 31 publications describing experiences of four epidemics in 11 countries were included. Synthesis of findings identified six key lessons: (i) improve collaboration, communication and integration between public health and primary care; (ii) strengthen the primary health care system; (iii) provide consistent, coordinated and reliable information emanating from a trusted source; (iv) define the role of primary care during pandemics; (v) protect the primary care workforce and the community and (vi) evaluate the effectiveness of interventions. Conclusions Evidence highlights distinct challenges to integrating and supporting primary care in response to infectious disease epidemics that have persisted over time, emerging again during COVID-19. These insights provide an opportunity for strengthening, and improved preparedness, that cannot be ignored in a world where the frequency, virility and global reach of infectious disease outbreaks are increasing. It is not too soon to plan for the next pandemic, which may already be on the horizon.

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Section: Resultsmentioning

confidence: 99%

Lessons for the global primary care response to COVID-19: a rapid review of evidence from past epidemics

et al. 2021

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“…The methods used to construct the cells of the modified Haddon matrix have been detailed elsewhere [16]. In brief, a team with expertise in social science, public health and general practice reviewed objectives and strategies in WHO guidelines for preparing and responding to a pandemic [17] to define the context and potential contributions of general practice.…”

Section: Development Of the Frameworkmentioning

confidence: 99%

“…Some acute care usually undertaken in hospitals, like acute asthma or injuries, may be transferred to the community. In an earlier paper, we advanced a range of models of practice to balance clinical services for influenza and non-influenza care [16].…”

Section: Clinical Carementioning

confidence: 99%

General Practice and Pandemic Influenza: A Framework for Planning and Comparison of Plans in Five Countries

et al. 2008

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BackgroundAlthough primary health care, and in particular, general practice will be at the frontline in the response to pandemic influenza, there are no frameworks to guide systematic planning for this task or to appraise available plans for their relevance to general practice. We aimed to develop a framework that will facilitate planning for general practice, and used it to appraise pandemic plans from Australia, England, USA, New Zealand and Canada.Methodology/Principal FindingsWe adapted the Haddon matrix to develop the framework, populating its cells through a multi-method study that incorporated the peer-reviewed and grey literature, interviews with general practitioners, practice nurses and senior decision-makers, and desktop simulation exercises. We used the framework to analyse 89 publicly-available jurisdictional plans at similar managerial levels in the five countries. The framework identifies four functional domains: clinical care for influenza and other needs, public health responsibilities, the internal environment and the macro-environment of general practice. No plan addressed all four domains. Most plans either ignored or were sketchy about non-influenza clinical needs, and about the contribution of general practice to public health beyond surveillance. Collaborations between general practices were addressed in few plans, and inter-relationships with the broader health system, even less frequently.ConclusionsThis is the first study to provide a framework to guide general practice planning for pandemic influenza. The framework helped identify critical shortcomings in available plans. Engaging general practice effectively in planning is challenging, particularly where governance structures for primary health care are weak. We identify implications for practice and for research.

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“…Australian state and national pandemic influenza management plans provide broad details about how pandemic influenza will be managed within primary care, and the tasks that GPs will be expected to carry out 3 . ‐ 6 There is an expectation that GPs will have a role in surveillance and early detection of cases and in treating influenza patients in their practices or specialised flu clinics 7 . It is likely that the expectation that GPs will continue to work during an influenza pandemic is shared by the wider Australian community.…”

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confidence: 99%

How will Australian general practitioners respond to an influenza pandemic? A qualitative study of ethical values

Anikeeva

Braunack-Mayer

Street

2008

Medical Journal of Australia

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Objectives: To explore general practitioners’ perceptions of their preparedness for an influenza pandemic, the changes they would make to their practice, and the ethical justifications for their planned actions. Design and setting: A qualitative study was performed among South Australian GPs between March and October 2007. A semi‐structured interview was carried out with each participant in his or her practice, and the interviews were audio‐recorded, transcribed and analysed thematically. Participants: 10 GPs were recruited: five from a metropolitan Division and five from a rural Division of General Practice. Results: Some participants felt they would not be able to cope with an influenza pandemic, while others felt it would simply mean an increase in their workloads. Most respondents considered creating separate waiting rooms, moving the reception desk outside of the practice and delaying all non‐urgent consultations in order to deal with a pandemic more effectively. Respondents mentioned the conflict between their various roles and responsibilities as a primary source of tension when thinking about the way they would organise their work in the event of a pandemic. A number of GPs said they would not practise in the event of a pandemic, as they felt their responsibility to their families outweighed that to their patients. Conclusions: Professional codes of ethics should include guidance about the scope of the duty to treat during infectious disease outbreaks. The community has to uphold the value of reciprocity, and ensure that GPs and their families are provided with support during a pandemic and are given the opportunity to be actively involved in pandemic preparedness planning.

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Australian general practice and pandemic influenza: models of clinical practice in an established pandemic

Cited by 12 publications

References 6 publications

Lessons for the global primary care response to COVID-19: a rapid review of evidence from past epidemics

Lessons for the global primary care response to COVID-19: a rapid review of evidence from past epidemics

General Practice and Pandemic Influenza: A Framework for Planning and Comparison of Plans in Five Countries

How will Australian general practitioners respond to an influenza pandemic? A qualitative study of ethical values

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