Primary healthcare practitioners play a pivotal role in postpartum care. Many countries encourage women to attend a postnatal check after birth, providing an ideal opportunity for contraceptive care. However, contraception is often not discussed, increasing the risk of unintended pregnancy and short interpregnancy intervals. To explore primary healthcare practitioners' views and experiences of providing postpartum contraceptive counselling and care to better understand the gaps, needs, and opportunities. A rapid review was conducted of English language peer-reviewed primary research studies from high-income countries focussing on primary healthcare practitioners' views and experiences of providing postpartum contraceptive counselling and care. Studies were retrieved from five databases, supplemented by Google Scholar and citation searching. Key characteristics were extracted, and thematic analysis identified key themes. Altogether, 2255 references were identified, with eight studies included. Four themes were constructed: (1) varied knowledge and attitudes regarding postpartum contraception, including views on of long-acting reversible contraception (LARC), safety concerns, and optimal counselling timing; (2) structural and logistical barriers to contraception provision in primary healthcare, including lack of LARC availability, time constraints, and funding issues; (3) limited contraception education and training for practitioners in LARC provision, with practitioners lacking skills or motivation to upskill; and (4) gaps in postpartum contraception resources and guidelines needed to promote postpartum contraceptive care. Improving postpartum contraceptive counselling requires embedding comprehensive contraceptive training in healthcare education, developing standardized guidelines for postpartum appointments, and addressing barriers such as time constraints, lack of resources and funding to support effective contraception care for postpartum women.

The rapid integration of e-health technologies-such as telehealth, mobile health (mHealth), and electronic health records-has transformed primary care delivery, especially during the COVID-19 pandemic. However, this transformation has revealed significant vulnerabilities in data privacy and security, particularly in decentralized and resource-limited primary care settings. This scoping review aims to map current evidence on privacy and security concerns related to e-health technologies in primary care and to identify mitigation strategies and research gaps. A systematic search was conducted in PubMed, ACM, Scopus, and Web of Science for studies published between 2019 and 2024. Eligible studies addressed both privacy/security issues and e-health technology use in primary care. A two-stage screening process and full-text review were applied. Data were extracted and thematically synthesized. Fifty-two studies were included. E-health technologies examined included teleconsultations, patient portals, digital decision support tools, and artificial intelligence (AI)-based systems. Among included studies, telehealth accounted for 28%, mHealth and wearables 20%, electronic health records 16%, and AI applications 6%. Common concerns involved data breaches, insufficient encryption, lack of interoperability, consent ambiguity, and challenges in securing virtual consultations. Vulnerable groups-such as older adults and low-literacy populations-faced higher risks. Recommended strategies included privacy-by-design principles, secure infrastructure, user-centered design, clearer governance policies, provider training, and hybrid care models. Addressing privacy and security in e-health requires more than technical solutions. Equitable, safe, and trustworthy systems must incorporate legal, ethical, and human-centered approaches. In primary care, privacy must be positioned as a core element of digital health equity, not an optional enhancement.

Caregiver burden represents a pressing public health challenge in aging societies. The quality of primary care may shape caregiver experiences, yet current evidence remains scarce. To examine the association between primary care quality and overall and domain-specific caregiver burden among family caregivers aged ≥60 years in Shirakawa City, Japan. We conducted a cross-sectional study involving adults aged ≥60 years in Shirakawa City, Japan, as part of the 2023 Shirakawa Quality of Life (QOL) Project. The sample included 250 family caregivers who self-identified as providing care for a relative. Primary care quality was measured using the Person-Centered Primary Care Measure (PCPCM) (score range: 0-4; higher scores = better quality) and caregiver burden using the Burden Index of Caregivers (BIC) (score range: 0-44; higher scores = greater burden). Multivariable linear regression with multiple imputations was performed. Higher quality of primary care was significantly associated with lower caregiver burden overall (adjusted β = -2.8; 95% CI, -4.1 to -1.5). Consistent associations were found across time-dependent, emotional, existential, and physical burden domains. A weaker but still statistically significant association emerged from service-related burden. These findings indicate that person-centered primary care may contribute to reducing multiple dimensions of caregiver burden. Longitudinal studies are needed to clarify causal relationships and guide the development of targeted interventions.

BackgroundGeneral practice across Europe faces a workforce crisis, with a projected shortfall of up to 1660 general practitioners in Ireland by 2028. While policy interventions have been proposed, a gap remains between the Irish health system's strategic objectives and the day-to-day realities experienced by general practitioners.ObjectiveThe aim of this study is to explore the perspectives of Irish general practitioners in addressing recruitment and retention challenges in general practice. Specific objectives include identifying solutions and the supports necessary for sustainable future general practice.MethodsA qualitative study design was employed, utilizing semi-structured online interviews with general practitioners recruited through a network affiliated with a university. Thematic analysis was conducted by four experienced researchers. Data collection continued until thematic saturation was achieved.ResultsThree primary themes emerged: (i) Towards a More Effective Health Service—participants emphasized the necessity for a whole-system approach to address recruitment and retention shortfalls; (ii) Role Clarification, Boundary Setting, and Support—participants highlighted the need for role reallocation within multidisciplinary teams to allow them to focus on complex cases; and (iii) Practice-Level Response—digital infrastructure improvements and administrative task reallocation were identified as key strategies to reduce workload and enhance patient care.ConclusionTo address the general practice workforce crisis, systemic reforms, expanded multidisciplinary teams, and practice-level adaptations are needed. The findings reflect the importance of general practitioner involvement in healthcare planning and policy development. These insights will inform targeted policy interventions in Ireland and in healthcare systems facing similar workforce challenges.

BackgroundVirtual care accelerated to the forefront of family physician (FP) care following the COVID-19 pandemic and continues to play a significant role in patient care. The choice between virtual and in-person primary care must be sensitive to patients’ contexts particularly for those with multi-morbidity.ObjectivesThis study explored how to make the choice between virtual and in-person FP care for persons living with multi-morbidity that is acceptable to patients and FPs.MethodsWe conducted a constructivist grounded theory study to understand the processes patients and FPs employ when deciding on the mode of primary care delivery. We used individual interviews to understand the perspectives and expectations of patients with multi-morbidity (2+ chronic conditions) and FPs.ResultsThere were two main themes revealed in data analysis: Considerations in choosing mode of delivery (including reason for visit, impact on access, technological logistics, and reimbursement for virtual care) and Process for choosing mode of delivery (including endorsing the patient choice when possible and scheduling visits).ConclusionThis paper integrated the experience of both patients and FPs to understand how to make the choice between virtual and in-person care. This understanding can support the future of FP care where diverse modes of delivery are employed, but currently technological barriers remain. Clinical scheduling systems that depend on telephone interactions between clinic staff and patients do not always support the process patients and FPs indicated they prefer; that is, one that respects patient preference and FP clinical expertise.

BackgroundPersons with dementia living in the community are vulnerable to service disruptions as they rely on a mix of outpatient care from different types of physicians. To demonstrate how outpatient physician visits evolved among persons with dementia during a health crisis compared to the prior year.MethodsUsing administrative databases, two retrospective cohorts (2019/pre-COVID-19 pandemic; 2020/pandemic) of community-dwelling persons with dementia aged 65+ were identified within three Canadian provinces (Alberta, Ontario, and Quebec). We measured the rates of visits (total/virtual/in-person) to family physicians, cognitive specialists (neurologists, geriatricians, and psychiatrists), and other specialists. Provincial incident rate ratios (IRR) and 95% confidence intervals (CIs) were calculated by comparing three pandemic periods (first wave; interim period; second wave) to the corresponding pre-pandemic periods (reference) and subsequently pooled using a meta-analysis to obtain overall estimates.ResultsPre-pandemic (n = 160 288) and pandemic (n = 166 392) cohorts had similar characteristics. Although significant increases in family physician visits within provinces were observed during certain periods, there was no significant change in overall estimates compared to pre-pandemic levels. Overall cognitive (IRR 0.85, CI 0.80–0.90) and other specialist (IRR 0.71, 0.56–0.90) visits were significantly lower in the first wave compared to pre-pandemic period. There was a significant increase in virtual visits and a significant decline in in-person visits across all physician types throughout the pandemic periods.ConclusionFamily physicians are the cornerstone of sustaining dementia care during health crises such as the COVID-19 pandemic, in part due to virtual care. Future research may investigate long-term outcomes of abrupt disruption in specialist and other community care.

Chronic kidney disease (CKD) is increasing in prevalence and is associated with substantial morbidity and mortality. Early initiation of cardiorenal protective medications is recommended to improve outcomes. Barriers to implementation include renal function monitoring and resources to initiate and titrate treatment. We aimed to evaluate the feasibility and acceptability of a protocolled point-of-care testing (POCT) pathway to optimise people living with proteinuric CKD in primary care. A pilot quality improvement study conducted across three general practices in Greater London, United Kingdom. Inclusion criteria were adults (18-80 years) with hypertension and/or type 2 diabetes mellitus, proteinuria, and reduced kidney function (eGFR 30-75 ml/min/1.73m2), who were identified using electronic health records. POCT for creatinine and potassium enabled real-time decision-making using a traffic light clinical decision support system. The primary outcome was recruitment rate and patient acceptability. Secondary efficacy outcomes included medication optimisation and renal function changes. Twenty-five (52%) of 48 patients agreed to participate. Overall, 23/25 (92%) completed the pathway and 20/25 (80%) achieved pharmacological optimisation. There were no significant adverse events. POCT was successful in 44/57 (77%) of cases and well tolerated by most participants (10/13; 77%). Patient satisfaction was high (12/13; 92%), with most preferring advanced nurse practitioners or pharmacists in future clinics. A POCT-led CKD optimisation pathway is feasible and well-accepted in primary care. While high medication optimisation rates were achieved, barriers to recruitment and engagement remain. Future studies should evaluate scalability, long-term clinical impact, and cost-effectiveness to inform wider implementation.

The current war in Gaza has created a thick cloud over the surrounding region: a cloud of anger, frustration, and despair. Palestinians make up a large portion of the population in Jordan with 2.39 million registered refugees alone, not including non-registered refugees. Many have relatives living in Gaza, making them particularly invested in the conflict. The ongoing suffering of loved ones preoccupies them, making it difficult to focus on anything else. I also sometimes fall into despair even though I am a foreigner living in Jordan. A bright spot between the thick clouds occurred during my time with Ali at "Camp for All," a camp for students with disabilities in Jordan.

Mapping general practitioners' antibiotic prescribing practices is essential to optimize antibiotic use in primary care and mitigate antibiotic resistance. The objective of this study was to examine the adherence of Dutch general practitioners to prescribing guidelines for ear and respiratory tract symptoms and conditions. A cross-sectional study was conducted on Dutch electronic health records from 2018 to 2021. Antibiotic prescribing frequency and type were examined for ear and respiratory tract symptoms and conditions based on professional prescribing guidelines. Descriptive statistics and multilevel logistic regression analyses were applied. Patient records from up to 384 general practices were analysed for 15 ear and 27 respiratory tract conditions. For 11 of the 15 (73%) ear and 17 of the 27 (63%) respiratory tract conditions, more than 95% of patients were treated according to the prescribing guidelines. Most potential non-adherence to antibiotic prescribing guidelines occurred for acute otitis media (31%-34%), acute bronchitis/bronchiolitis (26%-39%), and acute sinusitis (25%-34%). Several other respiratory tract conditions showed non-indicated prescribing rates above 10%. For otitis externa, many broad-spectrum antibiotics were prescribed, which rarely happened for respiratory conditions. High variation in prescribing frequency and type between general practices occurred. For most conditions, Dutch general practitioners adhere well to antibiotic prescribing guidelines. There are conditions for which there is a high potential for inappropriate prescribing. High variation between practices suggests room for improvement. Stricter implementation of prescribing guidelines may help improve prescribing practice. Alternatively, a practice-specific approach could be effective. The Dutch setting may be exemplary for international antibiotic prescribing practice.

Primary care researchers and clinicians are facing an ever-growing evidence base, more options to access research evidence, and increasingly limited time. Incorporating search filters into primary care systematic reviews can significantly improve the efficiency and confidence of the search process. Search filters, or hedges, are predeveloped search strategies that combine controlled vocabulary and free text terms using Boolean operators (words like "AND," "OR"). Search filters help to manage the diverse terminology in the literature, such as the various synonyms for primary care, and can be tailored to the specific needs of the review, whether it aims to be exhaustive or more focussed. Resources such as specialized librarians, databases such as PubMed, and repositories such as the InterTASC Information Specialists Sub-Group provide access to these valuable tools. However, as primary care terminology continues to evolve, regular updates to these filters are necessary to maintain their relevance and effectiveness. This method brief presents search filters and highlights their value for finding research literature in primary care.