BACKGROUND:To date, traditional primary care practices are often organized around the capacities of one or more physicians. New models of primary care practices involving other health professionals such as advanced practice nurses (APNs) require modified triage models for more adequate patient allocation. OBJECTIVE:Therefore, a modified triage model was developed, informed by experts and reviewed by stakeholders. METHODS:A convergent mixed-method design with four phases was employed. The study was conducted in Swiss primary care practices. Readiness for change of health professionals working in these primary care practices was surveyed. Triage was reviewed and modified according to expert recommendations, and its feasibility explored in two Delphi rounds with health professionals and stakeholders. RESULTS:Health professionals in primary care practices were interested in improving access to care. Observed triage continued to focus primarily on physicians. The modified triage model was viewed to be practicable, offering a potential way to support more systematic allocation of patients to physicians, APNs, and other health professionals depending on the reason for consultation. CONCLUSIONS:Drawing on international guidelines on triage in primary care practices, expert opinion on who seeks care in these practices, and review by stakeholders led to a modified triage model to include other health professionals than primary care physicians. TRIAL REGISTRATION:This study did not involve patients but focused on triage in primary care practices. Hence, no trial registration was obtained.
BACKGROUND:Trust between healthcare providers is important in facilitating collaborative practices, especially in primary care, where disciplines collaborate across communities to deliver patient-centred care. OBJECTIVE:To identify the facilitators and barriers that influence trust in interprofessional partnerships within primary care settings. METHODS:We searched PubMed, PsycInfo, Embase, and CINAHL using key words to identify articles published up to 16 August 2023. Facilitators and barriers to trust were mapped onto the Consolidated Framework for Implementation Research (CFIR). Quality assessment utilized the Mixed Methods Appraisal Tool (MMAT). RESULTS:From 5750 screened articles, 11 studies were included. Sixteen facilitators and seven barriers were identified. Facilitators included co-location, familiarity, competence, professional identities, and effective communication. Barriers included perceived conflicts of interest, lack of familiarity, and transgressions of professional boundaries. Trust was often unbalanced, with a perception among non-medical healthcare professionals that they need to earn trust from medical healthcare professionals. CONCLUSIONS:Formation and nurturing of interprofessional trust is the foundation for building strong partnerships between healthcare professionals that promote collaborative practice in primary care. Future research should include non-English and grey literature and focus on the unequal trust dynamics.
Lay Summary Artificial intelligence (AI) systems designed to assist doctors in decisions regarding diagnoses, investigations, and treatment of patients, called generative AI clinical decision support tools (GenAI CDS), are rapidly entering medical practice. While such tools promise to improve care by identifying conditions doctors might otherwise miss, they raise difficult legal and ethical questions. When a GenAI CDS recommends a test that a physician declines to order, and the patient later develops a serious condition that earlier testing might have detected, who bears responsibility?
BACKGROUND AND OBJECTIVE:Post-COVID-19 condition (PCC) is a complication of acute COVID-19, which often presents with a variety of symptoms. It can also impact individuals' overall well-being, capacity to carry out daily activities, engage in physical exercise, maintain employment, and their general quality of life. Therefore, this review aimed to examine the role of patient-reported outcome measures (PROMs) questionnaires in assessing patients with PCC through prevalence of abnormal tests. METHODS:We searched three databases. Two reviewers independently screened articles using Laser Al and extracted relevant data using a piloted Google Sheets. We performed a meta-analysis using OpenMeta and RevManWeb and conducted a subgroup analysis based on the setting of the patients during their acute COVID-19 infection. We assessed the risk of bias using a modified ROBINS-I tool and the certainty using the Grading of Recommendations Assessment, Development, and Evaluation approach. RESULTS:No studies reported diagnostic test accuracy measures for questionnaires in PCC. However, 23 comparative studies reported on the prevalence of abnormal questionnaire results in patients with PCC. Outcomes showed that patients with PCC have higher abnormal results than controls, regardless of their setting during acute COVID-19 infection. The overall certainty of the evidence was low due to the high risk of bias, indirectness, and imprecision. CONCLUSION:This review sheds light on the importance of testing PROMs in patients with PCC using these questionnaires and the need for further testing their validity in this condition.
BACKGROUND:Multimorbidity is rising in primary care, yet adherence to guidelines is hindered by fragmented, disease-specific recommendations. This study sought to establish consensus among general practitioners (GPs) on indicators of adherence to Australian guidelines in managing five common chronic conditions [type 2 diabetes mellitus (T2DM), obesity, hypertension, cardiovascular disease, and chronic kidney disease (CKD)], aiming to develop a unified tool for holistic care. METHODS:A two-round reactive Delphi survey was conducted with 21 GPs in Western Australia, following RAND methodology. Indicators were drawn from the Royal Australian College of General Practitioners' guidelines and covered biophysical markers, lifestyle risks, and pharmacological management. Participants rated indicators for relevance and clarity on a 4-point Likert scale without a neutral option. Consensus was defined as ≥70% of GPs rating an indicator ≥3 for mean relevance. The process ended when ≥80% of indicators reached this threshold, and no new items were proposed. Feedback refined wording and, where relevant, was reported verbatim. RESULTS:In Round 1, 57 indicators achieved consensus on relevance, with four additional items suggested. By Round 2, consensus was reached on 61 indicators. Most were rated clear, except two addressing pharmacological management of CKD with T2DM, which require clearer guidance. Feedback emphasized the need for refined lipid management guidelines, prioritizing obesity management for prevention, and challenges in lifestyle counselling. CONCLUSION:This study represents the first integration of disease-specific indicators into a GP-informed tool for multimorbidity management. Strong consensus highlights its practicality, warranting piloting to evaluate effects on guideline adherence and patient outcomes.
BACKGROUND:Cognitive impairment is common in older adults, and its early detection in primary care remains challenging. The Clock Drawing Test (CDT) is a practical tool, but variability in its scoring limits standardization. OBJECTIVE:To evaluate artificial intelligence (AI)-based automated CDT scoring in primary care by examining its association with Mini-Mental State Examination (MMSE) scores, discriminative performance for cognitive impairment, and agreement with clinician rating. METHODS:In this cross-sectional study, 207 adults aged ≥65 years were assessed in a primary care setting. CDT drawings were scored manually by a neurologist and automatically using a multimodal generative AI system based on the Manos and Wu 10-point method. Associations with MMSE were analyzed, and discriminative performance was assessed using receiver operating characteristic analysis. Agreement was evaluated using intraclass correlation coefficient and Bland-Altman analysis. RESULTS:AI-based CDT scores demonstrated a moderate positive correlation with MMSE (ρ = .437, P < .001). Both methods significantly discriminated MMSE-defined cognitive impairment, although manual scoring yielded a significantly higher area under the receiver operating characteristic curve than AI-based scoring (.779 vs .715; DeLong P = .028). AI-based scoring provided higher sensitivity but lower specificity. Agreement between methods was good (intraclass correlation coefficient = .721), with AI tending to assign slightly higher scores (mean difference: 1.13). CONCLUSION:AI-based CDT scoring is associated with global cognitive performance and offers meaningful discrimination of cognitive impairment in primary care. However, given lower accuracy and individual-level variability, it should be considered a supportive tool rather than a replacement for clinician assessment.
Background Excessive use of antibiotics promotes antibiotic resistance. Deferred prescribing (prescriptions dispensed according to clinical progress) is a strategy to reduce this overconsumption. Recognized in some countries, this practice is poorly documented and not recommended in France.Objectives To determine the rate of deferred outpatient prescriptions, their dispensing rate, and their characteristics.Methods This observational study was conducted over 1 year in 20 pharmacies and focused on prescriptions with a handwritten note indicating deferred dispensing. The data collected included patient age and sex, prescriber specialty, drug class, dispensing delay, and population density. Feedback from pharmacists was also collected.Results Of 174 deferred prescriptions (0.021% of prescriptions), 38% were dispensed immediately, 20% were dispensed later, and 42% were not dispensed. The majority were prescribed by general practitioners (84%). Dispensing was significantly more immediate in urban areas (P = 0.02). Feedback analysis showed that pharmacists had a positive perception of deferred prescribing, seeing it as a tool for empowerment, antibiotic reduction, and collaboration. However, its implementation was limited by logistical constraints and patients' perception of the prescription as a right to dispensing.Conclusion Effectiveness of deferred prescribing in reducing antibiotic consumption appears to be limited, especially in urban areas. Deferred prescription has little effect on antibiotic consumption. It seems more important to learn not to prescribe antibiotics when infections are viral. Delaying the prescription may help, but communication between pharmacists, doctors, and patients needs to be strengthened. Harmonization of practices and patient education need to be improved in this context of cascading uncertainties.
BACKGROUND:Tisdale risk score has been validated for predicting drug-induced QTc prolongation (QTP) in cardiac care. This study aims to determine whether it can guide prescribing and monitoring of QTc-prolonging medications in primary care. METHODS:A retrospective chart audit using Tisdale Risk Score was conducted. Data from 486 primary care patients from two Family Medicine Clinics, prescribed medications with known or possible risk of Torsades de Pointes (TdP) were reviewed. Eighty-five patients with pre- and post-pharmacotherapy ECGs comprised the cases. A control group of 184 patients not on QTc-prolonging medications was assessed. Patients were categorized as low, moderate, or high risk for QTP. RESULTS:Psychotropics were the most frequently prescribed QTc-prolonging medications. Baseline QTc did not differ significantly between cases (428 ms) and controls (426 ms). Among cases, most were stratified as low risk (69.4%), with fewer in moderate (25.9%) and high-risk (4.7%) categories. Comparatively, 99.5% of control patients were at low risk. QTc prolongation occurred in 5/85 (5.9%) post-pharmacotherapy, with none in the high-risk category. Odds ratio for QTP in moderate-risk patients versus low-risk was 0.71 (95% CI: 0.07-6.98). CONCLUSIONS:Most primary care patients were at low risk for drug-induced QTc prolongation. QTP events were low with none in the high-risk category, which limited evaluation of association between risk categories and QTc prolongation. The study highlights commonly prescribed QTc-prolonging medications in family medicine and their variable QTc effects, emphasizing the need for an outpatient-tailored risk assessment tool.
Background The 2016 NICE guidelines recommend offering HIV testing alongside routine blood tests in areas of high HIV prevalence (>2 per 1000 adults aged 18-59). Despite this, implementation in primary care has been limited. Method A universal-offer HIV testing intervention was implemented across seven general practices in Brighton and Hove. Data were collected on all blood test appointments between June 2022 and February 2024, including demographics, whether an HIV test was offered, patient acceptance, and test results. Mixed-effects logistic regression was used to assess factors associated with test offer and uptake. An electronic survey was disseminated to staff to gather views on feasibility and acceptability. Results Seven sites were recruited, although only four successfully engaged and provided complete data. A total of 6105 HIV tests were conducted, with one new diagnosis identified. HIV testing was offered to 45% of eligible patients, with 74% accepting. Older adults were significantly less likely to be offered a test [aOR 71-80: 0.79 (95% CI: 0.69-0.91); 81+: 0.50 (0.42-0.60)]. Amongst those offered testing, patients aged over 50 were less likely to accept [aOR: 0.72 (0.57-0.91)], with the lowest uptake amongst those aged 81+ [aOR: 0.44 (0.32-0.61)]. Staff reported no barriers to feasibility or patient acceptability. Conclusion Routine HIV testing in primary care is well-accepted and can identify new cases. However, site engagement can be challenging, with closer monitoring, support, and rigorous on-boarding processes required.
BACKGROUND:Residential aged care homes (RACHs) in Australia support a growing population with complex healthcare needs. General practitioners (GPs), supported by practice nurses (PNs) and practice managers (PMs), play a central role providing medical care. Care models vary widely in these settings, and evidence on provider satisfaction and workforce sustainability is fragmented. OBJECTIVE:To describe general practice care models in Australian RACHs, and examine satisfaction and workforce intentions among GPs, PNs, and PMs. METHODS:A national online survey of GPs, PNs, and PMs involved in RACH care was conducted between June and August 2023. Descriptive and bivariate analyses examined associations between demographic and practice characteristics, satisfaction across care elements, and GP intentions to continue working in aged care. RESULTS:Of 105 GP respondents, 87% were currently providing RACH care (58% aged 40-59 years; 53% female). Care was predominantly delivered through unstructured models (70%). Over half (53%) reported high satisfaction with their care model, while 59% were dissatisfied with remuneration; satisfaction did not differ by model type. Twenty-four PNs and 23 PMs participated, reporting high satisfaction with GP collaboration yet lower satisfaction with RACH staff relationships. Younger, less experienced GPs were more likely to plan to cease RACH work within one year (both P = .001, Cramér's V = 0.33-0.39), and metropolitan GPs were less likely to anticipate long-term involvement (P = .016, Cramér's V = 0.32). CONCLUSION:General practice remains central to aged care but faces persistent workforce and structural pressures. Addressing remuneration, workload, and cross-sector collaboration is critical to sustaining high-quality general practice in RACHs.
BACKGROUND:The healthcare sector contributes substantially to greenhouse gas emissions, and family doctors are well placed to reduce this impact, but their preparedness depends on adequate education in sustainable healthcare. OBJECTIVES:The objective of this study was to describe self-reported knowledge of sustainable healthcare and perceived educational gaps among family doctors and trainees affiliated with the European Young Family Doctors Movement (EYFDM) network. METHODS:A cross-sectional, web-based survey was distributed through EYFDM. The instrument comprised one open-ended question, five knowledge items (four single-best-answer and one multiselect), and two yes/no items. Open-ended responses were scored independently by three authors using a rubric anchored to the World Health Organization definition of environmentally sustainable health systems. Data were analysed in SPSS v27. RESULTS:A total of 130 family doctors and trainees from 15 European countries responded; 83.8% came from three countries (the Netherlands, Türkiye, and the UK). Of those who answered, 64.7% (75/116) reported no prior experience with sustainable healthcare, and 72.5% (58/80) had received no related teaching during training. The median total knowledge score was 3/5 [interquartile range (IQR) 2]. Scores were higher in participants aged under 45 years (P < .001), in female respondents (P = .014), and in trainees (P < .001). Nearly everyone who responded agreed that planetary health should be included in the family medicine curriculum. CONCLUSIONS:Within this EYFDM sample, prior formal education in sustainable healthcare was uncommon, and interest in further training was high. Findings are exploratory and not generalizable to all European family doctors, but they support the development of validated instruments and the integration of planetary health into family medicine curricula.
Purpose Professional medical interpreters aim to provide high-quality interpretation for non-English language preference (NELP) patients; however, the impact of various interpreter modalities (virtual versus in-person) is unclear. This project explored the impact of interpreter modality on the in-person care experience through focus groups with medical interpreters to identify strengths, limitations, and clinical situations where in-person or virtual interpretation modalities are most beneficial.Methods We conducted a qualitative study using focus groups with professional medical interpreters. Sessions were recorded, transcribed, and anonymized. Transcripts were then coded and analyzed using thematic analysis.Results We conducted five focus groups with 24 professional medical interpreters and identified four themes: relationship development; understanding and accuracy; accessibility, flexibility, and flow; and care quality. Interpreters found many functions are best served through in-person interpreters. However, there are certain circumstances in which virtual interpreters can be effectively utilized to increase access and allow flexibility.Conclusions Interpreters primarily promote in-person interpreters for increased understanding, equity, and human connection to best serve patients. They provided salient examples and a deep understanding to inform the utility of different modalities in various clinical situations. There are opportunities for health systems, clinicians, and families to improve access to interpretation and ensure interpreters can use their full skill set to improve patient care and equity.
BACKGROUND:Direct access (DA) to physiotherapy enables patients with musculoskeletal disorders (MSDs) to consult physiotherapists without prior GP referral. Despite its growing implementation, no quantitative synthesis has assessed its impact on prescribing outcomes relevant to GP workload. OBJECTIVE:To estimate the pooled effect of DA versus GP-led care on medication and imaging prescriptions for adults with MSDs in primary care. METHODS:This PRISMA-compliant meta-analysis, based on a registered review (OSF: 897ub), searched MEDLINE, Embase, CINAHL, Cochrane Library, and PEDro up to November 2025. Eligible studies compared DA with GP-referred care and reported medication and/or imaging prescriptions. Risk ratios (RRs) were pooled using random-effects models; shared-comparator correlation was managed by combining relevant arms, with sensitivity analyses examining them separately. RESULTS:Four studies (2993 participants) contributed to medication outcomes. Compared with GP-led pathways, DA was associated with fewer medication prescriptions (RR 0.57, 95% CI 0.40-0.83, I2 60%; sensitivity: RR 0.56, 95% CI 0.43-0.73, I2 45%; GRADE: low certainty). Evidence for imaging was insufficient. The planned X-ray-only analysis was uninformative due to sparse, zero-event data. A multi-modality sensitivity analysis suggested reduced imaging but without statistical significance (RR 0.48, 95% CI 0.16-1.41; very low certainty). CONCLUSION:DA may reduce medication prescribing in MSDs, though evidence certainty remains low. Imaging results are inconclusive. Further high-quality, adequately powered trials with prespecified prescribing and imaging endpoints are warranted to guide equitable primary care workforce planning.
OBJECTIVE:Herpes zoster has been associated with immune and metabolic disturbances; however, its relationship with newly diagnosed Type 2 diabetes mellitus (T2DM) remains unclear. This study aimed to investigate whether herpes zoster may serve as a clinical marker of previously unrecognized T2DM among people aged 65-84 years. METHODS:We conducted a retrospective cohort study using de-identified electronic health records from TriNetX (2006-24). Patients aged 65-84 years with a diagnosis of herpes zoster (ICD-10 code B02) were compared with age-matched patients without herpes zoster. Propensity score matching was applied to balance baseline characteristics. The primary outcome was newly diagnosed T2DM. Hazard ratios and 95% confidence intervals were estimated using Cox proportional hazards models within the TriNetX platform. RESULTS:After propensity score matching and exclusion of patients who developed the outcome prior to the predefined follow-up window, 16 175 herpes zoster patients and 16 336 matched controls were included. During 1 year of follow-up, the cumulative incidence of T2DM was 2.362% in the herpes zoster group and 0.343% in controls. Herpes zoster was associated with a significantly higher likelihood of newly diagnosed T2DM (hazard ratio, 6.517; 95% confidence interval, 4.923-8.627). CONCLUSIONS:Herpes zoster was associated with newly diagnosed T2DM in older people. These findings support the hypothesis that herpes zoster may serve as an early clinical marker of previously unrecognized T2DM. Prospective studies are warranted to clarify temporal relationships and to determine whether targeted glycemic evaluation is clinically beneficial.
Background Universal telehealth aims to support access to timely coordinated chronic disease care. Large-scale evidence on the extent to which this occurs to guide telehealth policy is limited. Objective To examine temporal changes in uptake and timeliness of general practitioner chronic disease management (GP-CDM) services in Australia following universal telehealth introduction (March 2020) and removal of subsidized telephone (but not video) GP-CDM services (July 2021). Methods Whole-of-population cohort study of linked national claims and death data, 2018-2022. Interrupted time-series analyses quantified temporal changes in GP-CDM service uptake and timeliness following telehealth policy changes. Results From 2018 to 2022, each month an average of 568 858 GP-CDM services were delivered, with 25-43 users and 44-76 services per 1000 population aged 45-<85 per month. After universal telehealth introduction, GP-CDM uptake remained stable, with similar trends pre- and early-pandemic. Monthly uptake decreased substantially following the removal of telephone GP-CDM services [decrease of 4.0 users (95%CI -6.3, -1.7) and 6.9 services (-10.5, -3.3) per 1000 population]. In the first month of telehealth, 38.7% of people using GP-CDM services used telehealth (37% telephone, 1.7% video), declining to 2.2-5.4%/month after removal of telephone GP-CDM services. Small improvements in GP-CDM timeliness stalled once telephone services were no longer available. Patterns were similar across population subgroups. Conclusions Telehealth policies in Australia sustained access to chronic disease care during the pandemic. Limiting access to these services to video alone was associated with a greater than expected decline in use had the pandemic and introduction of telehealth not occurred.
BACKGROUND:Interprofessional collaborative practice (ICP) benefits patients with complex conditions such as osteoporosis that require care from multiple professions. ICP is not consistently applied in osteoporosis management in primary healthcare today. OBJECTIVES:To explore how an ICP intervention promoting co-creation of osteoporosis management was conducted and how it was experienced by nurses and physicians in primary healthcare. METHODS:The intervention part was guided by participatory health research approach. In total, 12 nurses and physicians from five primary healthcare centres participated in three workshops aimed at supporting co-creation of local osteoporosis management. The evaluation part consisted of group and individual interviews and surveys capturing self-reported experiences. Data were analysed using qualitative content analysis with inductive approach. RESULTS:Participants reviewed local osteoporosis management and co-created work procedures tailored to their settings. The analysis generated three categories with seven subcategories. The categories were innovative learning processes, perceived effects, and factors influencing changes in work procedures. Innovative learning processes described shared learning, reflection, and adaptation in developing work procedures. Perceived effects included expected benefits for patients, changes in professional roles, and increased interprofessional collaboration. Participants described a strengthened role for nurses in osteoporosis management. Factors influencing changes in work procedures included organizational, professional, and resource-related conditions. The survey findings supported those from the interviews. CONCLUSION:A participatory approach facilitated collaborative revision of osteoporosis management by leveraging local knowledge and promoting interprofessional learning. Participatory health research appears useful for developing ICP in managing complex conditions such as osteoporosis in primary healthcare.
BACKGROUND:Colorectal cancer screening is an evidence-based preventive approach. Singapore has a national screening programme, but local studies suggest poor uptake. Gender differences in screening uptake exist in the literature, and women in Singapore are exposed to cancer screening (via breast and cervical programmes) earlier than men. This study aimed to identify gender differences, as well as analyse barriers and facilitators associated with being screen-current for colorectal cancer within the genders, using the Health Belief Model. METHODS:This was a cross-sectional study conducted in a large public primary care institution in Singapore. Using consecutive sampling, 426 colorectal cancer screening age-eligible (50 years and above) individuals (232 females, 54.5%) completed a single questionnaire measuring knowledge of colorectal cancer symptoms and prevention, Health Belief Model factors, and colorectal cancer information sources. RESULTS:Women had higher knowledge of colorectal cancer symptoms but perceived more barriers. Fewer women were screen-current (33.6%) compared to men (43.4%). Factors associated with knowledge of colorectal cancer symptoms and prevention differed between men (F[13, 178] = 4.51, R2 = 0.138) and women (F[13, 217] = 5.18, R2 = 0.171). Knowledge of symptoms and cues to action was associated with screen-currency in men (Wald χ2 = 33.93, pseudo R2 = 0.18), but the regression model failed to reach significance for women. CONCLUSIONS:A one-size-fits-all approach to health promotion is likely insufficient in boosting compliance with colorectal cancer screening recommendations. Further work must be done to understand the more qualitative nuances surrounding women's challenges in being screen-current in Singapore.
BACKGROUND:Electronic problem lists (PLs) are central to the problem-oriented medical record and increasingly underpin clinical decision support (CDS), interoperability, and emerging artificial intelligence applications in primary care. However, persistent concerns regarding PL accuracy, completeness, and governance limit their clinical value. OBJECTIVE:To update the foundational framework proposed by Hodge and Narus by synthesizing contemporary evidence on electronic PLs in primary care and primary care-relevant settings. METHODS:We conducted a rapid scoping review following Joanna Briggs Institute guidance and PRISMA-ScR reporting standards. MEDLINE (Ovid) was searched for peer-reviewed studies published between March 2016 and May 2026. Eligible studies examined digital PLs or extractable PL-related practices relevant to primary care. Findings were synthesized using a hybrid inductive-deductive approach and mapped to the seven Hodge and Narus themes. RESULTS:A total of 103 studies were included. Across settings, PLs were widely recognized as foundational for longitudinal care, safety, and coordination. However, incomplete, outdated, or inconsistently maintained PLs remained common. Persistent challenges included unclear ownership, workflow misalignment, and variability in what constitutes a "problem." Emerging technologies-including CDS, natural language processing, and machine learning-were increasingly used to support PL generation, curation, reconciliation, and organization, with greatest benefit when embedded within clinician-led workflows. CONCLUSION:Despite technological advances, the clinical value of electronic PLs in primary care continues to depend on governance, workflow integration, and shared accountability. Updating the Hodge and Narus framework highlights the need for sociotechnical approaches to PL improvement as PLs become integral to CDS and artificial intelligence-enabled care.
BACKGROUND:Primary care is essential for health care systems to promote health, prevent disease, and manage chronic conditions. However, a shortage of primary care physicians challenges the delivery of high-quality primary care services to the population, especially for those living with multimorbidity. To address this challenge, interprofessional primary teams consisting of primary care physicians, nurses, and allied health professionals (AHPs) have been rolled out in many jurisdictions. This approach allows physicians to focus on complex patient care, where less complex care can be delegated to nurses and AHPs. METHODS:We conducted a scoping review of the literature on the scope of practice of nurses and AHPs in interprofessional primary care teams in Ontario, Canada. RESULTS:Nurse practitioners and registered nurses are heavily involved in providing direct patient care, whereas registered practical nurses are less involved. Pharmacists focus on medication management and patient education, dieticians focus on dietary assessments and nutrition education, and social workers focus on counselling and psychosocial assessments. Pharmacists and nurse practitioners often face challenges in defining their independent roles. Some physicians struggle with teamwork, whereas others appreciate multidisciplinary approaches. CONCLUSIONS:Effective integration of nurses and AHPs in a primary care setting would enable physicians to delegate several tasks and address primary care physician shortages in various jurisdictions. Clarifying the professional roles of AHPs in primary care would enhance interprofessional team functioning, helping to increase both the quality and quantity of primary care.
