The objective of this study is to determine whether primary care electronic health record (EHR) data are sufficiently complete and plausible to support automated audits of antimicrobial prescribing quality.Cross-sectional descriptive assessment of antimicrobial auditing-related fields in Patron, a large Australian primary care EHR dataset with 3.5 million patients from 129 consenting general practices. Data from 2018 to 2022 were evaluated using the Harmonized Data Quality Assessment Terminology and Framework, covering conformance, completeness, and plausibility.Thirty-one fields (137,776,804 rows; 1,406,364 patients across 116 practices) were assessed. Value conformance and plausibility were high for most core audit variables, including demographics, antimicrobial name, dose, allergy status, and visit date. Prescribing indication was incompletely captured (13-27% completeness), and allergy severity was recorded in 26% of allergy entries. Vendor-level heterogeneity contributed substantially to variation in field completeness.Australian primary care EHR data capture the core structured elements required for automated antimicrobial prescribing audits, enabling assessments of spectrum suitability, microbiology mismatch, and prescribing prevalence. Incomplete and inconsistent documentation of indication and allergy severity necessitates the use of proxy fields or inference for more complex evaluations. Greater standardization across EHR systems is required to enhance the scalability and clinical utility of automated audits in primary care.

BACKGROUND:The COVID-19 pandemic accelerated the adoption of digital health technologies, including telehealth, electronic medical records, and patient-facing applications. These tools maintained access to care during periods of restriction but exposed gaps in workforce readiness, patient trust, digital literacy, and equity. Despite widespread implementation, limited evidence exists on how patients and healthcare providers experienced this transition and how these experiences influenced digital health adoption. OBJECTIVE:To compare the experiences of patients and healthcare providers in XXXXXXXX during the pandemic, identify key barriers and enablers of digital health adoption, and inform sustainable models of care for future disruptions. METHODS:A qualitative study was conducted between March 2023 and September 2024. Semi-structured Zoom interviews were undertaken with 20 patients diagnosed with COVID-19 and 21 healthcare providers involved in pandemic care in New South Wales and Victoria. Data was analyzed using reflexive thematic analysis and interpreted through the Technology Acceptance Model and Diffusion of Innovations framework to examine technology adoption, communication, and system preparedness. RESULTS:Four themes captured patient and provider experiences. First, rapid digitization shifted healthcare-seeking behavior, with many patients delaying in-person care due to safety concerns. Second, providers reported limited readiness, increased digital workload, and workflow disruption. Third, differences in digital literacy and misaligned expectations undermined trust, communication, and diagnostic confidence in virtual settings. Finally, long-term sustainability requires hybrid models of care, interoperable infrastructure, and supportive governance. Overall, the findings highlight the dual nature of crisis-driven digital transformation: while innovation accelerated rapidly, systemic and relational vulnerabilities in care delivery were also exposed. CONCLUSION:Digital care was essential for maintaining access during the pandemic; however, rapid deployment alone cannot ensure safety, equity, or quality of care. Sustainable integration requires coordinated investment in interoperable infrastructure, workforce capability, and patient-centered design to support hybrid delivery models and strengthen preparedness for future healthcare disruptions.

Introduction and aims: Antimicrobial resistance is a global public health emergency and a prominent issue in Southeast Asia. There is also a lack of dental-specific drug resources to assist with medication management for dentists. Our dental-specific decision support tool, MIMS Drugs4dent, was developed to assist Australian dentists optimize their prescribing. The aim of this study was to trial MIMS Drugs4dent for acceptability and usability with dental practitioners in Indonesia, Malaysia, Singapore, and Thailand. Methods: This was a cross-sectional study of MIMS Drugs4dent with dental practitioners in Indonesia, Malaysia, Singapore, and Thailand. Dental practitioners were provided access to MIMS Drugs4dent for 1 month. After the intervention period, participants completed an online survey that assessed their perceptions of the tool. The primary outcome was the acceptability and usability of MIMS Drugs4dent, using the Framework for Acceptability and System Usability Scale, respectively. The secondary outcome was to determine the resources used by dental practitioners for drug information. Descriptive statistics and thematic analysis were used for quantitative and qualitative data analysis, respectively. Results: From January to June 2025, 30 dentists from each country participated. Most participants (93.4% and 94.2%) agreed or strongly agreed that MIMS Drugs4dent can improve their ability to prescribe according to guidelines and access dental-relevant drug information, respectively. Most participants (88.3% and 82.5%) agreed or strongly agreed that MIMS Drugs4dent was easy to use and that information could be located quickly. However, participants preferred a local drug database and a mobile-rendered version to improve usability. A wide range of sources (n = 62) were reported to be used for medicines information. Conclusion: MIMS Drugs4dent had high acceptability and usability in this study. With adaptation using country-specific localised drug databases, the tool has potential for use in dentistry in these countries. The study underscores the importance of including dentistry in broader digital health strategies.

Background/Objectives: Inappropriate use of antibiotics contributes to the rise in antibiotic-resistant bacteria and can result in adverse drug effects for individuals. Informed discussions between patients and general practitioners (GPs) can help ensure that treatment decisions about antibiotic use align with the best health outcomes for individuals. Methods: We implemented a set of information resources designed to support clinical discussions and decision-making for patients with common infections in primary care. A suite of patient information sheets, which had been co-designed with primary care providers and consumers, were implemented in eight general practices in metropolitan Melbourne and regional Victoria, from August to November 2020. Results: Post-implementation evaluation, conducted through interviews with 15 primary care providers and 13 patients, revealed that the information sheets were simple, easy to use and generated discussion within consultations. GPs reported using the sheets to reinforce their decision-making during consultations with patients, reduce potential conflict, provide alternatives to antibiotic prescriptions, and offer patients a written summary of management recommendations. Patients found the sheets informative and that they made it easier to understand their diagnosis and to manage their conditions. Both GPs and patients agreed that the content was relevant and effectively enhanced patients' knowledge of disease conditions, treatment options, and when to seek medical advice and were facilitators of meaningful conversations during consultations. Conclusion: These resources are acceptable in Australian primary care and publicly available for use by GPs, pharmacists and patients in Australia.

While drugs have a limited role in the management of dental presentations, Australian dentists have high rates of inappropriate prescribing of antibiotics. There is also a lack of relevant drug resources for dentists in Australia. Our team developed Drugs4dent®, a medicines decision support tool, that provides dentists with relevant drug knowledge, assists with appropriate prescribing and provides safety checks to reduce prescribing errors. The aim of this pilot study was to improve Drugs4dent® with focus groups of dentists, and assess the acceptability, usability, and user experience, of Drugs4dent®. Focus groups of ten dentists were established to inform the improvement of Drugs4dent®. Acceptability and usability testing of Drugs4dent® was then undertaken with a further ten dentists using interviews and a survey. The survey was based on the Framework for Acceptability and System Usability Scale. Inductive thematic analysis was undertaken using Nvivo for the focus groups and interviews, and descriptive statistics for analysis of survey results. Dentists from the focus group and interviews found the content of Drugs4dent® acceptable and useful for dentistry, recognising that similar drug information is currently not available. The majority agreed that Drugs4dent® would improve their ability to prescribe according to guidance. Participants reported Drugs4dent® was intuitive, and information was easy to locate. Most dentists preferred Drugs4dent® integrated with their dental practice software. In the absence of this functionality, they preferred Drugs4dent® as a standalone resource, without needing to input patient data. Drugs4dent® was subsequently commercialised with MIMS Australia, to create the decision support tool: MIMS Drugs4dent®. Drugs4dent® is the first dental medicines decision tool in Australia. The high acceptability and usability of the tool, and subsequent commercialisation indicates that MIMS Drugs4dent® has substantial promise for the future, and can transform access to relevant drug information for Australian dentists.

BACKGROUND:Recruiting participants for clinical trials poses significant challenges, which can result in escalating costs, delay, and possible abandonment of the trial. Torch Recruit is a software tool that is developed to streamline recruitment process by identifying general practice patients who meet the recruitment criteria specific to a clinical trial by interrogating the patient electronic medical record (EMR) database, thereby optimizing trial recruitment. The aim of the study was to explore the use, acceptability and feasibility of Torch Recruit to support patient recruitment in Australian general practice. METHODS:Twenty-three semi-structured interviews were completed with four practice staff, nine research staff and ten patients. between January to September 2023, to explore the use of Torch Recruit to recruit and manage patients in clinical trials. Data were thematically analysed and interpreted using the updated Consolidated Framework of Implementation Research. RESULTS:Both practice and research staff expressed that Torch Recruit was a well-designed, intuitive tool, enabling accurate and automatic identification of eligible patients for clinical trials. Identifying eligible patients using trial inclusion and exclusion reduced time spent on otherwise traditional methods such as identifying patients through practice electronic medical records or through waiting room recruitment. Patient privacy was mentioned as a possible concern for participants. However, having patient related data stored within the practice, limiting patient information access, as well as having practice and research staff trained in patient recruitment using Torch Recruit, alleviated most concerns. Patients' trust in their GPs and their general practice were seen as a facilitator in patient trial recruitment. CONCLUSIONS:Patient recruitment into any clinical trial is often difficult. This study demonstrated that using an innovative tool such as Torch Recruit provides accurate identification of eligible participants, can streamline a time-consuming process that aligns with practice workflow.

Background Patients presenting with dental pain are common in general practice, despite dental infections being most appropriately managed with dental treatment to address the cause of the infection. Although antibiotics are not appropriate for the management of localised toothache without signs of systemic spread, general practitioners (GPs) often prescribe antibiotics and analgesics for the management of dental pain. The aim of this study was to explore GPs’ perceptions and management of dental presentations in Australia. Methods Twelve semi-structured interviews were conducted with GPs across Victoria, Australia, between October 2022 and January 2023. Data were thematically analysed. Results The study found that dental pain was the most common presenting complaint for patients attending general practice with a dental problem. Five major themes were identified in this study: knowledge, beliefs about capabilities, emotion, environmental context and resources, and social influences/social professional role and identity. In terms of knowledge and capabilities, GPs would advise patients to seek dental care, as they are aware that antibiotics would not resolve the underlying issue. Challenges for GPs included limited training in oral and dental treatment, as well as emotions, such as patient anxiety and phobia resulting in patients seeking dental care through a GP rather than a dentist. Barriers due to the context, such as access to dental care, long waiting lists within the public dental system and cost, were some of the reasons patients present to general practice rather than a seeing a dentist. Furthermore, issues that influenced GPs’ antibiotic prescribing included patients’ expectations for antibiotics to treat their dental pain, as well as dentists advising their patients to attend their GP for antibiotics prior to dental treatment. Conclusions This study identified factors that influenced GPs’ management of patients with dental conditions. To address these issues, it is imperative to develop interventions addressing patients’ knowledge around oral health, as well as providing improved access to dental care for these patients.

AimsDental pain is a common presentation in general medical practice for which patients are often prescribed antibiotics. The aim of this pilot study was to assess prescriptions by general medical practitioners (GPs) for dental presentations in Australia.MethodsAnonymised electronic medical data relating to antibiotic prescribing across 2 periods (3 August–30 November 2019 and 3 August–30 November 2020) were extracted from 8 general practices in Victoria that contributed data to the University of Melbourne's Data for Decisions programme. Extracted de‐identified data included antibiotics prescribed for dental presentations, practice site number, visit date, patient age, sex, reason for prescription, reason for visit and the regimen of the antibiotic. Appropriateness of the prescribed antibiotic was assessed against the Australian national dental guidelines Therapeutic Guidelines Oral and Dental.ResultsFrom 13 641 recorded prescriptions, 178 were recorded for dental presentations, representing 1.3% of all antibiotic prescriptions. When assessed against the guidelines, 23.6% (n = 42) were considered appropriate. The top 3 most commonly prescribed antibiotics were amoxicillin (n = 84, 47.2%), amoxicillin/clavulanic acid (n = 52, 29.2%) and metronidazole (n = 15, 8.4%). The reasons for inappropriate prescribing were as follows: third‐line treatment being chosen, inappropriate spectrum, incorrect regimen or prescribing an antibiotic not recommended in the guidelines.ConclusionThese results indicate a need to better understand the potential patient drivers for antibiotic prescription for GPs and patients, and resources GPs need to manage dental presentations. These results will inform the codesign of targeted interventions to address any educational gaps and barriers to accessing dental treatment and thus improving antibiotic prescribing.

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.

Antibiotic resistance is a threat to global health, and inappropriate antibiotic use can be associated with adverse effects. Developing tools to encourage better communication between patients and general practitioners may reduce inappropriate use of antibiotics. The aim of the study was to develop shared decision support tools on common infections using a co-design methodology to address antimicrobial stewardship (AMS) in primary care. Three co-design/interview sessions were conducted with primary care providers and consumers between October 2019-April 2020 in Melbourne, Australia. Participants critiqued existing AMS tools, identified key elements required and optimised resulting prototypes. Primary care providers and consumers prioritised information to include in the AMS tools, such as when to see a doctor, management options, disease symptoms and cause of infection differently. However, both agreed content should be communicated in a plain, concise and logical manner, using inclusive and simple language accompanied by illustrations. Information sheets should be single-sided and A4-sized, appropriate for use before, during or after consultations. Co-design provided a collaborative forum to systematically design and develop products that meet the needs of both primary care providers and consumers. This resulted in the development of seven patient information sheets on common infections that encourage discussion of these infections, conservative management options and appropriate antibiotic use in primary care.

Chronic disease identification and management is a significant issue in Australia, with general practice being the primary contact point for those at risk of, or living with, chronic disease. However, there is a well-described gap between guideline recommendations for chronic disease management and translation in the general practice setting. In 2018, a group of researchers, clinicians and software developers collaborated to develop a tool to support the identification and management of chronic disease in general practice, with the aim to create a platform that met the needs of general practice. The co-design process drew together core principles and expectations for the establishment of a technological platform, called Future Health Today (FHT), which would sit alongside the electronic medical record (EMR) management system within general practice. FHT used algorithms applied to EMR data to identify patients with, or at risk of, chronic disease and requiring review. Using chronic kidney disease as a clinical focus, the FHT prototype was piloted in a large, metropolitan general practice, and a large regional general practice. Based on user feedback, the prototype was further developed and improved. This paper provides a report on the key features and functionalities that participants identified and implemented in practice.

Australia's COVID-19 vaccine rollout included prioritizing older adults and those with underlying conditions. However, little was known around the factors impacting their decision to accept the vaccine. This study aimed to assess vaccine intentions, information needs, and preferences of people prioritized to receive the COVID-19 vaccine at the start of the Australian vaccine rollout. A cross-sectional online survey of people aged ≥70 years or 18–69 with chronic or underlying conditions was conducted between 12 February and 26 March 2021 in Victoria, Australia. The World Health Organization Behavioural and Social Drivers of COVID-19 vaccination framework and items informed the survey design and framing of results. Bivariate logistic regression was used to investigate the association between intention to accept a COVID-19 vaccine and demographic characteristics. In total, 1828 eligible people completed the survey. Intention to vaccinate was highest among those ≥70 years (89.6%, n = 824/920) versus those aged 18–69 years (83.8%, n = 761/908), with 91% (n = 1641/1803) of respondents agreeing that getting a COVID-19 vaccine was important to their health. Reported vaccine safety (aOR 1.4, 95% CI 1.1 to 1.8) and efficacy (aOR 1.9, 95% CI 1.5 to 2.3) were associated with intention to accept a COVID-19 vaccine. Concerns around serious illness, long-term effects, and insufficient vaccine testing were factors for not accepting a COVID-19 vaccine. Preferred communication methods included discussion with healthcare providers, with primary care providers identified as the most trusted information source. This study identified factors influencing the prioritized public's COVID-19 vaccine decision-making, including information preferences. These details can support future vaccination rollouts.

BACKGROUND:Antibiotic resistance is a rising global threat with only two options for mitigation: 1) invent new antibiotics and/or 2) use current antibiotics more wisely. In Australia, the majority of antibiotic usage is in the community, hence primary care has a key role.  OBJECTIVE: With no single 'magic bullet', a range of approaches is needed. The aim of this article is to describe the options and evidence in three broad categories: 1) regulatory changes such as repeats and pack sizes, 2) policy initiatives such as public campaigns, academic detailing and education and 3) clinical strategies including delayed prescribing, clinical decision support tools, practice-based audit and feedback, and patient information sheets.DISCUSSION:Australia has good antibiotic regulation and guidelines but must invest in sustained primary care stewardship programs, which should include surveillance, information for consumers, support for general practitioners and general practice training, and an ongoing evaluation and research program.

BACKGROUND AND OBJECTIVES:Australia has relatively high rates of antibiotic prescribing in the community. The aim of this study was to identify clinical insights regarding antibiotic prescribing choices for the management of common upper respiratory tract infections through analysis of anonymised primary care electronic medical records (EMRs).METHOD:EMR data relating to 1926 antimicrobial prescriptions for tonsillitis, pharyngitis and acute rhinosinusitis in adults and acute otitis media (AOM) in children were extracted from 11 general practices in Victoria and analysed for consistency with Australian Therapeutic Guidelines recommendations.RESULTS:The analysis suggests that underdosing of amoxicillin for AOM in children, prescription of phenoxymethylpenicillin at doses not consistent with Therapeutic Guidelines recommendations for tonsillitis and pharyngitis in adults, and potential overprescription of antibiotics for patients with acute rhinosinusitis are not infrequent in general practice.DISCUSSION:Anonymised EMR data provide an opportunity to analyse antibiotic prescribing practices at scale and provide insights relevant to clinical practice.

Background Responding to the COVID-19 pandemic requires safe and efficient testing on a large scale over a prolonged period. Outpatient testing facilities can clinically assess and test symptomatic individuals and test asymptomatic contacts. This study identified the resources required to establish and maintain an Australian general practitioner (GP) led testing facility that combined a respiratory clinic for clinical assessment and testing with a drive-through testing facility. Methods Data were taken from clinic administrative records to identify the number of patients tested over the period April-June 2020. An independent auditor’s report identified the resources used in establishing, running, and staffing both clinics for the same period. Analyses were performed using the minimum and maximum daily throughput to understand the effect of demand on price per sample collected. Results The respiratory clinic tested an average of 19 patients per day, at an estimated cost of $340.04 AUD. This varied to $687.99 AUD during the lowest demand scenario, and $281.04 AUD during the high demand scenario. The drive-through clinic tested an average of 47 patients per day, at an estimated cost of $153.57 AUD. This varied to $279.51 AUD during the lowest demand scenario, and $99.92 AUD during the high demand scenario. Conclusion This study provides insight into the cost of testing at a drive through and respiratory clinic in Australia. The evidence highlights importance of considering variation in demand and the impact on efficiency, particularly where resource use is fixed in the short term.

Inappropriate antimicrobial prescribing contributes to increasing antimicrobial resistance. An antimicrobial stewardship (AMS) program in the form of quality improvement activities that included audit and feedback, clinical decision support and education was developed to help optimise prescribing in general practice. The aim of this study was to evaluate the implementation of this program (Guidance GP) in three general practices in Melbourne, Australia, between November 2019 and August 2020. Thirty-one general practitioners (GPs) participated in the program, with 11 GPs and three practice managers participating in follow-up focus groups and interviews to explore the acceptability and feasibility of the program. Our findings showed that the quality improvement activities were acceptable to GPs, if they accurately fit GPs’ decision-making process and workflow. It was also important that they provided clinically meaningful information in the form of audit and feedback to GPs. The time needed to coordinate the program, and costs to implement the program were some of the potential barriers identified. Facilitators of success were a “whole of practice” approach with enthusiastic GPs and practice staff, and an identified practice champion. The findings of this research will inform implementation strategies for both the Guidance GP program and AMS programs more broadly in Australian general practice, which will be critical for general practice participation and engagement.