Aust Fam Physician
-
In the BEACH program between April 2008 and March 2013, general practitioners (GPs) recorded details of 7380 patient encounters with people who identified themselves as Aboriginal and Torres Strait Islander, which accounted for 1.5% of all BEACH encounters. The rates at which type 2 diabetes and asthma were managed at encounters with patients who identified as Aboriginal and Torres Strait Islander people were compared with those of other patients.
-
Like the featured authors, we have spent most of our working lives in remote, mostly Aboriginal communities. A common theme in these papers is the need to link clinical practice, prevention and appropriate policy to improve health outcomes. We need to consider our patients and their wider social context.
-
Although all Australian healthcare providers are acutely aware of the health outcomes for Aboriginal and Torres Strait Islander peoples, many general practitioners may feel unprepared to take on the challenge of working in an Aboriginal medical service or in a remote Indigenous community. To highlight the immense rewards, without minimising the challenges, AFP invited Dr Lara Wieland, a GP with longstanding experience in the front-line of providing primary care for Aboriginal peoples, to share her thoughts.
-
Smoking is the most important preventable cause of adverse outcomes in pregnancy. However, most smokers who become pregnant continue to smoke and most of those who quit relapse after delivery. ⋯ Continuing to smoke during pregnancy is strongly associated with socioeconomic disadvantage, mental illness and Aboriginal and Torres Strait Islander populations. Quitting is more difficult for these groups and interventions assist only sixin every 100 pregnant smokers to quit. Behavioural counselling is the first-line treatment. Nicotine replacement therapy (NRT) can be offered if the smoker is unable to quit without it, although its efficacy is uncertain. Adequate doses of nicotine and good adherance may be required for the best results. The use of NRT in pregnancy is likely to be less harmful than continuing to smoke. Women should be encouraged to quit smoking before becoming pregnant.
-
Mental health problems in Aboriginal and Torres Strait Islander peoples are common, changing and challenging. Particularly in remote settings, doctors will need to untangle the complex interplay of culture, context and clinical significance. ⋯ Anxiety, depression, psychosis, self-harm and problems of childhood and old age are used to exemplify differences by comparison with practice in non-Indigenous populations.