Background: The newest version of the Therapeutic Guidelines’ antibiotic chapter introduced patient- and clinician-facing resources to support decision-making about antibiotic use for self-limiting infections. It is unclear whether General Practitioners (GPs) are aware of the natural history information in these resources and use them. We explored GPs' perception of the value of access to natural history information and awareness and use of Therapeutic Guidelines’ resources (summary table, discussion boxes, decision aids) to support antibiotic decision-making.
Methods: Semi-structured interviews with 21 Australian GPs. Interviews were recorded, transcribed, and thematically analysed by two independent researchers.
Results: Four themes emerged: (1) GPs perceive natural history information as valuable in consultations for self-limiting conditions and use it for a range of purposes, but desire specific information for infectious and non-infectious conditions; (2) GPs' reasons for using patient-facing resources were manifold, including managing patients' expectations for antibiotics, legitimising the decision to not provide antibiotics, and as a prescription substitute; (3) The guidelines are a useful and important educational resource but typically not consulted at the time of deciding whether to prescribe antibiotics; and (4) Experience and attitude towards shared decision making and looking up information during consultations influenced whether GPs involved patients in decision-making and used a decision aid.
Conclusions: GPs perceived natural history information to be valuable in discussions about antibiotic use for self-limiting conditions. Patient and clinician resources were generally perceived as useful, although reasons for use varied, and a few barriers to use were reported.

1. GPs are supportive of using natural history information in consultations for self-limiting conditions.
2. Evidence-based synthesis of natural history information for various infectious and non-infectious conditions can facilitate access to guideline developers.
3. Further research is needed to explore the best approach to communicate natural history information to patients.

Background:
General practitioner (GP)-patient relationships are the basis of general practice whole person care. According to Ridd et al (2009) deep doctor-patient relationships are characterised by trust, knowledge, loyalty and regard and have been shown to improve patient outcomes. This study aimed to further our understanding of GP-patient relationships that patients identify as having depth, through exploring how these relationships are cultivated and experienced from the perspective of GP-patient dyads.

Methods:
Qualitative thematic design. Participating GPs’ patients were surveyed regarding their depth of relationship with their GP. Patients reporting deep relationships were purposively selected for interview. Interviews were conducted with patients and their GPs separately, regarding how they experience and cultivate the GP-patient relationship. Interview participants also completed a survey regarding their attachment style and (for patients) the person-centredness of their GPs’ practice. Interviews were analysed using inductive thematic analysis.

Findings:
Five GPs and 13 patients were interviewed. Data suggest that deep GP-Patient relationships are asymmetrical professional relationships underpinned by genuine, realistic ‘real relationships’. These relationships were valued by patients, and display some, but not all, features of ‘attachment relationships’ as described in the psychological literature. Deep relationships were cultivated through the GPs’ clinical expertise and genuine interpersonal care, and came at some cost (but also reward) to the GP.

Implications:
These findings further emphasise the importance of relational work in general practice care, which is more than a series of transactional encounters. Health system policy that fails to recognise this, risks sacrificing the foundation of effective primary care. Additionally, this research summarises specific actions of GPs and patients to cultivate deep relationships, which could inform training and practice.

At the conclusion of this presentation attendees will:

1. Be familiar with recent research regarding the nature of deep GP-patient relationships
2. Identify GP and patient actions that support the cultivation of these relationships
3. Consider the relevance of these findings to primary care practice and policy

Background: Primary care research (PCR) is fundamental for advancing primary and community medicine. As primary care implementation differs between regions, PCR needs to be locally relevant. If not local, might not be relevant, and therefore, not applicable, and useful. Although certain PCR priorities have been identified, there is no map describing PCR across regions to support global PCR priority setting.
Purpose: To map PCR, identify disparities between countries, and explore potential correlates.
Methods: Retrospective ecological study. Primary care publications were extracted from PubMed for each country indexed in the World Bank list of countries. Using MeSH terms for countries and primary care services, annual counts of publications were extracted from database creation until December 31st, 2022. Health, Nutrition, and Population Statistics Data from the World Bank were used to study correlates of primary care publications, including demographic, economic, primary care implementation, and health workforce indicators. Trends in publications were compared between regions using multilevel mixed-effects generalized regression models with negative binomial distribution to account for the over-dispersion of publications between countries. Incidence risk ratios (IRRs) and 95% confidence intervals (95% CI) for each subgroup were estimated.
Results: A total of 159,880 publications were identified, most being published since 2008 (51.8%). 63.6% of publications came from 4 nations: United States, United Kingdom, Australia, and Canada. High-income countries produced 88.8% of all publications, while middle- and low-income nations produced 10.2% and 1.0%, respectively. In addition, large within-group differences were identified (p<0.001). The total number of publications for each country was independently associated with the country’s region, universal health coverage index, and the number of nurses per 1,000 people.
Conclusion: Mapping PCR enabled identifying where primary care knowledge comes from, the existing disparities between and within regions and economic groups, and correlates. This map can support global PCR priority setting.

1. Most primary care research has been published in the last 15 years.
2. Most primary care research comes from high-income countries.
3. Primary care research is correlated with countries' demographic, economic, primary care implementation and primary care workforce indicators.

Aim:
Academic research in primary care is essential to improving and maintaining high-quality primary care. Unfortunately, the rate of general practitioners (GPs) entering the academic workforce remains low in Australia and internationally. We analysed a large dataset of Australian medical practitioners (MABEL - The Medicine in Australia: Balancing Employment and Life survey - 2018 wave) to determine the proportion of specialist GPs that have completed a higher degree by research.

Content:
A total of 4643 medical practitioners (female = 2261) were included in the analysis. Of these, 2770 were GPs and 1873 were non-GP specialists. Five non-GP specialties were examined, including obstetrics and gynaecology (n=180), paediatrics (n=210), internal medicine (n=873), psychiatry (n=307), and surgery (n=303). In a multivariable logistic regression analysis, medical practitioners from all five disciplines had higher odds of completing a higher degree by research than GPs. The odds ratio ranged from 1.5 (95% confidence interval 1.0-2.1, p=0.05) for obstetrics and gynaecology to 2.8 for internal medicine (95% confidence interval 2.3-3.4, p<0.001). Increasing age, teaching medical students and obtaining the primary medical degree from Australia but not gender or rurality, were associated with increased odds of a higher degree by research completion.

Goals:
Our analysis of a large dataset of medical practitioners in Australia shows that GPs have a lower rate of completion of a higher degree by research than medical practitioners working in other specialties. Our findings contribute to the evidence base showing inadequate engagement with, promotion of, and investment in primary care research in Australia and internationally.

A robust strategy from the policymakers, universities, research institutes and professional organisations is required to address the imbalance and encourage more GPs to undertake formal research training to ensure that primary care practice is informed by high-quality research.

At the conclusion of my presentation, the attendees will be able to:
1. Compare and contrast the pattern of higher degree by research completion for Australian general practitioners with non-GP specialists
2. Describe how this pattern compares with GPs/family physicians internationally.
3. Summarise strategies that could be used to increase the rate of higher degree by research completion in Australia and internationally.

Background: Elder people represent a quarter part of our society. Ageing is associated with an increase in chronic diseases and reduced functional and social independence. Informal caregivers (ICs) are essential figures to counterbalance the effects of dependence in the elderly. However, this responsibility creates distress to ICs, statistics showing that they suffer from poorer health-related quality of life, particularly regarding mental health. Social support is crucial for mitigating the effects that caregiving produces in ICs. Salutogensis theory explores the contributing factors for the promotion and maintenance of health. These factors can be worked through participatory projects, providing ICs with agency to become the motor of their own change.
Objectives: We aim to build a bidirectional relationship with the ICs community and health professionals by creating a communication space where ICs can identify their problems and engage in the decision-making process for creating possible solutions.
Methodology: This project will have three phases spread over a year and will take place in three primary health centres of Barcelona. We propose the participatory method of photovoice, which aims to promote critical dialogue and knowledge through the discussion of photographs. After introducing the salutogenic model to the participants, ICs will take pictures of their environment that they think are representative of health. In small groups, participants will discuss the photographs presented and, through a consensus-building process, they will identify the main issues that are affecting their health. Following next, ICs and health professionals will gather to find possible solutions about the topics generated from the photovoice. Lastly, we will create a focus group and conduct interviews to evaluate both interventions.
Expected results: This project aims to enhance social network and community-generated health promotion and to start a resilient system in the area.

Introduction:
Since 2014, over 50% of rural counties in the United States have had limited access to hospital-based obstetric services. For rural residents, further access instability surfaced during the COVID-19 pandemic contributing to increased maternal mortality and morbidities. The struggle to access quality care has been a systemic barrier for rural women of color.

Aim:
Improving access to quality care and specialized clinicians is a valuable strategic and patient-focused goal for rural hospital leaders, rural communities, and the patients served.

Methods:
This case study explored strategies rural hospital leaders implemented to enhance access to maternity services in rural areas. Results and conclusion. Developing synergies with providers and health systems, utilizing technology, and creating effective telehealth programs were central themes that evolved from this study.

1. Strategies to enhance access to care
2. Synergies to cultivate with providers and health systems
3. Technology options to leverage to provide care