Introduction: Kameda Family Clinic Tateyama (hereafter referred to as "the clinic" ) has been providing antenatal care by family physicians in collaboration with the Department of Obstetrics and Gynecology of Kameda General Hospital (hereafter referred to as "the main hospital" ) since 2006, but the scope of the program was limited to low-risk pregnant women up to 34 weeks of pregnancy. The program was expanded to include some high-risk pregnant women and full-term pregnant women. We conducted a retrospective study to determine how much the burden of hospital visits by pregnant women was reduced.Methods: We compared the actual situation of antenatal checkups with that assumed in the management before 2021, and analyzed the reduced number of visits to the main hospital and the total distance of visits to the main hospital.Results: Twenty-seven pregnant women were included in the study, and the median number of visits to the main hospital was reduced by 3 visits and the median distance of the main hospital visits was reduced by 183.6 km. In the high-risk group, the median number of visits to the main hospital was reduced by 5.5 times, and the median distance of visits was reduced by 257.6 km.Conclusion: Expansion of antenatal checkups using ICT technology safely reduced the distance of hospital visits for pregnant women.

Sports medicine requires a multidisciplinary and comprehensive approach, making it highly compatible with primary care. Internationally, there are many primary care physicians in the field of sports medicine; however, there are few in Japan. Although the demand for learning about sports medicine is high, there are few facilities where primary care physicians can undergo training. This report discusses the initiatives and prospects of the Kameda Family Clinic Tateyama Primary Care Sports Medicine Fellowship Program, which was established in 2009 and revised and implemented in 2022.

Sports medicine requires a multidisciplinary and comprehensive approach, making it highly compatible with primary care. Internationally, there are many primary care physicians in the field of sports medicine; however, there are few in Japan. Although the demand for learning about sports medicine is high, there are few facilities where primary care physicians can undergo training. This report discusses the initiatives and prospects of the Kameda Family Clinic Tateyama Primary Care Sports Medicine Fellowship Program, which was established in 2009 and revised and implemented in 2022.

We have conducted driving fitness evaluations for post-illness patients in our clinic since 2008. Many patients expressed a desire to resume driving; thus, primary care physicians and rehabilitation staff collaborated to establish an evaluation system. We conducted cognitive dysfunction evaluation, driving simulator evaluation, and evaluation at driving schools. Among 160 patients, we evaluated 87 to be fit to drive, and eight to be unfit. We describe the significance and challenges of assessing patients' driving aptitude in primary care.

Introduction: Vaccine policies have changed in recent years in Japan. In the present study, we assessed practices, recommendations, knowledge, and sources of information among primary care physicians (PCPs) regarding vaccinations in Japan. Methods: We conducted a nationwide cross-sectional study targeting PCPs in Japan. We used a web-based self-administered questionnaire targeting physicians that were members of the Japan Primary Care Association in 2019. We analyzed respondent administrations, recommendations, knowledge, and sources of information regarding vaccinations. Results: We received responses from 1,084 PCPs (20.1%) and invited 981 participants for the analysis. The rates at which physicians gave routine and voluntary vaccines in their own practices were 23.3-95.5% and 13.2-94.4%, respectively. The active recommendation rates for routine and voluntary vaccines were 41.6-92.0% and 13.6-75.5%, respectively. Furthermore, among routine vaccines, human papillomavirus vaccine was the least administered and recommended. PCPs working at clinics had the most accurate knowledge about vaccinations, and PCPs utilized academic organizations most readily as an information resource. Conclusion: We clarified practices, recommendations, knowledge, and sources of information regarding vaccinations among PCPs in Japan.

In recent years, the integration of mental health into primary care has become a global trend, as it is recognized to be effective for providing appropriate treatment, improving outcomes, and using resources appropriately. Therefore, in many countries, mental health education in primary care has been developed and delivered. However, systematic training on mental health for family physicians has not been sufficiently provided in Japan. We performed a scoping review in order to clarify the mental health competencies of primary care physicians by analyzing the educational curricula in other countries using thematic analysis. The competencies extracted were comprehensive and classified into three domains: "general competencies in primary care," "general competencies in mental health in primary care," and "specific competencies in mental health in primary care". In the future, it will be necessary to create a competency list based on the reported data and formulate a model curriculum based on the current situation in Japan.

HANDS-FDF (Home and Away Nine DayS-Faculty Development Fellowship) is probably the first home and away format, continuous faculty development program for primary care physicians deliberately developed by officially FD trained director based on the existing successful programs and pilot testing by officially FD trained director. This fellowship has many unique features with 146 stellar graduates and 15 year history. Other prospective course developer may benefit from studying this course in detail.

Introduction: The learning and practice of bereavement care by Japanese family practitioners has largely been unexplored. The purpose of this study was to clarify what family doctors thought they learned by providing care for bereaved families and how they changed because of it.Methods: Semi-structured interviews were conducted with seven family practitioners working in bereaved family outpatient care at the researcher's hospital. A modified grounded theory approach was used for the analysis.Results: The analysis identified five thematic categories: 1) the doctor's feelings and thoughts before learning about bereavement care, 2) things they learned from providing bereavement care, 3) things they learned by interacting with the families and things they learned upon reflections afterward, 4) changes in themselves, and 5) changes in their feelings after learning about bereavement care.Conclusion: The doctors learned to provide bereavement care by directly interacting with families and by reflecting on those experiences; for example, they learned to listen and be empathetic, and to understand individuals' personal responses to grief. As a result, they may have gained the ability to have a more rounded view of life and death and of their role in helping families adjust to the death of a family member.

In the 1980s, some researchers started using the word "multimorbidity", which is defined as "the co-existence of two or more long-term conditions in an individual". Multimorbidity has become one of the most important topics in recent primary care because of its clinical significance. Multimorbidity is more common among the elderly, and was suggested to be associated with female sex, lower socio-economic status and mental disease. Multimorbidity is associated with a higher mortality, lower quality of life and reduced functional status. It is also associated with the treatment burden such as consultation frequency, fragmented healthcare provision and inadequate polypharmacy. Multimorbidity has negative impact on health care resource use such as hospital visits, unexpected admission and total health care costs. However, the total picture and health care effects of multimorbidity have only been reported in observational studies, and there is little evidence of which interventions are effective for multimorbidity patients. In this review paper, we carried out a literature review of high-quality reports from Japan and overseas. We provide an overview of the current situation of multimorbidity research and highlight the research gaps. Based on these results, we would like to propose approaches for multimorbidity patients in clinical settings.