Evaluation Of Multidisciplinary Care Plans For Patients With Diabetes
Funder
National Health and Medical Research Council
Funding Amount
$83,500.00
Summary
Care planning for patients with chronic illnesses and complex needs is a major part of the Commonwealth Enhanced Primary Care package. This initiative, announced in late 1999, provides access to Medicare Benefits Schedule (MBS) items to remunerate general practitioners, involved in developing multidisciplinary care plans in cooperation with other health care providers. An issue of importance, and the one that this project investigates, is whether disease specific care is addressed in care plans ....Care planning for patients with chronic illnesses and complex needs is a major part of the Commonwealth Enhanced Primary Care package. This initiative, announced in late 1999, provides access to Medicare Benefits Schedule (MBS) items to remunerate general practitioners, involved in developing multidisciplinary care plans in cooperation with other health care providers. An issue of importance, and the one that this project investigates, is whether disease specific care is addressed in care plans and whether the care planning process is associated with improved provision and outcomes of care for a specific chronic illness. The chronic illness that has been chosen for this research project is diabetes because of its prevalence in the community, importance in general practice and because there are accepted standards of process and outcomes of care against which diabetes care contained in EPC care plans can be bench marked. Diabetes is estimated to affect 7.5% of the adult Australian population with more than 85% of those affected having type 2 or mature onset diabetes. Increasingly care of type 2 diabetes is provided in primary care under share care arrangements with specialist diabetes services and in a multidisciplinary team approach involving the patient and their carer as well as relevant health professionals. A recent review has shown that there is a lack of evidence on whether multidisciplinary care is associated with improved process and outcomes of diabetes care. The project will involve 50 general practitioners and 200 of their patients with diabetes in South West Sydney. The design of the project involves audit of the care plans to examine the extent and quality of the diabetes care contained in comparison to accepted benchmarks. The project will also audit the patients' medical records for the year of care before and after the care plan. This care will be compared to published guidelines for process of care and goals for outcomes.Read moreRead less
The Diamond Cohort Study- Examining Depressive Symptoms In Primary Care
Funder
National Health and Medical Research Council
Funding Amount
$570,886.00
Summary
Depression is the single largest cause of disability for people in Australia. It is mainly managed in general practice-primary care, yet many people experiencing depression go unrecognised by their family doctor or general practitioner (GP). Some people, even when given treatment, remain depressed. Guides on how to manage depression have been mainly based upon people attending psychiatrists and hospitals. In addition, there have been a number of large studies overseas testing new ways of helping ....Depression is the single largest cause of disability for people in Australia. It is mainly managed in general practice-primary care, yet many people experiencing depression go unrecognised by their family doctor or general practitioner (GP). Some people, even when given treatment, remain depressed. Guides on how to manage depression have been mainly based upon people attending psychiatrists and hospitals. In addition, there have been a number of large studies overseas testing new ways of helping people with depression. Unfortunately, they do not seem any better than usual care by a GP. We are currently funded by the NHMRC for diamond 1 to follow 800 people to investigate the factors from the patient's and doctor's point of view that are likely to aid recovery from depression, and to detail the way in which people are cared for in the primary health care system. There is increasing research showing that depression is a chronic and relapsing condition and that a one-year follow-up, whilst longer than most previous studies, will capture only a small glimpse of the health service use and relapse patterns of the patients enrolled in our study. In this application, we request funding to continue to follow participants. diamond 2 aims to explore the patient characteristics and health service use patterns of patients who experience persistent major depression with patients who experience a single episode of depression within a 3-year period. We will use the data gathered to develop models that predict recovery-relapse-persistence of depression. Such models will enable us to develop guidelines and design interventions that better target those at risk of continuing and disabling illness. This work will be of international significance and has the potential to influence the entire primary mental health care system and contribute to substantial system change.Read moreRead less
Primary Health Care Errors Study: Qualification And Quantification Of Errors Occurring In General Practice
Funder
National Health and Medical Research Council
Funding Amount
$191,000.00
Summary
The General Practice Errors Study (GPES) is a project that aims to examine errors that GPs notice in their daily practice, that affect patient well-being or care. Very little work has been done on this subject in General Practice in any other country, and Australia is the only country with previous research that has attempted to describe GP errors with the Quality in Australia Health Care Study (QAHCS). However, we have so far not had any research that has been done on a representative sample of ....The General Practice Errors Study (GPES) is a project that aims to examine errors that GPs notice in their daily practice, that affect patient well-being or care. Very little work has been done on this subject in General Practice in any other country, and Australia is the only country with previous research that has attempted to describe GP errors with the Quality in Australia Health Care Study (QAHCS). However, we have so far not had any research that has been done on a representative sample of GPs, or been able to quantify the frequency with which different types of errors occur. This study plans to ask a representative sample of GPs in both urban and rural areas to report their errors, so that we can try to quantify the incidence and prevalence of these different error types. No previous work has been done in Primary care which has attempted to determine the rate of recognized errors that occur in the community. In addition, since the last major work on this topic was done between 1993 and 1998, there have been many changes to General Practice, especially in the area of computerisation, and the types of problems that GPs face now may have changed significantly. Anonymous reporting is very important in order to encourage health professionals to admit to their mistakes, and in the past, projects have used paper based reporting forms, making it difficult to offer anonymity and requiring protection for participants under a Commonwealth Act of Parliament. However the GPES project will be the first major study of General Practice errors that uses an on-line anonymous reporting form, and high level encryption, located on a secure web-site, to encourage honest reporting. The reporting form was trialled in the 2001 pilot study. By analysing the types of errors occurring, and their contributing factors, we can target at-risk population groups and develop strategies to improve patient care and prevent future harm.Read moreRead less
Randomized Control Trial Of A Cancer Shared Care Model
Funder
National Health and Medical Research Council
Funding Amount
$242,400.00
Summary
Cancer care in Australia remains fragmented. Shared care has been seen as a potentially more effective way to manage patients with chronic and subacute diseases, by overcoming many of the difficulties which beset the traditional hospital-based model. These difficulties include poor communication between hospital-based and community-based carers, the high costs of hospital-based care and the loss of involvement of the primary care health professional in ongoing care. This project is a trial of a ....Cancer care in Australia remains fragmented. Shared care has been seen as a potentially more effective way to manage patients with chronic and subacute diseases, by overcoming many of the difficulties which beset the traditional hospital-based model. These difficulties include poor communication between hospital-based and community-based carers, the high costs of hospital-based care and the loss of involvement of the primary care health professional in ongoing care. This project is a trial of a Shared Care Model (SCM) with cancer patients in a hospital in Western Australia. The project is designed to improve the emotional well-being and feelings of empowerment of the patients as well as reduce the number of unplanned admissions these patients need to make during their cancer treatment. The SCM intervention includes: -A patient-held record (PHR) comprising chemotherapy road map, treatment intention, medication list and communication pages for health workers; - Earlier and timely direct communication between specialist and general practitioner; -A Shared Care coordinator to assist with patient care and information; and - General practitioner educational and resource packages with tailored side effects table detailing anticipated side effects and actions to be taken. - For rural patients, the model can be expanded to include general practitioner administration of selected chemotherapeutic agents on alternate cycles. - Protocols for general practitioners administration of selected chemotherapeutic agents.Read moreRead less
Reducing Depression And Suicide Amongst Older Australians: A Clustered Randomised Clinical Trial In Primary Health Care
Funder
National Health and Medical Research Council
Funding Amount
$765,050.00
Summary
Like many industrialised nations, Australia's population is ageing. By the year 2051, the population aged 65 years and over is projected to triple in size, while those over 85 will increase five-fold. The social, financial, and health consequences of a rapidly ageing society cannot be ignored. Accompanying this population explosion will be greater numbers of individuals experiencing age-related physical disorders and disabilities that give rise to social and psychological problems, including dep ....Like many industrialised nations, Australia's population is ageing. By the year 2051, the population aged 65 years and over is projected to triple in size, while those over 85 will increase five-fold. The social, financial, and health consequences of a rapidly ageing society cannot be ignored. Accompanying this population explosion will be greater numbers of individuals experiencing age-related physical disorders and disabilities that give rise to social and psychological problems, including depression and suicide. Suicide rates are very high in later life, with the ratio of men who kill themselves in late old age greater than that found in their youthful counterparts. Depression is most often linked to suicidal behaviour in this age group, with research suggesting that the treatment of this mental disorder may directly lead to a reduction in suicide in the aged. Approximately 80% of older adults will visit their general practitioner at least once per year in Australia, while up to 70% of older people will consult their GP in the month prior to their death by suicide. This suggests that GPs are in the best possible position to detect and manage depression and suicide risk in later life. Unfortunately, depression is consistently reported to be underdiagnosed and undertreated in this setting. The purpose of this study is to determine whether an educational programme targeting Australian GPs can enhance doctors' detection rates of depression and suicide risk, thereby leading to a reduction in depression and suicidal behaviour among those older patients visiting their surgeries.Read moreRead less