Personalised Care For Type 2 Diabetes In Primary Care: Empowering Patients And Clinicians To Treat To Target
Funder
National Health and Medical Research Council
Funding Amount
$177,197.00
Summary
This Fellowship program focuses on evidence based clinical care of people with type 2 diabetes (T2D) in general practice. In particular it seeks to translate evidence about progressive intensification of treatment of elevated glucose levels to achieve “target levels” into real world everyday general practice care of people with T2D. Doing so will play an important role in reducing the long term serious complications and could reduce the costs to the community of this condition.
Trial Of Structured Support To Enhance The Role Of Non-GP Staff In Chronic Disease Management In General Practice
Funder
National Health and Medical Research Council
Funding Amount
$780,625.00
Summary
Chronic disease presents a significant burden to individuals and the health care system , contributing to both an increasing proportion of the work of primary health care practitioners and to health expenditure. A number of interventions have been shown to result in sustained improvement of health outcomes for people with chronic diseases, including: more effective use of non-physician providers of care and nurse case management; integration of self-management support programs with guideline bas ....Chronic disease presents a significant burden to individuals and the health care system , contributing to both an increasing proportion of the work of primary health care practitioners and to health expenditure. A number of interventions have been shown to result in sustained improvement of health outcomes for people with chronic diseases, including: more effective use of non-physician providers of care and nurse case management; integration of self-management support programs with guideline based treatment plans; more intensive follow up and registries that provide reminders and feedback. While some of these approaches have been pursued within the Coordinated Care Trials and the Enhanced Primary Care (EPC) program in Australia, the role of non medical staff within general practice in chronic disease care has not been systematically investigated. In 2001 the Commonwealth introduced a number of initiatives to support better quality of care for diabetes and asthma in general practice and $104.2 million over four years was provided for general practices in areas of high workforce pressure to employ more Nurses. The roles of the Practice Manager and Receptionist have received much less attention. They include faclitating access to care, supporting the delivery of quality clinical care by the practitioners through the provision of expert management services (primarily information technology, staff, financial and facilities management) to the practice. With recent government initiatives expanding the role of general practice in Australia, effective management structures and processes within general practices are vital. Non-GP general practice staff may be the means by which more effective chronic disease management can be achieved at a time of increasing workforce pressure. This project aims to evaluate the impact of a program in which non-GP staff are trained and facilitated to be involved in the management of patients with chronic disease.Read moreRead less
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
PEACH: Patient Engagement And Coaching For Health: An Intensive Treatment Intervention For Patients With Type 2 Diabetes
Funder
National Health and Medical Research Council
Funding Amount
$304,300.00
Summary
Diabetes care is a partnership between health professionals and patients, but each faces difficulties in optimising medical care. The PEACH study exoplores how practice nurses can work with patients to empower them to manage their own condition and medicines better and be more active in working with their doctor to improve their diabetes control. The study could have important implications for patients and the way Governments fund primary care.
General Practice Optimising Structured MOnitoring To Improve Clinical Outcomes In Type 2 Diabetes: GP-OSMOTIC T2D
Funder
National Health and Medical Research Council
Funding Amount
$864,980.00
Summary
We will study the use of a new technology, retrospective continuous glucose monitoring (r-CGM), to help achieve glucose targets for people with type 2 diabetes (T2D) in General Practice (GP). This is important because controlling glucose levels improves disease outcomes and because T2D is mostly managed in GP where the majority of people are out of glucose target levels and GPs and patients currently don’t have a simple effective method for monitoring blood glucose levels to guide treatment.
Stepping Up To Insulin: A Cluster Randomised Trial Of Team-based Transition To Insulin In Primary Care For Patients With Poorly Controlled Type 2 Diabetes
Funder
National Health and Medical Research Council
Funding Amount
$796,751.00
Summary
Helping people control their diabetes through the best possible medical care is important. Most people with diabetes eventually need insulin yet this is a step in treatment that is often resisted by patients and GPs. This study will help GPs and Practice Nurses work with patients who have reached this stage make the change to insulin treatment in a safe, effective, convenient and timely way. This will have enormous benefits through reduced diabetes complications and improved quality of life.
Systematic Diabetic Retinopathy Screening And Monitoring Of Early Stage Disease In General Practice
Funder
National Health and Medical Research Council
Funding Amount
$260,569.00
Summary
The project will assess the accuracy, acceptability and relative cost effectiveness of general practice based diabetic retinopathy (DR) screening and monitoring, with ophthalmic support and education via videoconferencing. Accredited GPs will screen for DR using non-mydriatic cameras as part of the Diabetes Annual Cycle of Care and monitor patients with minimal to moderate levels of DR but no sight threatening signs, with virtual ophthalmology support. Positive project outcomes have the capacity ....The project will assess the accuracy, acceptability and relative cost effectiveness of general practice based diabetic retinopathy (DR) screening and monitoring, with ophthalmic support and education via videoconferencing. Accredited GPs will screen for DR using non-mydriatic cameras as part of the Diabetes Annual Cycle of Care and monitor patients with minimal to moderate levels of DR but no sight threatening signs, with virtual ophthalmology support. Positive project outcomes have the capacity to effect policyRead moreRead less
Systematic Medical Assessment, Referral And Treatment For Diabetes Care In China Using Lay Family Health Promoters - SMART Diabetes
Funder
National Health and Medical Research Council
Funding Amount
$1,385,858.00
Summary
Type 2 Diabetes (T2DM) affects 113.9 million people in China. Prevalence has risen dramatically to over 10% and is expected to continue rising. Few Chinese with T2DM are achieving adequate management targets to prevent complications and the current health system infrastructure is struggling to meet these gaps in care. Our project will expand the family health promoter model to develop a scalable model for low cost, high quality diabetes care in urban and rural China.
A Randomized Controlled Trial Of A General Practice Based Intervention To Prevent Chronic Vascular Disease
Funder
National Health and Medical Research Council
Funding Amount
$774,357.00
Summary
Chronic diseases such as heart disease, stroke and diabetes contribute greatly to the burden of disease in Australian society. Prevention of these conditions is a high priority for the health system. There is increasing evidence for the effectiveness of interventions to prevent chronic disease in those at high risk. However the feasibility of intervening through general practice and other existing services has not been demonstrated. We have previously conducted research on a structured approach ....Chronic diseases such as heart disease, stroke and diabetes contribute greatly to the burden of disease in Australian society. Prevention of these conditions is a high priority for the health system. There is increasing evidence for the effectiveness of interventions to prevent chronic disease in those at high risk. However the feasibility of intervening through general practice and other existing services has not been demonstrated. We have previously conducted research on a structured approach to helping patients with risk factors for chronic disease (such as smoking, poor nutrition, hazardous alcohol consumption and physical inactivity) including both cardiovascular disease and diabetes in general practice. This study aims to evaluate the impact of recalling patients to general practice for a visit to assess their risk of chronic disease and to help them to lower their risk by changes to smoking, diet, alcohol consumption and physical activity behaviours. Practices in the intervention group will receive training, practice visits, resources, and referral pathways to enable them to invite eligible patients to attend the practice for an assessment and management of their risk factors. This will include provision of education materials, support for behaviour change, referral to diet education and physical activity program and follow up. The feasibility of this type of vascular disease prevention intervention for high-risk patients has not been trialled previously in Australia. The findings of this research will help to inform Australian and State health policy especially the preventive care initiatives recently announced by the Council of Australian Governments. It will also inform practice leading to better guidelines for general practice preventive care, better support for general practice to provide preventive care for patients at risk of chronic disease and better support for patients to reduce their risk of chronic disease by changing their behaviour.Read moreRead less