scholarly journals Program logic: a framework for health program design and evaluation - the Pap nurse in general practice program

2010 ◽  
Vol 16 (4) ◽  
pp. 319 ◽  
Author(s):  
Christine M. Hallinan
Keyword(s):  
General Practice ◽  
Data Set ◽  
Activity Increase ◽  
Program Logic ◽  
Policy Makers ◽  
Health Initiatives ◽  
Australian General Practice ◽  
Practice Activity ◽  
Planning Development ◽  
Time Frames

In this paper, program logic will be used to ‘map out’ the planning, development and evaluation of the general practice Pap nurse program in the Australian general practice arena. The incorporation of program logic into the evaluative process supports a greater appreciation of the theoretical assumptions and external influences that underpin general practice Pap nurse activity. The creation of a program logic model is a conscious strategy that results an explicit understanding of the challenges ahead, the resources available and time frames for outcomes. Program logic also enables a recognition that all players in the general practice arena need to be acknowledged by policy makers, bureaucrats and program designers when addressing through policy, issues relating to equity and accessibility of health initiatives. Logic modelling allows decision makers to consider the complexities of causal associations when developing health care proposals and programs. It enables the Pap nurse in general practice program to be represented diagrammatically by linking outcomes (short, medium and long term) with both the program activities and program assumptions. The research methodology used in the evaluation of the Pap nurse in general practice program includes a descriptive study design and the incorporation of program logic, with a retrospective analysis of Australian data from 2001 to 2009. For the purposes of gaining both empirical and contextual data for this paper, a data set analysis and literature review was performed. The application of program logic as an evaluative tool for analysis of the Pap PN incentive program facilitates a greater understanding of complex general practice activity triggers, and also allows this greater understanding to be incorporated into policy to facilitate Pap PN activity, increase general practice cervical smear and ultimately decrease burden of disease.

Management of Cannabis and Psychostimulant Use among General Practice Patients

2008 ◽  
Vol 14 (3) ◽  
pp. 132 ◽  
Author(s):  
A. Frewen ◽  
A. Arcuri ◽  
H. Britt ◽  
J. Copeland ◽  
C. Harrison
Keyword(s):  
General Practice ◽  
Drug Use ◽  
Illicit Drug ◽  
National Study ◽  
Psychotic Symptoms ◽  
Drug Problem ◽  
Patient Demographics ◽  
Australian General Practice ◽  
Practice Activity ◽  
Significant Health

While regular and heavy cannabis and psychostimulant use has been associated with significant health and psychological impairments, the extent to which their use is being identified and managed by general practitioners (GPs) remains unclear. The aim of this study was to explore the management of cannabis- and psychostimulant-related problems in Australian general practice. Data from the Bettering the Evaluation and Care of Health (BEACH) study of general practice between April 2000 and March 2007 were analysed. BEACH is an ongoing national study of general practice activity in Australia. It was estimated that during this period GPs in Australia managed illicit drug use about 55,000 times per year and that cannabis and psychostimulants made up 3.2% and 1.6%, respectively, of all encounters at which the illicit drug was specified. The only difference in patient demographics between patients in the two drug groups was that cannabis users were younger than psychostimulant users. Cannabis users were more likely to be managed concurrently for psychotic symptoms but less likely to be treated with antipsychotics. Conversely, patients using psychostimulants were more likely to be prescribed an antipsychotic and/or an anxiolytic for their presenting drug problem. These results suggest that GPs do manage problematic cannabis and psychostimulant use among their patients, and thus should be supported in carrying out appropriate screening, intervention and referral.

scholarly journals The Role of Practice Nurses in an Integrated Model of Cardiovascular Disease Management in Australian General Practice

2006 ◽  
Vol 12 (2) ◽  
pp. 34 ◽  
Author(s):  
Elizabeth J Halcomb ◽  
Patricia M Davidson
Keyword(s):  
Cardiovascular Disease ◽  
General Practice ◽  
Disease Management ◽  
Policy Makers ◽  
Management Framework ◽  
Practice Nurses ◽  
Australian General Practice ◽  
Minimal Data ◽  
Multidisciplinary Model

While various models of chronic disease management have been developed and evaluated, minimal data is available relating specifically to Australian general practice and, in particular, the role of the nurse within the multidisciplinary general practice team. This paper presents a multidisciplinary model of cardiovascular disease management, focused on Australian general practice, and identifies barriers and facilitators to its implementation. This model was developed from data arising from a series of investigations that (1) examined the epidemiology and current general practice management of cardiovascular disease (2) explored the demographics and role of the practice nurse, and (3) established strategic recommendations for future practice development. The model proposes an integrated and multidisciplinary cardiovascular disease management framework to inform policy-makers and health planners in the development of primary health services in Australian general practice.

scholarly journals Variation in Documenting Diagnosable Chronic Kidney Disease in General Medical Practice: Implications for Quality Improvement and Research

2019 ◽  
Vol 10 ◽  
pp. 215013271983329 ◽  
Author(s):  
Alex Kitsos ◽  
Gregory M. Peterson ◽  
Matthew D. Jose ◽  
Masuma Akter Khanam ◽  
Ronald L. Castelino ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
General Practice ◽  
Kidney Disease ◽  
Patient Specific ◽  
Free Text ◽  
Specific Information ◽  
Prescription Data ◽  
Quality Of Data ◽  
Data Set ◽  
Australian General Practice

Background: National health surveys indicate that chronic kidney disease (CKD) is an increasingly prevalent condition in Australia, placing a significant burden on the health budget and on the affected individuals themselves. Yet, there are relatively limited data on the prevalence of CKD within Australian general practice patients. In part, this could be due to variation in the terminology used by general practitioners (GPs) to identify and document a diagnosis of CKD. This project sought to investigate the variation in terms used when recording a diagnosis of CKD in general practice. Methods: A search of routinely collected de-identified Australian general practice patient data (NPS MedicineWise MedicineInsight from January 1, 2013, to June 1, 2016; collected from 329 general practices) was conducted to determine the terms used. Manual searches were conducted on coded and on “free-text” or narrative information in the medical history, reason for encounter, and reason for prescription data fields. Results: From this data set, 61 102 patients were potentially diagnosable with CKD on the basis of pathology results, but only 14 172 (23.2%) of these had a term representing CKD in their electronic record. Younger patients with pathology evidence of CKD were more likely to have documented CKD compared with older patients. There were a total of 2090 unique recorded documentation terms used by the GPs for CKD. The most commonly used terms tended to be those included as “pick-list” options within the various general practice software packages’ standard “classifications,” accounting for 84% of use. Conclusions: A diagnosis of CKD was often not documented and, when recorded, it was in a variety of ways. While recording CKD with various terms and in free-text fields may allow GPs to flexibly document disease qualifiers and enter patient specific information, it might inadvertently decrease the quality of data collected from general practice records for clinical audit or research purposes.

scholarly journals Associations between multimorbidity and glycaemia (HbA1c) in people with type 2 diabetes: cross-sectional study in Australian general practice

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039625
Author(s):  
Jason I Chiang ◽  
John Furler ◽  
Frances Mair ◽  
Bhautesh D Jani ◽  
Barbara I Nicholl ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
General Practice ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Linear Regression Models ◽  
Sectional Study ◽  
Cross Sectional ◽  
Long Term Conditions ◽  
Australian General Practice

ObjectivesTo explore the prevalence of multimorbidity as well as individual and combinations of long-term conditions (LTCs) in people with type 2 diabetes (T2D) attending Australian general practice, using electronic health record (EHR) data. We also examine the association between multimorbidity condition count (total/concordant(T2D related)/discordant(unrelated)) and glycaemia (glycated haemoglobin, HbA1c).DesignCross-sectional study.SettingAustralian general practice.Participants69 718 people with T2D with a general practice encounter between 2013 and 2015 captured in the MedicineInsight database (EHR Data from 557 general practices and >3.8 million Australian patients).Primary and secondary outcome measuresPrevalence of multimorbidity, individual and combinations of LTCs. Multivariable linear regression models used to examine associations between multimorbidity counts and HbA1c (%).ResultsMean (SD) age 66.42 (12.70) years, 46.1% female and mean (SD) HbA1c 7.1 (1.4)%. More than 90% of participants with T2D were living with multimorbidity. Discordant conditions were more prevalent (83.4%) than concordant conditions (69.9 %). The three most prevalent discordant conditions were: painful conditions (55.4%), dyspepsia (31.6%) and depression (22.8%). The three most prevalent concordant conditions were hypertension (61.4%), coronary heart disease (17.1%) and chronic kidney disease (8.5%). The three most common combinations of conditions were: painful conditions and hypertension (38.8%), painful conditions and dyspepsia (23.1%) and hypertension and dyspepsia (22.7%). We found no associations between any multimorbidity counts (total, concordant and discordant) or combinations and HbA1c.ConclusionsMultimorbidity was common in our cohort of people with T2D attending Australian general practice, but was not associated with glycaemia. Although we did not explore mortality in this study, our results suggest that the increased mortality in those with multimorbidity and T2D observed in other studies may not be linked to glycaemia. Interestingly, discordant conditions were more prevalent than concordant conditions with painful conditions being the second most common comorbidity. Better understanding of the implications of different patterns of multimorbidity in people with T2D will allow more effective tailored care.

scholarly journals Study protocol: content and perceived educational utility of different modalities of clinical teaching visit (CTV) workplace-based assessments within Australian general practice vocational training: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e045643
Author(s):  
Alison Fielding ◽  
Benjamin Eric Mundy ◽  
Amanda Tapley ◽  
Linda Klein ◽  
Sarah Gani ◽  
...  
Keyword(s):  
General Practice ◽  
Clinical Teaching ◽  
Educational Practice ◽  
Cross Sectional Study ◽  
Practice Session ◽  
Cross Sectional ◽  
Human Research Ethics ◽  
General Practice Registrar ◽  
Australian General Practice ◽  
The University

IntroductionClinical teaching visits (CTVs) are formative workplace-based assessments that involve a senior general practitioner (GP) observing a clinical practice session of a general practice registrar (specialist vocational GP trainee). These visits constitute a key part of Australian GP training. Despite being mandatory and resource-intensive, there is a paucity of evidence regarding the content and educational utility of CTVs. This study aims to establish the content and educational utility of CTVs across varying practice settings within Australia, as perceived by registrars and their assessors (‘CT visitors’). In addition, this study aims to establish registrar, CT visitor and practice factors associated with CTV content and perceived CTV utility ratings.Methods and analysisThis study will collect data prospectively using online questionnaires completed soon after incident CTVs. Participants will be registrars and CT visitors of CTVs conducted from March 2020 to January 2021. The setting is three Regional Training Organisations across four Australian states and territories (encompassing 37% of Australian GP registrars).Outcome factors will be a number of specified CTV content elements occurring during the CTV as well as participants’ perceptions of CTV utility, which will be analysed using univariate and multivariable regression.Ethics and disseminationEthics approval has been granted by the University of Newcastle Human Research Ethics Committee, approval number H-2020-0037. Study findings are planned to be disseminated via conference presentation, peer-reviewed journals, educational practice translational workshops and the GP Synergy research subwebsite.

Cancer care coordination: building a platform for the development of care coordinator roles and ongoing evaluation

2015 ◽  
Vol 21 (2) ◽  
pp. 157 ◽  
Author(s):  
Louise Freijser ◽  
Lucio Naccarella ◽  
Rosemary McKenzie ◽  
Meinir Krishnasamy
Keyword(s):  
Cancer Care ◽  
Research Policy ◽  
Contextual Influences ◽  
Policy And Practice ◽  
Care Coordinator ◽  
Program Logic ◽  
Policy Makers ◽  
Patient Advocates ◽  
The Individual ◽  
Ongoing Evaluation

Continuity of care is integral to the quality and safety of care provided to people with cancer and their carers. Further evidence is required to examine the contribution Nurse Cancer Care Coordinator (NCCC) roles make in improving the continuity. The aim of the present study was to clarify the assumptions underpinning the NCCC roles and provide a basis for ongoing evaluation. The project comprised a literature review and a qualitative study to develop program logic. The participants who were purposively sampled included policy makers, practitioners, patient advocates, and researchers. Both the literature and participant reports found that NCCC roles are diverse and responsive to contextual influences to coordinate care at the individual (patient), organisational, and systems levels. The application of the program logic for the development of NCCC roles was explored. The conceptualisation of NCCC roles was also examined in relation to Boundary Spanning and Relational Coordination theory. Further research is required to examine how NCCCs contribute to improving equity, safety, quality and coordination of care. The project has implications for research, policy and practice, and makes explicit existing assumptions to provide a platform for further development and evaluation of these roles.

scholarly journals Mental Illness in Primary Care Settings

1985 ◽  
Vol 9 (1) ◽  
pp. 12-13 ◽  
Author(s):  
Greg Wilkinson
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
General Practice ◽  
Social Security ◽  
General Practitioners ◽  
Research Unit ◽  
Practice Research ◽  
Policy Makers ◽  
Department Of Health ◽  
Primary Care Settings

A Conference on the above topic took place at the Institute of Psychiatry, London, on 17 and 18 July 1984. The Conference was sponsored by the Department of Health and Social Security and was organized by the General Practice Research Unit. Over 100 invited clinicians, research workers and policy-makers took part. The majority of the participants were either psychiatrists or general practitioners, but representatives of all relevant disciplines attended.

scholarly journals Persistent pain management in Australian general practice

2017 ◽  
Vol 23 (2) ◽  
pp. 105
Author(s):  
Felicity C. Veal ◽  
Angus J. Thompson ◽  
Luke R. Bereznicki ◽  
Gregory M. Peterson
Keyword(s):  
General Practice ◽  
Pain Management ◽  
Persistent Pain ◽  
Australian General Practice

scholarly journals TARGETED ADVERTISING IN THE BREAKFAST CEREAL INDUSTRY

2017 ◽  
Vol 49 (3) ◽  
pp. 382-399 ◽  
Author(s):  
JOSHUA BERNING ◽  
ADAM N. RABINOWITZ
Keyword(s):  
Product Differentiation ◽  
Food Product ◽  
Television Advertising ◽  
Breakfast Cereal ◽  
Data Set ◽  
Policy Makers ◽  
Relationship Of ◽  
Cereal Industry ◽  
The Relationship ◽  
Insight Into

AbstractWe examine the relationship of product characteristics of ready-to-eat breakfast cereal and targeted television advertising to specific consumer segments. We compile a unique data set that includes brand-packaging characteristics, including on-box games, nutrition information, and cobranding. We find that the relationship of television advertising and a cereal's brand-packaging characteristics varies by target audience. Our results provide insight into understanding how manufacturers strategically utilize branding, packaging, and television advertising. This can help industry and policy makers develop food product advertising policy. This analysis extends to other product markets where extensive product differentiation and promotion are present as well.

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