scholarly journals Updating and validating quality prescribing indicators for use in Australian general practice

2020 ◽  
Vol 26 (1) ◽  
pp. 31
Author(s):  
Cuu Phuong Linh Dang ◽  
Li Shean Toh ◽  
Nick Cooling ◽  
Shane Jackson ◽  
Colin Curtain ◽  
...  
Keyword(s):  
General Practice ◽  
Delphi Technique ◽  
Online Survey ◽  
Delphi Panel ◽  
Medicines Management ◽  
Group Discussions ◽  
Prescribing Indicators ◽  
Australian General Practice ◽  
Two Phases ◽  
Quality Prescribing Indicators

This study aims to update and validate quality prescribing indicators (QPIs) for Australian general practice. The study comprised two phases: (1) developing preliminary potential QPIs based on the 2006 National Prescribing Service (NPS) MedicineWise indicators, published literature, international indicators and guidelines, and through qualitative focus group discussions; and (2) validating the proposed QPIs through a two-round online survey using the Delphi technique. The Delphi panel included four GPs, four pharmacists and two clinical pharmacologists. The Delphi panel rated the potential QPIs for their validity, importance and feasibility using a 1–10 Likert scale. In round one, all proposed QPIs presented as ‘prescribing rules’ achieved high scores regarding validity, importance and feasibility No rule was eliminated and three new rules were introduced. Rules were reworded into ‘prescribing indicators’ for round two, which resulted in 35 indicators being accepted and two indicators being eliminated. The final QPIs also include seven drug–drug interactions, which received high scores in round one. In conclusion, 42 QPIs were nominated for use in Australian general practice, based on their validity, importance and feasibility. If implemented, these QPIs have the potential to assist in efforts to improve the quality and safety of medicines management.

Validity of prescribing indicators for assessing quality of antibiotic use in Australian general practice

2016 ◽  
Vol 25 (1) ◽  
pp. 66-74
Author(s):  
Lisa G. Pont ◽  
Tessa K. Morgan ◽  
Margaret Williamson ◽  
Flora M. Haaijer ◽  
Mieke L. van Driel
Keyword(s):  
General Practice ◽  
Antibiotic Use ◽  
Prescribing Indicators ◽  
Australian General Practice

scholarly journals Management or missed opportunity? Mental health care planning in Australian general practice

2019 ◽  
Vol 25 (4) ◽  
pp. 332
Author(s):  
Michelle Banfield ◽  
Louise M. Farrer ◽  
Christopher Harrison
Keyword(s):  
General Practice ◽  
Mental Disorders ◽  
Online Survey ◽  
Care Plan ◽  
Health Care Planning ◽  
Allied Health Professionals ◽  
Cross Sectional ◽  
Care Plans ◽  
Australian General Practice ◽  
Gp Care

General practice care plans are designed to improve the management of chronic illness, facilitating multidisciplinary care and enabling GPs and consumers to work collaboratively. Evidence suggests that they work well for chronic physical illnesses, but it is unclear if they operate as intended for people with mental disorders. The aims of this study were to: (1) compare rates of creation and review of GP care plans for mental disorders and type II diabetes; and (2) examine consumer experiences. Secondary analysis of 109589 recorded encounters from a national cross-sectional study in Australian general practice (2006–16) demonstrated that encounters involving creation of a care plan for depression or anxiety were significantly higher than those for diabetes, bipolar disorder and schizophrenia. Rates of review were commensurate with creation of plans for diabetes, but not for mental disorders. Eighteen people with a GP care plan completed an online survey about their experiences, reporting that care plans facilitated access to allied health professionals, but did not improve the quality of care they received. Findings suggest that care plans are underutilised for people with low prevalence mental disorders, and while they offer financial benefits to consumers, they may not result in ongoing, collaborative care.

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 A comparative assessment of two tools designed to support patient safety culture in UK general practice

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ian Litchfield ◽  
Kate Marsden ◽  
Lucy Doos ◽  
Katherine Perryman ◽  
Anthony Avery ◽  
...  
Keyword(s):  
General Practice ◽  
Patient Safety ◽  
Focus Group ◽  
Safety Culture ◽  
Improve Patient Safety ◽  
Patient Safety Culture ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Staff Members ◽  
Practice Team

Abstract Background The NHS has recognised the importance of a high quality patient safety culture in the delivery of primary health care in the rapidly evolving environment of general practice. Two tools, PC-SafeQuest and MapSaf, were developed with the intention of assessing and improving patient safety culture in this setting. Both have been made widely available through their inclusion in the Royal College of General Practitioners’ Patient Safety Toolkit and our work offerss a timely exploration of the tools to inform practice staff as to how each might be usefully applied and in which circumstances. Here we present a comparative analysis of their content, and describe the perspectives of staff on their design, outputs and the feasibility of their sustained use. Methods We have used a content analysis to provide the context for the qualitative study of staff experiences of using the tools at a representative range of practices recruited from across the Midlands (UK). Data was collected through moderated focus groups using an identical topic guide. Results A total of nine practices used the PC-SafeQuest tool and four the MapSaf tool. A total of 159 staff completed the PC-SafeQuest tool 52 of whom took part in the subsequent focus group discussions, and 25 staff completed the MapSaf tool all of whom contributed to the focus group discussions. PC-SafeQuest was perceived as quick and easy to use with direct questions pertinent to the work of GP practices providing useful quantitative insight into important areas of safety culture. Though MaPSaF was more logistically challenging, it created a forum for synchronous cross- practice discussions raising awareness of perceptions of safety culture across the practice team. Conclusions Both tools were able to promote reflective and reflexive practice either in individual staff members or across the broader practice team and the oversight they granted provided useful direction for senior staff looking to improve patient safety. Because PC SafeQuest can be easily disseminated and independently completed it is logistically suited to larger practice organisations, whereas the MapSaf tool lends itself to smaller practices where assembling staff in a single workshop is more readily achieved.

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.

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

Incidental specialised vocabulary acquisition: a case of incidental medical terms acquisition from students’ perspective

2021 ◽  
Author(s):  
Elham Abdullah Ghobain ◽  
Keyword(s):  
Negative Relationship ◽  
Extended Period ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Medical Terms ◽  
Significant Negative Relationship ◽  
Post Test ◽  
Two Phases ◽  
The Relationship ◽  
Technical Terms

This study observes a particular group of students learning medical terms (MT) implicitly through studying medical subjects. That is, based on the policy followed in the context of the study, students shall not receive any deliberate terms instruction. This paper investigates their experiences and attitudes towards acquiring MT in such a situation. Students’ acquisition and proficiency, hypothesizing a positive relationship between the two constructs, are self-assessed through pre- and post-test surveys. The surveys included 114 and 95 students in each phase, respectively. Prior to the surveys, focus group discussions were conducted, according to which the questionnaire was developed. A statistical correlational Pearson test was done to examine the relationship between students’ proficiency and incidental terms acquisition. The results indicated a significant negative relationship between the two constructs tested. The study also tested the effect of time on increasing acquisition through conducting a paired independent t-test between the two sets of data. The results found that a more extended period was significant to incidental acquisition. Overall, through comparing the means, modes, and medians in the two phases (pre- and post-test), the findings reveal an increase in the students’ terms acquisition volume. However, students seem not to favour the approach and still advocate explicit instruction for technical terms.

scholarly journals Telehealth consultations in general practice during a pandemic lockdown: survey and interviews on patient experiences and preferences

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Fiona Imlach ◽  
Eileen McKinlay ◽  
Lesley Middleton ◽  
Jonathan Kennedy ◽  
Megan Pledger ◽  
...  
Keyword(s):  
Health Care ◽  
General Practice ◽  
Access To Health Care ◽  
Online Survey ◽  
Sudden Change ◽  
High Satisfaction ◽  
The Future ◽  
Clinical Relationship ◽  
General Practices ◽  
Key Aspects

Abstract Background During the first COVID-19 pandemic ‘lockdown’ in Aotearoa/New Zealand (March–May 2020, in which strict ‘stay at home’ measures were introduced), general practices were advised to use telephone and video consultations (telehealth) wherever possible instead of the usual in-person visits. This was a sudden change for most practices and patients. This research aimed to explore how patients accessed general practice during lockdown and evaluate their experiences with telehealth, to inform how telehealth could be most effectively used in the future. Methods Using a mixed-method approach, we undertook an online survey and in-depth interviews with adults (> 18 years) who had contact with practices during lockdown, recruited through social media and email lists. We present descriptive statistics from the survey data (n = 1010) and qualitative analysis of interview data (n = 38) and open-ended survey questions, using a framework of access to health care, from the patient’s perspective. Results In general, patients reported high satisfaction with telehealth in general practice during lockdown. Telehealth was convenient and allowed patients to safely access health care without having to weigh-up the fear of COVID-19 infection against the need to be seen. Telehealth worked best for routine and familiar health issues and when rapport was established between patients and clinicians. This was easier with a pre-existing clinical relationship, but not impossible without one. Telehealth was less suitable when a physical examination was needed, when the diagnosis was unknown or for patients who had a strong preference to be seen in-person. Conclusions Even in this disruptive lockdown period, that prompted an unexpected and rapid implementation of telehealth services in general practices, most patients had positive experiences with telehealth. In the future, patients want the choice of consultation type to match their needs, circumstances, and preferences. Technological issues and funding barriers may need to be addressed, and clear communication for both patients and clinicians is needed about key aspects of telehealth (e.g. cost, appropriateness, privacy). Maintaining telehealth as an option post-lockdown has the potential to increase timely and safe access to primary health care for many patients.

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