scholarly journals mHealth App Prescription in Australian General Practice: Pre-Post Study

10.2196/16497 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e16497 ◽  
Author(s):  
Oyungerel Byambasuren ◽  
Elaine Beller ◽  
Tammy Hoffmann ◽  
Paul Glasziou
Keyword(s):  
General Practice ◽  
Median Number ◽  
Implementation Intervention ◽  
Electronic Reporting ◽  
Before And After ◽  
Australian General Practice ◽  
Prescription Rates ◽  
Drug Interventions ◽  
The Impact ◽  
Mhealth Apps

Background Evidence of effectiveness of mobile health (mHealth) apps as well as their usability as non-drug interventions in primary care are emerging around the globe. Objective This study aimed to explore the feasibility of mHealth app prescription by general practitioners (GPs) and to evaluate the effectiveness of an implementation intervention to increase app prescription. Methods A single-group, before-and-after study was conducted in Australian general practice. GPs were given prescription pads for 6 mHealth apps and reported the number of prescriptions dispensed for 4 months. After the reporting of month 2, a 2-minute video of one of the apps was randomly selected and sent to each GP. Data were collected through a prestudy questionnaire, monthly electronic reporting, and end-of-study interviews. The primary outcome was the number of app prescriptions (total, monthly, per GP, and per GP per fortnight). Secondary outcomes included confidence in prescribing apps (0-5 scale), the impact of the intervention video on subsequent prescription numbers, and acceptability of the interventions. Results Of 40 GPs recruited, 39 commenced, and 36 completed the study. In total, 1324 app prescriptions were dispensed over 4 months. The median number of apps prescribed per GP was 30 (range 6-111 apps). The median number of apps prescribed per GP per fortnight increased from the pre-study level of 1.7 to 4.1. Confidence about prescribing apps doubled from a mean of 2 (not so confident) to 4 (very confident). App videos did not affect subsequent prescription rates substantially. Post-study interviews revealed that the intervention was highly acceptable. Conclusions mHealth app prescription in general practice is feasible, and our implementation intervention was effective in increasing app prescription. GPs need more tailored education and training on the value of mHealth apps and knowledge of prescribable apps to be able to successfully change their prescribing habits to include apps. The future of sustainable and scalable app prescription requires a trustworthy electronic app repository of prescribable mHealth apps for GPs.

scholarly journals mHealth App Prescription in Australian General Practice: Pre-Post Study (Preprint)

2019 ◽  
Author(s):  
Oyungerel Byambasuren ◽  
Elaine Beller ◽  
Tammy Hoffmann ◽  
Paul Glasziou
Keyword(s):  
General Practice ◽  
Median Number ◽  
Implementation Intervention ◽  
Electronic Reporting ◽  
Before And After ◽  
Australian General Practice ◽  
Prescription Rates ◽  
Drug Interventions ◽  
The Impact ◽  
Mhealth Apps

BACKGROUND Evidence of effectiveness of mobile health (mHealth) apps as well as their usability as non-drug interventions in primary care are emerging around the globe. OBJECTIVE This study aimed to explore the feasibility of mHealth app prescription by general practitioners (GPs) and to evaluate the effectiveness of an implementation intervention to increase app prescription. METHODS A single-group, before-and-after study was conducted in Australian general practice. GPs were given prescription pads for 6 mHealth apps and reported the number of prescriptions dispensed for 4 months. After the reporting of month 2, a 2-minute video of one of the apps was randomly selected and sent to each GP. Data were collected through a prestudy questionnaire, monthly electronic reporting, and end-of-study interviews. The primary outcome was the number of app prescriptions (total, monthly, per GP, and per GP per fortnight). Secondary outcomes included confidence in prescribing apps (0-5 scale), the impact of the intervention video on subsequent prescription numbers, and acceptability of the interventions. RESULTS Of 40 GPs recruited, 39 commenced, and 36 completed the study. In total, 1324 app prescriptions were dispensed over 4 months. The median number of apps prescribed per GP was 30 (range 6-111 apps). The median number of apps prescribed per GP per fortnight increased from the pre-study level of 1.7 to 4.1. Confidence about prescribing apps doubled from a mean of 2 (not so confident) to 4 (very confident). App videos did not affect subsequent prescription rates substantially. Post-study interviews revealed that the intervention was highly acceptable. CONCLUSIONS mHealth app prescription in general practice is feasible, and our implementation intervention was effective in increasing app prescription. GPs need more tailored education and training on the value of mHealth apps and knowledge of prescribable apps to be able to successfully change their prescribing habits to include apps. The future of sustainable and scalable app prescription requires a trustworthy electronic app repository of prescribable mHealth apps for GPs.

scholarly journals Impact of the pan-Canadian Oncology Drug Review on provincial concordance with respect to cancer drug funding decisions and time to funding

2017 ◽  
Vol 24 (5) ◽  
pp. 295 ◽  
Author(s):  
A. Srikanthan ◽  
H. Mai ◽  
N. Penner ◽  
E. Amir ◽  
A. Laupacis ◽  
...  
Keyword(s):  
Linear Models ◽  
Drug Product ◽  
Median Number ◽  
Cancer Drug ◽  
Cancer Drugs ◽  
Oncology Drug ◽  
Before And After ◽  
Canadian Provinces ◽  
The Impact ◽  
Drug Review

Background The pan-Canadian Oncology Drug Review (pcodr) was implemented in 2011 to address uneven drug coverage and lack of transparency with respect to the various provincial cancer drug review processes in Canada. We evaluated the impact of the pcodr on provincial decision concordance and time from Notice of Compliance (noc) to drug funding.Methods In a retrospective review, Health Canada’s Drug Product Database was used to identify new indications for cancer drugs between January 2003 and May 2014, and provincial formulary listings for drug-funding dates and decisions between 1 January 2003 and 31 December 2014 were retrieved. Multiple linear models and quantile regressions were used to evaluate changes in time to decision-making before and after the implementation of the pcodr. Agreement of decisions between provinces was evaluated using kappa statistics.Results Data were available from 9 provinces (all Canadian provinces except Quebec), identifying 88 indications that represented 51 unique cancer drugs. Two provinces lacked available data for all 88 indications at the time of data collection. Interprovincial concordance in drug funding decisions significantly increased after the pcodr’s implementation (Brennan-Prediger coefficient: 0.54 pre-pcodr vs. 0.78 post-pcodr; p = 0.002). Nationwide, the median number of days from Health Canada’s noc date to the date of funding significantly declined (to 393 days from 522 days, p < 0.001). Exploratory analyses excluding provinces with incomplete data did not change the results.Conclusions After the implementation of the pcodr, greater concordance in cancer drug funding decisions between provinces and decreased time to funding decisions were observed.

scholarly journals Telehealth to support referral management in a universal health system: a before-and-after study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sabrina Dalbosco Gadenz ◽  
Josué Basso ◽  
Patrícia Roberta Berithe Pedrosa de Oliviera ◽  
Stephan Sperling ◽  
Marcus Vinicius Dutra Zuanazzi ◽  
...  
Keyword(s):  
Linear Models ◽  
Patient Flow ◽  
Waiting Times ◽  
Median Number ◽  
Waiting Lists ◽  
Referral Management ◽  
Before And After ◽  
The Impact ◽  
Universal Health ◽  
Before And After Study

Abstract Background Management of patient flow within a healthcare network, allowing equitable and qualified access to healthcare, is a major challenge for universal health systems. Implementation of telehealth strategies to support referral management has been shown to increase primary care resolution and to promote coordination of care. The objective of this study was to assess the impact of telehealth strategies on waiting lists and waiting times for specialized care in Brazil. Methods Before-and-after study with measures obtained between January 2019 and February 2020. Baseline measurements of waiting lists were obtained immediately before the implementation of a remotely operated referral management system. Post-interventional measurements were obtained monthly, up to six months after the beginning of operation. Data was extracted from the database of the project. General linear models were applied to assess interaction of locality and time over number of cases on waiting lists and waiting times. Results At baseline, the median number of cases on waiting lists ranged from 2961 to 12,305 cases. Reductions of the number of cases on waiting lists after six months of operation were observed in all localities. The magnitude of the reduction ranged from 54.67 to 88.97 %. Interaction of time measurements was statistically significant from the second month onward. Median waiting times ranged from 159 to 241 days at baseline. After six months, there was a decrease of 100 and 114 waiting days in two localities, respectively, with reduction of waiting times only for high-risk cases in the third locality. Conclusions Adoption of telehealth strategies resulted in the reduction of number of cases on waiting lists. Results were consistent across localities, suggesting that telehealth interventions are viable in diverse settings.

Moving Towards a More Integrated Approach to Chronic Disease Prevention in Australian General Practice

2008 ◽  
Vol 14 (3) ◽  
pp. 112 ◽  
Author(s):  
Mark F. Harris ◽  
Cheryl L. Amoroso ◽  
Rachel A. Laws
Keyword(s):  
General Practice ◽  
Risk Factor ◽  
Chronic Disease ◽  
Disease Prevention ◽  
Integrated Approach ◽  
Chronic Disease Prevention ◽  
Behavioural Risk Factor ◽  
Risk Factor Management ◽  
Australian General Practice ◽  
The Impact

There is increasing evidence that prevention of chronic disease is possible and that primary care can contribute to this. This paper aims to explore the development of policies and programs to improve chronic disease prevention via behavioural risk factor management in Australian general practice and the impact of these between 2001 and the present. This involved a review of policy initiatives and developments in Australian general practice, drawing on published research over this period. Behavioural risk factor management has not been comprehensively implemented in the way in which it was originally envisaged under the SNAP (Smoking, Nutrition, Alcohol and Physical Activity) framework, with initiatives and programs emerging over time in a much less planned way, including Lifescripts and more recently the 45 - 49 year health check. There has been a gradual development in capacity, especially in relation to workforce, education and training, educational materials, financial and decision support with divisions of general practice emerging to play a key facilitation role. Despite this, important gaps remain especially in relation to the use of team approaches within and outside the practice including access to referral services and programs.

scholarly journals A before and after study of the impact of academic detailing on the use of diagnostic imaging for shoulder complaints in general practice

2007 ◽  
Vol 8 (1) ◽  
Author(s):  
Norm A Broadhurst ◽  
Christopher A Barton ◽  
Debra Rowett ◽  
Lisa Yelland ◽  
David K Martin ◽  
...  
Keyword(s):  
General Practice ◽  
Diagnostic Imaging ◽  
Academic Detailing ◽  
Before And After ◽  
The Impact ◽  
Before And After Study

scholarly journals Experiences of telehealth in general practice in Australia: research protocol for a mixed methods study

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0187
Author(s):  
Sarah J White ◽  
Amy Nguyen ◽  
Peter Roger ◽  
Tim Tse ◽  
John A Cartmill ◽  
...  
Keyword(s):  
General Practice ◽  
Conversation Analysis ◽  
General Practitioners ◽  
Direct Evidence ◽  
Mixed Methods Study ◽  
Evidence Based ◽  
Practice Setting ◽  
Australian General Practice ◽  
Evidence Based Guidelines ◽  
The Impact

BackgroundDue to the COVID-19 pandemic, use of telehealth has expanded rapidly. However, little is known about the impact of delivering care through telehealth on communication between clinicians and patients. At an interactional level, the ways in which clinicians establish rapport and connection with their patients in telehealth consultations is not well understood.AimThis study will explore interactional practices of general practitioners (GPs) and patients in telehealth consultations to develop evidence-based resources to improve communication.Design & settingThe study will be conducted within the Australian general practice setting.MethodConversation analysis and sociolinguistic discourse analysis of recorded telehealth consultations will provide direct evidence of specific elements contributing to successful and less successful instances of telehealth communication. This analysis will be complemented by co-design techniques such as qualitative and reflective interviews and collaborative workshops with telehealth users, including both general practitioners and patients.ConclusionEffective communication is critical for telehealth consultations and is central to achieving optimal clinical outcomes and patient satisfaction. This study will co-develop with end-users, evidence-based guidelines encompassing effective telehealth communication strategies.

scholarly journals Barriers to and Facilitators of the Prescription of mHealth Apps in Australian General Practice: Qualitative Study

10.2196/17447 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e17447 ◽  
Author(s):  
Oyungerel Byambasuren ◽  
Elaine Beller ◽  
Tammy Hoffmann ◽  
Paul Glasziou
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
Barriers And Facilitators ◽  
Management Tool ◽  
Safety Issues ◽  
Time Commitment ◽  
Health Apps ◽  
Australian General Practice ◽  
Younger Generation ◽  
Mhealth Apps

Background The ubiquity of smartphones and health apps make them a potential self-management tool for patients that could be prescribed by medical professionals. However, little is known about how Australian general practitioners and their patients view the possibility of prescribing mobile health (mHealth) apps as a nondrug intervention. Objective This study aimed to determine barriers and facilitators to prescribing mHealth apps in Australian general practice from the perspective of general practitioners and their patients. Methods We conducted semistructured interviews in Australian general practice settings with purposively sampled general practitioners and patients. The audio-recorded interviews were transcribed, coded, and thematically analyzed by two researchers. Results Interview participants included 20 general practitioners and 15 adult patients. General practitioners’ perceived barriers to prescribing apps included a generational difference in the digital propensity for providers and patients; lack of knowledge of prescribable apps and trustworthy sources to access them; the time commitment required of providers and patients to learn and use the apps; and concerns about privacy, safety, and trustworthiness of health apps. General practitioners perceived facilitators as trustworthy sources to access prescribable apps and information, and younger generation and widespread smartphone ownership. For patients, the main barriers were older age and usability of mHealth apps. Patients were not concerned about privacy and data safety issues regarding health app use. Facilitators for patients included the ubiquity of smartphones and apps, especially for the younger generation and recommendation of apps by doctors. We identified evidence of effectiveness as an independent theme from both the provider and patient perspectives. Conclusions mHealth app prescription appears to be feasible in general practice. The barriers and facilitators identified by the providers and patients overlapped, though privacy was of less concern to patients. The involvement of health professionals and patients is vital for the successful integration of effective, evidence-based mHealth apps with clinical practice.

scholarly journals PICU Passport: Pilot study of a handheld resident curriculum

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Adrian D. Zurca ◽  
Conrad Krawiec ◽  
Daniel McKeone ◽  
Adil Z. Solaiman ◽  
Brandon M. Smith ◽  
...  
Keyword(s):  
Pediatric Intensive Care ◽  
Median Number ◽  
Educational Tool ◽  
Knowledge Gaps ◽  
Specific Knowledge ◽  
Pediatric Residents ◽  
Before And After ◽  
Satisfaction With Education ◽  
Resident Learning ◽  
The Impact

Abstract Background To explore the impact of an educational tool designed to streamline resident learning during their pediatric intensive care (PICU) rotations. Methods Topics and procedures were chosen for inclusion based on national requirements for pediatric residents. Residents received a PICU Passport at the beginning of their rotations. PICU faculty were provided learning objectives for each topic. Residents and faculty were surveyed before and after starting use of the Passport. Results Twenty-two residents pre-Passport and 38 residents post-Passport were compared. Residents were more satisfied with their educational experiences (27 % vs. 79 %; P < 0.001), more likely to report faculty targeted teaching towards knowledge gaps (5 % vs. 63 %; P < 0.001) and felt more empowered to ask faculty to discuss specific topics (27 % vs. 76 %; P = 0.002). The median number of teaching sessions increased from 3 to 10 (Z = 4.2; P < 0.001). Most residents (73 %) felt the Passport helped them keep track of their learning and identify gaps in their knowledge. Conclusions The PICU Passport helps residents keep track of their learning and identify gaps in their knowledge. Passport use increases resident satisfaction with education during their PICU rotation and empowers residents to ask PICU faculty to address specific knowledge gaps.

A tool to evaluate patients’ experiences of nursing care in Australian general practice: development of the Patient Enablement and Satisfaction Survey

2014 ◽  
Vol 20 (2) ◽  
pp. 209 ◽  
Author(s):  
Jane Desborough ◽  
Michelle Banfield ◽  
Rhian Parker
Keyword(s):  
General Practice ◽  
Nursing Care ◽  
Satisfaction Survey ◽  
Research Approach ◽  
Strong Positive Correlation ◽  
Practice Nurses ◽  
Alternate Form ◽  
Australian General Practice ◽  
Patient Enablement ◽  
The Impact

Australian health policy initiatives have increasingly supported the employment of nurses in general practice. An understanding of the impact of nursing care on patients in this setting is integral to assuring quality, safety and a patient-centred focus. The aim was to develop a survey to evaluate the satisfaction and enablement of patients who receive nursing care in Australian general practices. The survey was to be simple to administer and analyse, ensuring practicality for use by general practice nurses, doctors and managers. Two validated instruments formed the basis of the Patient Enablement and Satisfaction Survey (PESS). This survey was refined and validated for the Australian setting using focus groups and in-depth interviews with patients, and feedback from general practice nurses. Test-retest and alternate form methods were used to establish the survey’s reliability. Feedback resulted in 14 amendments to the original draft survey. Questions that demonstrated a strong positive correlation for the test-retest and alternate form measures were included in the final survey. The PESS is a useful, practical tool for the evaluation of nursing care in Australian general practice, its validity and reliability established through a patient-centred research approach, reflective of the needs of patients accessing nursing services in this setting.

Sign in / Sign up

Export Citation Format

Share Document