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 Barriers to and Facilitators of the Prescription of mHealth Apps in Australian General Practice: Qualitative Study (Preprint)

2019 ◽  
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. CLINICALTRIAL

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.

Prevalence and characteristics associated with concurrent smoking and alcohol misuse within Australian general practice patients

2020 ◽  
Vol 44 (1) ◽  
pp. 125
Author(s):  
Breanne Hobden ◽  
Jamie Bryant ◽  
Kristy Forshaw ◽  
Christopher Oldmeadow ◽  
Tiffany-Jane Evans ◽  
...  
Keyword(s):  
General Practice ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
General Practitioners ◽  
Alcohol Misuse ◽  
Smoking Status ◽  
Demographic Characteristics ◽  
International Studies ◽  
Australian General Practice ◽  
Different Levels

Objectives This study sought to determine, among a large sample of Australian general practice patients: (1) the prevalence of smoking among different levels of alcohol misuse; and (2) whether the associations between demographic characteristics and alcohol use differ according to smoking status. Methods A cross-sectional survey was administered from 2010 to 2011 to 3559 patients from 12 Australian urban general practices. Patients reported their demographic details, smoking status and their alcohol intake. Results The overall prevalence of reported concurrent smoking and alcohol misuse was 7.8%. Smokers were 3.81-fold more likely to have a higher level of alcohol consumption than non-smokers (95% confidence interval 3.13–4.63; P<0.0001). There was evidence that smoking was an effect modifier of the relationship between alcohol misuse and chronic illness. Conclusions There was an increasing prevalence of smoking with increasing level of alcohol consumption. In addition, those with chronic conditions who smoked had greater odds of higher levels of alcohol consumption. Preventative interventions for these substances are needed to reduce the burden associated with concurrent smoking and alcohol misuse. What is known about the topic? Tobacco and alcohol are the most commonly used substances and contribute to over 10million deaths annually. The risk of disease is high when using either of these substances, however, concurrent use is associated with a greatly compounded risk. Australian data is limited regarding the prevalence of concurrent tobacco and alcohol misuse, however, international studies suggest variation in prevalence rates between different clinical settings. What does this paper add? This study examined the prevalence of concurrent smoking and alcohol misuse among different levels of alcohol misuse severity within an Australian general practice setting. Additionally it explored whether the associations between demographic characteristics and alcohol use differ according to smoking status. What are the implications for practitioners? This study has important implications for disease prevention and the delivery of preventive health services by general practitioners. Considering one in 100 clinical treatments provided in general practice relate to preventative smoking or alcohol counselling, it is critical that efforts are made to ascertain risk factors such as smoking and alcohol misuse to increase treatment rates. General practitioners should consider screening for smoking and alcohol misuse opportunistically during routine clinical encounters, as well as screening for smoking or alcohol misuse if one or the other is present.

scholarly journals Primary care management of chronic insomnia: a qualitative analysis of the attitudes and experiences of Australian general practitioners

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jenny Haycock ◽  
Nicole Grivell ◽  
Anne Redman ◽  
Bandana Saini ◽  
Andrew Vakulin ◽  
...  
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
Best Practice ◽  
Geographic Location ◽  
Behavioural Therapy ◽  
Chronic Insomnia ◽  
Structured Interviews ◽  
Treatment Pathways ◽  
Falling Asleep ◽  
Australian General Practice

Abstract Background Chronic insomnia is a highly prevalent disorder, with ten to thirty percent of Australian adults reporting chronic difficulties falling asleep and/or staying asleep such that it causes significant daytime impairment. Current Australian general practice guidelines recommend cognitive behavioural therapy for insomnia (CBTi) as first line treatment for insomnia, however research suggests that most general practice consultations for insomnia result in a prescription for hypnotic or sedative medicines. Although the first point of contact for patients experiencing symptoms of insomnia is often general practice, little is known about the current role, experiences and capacity of Australian general practitioners to manage insomnia. This study aimed to address that gap by exploring the attitudes and opinions of general practitioners regarding insomnia management, to inform the development and implementation of new models of best practice insomnia care within general practice. Methods A descriptive, pragmatic qualitative study. Purposive sampling was used to recruit practising Australian general practitioners, varying in age, years of experience and geographic location. Semi-structured interviews were conducted, and data analysed using thematic analysis.  Results Twenty-eight general practitioners participated in the study. Three major themes were identified: 1) Responsibility for insomnia care; 2) Complexities in managing insomnia; and 3) Navigating treatment pathways. Whilst general practitioners readily accepted responsibility for the management of insomnia, provision of care was often demanding and difficult within the funding and time constraints of general practice. Patients presenting with comorbid mental health conditions and insomnia, and decision-making regarding long-term use of benzodiazepines presented challenges for general practitioners. Whilst general practitioners confidently provided sleep hygiene education to patients, their knowledge and experience of CBTi, and access and understanding of specialised referral pathways for insomnia was limited.  Conclusions General practitioners report that whilst assessing and managing insomnia can be demanding, it is an integral part of general practice. Insomnia presents complexities for general practitioners. Greater clarity about funding options, targeted education about effective insomnia treatments, and referral pathways to specialist services, such as benzodiazepine withdrawal support and psychologists, would benefit insomnia management within general practice.

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.

Views of GPs and practice nurses on support needed to respond to pandemic influenza: a qualitative study

2011 ◽  
Vol 35 (1) ◽  
pp. 111 ◽  
Author(s):  
Christopher Pearce ◽  
Marianne Shearer ◽  
Christine Phillips ◽  
Sally Hall ◽  
Marjan Kljakovic ◽  
...  
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
Pandemic Influenza ◽  
Influenza A ◽  
Influenza Pandemic ◽  
Public And Private ◽  
Practice Nurses ◽  
Australian General Practice ◽  
Practice Method ◽  
Integral Element

Introduction. Five years ago Australia, and the world, placed itself on heightened alert for pandemic influenza, based on concerns about the potential spread of the avian influenza virus. This prompted a flurry of preparation activity involving general practice, with information from various sources; government, colleges and divisions of general practice. Method. To assess how general practitioners and practice nurses perceive this information, practice nurses and general practitioners were interviewed as part of a larger project exploring the role of the Australian general practice sector in an influenza pandemic. Results were validated by two focus groups and scenario sessions. Findings. Participants perceived that non-government organisations rarely gave useful information during a pandemic outbreak. Local divisions were perceived as having a practical and useful role, providing hands-on support to practices during a pandemic outbreak. Our participants did not perceive any coordination in the delivery of information sent by all the organisations involved in a pandemic response and therefore rejected our second hypothesis. Conclusions. More planning needs to go into the coordinated response of the general practice sector to a pandemic, and such a response should include the support of local Divisions, both as a conduit for information and to assist practices to develop response plans. What is known about the topic? Response to a pandemic will require a coordinated response between primary and secondary care, public and private sectors. What does this paper add? Outlines the support needs for general practice to respond effectively, in particular highlighting the important role Divisions can play. What are the implications for practitioners? Planning for a pandemic should include Divisions of general practice as an integral element of the response, both as a conduit for information and to assist practices to develop response plans.

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 Primary Care Management of Chronic Insomnia: A Qualitative Analysis of the Attitudes and Experiences of Australian General Practitioners

2020 ◽  
Author(s):  
Jenny Haycock ◽  
Nicole Grivell ◽  
Anne Redman ◽  
Bandana Saini ◽  
Andrew Vakulin ◽  
...  
Keyword(s):  
General Practice ◽  
General Practitioners ◽  
Best Practice ◽  
Geographic Location ◽  
Behavioural Therapy ◽  
Chronic Insomnia ◽  
Structured Interviews ◽  
Treatment Pathways ◽  
Falling Asleep ◽  
Australian General Practice

Abstract Background Chronic insomnia is a highly prevalent disorder, with ten to thirty percent of Australian adults reporting chronic difficulties falling asleep and/or staying asleep such that it causes significant daytime impairment. Current Australian general practice guidelines recommend Cognitive Behavioural Therapy for insomnia (CBTi) as first line treatment for insomnia however, research suggests that most general practice consultations for insomnia result in a prescription for hypnotic or sedative medicines. Although the first point of contact for patients experiencing symptoms of insomnia is often general practice, little is known about the current role, experiences and capacity of Australian general practitioners to manage insomnia. This study aimed to address that gap by exploring the attitudes and opinions of general practitioners regarding insomnia management, to inform the development and implementation of new models of best practice insomnia care within general practice. Methods A descriptive, pragmatic qualitative study. Purposive sampling was used to recruit practising Australian general practitioners, varying in age, years of experience and geographic location. Semi-structured interviews were conducted, and data analysed using Thematic Analysis. Results Twenty-eight general practitioners participated in the study. Three major themes were identified: 1) Responsibility for insomnia care; 2) Complexities in managing insomnia; and 3) Navigating treatment pathways. Whilst general practitioners readily accepted responsibility for the management of insomnia, provision of care was often demanding and difficult within the funding and time constraints of general practice. Patients presenting with comorbid mental health conditions and insomnia, and decision-making regarding long-term use of benzodiazepines presented challenges for general practitioners. Whilst general practitioners confidently provided sleep hygiene education to patients, their knowledge and experience of CBTi, and access and understanding of specialised referral pathways for insomnia was limited. Conclusions General practitioners report that whilst assessing and managing insomnia can be demanding, it is an integral part of general practice. Insomnia presents complexities for general practitioners, and greater clarity about funding options, targeted education about effective insomnia treatments, and referral pathways to specialist services would benefit insomnia management within general practice.

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