The Australian Primary Care Collaboratives: an Australian general practice success story

Prescribing guidelines are an essential component of antimicrobial stewardship programs in Australian hospitals. Nonetheless, the majority of antibiotic prescribing occurs in the community and the effectiveness of guidelines developed specifically to meet the needs of Australian general practice is unknown. This study aims to assess the uptake and effectiveness of a quick reference guide to antibiotic prescribing among primary care prescribers. A quick reference guide to antibiotic prescribing was developed and prescribers in five Tasmanian practices were surveyed regarding use of this guide. Thirty-three surveys were returned and, of those answering specific sections, 75% were aware of the guide and 71% had used it within the last month. The guide affected the antibiotic prescribing practice of 74% of responding prescribers; most often on choice of antibiotic; but also on duration of treatment, dose and dosing frequency. A quick reference guide to antibiotic prescribing was well received by prescribers and may usefully support efforts to improve antimicrobial stewardship in the community.

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Health promotion by primary care nurses in Australian general practice

Collegian Journal of the Royal College of Nursing Australia ◽

10.1016/j.colegn.2012.09.001 ◽

2013 ◽

Vol 20 (4) ◽

pp. 215-221 ◽

Cited By ~ 20

Author(s):

Helen Keleher ◽

Rhian Parker

Keyword(s):

Primary Care ◽

Health Promotion ◽

General Practice ◽

Primary Care Nurses ◽

Australian General Practice

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Medication prescribing quality in Australian primary care patients with chronic kidney disease

10.21203/rs.2.10733/v2 ◽

2019 ◽

Author(s):

Woldesellassie Bezabhe ◽

Alex Kitsos ◽

Timothy Saunder ◽

Gregory M. Peterson ◽

Luke R. Bereznicki ◽

...

Keyword(s):

Primary Care ◽

Chronic Kidney Disease ◽

General Practice ◽

Kidney Disease ◽

Quality Indicators ◽

Enzyme Inhibitor ◽

Inappropriate Medication ◽

Inappropriate Prescribing ◽

Prescribing Quality ◽

Australian General Practice

Abstract Background: Drugs are commonly used in patients with chronic kidney disease (CKD) to treat an underlying cause, or its numerous complications and comorbidities. The objective of this study was to examine the quality of prescribing in patients with CKD in Australian general practice from February 01, 2016 and June 01, 2016, using validated indicators. Methods: We evaluated Australian general practice data obtained from the NPS MedicineWise MedicineInsight dataset for patients with CKD and aged 18 years or older. We used 16 internationally validated prescribing quality indicators focused on medication need, choice and safety in patients with CKD, and we compared results for patients using clinical and sociodemographic factors. Results: Among 44,259 patients with evidence of CKD stages 3-5, 13,263 (30%) had documentation of a diagnosis of diabetes. Less than half of all patients (40.8%) with CKD stages 3-5 and aged 50 to 65 years were prescribed a statin. The use of an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) was higher in patients with concomitant diabetes (64.1%) compared with those without diabetes (51.5%; P<0.001), yet only 69.9% of the patients with diabetes and microalbuminuria were receiving an ACEI or ARB. There were 7,426 patients (16.8%) with CKD stages 3-5 potentially receiving non-steroidal anti-inflammatory drugs (NSAIDs), including 14.3% of those patients with an estimated glomerular filtration rate (eGFR) below 30 mL/min/1.73 m2. Potentially inappropriate medication use was more common in CKD patients living in relatively disadvantaged socioeconomic areas, as well as in regional and remote areas. Conclusions: We identified areas for possible improvement in the prescribing of preventive medications, as well as deprescribing of potentially nephrotoxic medication, in patients with CKD stages 3-5. Australian programs working to improve quality use of medication need to focus on improving the appropriate prescribing of recommended preventive medications in patients with CKD, such as an ACEI/ARB and statin, and deprescribing of NSAIDs in patients with concurrent ACEI/ARB therapy. Keywords: chronic kidney disease, drug therapy, quality indicators, inappropriate prescribing, general practice, quality use of medicine, primary care

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Advancing general practice nursing in Australia: roles and responsibilities of primary healthcare organisations

Australian Health Review ◽

10.1071/ah15239 ◽

2017 ◽

Vol 41 (2) ◽

pp. 127 ◽

Cited By ~ 4

Author(s):

Riki Lane ◽

Elizabeth Halcomb ◽

Lisa McKenna ◽

Nicholas Zwar ◽

Lucio Naccarella ◽

...

Keyword(s):

Primary Care ◽

General Practice ◽

Leadership Development ◽

Postgraduate Education ◽

System Level ◽

Delphi Consensus ◽

Practice Nurses ◽

Care Services ◽

Primary Care Services ◽

Australian General Practice

Objectives Given increased numbers and enhanced responsibilities of Australian general practice nurses, we aimed to delineate appropriate roles for primary health care organisations (PHCOs) to support this workforce. Methods A two-round online Delphi consensus process was undertaken between January and June 2012, informed by literature review and key informant interviews. Participants were purposively selected and included decision makers from government and professional organisations, educators, researchers and clinicians from five Australian states and territories Results Of 56 invited respondents, 35 (62%) and 31 (55%) responded to the first and second invitation respectively. Participants reached consensus on five key roles for PHCOs in optimising nursing in general practice: (1) matching workforce size and skills to population needs; (2) facilitating leadership opportunities; (3) providing education and educational access; (4) facilitating integration of general practice with other primary care services to support interdisciplinary care; and (5) promoting advanced nursing roles. National concerns, such as limited opportunities for postgraduate education and career progression, were deemed best addressed by national nursing organisations, universities and peak bodies. Conclusions Advancement of nursing in general practice requires system-level support from a range of organisations. PHCOs play a significant role in education and leadership development for nurses and linking national nursing organisations with general practices. What is known about the topic? The role of nurses in Australian general practice has grown in the last decade, yet they face limited career pathways and opportunities for career advancement. Some nations have forged interprofessional primary care teams that use nurses’ skills to the full extent of their scope of practice. PHCOs have played important roles in the development of general practice nursing in Australia and internationally. What does this paper add? This study delineates organisational support roles for PHCOs in strengthening nurses’ roles and career development in Australian general practice. What are the implications for practitioners? Effective implementation of appropriate responsibilities by PHCOs can assist development of the primary care nursing workforce.

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