Social and Behavioral Sciences Commons^™

Activating Primary Care Copd Patients With Multi-Morbidity (Apcom) Pilot Project: Study Protocol, Sameera Ansari, Hassan Hosseinzadeh, Sarah May Dennis, Nicholas Zwar

Faculty of Science, Medicine and Health - Papers: part A

Chronic obstructive pulmonary disease (COPD), third leading cause of mortality worldwide,1 is primarily caused by cigarette smoking in Australia.2 COPD often occurs in the presence of multi-morbidity, which is the simultaneous occurrence of two or more chronic conditions; this is a growing concern in a health system focused on single-disease management.3 Around 80% of older Australians have multi-morbidity, average prevalence of chronic respiratory disease being 9.5%.4 A systematic review of COPD education programs suggests that equipping patients with self-management skills is as important as disease knowledge.5 Studies exploring positive effects of chronic disease-management interventions6 also underline the lack of studies …

Improving The Uptake Of Pre-Travel Health Advice Amongst Migrant Australians: Exploring The Attitudes Of Primary Care Providers And Migrant Community Groups, Holly Seale, Rajneesh Kaur, Abela Mahimbo, C Raina Macintyre, Nicholas Arnold Zwar, Mitchell Smith, Heather Worth, Anita Heywood

Faculty of Science, Medicine and Health - Papers: part A

Background: Migrant travellers who return to their country of origin to visit family and friends (VFR) are less likely to seek travel-related medical care and are less likely to adhere to recommended medications and travel precautions. Through this study, we aimed to get an understanding of the views of stakeholders from community migrant centres and primary care providers on barriers for migrants, particularly from non-English speaking backgrounds, in accessing travel health advice and the strategies that could be used to engage them. Methods: A qualitative study involving 20 semi-structured interviews was undertaken in Sydney, Australia between January 2013 and September …

Addressing The Deficiencies In The Evidence-Base For Primary Practice In Regional Australia - Sentinel Practices Data Sourcing (Spds) Project: A Pilot Study, Abhijeet Ghosh, Karen E. Charlton, Lisa Girdo, Marijka J. Batterham, Keith Mcdonald

Dr Marijka Batterham

Background Chronic disease risk on a population level can be quantified through health surveys, either continuous or periodic. To date, information gathered from primary care interactions, using sentinel sites, has not been investigated as a potentially valuable surveillance system in Australia. Methods A pilot study was conducted in a single General Practice in a regional area of New South Wales, Australia to assess the feasibility of accessing data obtained through a computerised chronic disease management program that has been designed for desktop application (Pen Computer Systems (PCS) Clinical Audit Tool: ™ PCS CAT). Collated patient data included information on chronic …

Nutrition Status Of Primary Care Patients With Depression And Anxiety, Adrienne K. Forsyth, Peter G. Williams, Frank P. Deane

Peter Williams

The objective of this study was to evaluate the nutrition status of people referred to a nutrition and physical activity program for the management of mental health in a general practice.

A Randomised Controlled Trial Of A Consumer-Focused E-Health Strategy For Cardiovascular Risk Management In Primary Care: The Consumer Navigation Of Electronic Cardiovascular Tools (Connect) Study Protocol, Julie Redfern, Tim Usherwood, Mark Fort Harris, A Rodgers, Noel Hayman, Kathryn S. Panaretto, C Chow, A Lau, Lis Neubeck, G Coorey, F Hersch, E Heeley, Anushka Dr Anushka Patel, S Jan, Nicholas Arnold Zwar, David Peiris

Faculty of Science, Medicine and Health - Papers: part A

Introduction: Fewer than half of all people at highest risk of a cardiovascular event are receiving and adhering to best practice recommendations to lower their risk. In this project, we examine the role of an e-health-assisted consumer-focused strategy as a means of overcoming these gaps between evidence and practice. Consumer Navigation of Electronic Cardiovascular Tools (CONNECT) aims to test whether a consumer-focused e-health strategy provided to Aboriginal and Torres Strait Islander and non-indigenous adults, recruited through primary care, at moderate-to-high risk of a cardiovascular disease event will improve risk factor control when compared with usual care. Methods and analysis: Randomised …

Addressing The Deficiencies In The Evidence-Base For Primary Practice In Regional Australia - Sentinel Practices Data Sourcing (Spds) Project: A Pilot Study, Abhijeet Ghosh, Karen E. Charlton, Lisa Girdo, Marijka J. Batterham, Keith Mcdonald

Faculty of Science, Medicine and Health - Papers: part A

Background Chronic disease risk on a population level can be quantified through health surveys, either continuous or periodic. To date, information gathered from primary care interactions, using sentinel sites, has not been investigated as a potentially valuable surveillance system in Australia.

Methods A pilot study was conducted in a single General Practice in a regional area of New South Wales, Australia to assess the feasibility of accessing data obtained through a computerised chronic disease management program that has been designed for desktop application (Pen Computer Systems (PCS) Clinical Audit Tool: ™ PCS CAT). Collated patient data included information on chronic …

Patients Communicating With Their Primary Care Physician About Chronic Disease Treatment In Regional Australia: Is Health Literacy Important?, J Mullan, K Weston, A Bonney, C Magee, G Albert, B Gerges, Soheir Abadier, T Smith, V Bonney, B Dijkmans-Hadley, C Kielly-Carroll

Faculty of Science, Medicine and Health - Papers: part A

No abstract provided.

Preventive Evidence Into Practice (Pep) Study: Implementation Of Guidelines To Prevent Primary Vascular Disease In General Practice Protocol For A Cluster Randomised Controlled Trial, Mark Fort Harris, Jane Lloyd, John Litt, Mieke Van Driel, Danielle Mazza, Grant Russell, Jane Smith, Chris Del Mar, Elizabeth Denney-Wilson, Sharon M. Parker, Yordanka Krastev, Upali W. Jayasinghe, Richard J. Taylor, Nicholas Zwar, Jinty Wilson, Helen Bolger-Harris, Justine Waters

Faculty of Science, Medicine and Health - Papers: part A

Background: There are significant gaps in the implementation and uptake of evidence-based guideline recommendations for cardiovascular disease (CVD) and diabetes in Australian general practice. This study protocol describes the methodology for a cluster randomised trial to evaluate the effectiveness of a model that aims to improve the implementation of these guidelines in Australian general practice developed by a collaboration between researchers, non-government organisations, and the profession.Methods: We hypothesise that the intervention will alter the behaviour of clinicians and patients resulting in improvements of recording of lifestyle and physiological risk factors (by 20%) and increased adherence to guideline recommendations for: the …

Nutrition Status Of Primary Care Patients With Depression And Anxiety, Adrienne K. Forsyth, Peter G. Williams, Frank P. Deane

Frank Deane

The objective of this study was to evaluate the nutrition status of people referred to a nutrition and physical activity program for the management of mental health in a general practice.

Training Models For Psychiatry In Primary Care: A New Frontier, Mitchell Byrne, Rachael Murrihy

Mitchell K Byrne

No abstract provided.

Do Australian Primary School Environments Affect Children's Playground Physical Activity Levels?, Anne-Maree Parrish, Donald Iverson, Kenneth Russell, Heather Yeatman

Don C. Iverson

No abstract provided.

A Study Of Headache In North American Primary Care: Report For The Ambulatory Sentinel Practice Network, L A. Becker, Donald C. Iverson, F M. Read, N Calogne, R S. Miller, W L. Freeman

Don C. Iverson

Headache is a common symptom in primary care about which surprisingly little is known. Over a 14-month period 3847 patients making 4940 consecutive visits for headache to 38 primary care practices in the USA and Canada were studied. The clinical characteristics of patients, as well as the diagnostic and therapeutic strategies employed by their doctors, were examined. Visits for headache represented 1.5% of all visits during this period. Most patients (72.0%) made only one visit, and nearly half of the headaches reported were new. Only a small number of patients (3.0%) received a computerized tomographic scan; other investigations were used …

Spontaneous Abortion In Primary Care: A Report From Aspn, L Green, L Becker, W Freeman, E Elliott, Donald Iverson, F Reed

Don C. Iverson

The Ambulatory Sentinel Practice Network (ASPN) conducted an observational study of usual primary care of spontaneous abortion (SAB). Forty-nine practices in 18 states and four Canadian provinces reported and audited 171 SABs. Contrary to recommendations in some texts, 40 percent were managed completely in the office and/or at home, and only 51 percent had a dilation and curettage (D&C). SABs occurring later in pregnancy were more likely to be managed in the emergency room/hospital, receive consultation, and have a D&C. Patients managed with D&C had a greater frequency of excessive blood loss at diagnosis, but otherwise they did not differ …

Patients With New Headache In Primary Care: A Report From Aspn, L Becker, Donald Iverson, F Reed, N Calonge, R Miller, W Freeman

Don C. Iverson

From a consecutive series of 3,847 headache patients, 1,331 patients who made first visits for new headache to 120 primary care physicians were studied for usual care over a 14-month period. Either tension or vascular headache was the initial diagnosis in 23.8 percent and 12.8 percent of patients, respectively. Nearly one half (47.8 percent) were classified as having headaches other than tension or vascular. A total of 15.3 percent of headaches were undiagnosed or were regarded as a mixture of traditional diagnostic designations. At first visit, most patients (76.6 percent) were managed without diagnostic tests. Drugs were prescribed for 73.6 …

The Development And Management Of A Primary Care Research Network, 1978-87, Donald Iverson, B Calonge, R Miller, L Niebauer, F Reed

Don C. Iverson

The Ambulatory Sentinel Practice Network (ASPN) was created to increase the knowledge of primary care. Building on the experiences of other national and regional primary care research networks, ASPN has evolved as a North American network including practices in 25 U.S. states and four Canadian provinces in 1987. This paper summarizes ASPN's growth and development since 1978, the involvement of the ASPN practices, and the mechanisms used in developing and managing studies.

Carpal Tunnel Syndrome In Primary Care: A Report From Aspn. Ambulatory Sentinel Practice Network, R Miller, Donald Iverson, R Fried, L Green, Paul Nutting

Don C. Iverson

Carpaltunnelsyndrome is the entrapment neuropathy of the medign nerve at the wrist. It is the most common nerve compression disorder seen by physicians, affecting women up to five times more frequently than men, especially during the reproductive years. Carpaltunnelsyndrome is known to be aggravated during pregnancy and menopause. Primary care physicians can expect to see approximately 1.01 cases of carpaltunnelsyndrome per 1,000 office encounters, with a female age-adjusted rate of 1.49 per 1,000 person-years. Physicians can identify this syndrome with an accurate and detailed history and physical exam. In most cases, electrodiagnostic studies, such as nerve conduction velocities and/or electromyography, …

Barriers And Enablers To Implementation Of A New Zealand-Wide Guideline For Assessment And Management Of Cardiovascular Risk In Primary Health Care: A Template Analysis, Ann Mckillop, Jackie Crisp, Kenneth Walsh

Faculty of Health and Behavioural Sciences - Papers (Archive)

Aim: The aim of this study was to identify the enablers and barriers to guideline implementation in a primary healthcare setting by employing the Promoting Action on Research Implementation in Health Services (PARIHS) framework as a template for data analysis and interpretation. Background: The use of clinical practice guidelines is pivotal to improving health outcomes. However, the implementation of guidelines into practice is complex, unpredictable, and, in spite of much investigation, remains resistant to explanation of what works and why. Optimising the enablers and minimising the barriers to implementation of a guideline for reducing cardiovascular disease risk has the potential …

Nutrition Status Of Primary Care Patients With Depression And Anxiety, Adrienne K. Forsyth, Peter G. Williams, Frank P. Deane

Faculty of Health and Behavioural Sciences - Papers (Archive)

The objective of this study was to evaluate the nutrition status of people referred to a nutrition and physical activity program for the management of mental health in a general practice.

Comparison Of The Dietadvice Website In The Clinical Trial And Primary Healthcare Contexts, Yasmine Probst, Kathryn Boyd, Virva Walkington, Linda C. Tapsell

Faculty of Health and Behavioural Sciences - Papers (Archive)

The aim of this study was to evaluate the use of the DietAdvice website, a self-administered online dietary assessment, in the context of a dietary intervention randomized controlled trial [ACTRN 12608000425392]. Data available from a total of n=118 volunteers recruited to the dietary trial and using the website in the clinic at t=0, 3 and 12mo was compared with that obtained from diet histories (DH) and 3-day food record (FR). Fasting blood samples from these time points were also correlated with the macronutrient values obtained. Complete web based records were obtained for 65% of participants at t=0, 83% at t=3 …

Annual Influenza Vaccination: Coverage And Attitudes Of Primary Care Staff In Australia, Kirsten Ward, Holly Seale, Nicholas Zwar, Julie Leask, C Raina Macintyre

Faculty of Science, Medicine and Health - Papers: part A

Background Annual influenza vaccination is recommended for all Australian health care workers (HCWs) including those working in primary health care. There is limited published data on coverage, workplace provision, attitudes and personal barriers to influenza vaccination amongst primary health care staff. The aim of this study was to contribute to the limited literature base in this important area by investigating these issues in the primary health care setting in New South Wales (NSW), Australia. Methods A postal survey was sent to general practitioners (GPs) and practice nurses (PNs) from inner city, semi-urban and rural areas of NSW, Australia. There were …

The Commercial Food Landscape: Outdoor Food Advertising Around Primary Schools In Australia, Bridget P. Kelly, Michelle Cretikos, Kris Rogers, Lesley King

Faculty of Health and Behavioural Sciences - Papers (Archive)

Objective: Food marketing is linked to childhood obesity through its influence on children’s food preferences, purchase requests and food consumption. We aimed to describe the volume and nature of outdoor food advertisements and factors associated with outdoor food advertising in the area surrounding Australian primary schools. Methods: Forty primary schools in Sydney and Wollongong were selected using random sampling within population density and socio-economic strata. The area within a 500m radius of each school was scanned and advertisements coded according to pre-defined criteria, including: food or non-food product advertisement, distance from the school, size and location. Food advertisements were further …

Do Australian Primary School Environments Affect Children's Playground Physical Activity Levels?, Anne-Maree Parrish, Donald Iverson, Kenneth Russell, Heather Yeatman

Faculty of Health and Behavioural Sciences - Papers (Archive)

No abstract provided.

The Nature And Prevalence Of Psychological Problems In New Zealand Primary Healthcare: A Report On Mental Health And General Practice Investigation ( Magpie), John Bushnell, Deborah Mcleod, A D. Dowell, C Salmond, S Ramage, S Collings, P Ellis, Marjan Kljakovic, L Mcbain

Faculty of Science, Medicine and Health - Papers: part A

Aims This paper describes the methods used in a study of the prevalence and types of common mental disorders among patients attending New Zealand general practices, and reports some key findings from the first phase of the study. The study also aimed to determine the degree of associated disability and other factors influencing recognition, management, course and outcome of these disorders, and subsequent papers will address these issues. Methods General practitioners (GPs) were selected randomly. In the first phase of the study, all adult attenders at each practice on selected days were administered a short questionnaire, the General Health Questionnaire …

Psychological Problems In New Zealand Primary Health Care: A Report On The Pilot Phase Of The Mental Health And General Practice Investigation (Magpie), John Bushnell, Deborah Mcleod, A D. Dowell, C Salmond, S Ramage, S Collings, University Of Otago, Marjan Kljakovic, L Mcbain

Faculty of Science, Medicine and Health - Papers: part A

Aim. To carry out a pilot study in two regions in order to investigate prevalence of psychological problems in primary care in New Zealand. Method. General Practitioners (GPs) within two geographic regions were randomly selected. All adult attenders at their practice on selected days were administered a short questionnaire, the GHQ-12, which assesses the presence of psychological symptoms. The GP recorded the reasons for each consultation, and was interviewed at the end of each day about selected patients, to determine their opinion about the type of psychological problems experienced. Results. Three-quarters of selected GPs (76%) agreed to participate. 96% of …

A Study Of Headache In North American Primary Care: Report For The Ambulatory Sentinel Practice Network, L A. Becker, Donald C. Iverson, F M. Read, N Calogne, R S. Miller, W L. Freeman

Faculty of Health and Behavioural Sciences - Papers (Archive)

Headache is a common symptom in primary care about which surprisingly little is known. Over a 14-month period 3847 patients making 4940 consecutive visits for headache to 38 primary care practices in the USA and Canada were studied. The clinical characteristics of patients, as well as the diagnostic and therapeutic strategies employed by their doctors, were examined. Visits for headache represented 1.5% of all visits during this period. Most patients (72.0%) made only one visit, and nearly half of the headaches reported were new. Only a small number of patients (3.0%) received a computerized tomographic scan; other investigations were used …