Glycaemic control of Type 2 diabetes in older patients visiting general practitioners: An examination of electronic medical records to identify risk factors for poor control.

Objective: To investigate factors associated with glycaemic control of diabetes in older patients in the general practice setting in metropolitan Melbourne, Australia.

Method: This retrospective study used the data from 10,257 patients aged ≥ 65 years with Type 2 diabetes from the Melbourne East Monash General Practice Database (MAGNET), 2009-2014. Poor glycaemic control was defined as HbA1c ≥ 9.

The willingness of Saudi men with type 2 diabetes to discuss erectile dysfunction with their physicians and the factors that influence this.

Objectives: The study's objectives were to find out the proportion of Saudi men with type 2 diabetes who have been asked by their physicians about erectile dysfunction (ED) in the last year, to determine the willingness of Saudi men with type 2 diabetes to discuss ED, and to explore the factors that may be related to their willingness to discuss ED with their physicians.

Methods: This study employed a cross-sectional survey design using a quantitative self-administered questionnaire among 309 Saudi men with type 2 diabetes. The study was conducted in hospital-based primary care clinics at King Khalid University Hospital, Riyadh, Saudi Arabia during the period from July to September 2015.

General practitioners knowledge and management of whiplash associated disorders and post-traumatic stress disorder: implications for patient care.

Background: In Australia, general practitioners (GPs) see around two-thirds of people injured in road traffic crashes. Road traffic crash injuries are commonly associated with diverse physical and psychological symptoms that may be difficult to diagnose and manage. Clinical guidelines have been developed to assist in delivering quality, consistent care, however the extent to which GPs knowledge and practice in diagnosing and managing road traffic crash injuries concords with the guidelines is unknown.

Minimally disruptive medicine is needed for patients with multimorbidity: time to develop computerised medical record systems to meet this requirement.

Background: Minimally disruptive medicine (MDM) is proposed as a method for more appropriately managing people with multiple chronic disease. Much clinical management is currently single disease focussed, with people with multimorbidity being managed according to multiple single disease guidelines. Current initiatives to improve care include education about individual conditions and creating an environment where multiple guidelines might be simultaneously supported.

How general practitioners manage mental illness in culturally and linguistically diverse patients: an exploratory study.

Background: General practitioners (GPs) see a range of mental illnesses and a diversity of patients, including patients from culturally and linguistically diverse (CALD) backgrounds. The aim of this study was to understand the barriers and facilitators GPs encounter when managing mental illness in CALD patients.

Methods: Semi-structured interviews with 10 Melbourne GPs were undertaken between May and July 2013.

Refugee experiences of general practice in countries of resettlement: a literature review.

Background: Refugees and asylum seekers often struggle to use general practice services in resettlement countries.

Aim: To describe and analyse the literature on the experiences of refugees and asylum seekers using general practice services in countries of resettlement.

Design And Setting: Literature review using systematic search and narrative data extraction and synthesis methodologies.

Online continuing medical education (CME) for GPs: does it work? A systematic review.

Background: Numerous studies have assessed the effectiveness of online continuing medical education (CME) designed to improve healthcare professionals' care of patients. The effects of online educational interventions targeted at general practitioners (GP), however, have not been systematically reviewed.

Methods: A computer search was conducted through seven databases for studies assessing changes in GPs' knowledge and practice, or patient outcomes following an online educational intervention.

Impact on diabetes management of General Practice Management Plans, Team Care Arrangements and reviews.

Objectives: To investigate whether General Practice Management Plans (GPMPs), Team Care Arrangements (TCAs) and reviews of these improve the management and outcomes of patients with diabetes when supported by cdmNet, a web-based chronic disease management system; and to investigate adherence to the annual cycle of care (ACOC), as recommended in diabetes guidelines.

Design, Participants And Setting: A before-and-after study to analyse prospectively collected data on 577 patients with type 1 or 2 diabetes mellitus who were managed with a GPMP created using cdmNet between June 2008 and November 2012.

Main Outcome Measures: Completion of the clinical tests in the ACOC (process outcome) and values of six of these clinical measurements (clinical outcomes).

Evaluation of a theory-informed implementation intervention for the management of acute low back pain in general medical practice: the IMPLEMENT cluster randomised trial.

Introduction: This cluster randomised trial evaluated an intervention to decrease x-ray referrals and increase giving advice to stay active for people with acute low back pain (LBP) in general practice.

Methods: General practices were randomised to either access to a guideline for acute LBP (control) or facilitated interactive workshops (intervention). We measured behavioural predictors (e.

Care planning and adherence to diabetes process guidelines: medicare data analysis.

Objective: To test the association, in patients with a diagnosis of diabetes I and II, between having or not having a care plan, (i.e. General Practice Management Plans (GPMPs),Team Care Arrangements (TCAs)), and having the recommended number of biochemical checks according to the diabetes Annual Cycle of Care guideline.

Developing theory-informed behaviour change interventions to implement evidence into practice: a systematic approach using the Theoretical Domains Framework.

Background: There is little systematic operational guidance about how best to develop complex interventions to reduce the gap between practice and evidence. This article is one in a Series of articles documenting the development and use of the Theoretical Domains Framework (TDF) to advance the science of implementation research.

Methods: The intervention was developed considering three main components: theory, evidence, and practical issues.

The CDM-Net Project: The Development, Implementation and Evaluation of a Broadband-Based Network for Managing Chronic Disease.

Background. In Australia most chronic disease management is funded by Medicare Australia through General Practitioner Management Plans (GPMPs) and Team Care Arrangements (TCAs). Identified barriers may be reduced effectively using a broadband-based network known as the Chronic Disease Management Service (CDMS).

Fitness to drive - GP perspectives of assessing older and functionally impaired patients.

Background: General practitioners have expressed concern about their ability to assess patients' driving fitness. This study explores GP perspectives regarding assessing fitness to drive in older and functionally impaired patients.

Methods: We held face-to-face interviews with seven metropolitan GPs and a focus group with nine rural GPs.

Web based diabetes care planning - sociotechnical barriers to implementation in general practice.

Background: This research explored the sociotechnical barriers in the implementation of web based diabetes care plans in general practice from the perspective of implementing stakeholders.

Methods: A qualitative case study design was use to explore the sociotechnical barriers. Twenty-one stakeholders were purposely recruited and interviewed.

Data extraction and feedback - does this lead to change in patient care?

BACKGROUND Computers enable general practitioners to collate clinical data within their practices. The improvements that this can make to clinical care remain the subject of enquiry. OBJECTIVE Does the analysis of clinical data for the purpose of instigating quality improvement strategies in general practice, with support from a local division of general practice, lead to positive changes in measures of care after 12 months? DISCUSSION This study demonstrated that, in this setting, the collection and analysis of clinical data, with support from a division of general practice, led to modest increases in the recording of information rather than improvements in clinical outcomes.

Electronic care plans and medicolegal liability.

Background: Government policy encourages the use of care plans in general practice, and developments in information technology have the potential to facilitate their use via a shared electronic care plan. Sharing a comprehensive set of patient data raises privacy issues and questions about the nature and extent of potential liability.

Methods: A round table discussion was held with participants purposively selected for expertise in their fields.

The usefulness of a clinical 'scorecard' in managing patients with sore throat in general practice.

Objective: To evaluate the usefulness of a clinical scorecard in managing sore throat in general practice.

Design: Validation study of scorecard for sore throat with a throat swab culture used as the 'gold standard'.

Setting: A solo family practice in rural New South Wales, AustraliaParticipants: Patients attending with sore throat.

Identification of features of electronic prescribing systems to support quality and safety in primary care using a modified Delphi process.

Background: Electronic prescribing is increasingly being used in primary care and in hospitals. Studies on the effects of e-prescribing systems have found evidence for both benefit and harm. The aim of this study was to identify features of e-prescribing software systems that support patient safety and quality of care and that are useful to the clinician and the patient, with a focus on improving the quality use of medicines.

Are general practice networks 'ready' for clinical data management?

Background: Australian general practice networks (GPN) are required to report on national performance indicators under the Australian Government Department of Health and Ageing's National Quality Performance System (NQPS).

Objective: To investigate the extent to which Victorian GPN are 'ready' to manage clinical data from general practice for reporting under the NQPS.

Methods: A qualitative study using semistructured interviews from a purposive sample of chief executive officers from urban and rural Victorian GPN included those either participating or not participating in the Australian Primary Care Collaboratives Program.

GP registrar well-being: a cross-sectional survey.

Objectives: To investigate the major stressors affecting GP registrars, how those at risk can be best identified and the most useful methods of managing or reducing their stress.

Design, Setting And Participants: Cross-sectional postal questionnaire of all GP registrars in one large regional training provider's catchment area.

Main Outcome Measures: The Depression, Anxiety and Stress Scale (DASS), a specifically developed Registrar Stressor Scale consisting of five subscales of potential stressors, plus closed questions on how to identify and manage stress in GP registrars.

A bibliometric analysis of Australian general practice publications from 1980 to 2007 using PubMed.

Background: We analysed Australian general practice (GP) publications in PubMed from 1980 to 2007 to determine journals, authors, publication types, national health priority areas (NHPA) and compared the results with those from three specialties (public health, cardiology and medical informatics) and two countries (the UK and New Zealand).

Method: Australian GP publications were downloaded in MEDLINE format using PubMed queries and were written to a Microsoft Access database using a software application. Search Query Language and online PubMed queries were used for further analysis.

Clinical data extraction and feedback in general practice: a case study from Australian primary care.

Background: Quality improvement in general practice has increasingly focused on the analysis of its clinical databases to guide its improvement strategies. However, general practitioners (GPs) need to be motivated to extract and review their clinical data, and they need skills to do so. This study examines the initial experience of 15 practices in undertaking clinical data extraction and management and the support they were given by their local division of general practice.

GP and nurses' perceptions of how after hours care for people receiving palliative care at home could be improved: a mixed methods study.

Background: Primary health care providers play a dominant role in the provision of palliative care (PC) in Australia but many gaps in after hours service remain. In some rural areas only 19% of people receiving palliative care achieve their goal of dying at home. This study, which builds on an earlier qualitative phase of the project, investigates the gaps in care from the perspective of general practitioners (GPs) and PC nurses.

Laser acupuncture for chronic non-specific low back pain: a controlled clinical trial.

Objective: the primary aim was to determine if laser acupuncture (LA) is more effective than sham laser in reducing pain and disability in adults with chronic non-specific low back pain.

Methods: the design was a double blind, two-group parallel randomised controlled trial. The active intervention was an 830 nm (infrared), 10 mW, Ga-Al-As laser diode laser for acupuncture and a sham control.