Non-steroidal anti-inflammatory drugs in general practice: a decision-making dilemma.

Objectives: To examine the effect of the debate on the safety of non-steroidal anti-inflammatory drugs (NSAIDs) on decision making by Australian general practitioners and patients with osteoarthritis (OA), and to explore issues concerning the use of NSAIDs from both prescriber and consumer perspectives.

Design And Setting: A qualitative study in which five focus groups (three for GPs, and two for patients with OA) were conducted between 15 May and 4 August 2006 in south-western Sydney.

Participants: Five advanced general practice registrars, six experienced GPs, and 20 patients with OA aged 54-85 years.

Care of patients with chronic disease: the challenge for general practice.

General practice can provide good quality care for a range of high-prevalence chronic diseases, at the same time providing continuity of care and management of comorbidity. Although the quality of care for patients with chronic disease is improving in general practice, about half of patient care does not meet optimal standards. Factors contributing to the gap between optimal and current practice include the method of financing, the availability of other disciplines to participate in team care, limited engagement with self-management education, and lack of information and decision support systems.

The Macarthur GP After-hours Service: a model of after-hours care for Australia.

Introduction: The Macarthur GP After-hours Service (MGPAS) was established to streamline the provision of after-hours medical care in an outer-urban community. This paper reports on a process evaluation of the MGPAS.

Methods: A mixed methods approach involving surveys, stakeholder interviews and analysis of administrative data was used.

Multidisciplinary care plans for diabetic patients: what do they contain?

Background: The Enhanced Primary Care package, introduced in 1999, included an item number for multidisciplinary care plans. There has been little research into what is contained in care plans. This study investigated what general practitioners documented in care plans for their diabetic patients.

Do multidisciplinary care plans result in better care for patients with type 2 diabetes?

Background: Since the introduction of the Enhanced Primary Care package, care plans have become part of Australian general practice. Previous research has focused on barriers to the uptake of care plans. This study examined the effect of multidisciplinary care plans on provision and outcome of care for patients with type 2 diabetes.

Pretravel advice and hepatitis A immunization among Australian travelers.

Background: More Australians are traveling to overseas destinations where preventable infectious diseases, such as hepatitis A, are endemic. Yet, there is only limited data concerning the extent to which Australians seek travel advice and vaccination before their departures.

Method: Annual telephone surveys were conducted among adult Australians travelers.

Risk of exposure to hepatitis B and other blood-borne viruses among Australians who travel abroad.

Background: European studies indicate that up to 67% of travelers traveling abroad participate in activities that put them at risk of exposure to hepatitis B. Australians are increasingly traveling to destinations where hepatitis B is highly endemic, such as Asia, and are likely to have similar levels of involvement in activities with an associated risk of hepatitis B exposure.

Method: A series of annual telephone surveys of approximately 500 randomly selected Australian overseas travelers have been conducted under the auspice of the Travel Health Advisory Group over the years 2001 to 2003.

Supporting research in primary care: are practice-based research networks the missing link?

Despite the size and importance of primary health care (including general practice) within the health system, traditional research output has been relatively low, both here and overseas. General-practice and primary-care research in Australia has been criticised for the preponderance of small-scale, descriptive and survey-based studies. If we are to conduct larger-scale clinical, epidemiological and health-services research, new structures and processes are needed.

Weight management in general practice: what do patients want?

Objective: To explore patients' views of the role of general practitioners in weight management.

Design: Waiting-room questionnaire survey, including measurement of height, weight and waist circumference, May-August 2005.

Participants And Setting: 227 patients from five general practices located in metropolitan and rural New South Wales.

Better access to psychology services in primary mental health care: an evaluation.

Introduction: The Access to Allied Psychological Services program was introduced as part of the Better Outcomes in Mental Health Care initiative in 2001-2002. Divisions of General Practice are funded to establish programs that allow GPs to refer patients for psychological treatments. The University of New South Wales evaluated programs run by the Southern Highlands and Illawarra Divisions of General Practice.

Role of the general practitioner in smoking cessation.

This paper reflects on the role of general practitioners in smoking cessation and suggests initiatives to enhance general practice as a setting for effective smoking cessation services. This paper is one of a series of reflections on key issues in smoking cessation. In this article we highlight the extent that general practitioners (GPs) have contact with the population, evidence for effectiveness of GP advice, barriers to greater involvement and suggested future directions.

General practice and the management of chronic conditions--where to now?

Background: As of 1 July 2005, the Medicare Benefits Schedule includes additional chronic disease management (CDM) item numbers offering general practitioners more options for managing patients with chronic conditions, including those requiring multidisciplinary care. The new item numbers are not a substitute for normal medical care but expand the possibilities for GPs and their patients.

Objective: This article provides a practical overview of the use of the CDM item numbers.

Refugee health.

Background: Refugees and asylum seekers in Australia come from many countries. They present a significant challenge for general practice.

Objective: This article outlines the unique range of problems presented by refugee patients in general practice and some approaches to dealing with them.

General practitioner views on barriers and facilitators to implementation of the Asthma 3+ Visit Plan.

Aim: The Asthma 3+ Visit Plan is an initiative to promote organised asthma care in general practice. This study aimed to identify factors associated with uptake of the plan by general practitioners, and their views on barriers and facilitators to implementation of the plan.

Design: Postal survey sent to a random sample of GPs.

GPs' views of absolute cardiovascular risk and its role in primary prevention.

Background: Clinical guidelines recommend using absolute risk to inform clinical decisions in cardiovascular disease prevention. Absolute risk assessment tools have been disseminated to general practitioners, however current use and knowledge of this is approach among GPs is unknown.

Method: Transcribed audiotapes of focus groups with 36 GPs, analysed for key themes.

Smoking cessation guidelines for Australian general practice.

Background: The Smoking cessation guidelines for Australian general practice is based on published evidence, review of overseas guidelines, existing general practice programs, and a process of stakeholder consultation. It was distributed to Australian general practitioners in 2004.

Objective: This article describes the development and content of the guidelines.

Patients' views on chronic illness and its care in general practice.

Background: General practitioners have described barriers to the uptake of incentives such as the Enhanced Primary Care items introduced to support care of chronic illness. However patients' attitudes toward chronic illness and planned care are not known.

Methods: A qualitative study of adult patients with chronic illnesses using semi-structured interviews and a focus group, examining their experience of chronic illness and their attitudes toward health care.

Bupropion as an aid to smoking cessation: a review of real-life effectiveness.

Clinical trials rigorously demonstrate the efficacy of new products and justify their marketing. However, it is only after use in real-life settings that the clinical value (effectiveness) of a new treatment is fully known. The purpose of this review was to summarise the effectiveness data for bupropion SR as an aid to smoking cessation.