Prevention and Management of Long Term Conditions
Description and Aims
This stream is a response to the challenge of long-term conditions to health and health care services. These conditions include diabetes, cardiovascular disease, asthma and chronic obstructive lung disease, cancer and mental illness. They commonly occur as multi-morbidities. The aim is conduct research in the community which informs improvement in health care and programs which aim to prevent and manage these conditions.
Key Current Research Areas
Prevention
The program focuses on improving interventions to address the behavioural risk factors (especially Smoking, Nutrition, Alcohol and Physical activity) as well as physiological risk factors such as obesity and cardiovascular risk in primary health care. This uses the 5As framework (ask/assess, advise, agree and assist, arrange), approaches tailored to health literacy levels and use of wearable technology and social media.
Management
This program focuses on a patient centred approach based on the Chronic Care model and includes teamwork, information and communication systems (including e-health), self-management support and community resources. This is the focus of work on diabetes, cardiovascular disease, asthma, COPD, cancer, mental illness and multi-morbidity.
Key Partners
This research is conducted in partnership with primary health networks and local health districts along with other groups including Aboriginal Health organisations.
Stream lead
Mark Harris leads the stream.
Current
Projects
AMPACe – Accelerometers for Monitoring Physical Activity in Primary Care
AMPACe aims to assess the feasibility and any benefit of integrating accelerometer or activity tracker use in primary care as means of promoting physical activity. It follows on from a smaller 2016 pilot study.
Clinical Pathways: Multidisciplinary shared care plans (Clozapine shared e-care planning)
This project is evaluating the feasibility of an online shared care plan supporting communication between GPs, specialist services, consumers, carers and other care team members for clozapine treatment, preventive care and behavioural change in the long-term shared management of people with a lived experience of severe mental illness. The care plan sets out the tasks required, when they need to be completed and who is responsible. This intervention is being implemented with the My GP & Me shared care program currently running in the SESLHD, Eastern Suburbs Mental Health Service.
The project is one of 4 clinical pathways projects funded by Mindgardens Neuroscience Network.
Development of risk profiling matrix for chronic diseases and preventive smartphone application
This project aims to promote healthy ageing through a smartphone app-based intervention, specifically, by helping people prevent the onset of cardiovascular disease and type 2 diabetes mellitus.
Electronic shared care plan for long term care of cancer patients
A feasibility study to develop and determine how best to engage GPs and patients in a cancer shared e-care plan and assess how specialists, GPs and patients use the e-care planA feasibility study to develop and determine how best to engage GPs and patients in a cancer shared e-care plan and assess how specialists, GPs and patients use the e-care plan
Exploring immunisation providers’ views towards delivery of routine immunisations in the COVID-19 era and the rollout of COVID-19 vaccines through General Practice
International travellers are a primary factor in the spread of infectious diseases across borders and have been instrumental in spreading SARS-CoV-2 around the world. Diasporic people who travel back to their countries of origin to visit friends and relatives (VFR travellers) are at increased risk of acquiring a range of infectious diseases during travel, compared to other travellers. Pre-travel assessment and advice is an important opportunity to address VFR issues regarding health beliefs, health behaviours, current health status and pre-existing conditions.
General Practitioners (GPs) are an important source of pre-travel advice for travellers. An Australian population-based survey found that almost 90% of travellers used their general practitioner for travel health advice (1). Despite this, there has been little published research on the practice of travel medicine in primary care in Australia or internationally(2, 3) and few address the provision of travel medicine advice to migrant Australians travelling to visit friends and relatives (4). A 2012 study of GPs in migrant-rich suburbs of Sydney found a lack of awareness of the need for pre-travel health assessment of migrant Australians, particularly among migrant GPs (4). Further research is needed to identify barriers to care among a more generalisable sample of Australian GPs.
Traveller behaviour may differ in the post-COVID era and the practice of travel medicine is likely to change. Understanding GP knowledge, and perception of travel risks and barriers to the provision of advice is important, with previous research indicating a need for directed education and awareness of the need for opportunistic targeting of VFR travellers (5).
A cross-sectional survey of GPs practicing in Australia will be conducted. GPs will be sampled from the AMA Medical Directory of Australia database. Depending on contact details, GPs will be emailed a link to an online survey or posted a hard-copy survey and invited to participate.
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Completed
Projects
Supporting newly arrived migrant mothers in Canterbury from Bangladesh and China
Culturally and linguistically diverse migrant mothers are more likely to experience lower levels of access to health care. This project, funded by Healthdirect Australia and conducted in Sydney Local Health District, aims to increase equity of access to information and health care for non-English speaking migrant mothers.
A cluster randomised controlled trial of nurse and general practitioner partnership for care of COPD
Determination of the impact of nurse and GP partnership on the quality of care and health outcomes for patients with COPD at six months and twelve months follow-up
A pilot study in managing Anxiety and Stress in Cross-Cultural Encounters among Chinese-Australians (Beyondblue community grant in collaboration with Chinese Australian Services Society)
This project involved the delivery of ‘Assertive Communication Skills’ to help Chinese-Australians manage their stress and anxiety in cross-cultural encounters in everyday settings. This project also sought to bridge the cultural gap by equipping participants with culturally appropriate skills.
A project to assess the effectiveness and feasibility of case finding of Chronic Obstructive Pulmonary Disease (COPD) by practice nurses in General Practice
This project investigated the prevalence of COPD diagnosis in an Australian general practice setting, and whether an intervention utilising practice nurses addresses under-diagnosis of COPD.
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PhD
Projects
Advance Care Planning in Australian Primary Care
This study explores the key stakeholders, general practitioners and patients' views on how Advance Care Planning is currently conceptualised and implemented.
Development of risk profiling matrix for chronic diseases and preventive smartphone application
This project aims to promote healthy ageing through a smartphone app-based intervention, specifically, by helping people prevent the onset of cardiovascular disease and type 2 diabetes mellitus.
