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
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Completed
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Analysis of patterns of diabetes care and their outcomes from division registers

Division registers provide longitudinal data on the quality of care and health outcomes for patients with diabetes in general practice. The Macarthur and Southern Highlands Divisions have 9 been established for more than 9 years.

Assessment and management of weight in young children

This project is undertaken in partnership with the Premiers Task Force on Child Obesity.  It involves the development of face to face and online training and quality improvement activities for GPs and practice nurses in management of overweight and obesity in children in general practice. 

Barriers and facilitators of influenza vaccination in high risk groups aged less than 65

This study was done to explore issues in relation to influenza vaccination among people aged less than 65 years of age with high-risk factors.

Barriers and facilitators to use of the asthma 3+ visit plan

The Asthma 3+ Visit Plan is an initiative of the National Asthma Council to promote organized care of asthma in general practice. This study explores barriers and facilitators to Asthma 3+ Visit Plan in general practice.

Better Management of Weight in General Practice (BMWGP)

Socioeconomically disadvantaged adults are both more likely to be obese and have lower levels of health literacy. This trial evaluated the implementation and effectiveness of primary care nurses acting as prevention navigators to support obese patients with low health literacy to lose weight.

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PhD
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