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.
Completed
Projects
COPD Self-management in Nepal
Globally, Primary Health Care (PHC) is recognised as central to improving health for all, yet COPD patients in Nepal are not receiving adequate PHC, due to inadequate human resources for proper diagnosis and treatment and a lack of infrastructure. Our study will be co-designing a model of care, which aims to find local solutions/innovations to the identified problems at the level of the patient, health professional and health system for improving self-management practices. We expect our program to greatly improve the quality of care and COPD patients’ quality of life in Nepal.
Diabetes and cardiovascular disease quality improvement
This report depicts the contribution of primary care to the management of diabetes and cardiovascular disease (CVD).
Diabetes prevention
This study aims to determine within general practice and associated services the feasibility, requirements, barriers and benefits/harms for an intervention to detect impaired glucose tolerance and impaired fasting glycaemia and to provide physical activity and nutrition interventions which aim to reduce the risk of type 2 diabetes in this group.
Diagnosing obstructive sleep apnea in primary care
This project is aimed to simplify the method for diagnosing obstructive sleep apnea (OSA) in the primary care setting.
Do patient attitudes contribute to frequent readmissions?
This study determines the characteristics which differentiate frequently readmitted chronic disease patients from those self-managing