Potential implications of genomic medicine in general practice

• Genomic research can link specific molecular genetic information with specific diseases. • Implications of genomic medicine in general practice include developments in screening and diagnosis, predicting disease prognosis, and optimising preventive and therapeutic care. • As users or co-producers of genomic information, or as collaborators in genomic research, general practitioners can help realise the potential of advances in genomic research.</p

Asthma and older people in general practice

WHAT WE NEED TO KNOW: Why is there undiagnosed and untreated asthma in older people in the community and in general practice? What patient, general practitioner and organisational factors contribute to this? Are current best practice guidelines appropriate for older people with asthma? WHAT WE NEED TO DO: Undertake broad community and general practice screening to identify characteristics of older people with undiagnosed asthma. Analyse GPs' perspectives and decision-making processes for older people with dyspnoea. Undertake targeted research in general practice, trialling decision-making frameworks for older patients with dyspnoea. Undertake appropriate and relevant community and GP awareness campaigns about the prevalence of asthma in older people. Analyse current best practice management of asthma, including self-management and the Asthma 3+ Visit Plan, in older people

It hinges on the door: Time, spaces and identity in Australian Aboriginal Health Services

This paper explores how the structuring of places and time infl uence Aboriginal and Torres Strait Islander patient and carer experiences of health services. Face-to-face in-depth interviews were conducted with urban Aboriginal and Torres Strait Islande

Informal care and the self-management partnership: Implications for Australian health policy and practice

Objective. The Serious and Continuing Illness Policy and Practice Study (SCIPPS) aims to improve the care and support for patients with chronic illness and their family carers. Here we describe the carers' contribution to the self-management partnership and discuss the policy and practice implications that are relevant to improving the support available for informal care in Australia. Design. A secondary analysis of SCIPPS data. Fourteen carers of patients between 45 and 85 years with chronic heart failure, chronic obstructive pulmonary disease and diabetes were conveniently sampled from western Sydney and the Australian Capital Territory. Semi-structured interviews were conducted. Data were analysed using qualitative content analysis. Results. Key roles that carers perform in the self-management partnership included: home helper; lifestyle coach; advocate; technical care manager; and health information interpreter. Two negative consequences of juggling these roles included: self-neglect and conflict. Conclusions. Rigid eligibility criteria limit carers' access to essential support programs which underestimates and undervalues their contributions to the self-management partnership. Support services should focus on the development of practical skills to perform the caregiving roles. In addition, health professionals require support to work more effectively with carers to minimise the conflict that can overshadow the care and self-management partnership

Health professionals, patients and chronic illness policy: A qualitative study

Background and objective: This study investigates health professionals' reactions to patients' perceptions of health issues - a little-researched topic vital to the reform of the care of chronic illness. Methods: Focus groups were undertaken with doctors

Achieving a balanced life in the face of chronic illness

The increasing prevalence of chronic disease is a driver of health system reform in most economically advanced nations. A consistent theme within these reforms is building greater patient-centredness into the health care delivery. This study aims to develop an in-depth understanding of the experience of patients and family carers affected by chronic illness that will be the basis on which to propose policy and health system interventions that are patient-centred. Participants struggled with the ongoing tasks of balancing their lives with the increasing demands and intrusion of chronic illness. Their attempts to achieve a balance were seriously hampered by fragmented services, complexity in navigating health services, relationships with health professionals and others, and co-morbidity. Future policy directions include designing models of care and infrastructure that enable patients and their family carers to balance life and illness, and aligning patient-centred care not only within health services but also with community and social support services

Chronic kidney disease and automatic reporting of estimated glomerular filtration rate: new developments and revised recommendations

The publication of the Australasian Creatinine Consensus Working Group’s position statements in 2005 and 2007 resulted in automatic reporting of estimated glomerular filtration rate (eGFR) with requests for serum creatinine concentration in adults, facilitated the unification of units of measurement for creatinine and eGFR, and promoted the standardisation of assays. New advancements and continuing debate led the Australasian Creatinine Consensus Working Group to reconvene in 2010