Health information: where do patients obtain it and why does it matter?

While most agree that it is important for patients to have information about their health, and population based surveys of the Australian public show that General Practitioners (GPs) remain the most frequent health information source, people are increasingly exposed to health information from mainstream media sources such as the Internet and television.1,2 The quality and accuracy of that information can have a major impact on patient awareness and compliance, and in broader terms affect delivery and access to effective health care, as well as the development of health care policy.3,4 This RESEARCH ROUNDup explores recent reports about the ways in which Australians obtain health information, the quality of that information, and reviews the responsibility of GPs in responding and contributing to that information

Use of chronic disease management software in Australia

Computer based chronic disease management or clinical decision software packages are being developed partly in response to the barriers to optimal care identified by general practitioners: complexity of care regimens, administrative burden, and need for communication within multidisciplinary teams.1 The premise is that the cost of implementation may be offset by improved patient outcomes resulting in reduced complications and/or hospitalisation events. Achieving this is likely to require ongoing management and monitoring to ensure individuals receive optimal care over the long term, as well as practice support to manage the increasing numbers of patients and improve adherence to best‐practice. This RESEARCH ROUNDup summarises the latest evidence and current status of computer software use for chronic disease management in Australia

The growing burden of multimorbidity

Over the past decade the Australian government has initiated a number of health care reforms to address the needs of those with chronic conditions such as diabetes, and heart disease. However, the success of chronic care management models has not been universal. Failure to achieve care goals in some patients might be because many patients have multimorbidity. The recently established Medicare Locals may be well placed to play a central role in providing improved care for those with chronic conditions, and in particular development of management plans that take account of multimorbidity. In this RESEARCH ROUNDup we define some of the key findings central to future discussions of this issue in the Australian setting

Barriers to primary health care access—an update

The aim of this Expert Plus report is to provide a brief insight into current opinion and evidence on barriers to accessing primary health care services in Australia by people from disadvantaged groups

Generating a report card for type 2 diabetes in Australia

The National Diabetes Strategy and Action Plan proposed by Diabetes Australia, is the latest Australian initiative aimed at turning around the increasing burden of diabetes.1 Approximately 10% of all patients attending a General Practitioner (GP) in Australia have diabetes.2 An integral component of the Action plan is to establish a Commission whose responsibilities would include producing an annual report card to inform Australians of what we are doing well and where we need to do better. The aim of this RESEARCH ROUNDup is to generate a report card for diabetes type 2 based on nationally representative data

Home Medicine Reviews: Recent changes and potential implications

Earlier this year, the Pharmacy Guild of Australia announced the restructure of the Home Medicine Review (HMR) program. The new funding provision of this program requires a minimum two-year interval between each review conducted for a specific patient. Significant debate has arisen about the potential implications this will have on all stakeholders, particularly consumers, and on the incidence of medication errors and use of health care resources. The Pharmacy guild has announced that the changes will "ensure the ongoing viability" of the program and as part of this they will also work to identify patients who will most benefit from HMR services.1 This RESEARCH ROUNDup provides a brief overview of the current evidence of the benefits and limitations of HMRs and discusses cohorts of patients who might be targeted to maximise HMR benefits

Predictive risk models to identify people with chronic conditions at risk of hospitalisation

A disproportionately large percentage of health care costs and utilisation is spent on a small fraction of the population with complex and chronic conditions (Panattoni et al., 2011). It is widely agreed that effective and accessible primary health care (PHC) is central to reducing potentially avoidable hospitalisations (PAHs) associated with chronic disease. Predictive risk modelling is one method that is used to identify individuals who may be at risk of a hospitalisation event. The Predictive Risk Model (PRM) is a tool for identifying at-risk patients, so that appropriate preventive care can be provided, to avoid both exacerbation and complications of existing conditions, and acute events that may lead to hospitalisation. This Policy Issue Review identifies a selection of currently available PRMs, focusing on those applied in a PHC setting; and examines evidence of reliability in targeting patients with complex and chronic conditions

Primary health care-based programmes targeting potentially avoidable hospitalisations in vulnerable groups with chronic disease

This report reviews outcomes of intervention programmes targeting reductions in potentially avoidable hospitalisations (PAHs) and/or avoidable Emergency Department presentations (ED presentations) among people with chronic disease. The focus is on the role of primary health care and where possible programmes targeting specific vulnerable populations, namely Indigenous Australians, rural and remote residents and those at socioeconomic disadvantage. This report also aimed to examine trends in PAHs and ED presentations among people with chronic disease

The role of primary health care in primary and secondary prevention of diabetes

In Australia, diabetes represents a major burden in both human and financial terms, drawing heavily on limited health care resources including trained staff and carers. In contrast to many other health conditions, evidence suggests that many aspects of the burden imposed by diabetes could be avoided through preventive measures. Type 1 diabetes mellitus (T1DM) is a genetically linked autoimmune disease and there is currently no known prevention. However, the risk for complications associated with T1DM can be reduced by optimal management of blood glucose levels. Type 2 diabetes mellitus (T2DM) accounts for over 85 per cent of all diabetes in Australia. Obesity is a major contributor to the development of T2DM and weight loss has been shown to reduce the incidence of T2DM in people with impaired glucose tolerance (IGT). Therefore, primary prevention of T2DM has generally focused on weight loss and lifestyle interventions, while secondary prevention to reduce the risk of diabetes-related complications centres on use of pharmacotherapy in addition to diet and lifestyle interventions to manage surrogate markers of complication risk (e.g. blood glucose levels, blood pressure, and lipid levels). The aim of this research is to examine diabetes programmes reporting outcome data and used in general practice settings to identify and proactively manage individuals at high risk for developing diabetes; or where diabetes is diagnosed, at risk for development of, or deterioration in, diabetes-related complications. Comparison of programme structure with published evidence is used together with outcome data to assess programmes

Fly-in Fly-out/Drive-in Drive-out practices and health service delivery in rural areas of Australia

Many Australians have limited access to health care services due to a range of barriers including living a considerable distance from health services. Furthermore, there are significant shortages of healthcare workers in many rural and remote areas. Traditionally, many people have had to either travel long distances to access healthcare, or go without. Telehealth is an alternative approach, using telecommunications and informatioIt is recognised that rural and remote health services in Australia are in many cases challenged by a combination of inadequate facilities and insufficient staff. According to anecdotal accounts, this is further exacerbated by the demands placed on these health services by fly-in fly-out, drive-in drive-out, and bus-in bus-out workers and visitors (from here on referred to collectively as FIFO/DIDO). The focus of the current investigation was FIFO/DIDO in rural Australia involving mine workers, seasonal agricultural workers, and grey nomads. technology to supplement face-to-face delivery of healthcare services