Australian journal of primary health
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Multicenter Study
Dementia: opportunities for risk reduction and early detection in general practice.
This project aimed to measure general practitioner (GP), practice nurse and patient health literacy about memory problems, dementia and its risk factors. Data were collected from general practices across Australia and a smaller sample in England. Questionnaires explored sources and adequacy of dementia knowledge and a randomised controlled trial tested the intervention of a dementia risk reduction pamphlet on patient knowledge of dementia risk reduction strategies. ⋯ The frequency of documentation of Mini-Mental State Examination and dementia diagnosis in computerised medical records of patients over 75 years was less than 0.01. These results demonstrate that many adult patients attending GPs have memory concerns, associate dementia with memory loss, and are receptive to information about dementia risk reduction. Most general practitioners and their nurses rate their dementia knowledge as inadequate with few testing for memory problems or discussing dementia with their patients.
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Recruiting general practitioners to take part in research in primary care is important and challenging. This paper describes the process, barriers and achievements experienced by a research team whilst recruiting Divisions and general practitioners (GPs)/practices into a project related to management of obesity in children, which used Breakthrough Series methodology in the intervention arm. The research team chose to recruit GPs through Divisions of General Practice, because of the existing positive relationship between the research team and the Divisions, and the Divisions' positive relationships with the GPs/practices in their area. ⋯ Reflection on recruitment failure focussed on reasons from the perspective of Divisions, GPs, other projects using the Breakthrough Series methodology with a chronic disease focus and other projects conducted in Australia where the focus was childhood obesity. The results showed that even Divisions who were enthusiastic about joining a project may be unable to recruit sufficient GPs and practices, for reasons including staff changeover and GP reluctance. Caution is suggested when setting recruitment targets where the condition is sensitive, is not the presenting problem, is not routinely tackled in general practice, involves minors, where treatment is perceived to be of doubtful effectiveness, or where major government policies may need to be considered.
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The Australian general practitioner (GP) workforce, especially younger generation GPs and female GPs, increasingly prioritises work-life balance (WLB). Good WLB is associated with decreased interest of medical students in general practice as a speciality choice as well as good health and wellbeing, and decisions of GPs to retire early. Therefore, understanding the role played by different factors in achieving WLB is crucial to ensure a sufficient GP workforce necessary to meet the rising demands of health care. ⋯ Several factors relating to family and social circumstances were not significantly associated with WLB of GPs in this study. Only half of the GP workforce reported good WLB. Flexibility of work hours, opportunities for leisure activities and good health of GPs have the potential to enhance the WLB and hence promote greater GP participation in the workforce.
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Chronic diseases require a multidisciplinary approach to provide patients with optimal care in general practice. This often involves general practitioners (GPs) referring their patients to allied health professionals (AHPs). The Team-link study explored the impact of an intervention to enhance working relationships between GPs and AHPs in general practice regarding the management of two chronic diseases: diabetes and ischaemic heart disease (IHD) or hypertension. ⋯ There were no changes in AHP measure. This study demonstrates that the instrument is sensitive to differences between providers and conditions and is sensitive to change over time following an intervention. There were few associations with the other measures suggesting that the MoML might assess other aspects of teamwork involving practitioners who are not collocated or in the same organisation.
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General practice is an ideal setting to be providing nutrition advice; however, it is important that the role of general practitioners (GPs) and practice nurses in providing nutrition advice is acknowledged and defined. This article aims to discuss the role of GPs and practice nurses in the delivery of nutrition advice. Ten general practitioners and 12 practice nurses from a NSW urban Division of General Practice participated in questionnaires and a Lifescripts implementation study, as well as their consenting patients receiving Lifescripts (n=13). ⋯ The provision of basic nutrition advice is acknowledged to be part of the role of GPs and practice nurses, as they are the first point of contact for patients, allowing them to raise nutrition awareness. However, it is important that this advice is evidence based and able to be delivered in a time-efficient manner. Increased nutrition education and the availability of appropriate resources and nutrition-related best practice guidelines will assist in this process.