SCHOOL OF MEDICINE AND DENTISTRY
JAMES COOK UNIVERSITY
Jennifer Chamberlain-Salaun
PHCRED RDP Fellow
P: +61 7 4057 5778
E: jennifer.chamberlainsalaun@jcu.edu.au
Through the JCU-PHCRED Research Development Program I have received funding to investigate how clients with mental health illnesses are managed in the general practice setting.
In November 2006, the Australian Government Department of Health and Ageing introduced the Better Access to Mental Health Care initiativewhichincluded streamlining general practitioner referrals to clinical psychologists, psychiatrists and other allied mental health professionals (Australian General Practice Network, 2007). The Better Access initiative also introduced new MBS item numbers which general practitioners could claim for the management of clients with mental health illnesses. Whilst this initiative provides a mechanism for the provision of multi-disciplinary comprehensive mental health care in a general practice setting (Dunbar, Hickie, Wakeman, & Reddy, 2007) there is a gap in the literature that documents innovations in processes and skill mix in a way that others can learn from. This project plans to address this gap and identify strategies used in general practice that maximise outcomes for clients with mental health illnesses and resources utilisation, with a particular emphasis on the management of recall systems and teamwork.
Participants in the study are general practitioners and the teams that they work with in their practice. Data is in the process of being collected from participants in relation to their use of mental health MBS items numbers 2710 and 2712 during the period 1 January - 31 December 2008. Following descriptive statistical analysis of that data, semi-structured interviews with participants will be conducted and a descriptive exploration of interview responses undertaken.
Findings from this study will be widely disseminated to others through peer reviewed journal articles. Recommendations will inform participants, community groups and government about grassroots strategies that support the delivery of comprehensive mental health care in the general practice setting.
References
Australian General Practice Network. (2007). Better Access Initiative Orientation Manual (pp.69): Australian General Practice Network.
Dunbar J, Hickie I, Wakerman J, & Reddy P. (2007). New Money for mental health: will it make things better for rural and remote Australia? Medical Journal of Australia, 186 (11), 587-589.
SCHOOL OF PRIMARY HEALTH CARE
 MONASH UNIVERSITY
Shane Thomas
Professor of Primary Health Care Research
P: +61 3 8575 2245
E: shane.thomas@med.monash.edu.au
International research in chronic illness management
In Australia we have previously collaborated with clinical agencies on research using motivational interviewing to effect sustained positive changes in people with chronic illness. Recently we have been working in China to establish linked research in this area.
 The Happy Life Club is an initiative that uses clinical coaches to help patients better manage their chronic illness using a motivational interviewing framework in key target health behaviours. The Club involves Chinese adults aged over 50 with diabetes in Fangzhuang in the Fengtai District Beijing. The Happy Life Club clinical program is led by Dr Zhi Xin Li. Dr Helen Lindner from the Australian Psychological Society has led the coach training with Dr Yang Hui and Anna Chapman from Monash. The research is led by Professor Colette Browning with Professor Shane Thomas from Monash and Professor Tuohong Zhang from Peking University. The intervention is being delivered by 21 coaches who are experienced clinicians trained by us in Beijing.
In the Happy Life Club, key health actions have been targeted including: diet, alcohol, weight loss, physical activity, smoking, stress, health monitoring and medication adherence. Half the patients will immediately participate in the program and half will enter the program in six months time. The intervention takes place for one year with monitoring for another year. Other groups receiving standard current treatments are monitored. The next study cohort will include people with cardiovascular diseases.
Monash and Peking University academics are conducting research in the Happy Life Club to study the program effectiveness and predictors of successful management. An enhanced 'Framingham' data set with Quality of Life, stages of change and other behavioural data is collected using international standardised tools. The data are collected pre-program, at three months, six months, 12 months and two years following program entry.
UNIVERSITY DEPARTMENT OF RURAL HEALTH NORTHERN NSW
UNIVERSTIY OF NEWCASTLE
Judy Coates
Physiotherapist, RDP Fellow
E: judy.crebert@hnehealth.nsw.gov.au
Sally Moy
Dietician, RDP Fellow
E: sally.moy@hnehealth.nsw.gov.au
Introducing two Hunter New England Area Health Service (HNEAHS) clinicians who have started research projects as RDP research fellows at the University Department of Rural Health Northern NSW.
 Judy Coates: a Registered Physiotherapist working for the Transitional Aged Care Program (TACP) has a strong interest in developing and implementing preventative strategies for health issues aimed at “wellness” and her role has a strong focus on falls prevention in the elderly.
Judy became aware that while the TACP has provided services to more than 200 clients none have been of Aboriginal background. She began searching for more information that may provide insight into the falls risk for Indigenous elderly populations; to determine whether there is a problem with falls risk in this population group; what is associated with the risk and when that falls risk may occur. The long-term goal from this and possible on-going research is to develop a suitable falls prevention service specific to the elderly Indigenous population group.
Sally Moy: a Dietician, has developed a keen interest in the treatment of patients with eating disorders and is undertaking a literature review to determine if there are any best practice models of care for treating eating disorder patients in rural areas.
The aim of Sally’s research is to determine the health outcomes of eating disorder patients who have received dietetic treatment at Tamworth Rural Referral Hospital (TRRH). A retrospective review of medical records over the past five years will determine health outcomes compared to identified best practice goals.
Sally hopes to find out if patients treated for an eating disorder by the dietetics department at TRRH have positive health outcomes consistent with best practice. It is hypothesised that patients who are involved in a multi-disciplinary approach to treatment will have more positive health outcomes.
SCHOOL OF MEDICINE
 UNIVERSITY OF NOTRE DAME
A/Prof Tom Brett
Assoc Prof and Director, General Practice and Primary Health Care Research Unit
P: +61 8 9433 0571
E: tbrett@nd.edu.au
Consumer Health Forums
The Notre Dame Fremantle PHCRED team has been exploring consumer experiences of participating in the Fremantle Primary Prevention study into risk factor modification for cardiovascular disease. The recently completed fieldwork was undertaken at three WA general practices and involved 1200 men and women.
 To assess participants’ experiences in the study, consumer health forums were held at each of the three sites. The forums were attended by over 150 consumers and their feedback was much appreciated by the Notre Dame General Practice and Primary Health Care research team. Consumers’ interest in and suggestions for future primary health care research studies were also canvassed during the forums. The diversity of suggestions and motivating factors supporting their engagement in the research process provided valuable consumer input and helps Notre Dame access a broader range of views for planning and developing future research strategies.
RDP fellowships
This year the Notre Dame focus has been to encourage medical student interest in primary health care research. Second year graduate entry medical student, James Runciman, is using his fellowship to explore knowledge of and attitudes to radiation dosage for commonly ordered X-rays and CT scans among local general practitioners. Third year students Tharsa Thillainadesan and James Haridy are using their fellowships to explore patients’ views of the role of practice nurses in the primary care setting. This exposure to ‘hands-on’ research projects under the supervision of the PHCRED team has proved very successful in enhancing the profile of general practice and its potential to medical and nursing students.
Indigenous researcher, Erica Spry, has been awarded a RDP fellowship for her ongoing research work at the Nulungu Centre for Indigenous Studies at the Notre Dame Broome campus where she also receives valuable support from local academics, Prof Lyn Henderson-Yates and Mr Steve Kinnane. It is hoped that further primary care research collaborations between Notre Dame’s Fremantle and Broome campuses will be developed and strengthened in future years.
 DISCIPLINE OF GENERAL PRACTICE
UNIVERSITY OF NEWCASTLE
Debbie Mutton
PHCRED Administration Assistant
P: +61 2 4968 6724
E: Debbie.mutton@newcastle.edu.au
The PHCRED Program at the Discipline of General Practice has appointed two RDP fellows, Simon Morgan and Se Ok Ohr, for 2009.
Simon Morgan: I moved down to Newcastle in July last year after 13 years in the wilderness – a decade in the Northern Territory and a few years in north-west Ireland. I am a GP and Medical Educator, and have worked in medical student, junior doctor, GP registrar, International Medical Graduate and supervisor training. I am currently working as a Medical Educator with GP Training Valley to Coast, the regional GP training provider, with a particular interest in Indigenous Health and population health.
 Through the Discipline, I am undertaking a research project to investigate the content of clinical encounters by GP registrars during their training. The methodology is similar to the well known BEACH study of Australian general practice activity, but differs in its longitudinal nature and direct link to education. The project will inform our approach to vocational training ie. curriculum development and individual learning plans, act as a quality improvement resource, and provide a platform for a range of other research activities.
Se Ok Ohr: I am a Korean born registered nurse working as a Multicultural Health Liaison Officer with Hunter New England Health. I have two beautiful daughters and a husband who is very supportive of my research activities. I am enrolled part-time in a Research Masters at the School of Nursing and Midwifery at the University of Newcastle. My research topic is the experiences of Korean nurses and Australian nurses working together within an Australian health care system. With great support from staff of the Discipline, I am working on a research proposal. I must say “thanks” for giving a great start and an opportunity for me to improve my research skills. In my spare time, I manage the Newcastle Korean Language School (voluntary job), learn Chinese calligraphy and Pilates. My motto is “I will be happy”.
 COMBINED UNIVERSITIES CENTRE FOR RURAL HEALTH
Lyn Brun
Statewide PHCRED WA coordinator
P: +61 8 9956 0200
E: lynb@cucrh.uwa.edu.au
We are pleased to announce the following 2009 recipients of the Researcher Development Program (RDP) fellowship funding.
The University of Western Australia
 Dr Helen Wilcox, General Practitioner and Senior Lecturer at the School of Primary, Aboriginal and Rural Health Care. She will be continuing research into a topic she received a bursary for in 2008 - A prospective audit investigating current use of troponin testing by general practitioners in Western Australia and the effect of this testing on patient management together with the outcomes for those patients.
Andrew Webster, an undergraduate medical student. He is undertaking research into understanding symptom appraisal delay in rural cancer patients. This project will form part of a larger body of research, Improving Rural Cancer Outcomes (IRCO).
Dr Lucy Anne Gilkes, General Practitioner and Senior Lecturer in General Practice aims to establish whether a system of regular clinical audit in general practice can improve quality of care.
Combined Universities Centre for Rural Health
As part of the PHCRED program, the Combined Universities Centre for Rural Health (CUCRH), awards a number of mini-fellowships to those interested in developing their research interests in primary health care.
Courtney Gayfer, a high school teacher is undertaking an evaluation of the “Choose Respect” initiative. This program has been running for two years. Analysis of student behaviour reports and interviews with teachers will provide evidence on the outcomes of this innovative program.
CUCRH in conjunction with WA Country Health Service (WACHS) are developing collaborative fellowships to build capacity with Allied Health Professionals (AHP). The AHP reference group of WACHS and CUCRH has developed research priorities and are now working to identify a specific project for the first of these fellowships to be conducted with a group of AHP staff across WA.
DEPARTMENT OF GENERAL PRACTICE
 UNIVERSITY OF MELBOURNE
Dr Meredith Temple Smith
PHCRED Coordinator
Research Training Coordinator
P: +61 3 8344 3371
E: m.temple-smith@unimelb.edu.au
A GP: every primary care research project should have one!
The majority of primary care research which is conducted through the Department of General Practice relies on the interest and goodwill of both primary care staff and patients. Usually participants are recruited through individual general practices and at least part of the data collection needs to occur at the practice level. Increasingly, practices are recruited through VicReN, our practice-based research network which has been established using PHCRED funding. The development of VicReN has provided an opportunity for us to consider how to formalise an important but often previously unrecognised research team role which is significant to the success of a primary care research study. In addition to the involvement of an Academic GP as a Chief or Associate investigator, a key member of the research team is the general practitioner adviser and/or practice nurse adviser. This role is vital in assisting researchers to develop and refine the study protocol and ensure that the research can be placed in general practices with the least possible impact on the daily activity of the practice.
 GP, Dr Cathy Hutton has worked as GP Adviser on the HopSCOTCH project since mid 2008. This project, run through the Royal Children’s Hospital, Melbourne, aims to develop, implement and trial an innovative shared-care approach to the management of child obesity that is acceptable to GPs, parents and obesity specialists. Having a practicing GP as part of the project team means she intimately knows about the way research is and can be conducted through general practice, as well as how overweight children are currently being managed. Her ongoing input is vital to develop and refine the intervention and ensure that it is best placed to be integrated into the way that GPs work.
|
print version
email this page
