Australian Family Physician September 2008 - Chronic Disease Management
Vol 37, (9) 689-784
The theme for the September issue of AFP
is Chronic Disease Management. This month's articles include the
management of chronic problems, the role of general practice in cancer
care, management of recurrent depression and asthma management in
general practice - a chronic disease health priority.
Chronic disease management
Jennifer Presser
Stifling a yawn is sometimes one’s first reaction to talk of
chronic disease management. While at a student tutorial the
other day, I noticed there was a definite glazing over of eyes
when the talk turned to care plans and Medicare item
numbers.
Letters to the editor
The opinions expressed by correspondents in this column are in no way endorsed by either the Editors or The Royal Australian College of General Practitioners.
The management of chronic problems
Julie O’Halloran, Christopher Harrison, Helena Britt
The BEACH program (Bettering the Evaluation and Care of
Health) shows that between April 2006 and March 2007 at
least one chronic problem was managed at 39.7% of general
practice encounters.
The role of general practice in cancer care
Geoffrey K Mitchell
The incidence of cancer is rising, so the workload of managing
cancer is increasing rapidly. Among the advances in cancer
care are advances in coordination of care, with team care being
a preferred method.
Management of recurrent depression
Cate Howell, Charlotte Marshall, Melissa Opolski, Wendy Newbury
Depression is a potentially recurring or chronic disorder. The
provision of evidence based treatment and effective practice
organisation is central to chronic disease management, and
these principles can be applied to managing depression.
Asthma management in general practice - A chronic disease health priority
Steven Rudolphy
Asthma mortality rates in Australia have declined over the past
20 years but are not low by international standards. Evidence
based guidelines such as the National Asthma Council’s Asthma
management handbook, Enhanced Primary Care financial
incentives, and practice recall infrastructure can be utilised in
general practice to manage patients with asthma.
Challenges in diabetes management
Mark Harris
Type 2 diabetes and its macro- and micro-vascular
complications are increasingly common in general practice.
Reducing the risk of adverse thrombotic events - The role of aspirin and clopidogrel
Leslie Jackowski, Nigel Stocks, Debra Rowett
Clopidogrel and aspirin both inhibit platelet aggregation, but
have differing mechanisms of action that are additive
in terms of antithrombotic function.
Assessing elderly people to drive - Practical considerations
Ilian Kamenoff
Older drivers are likely to suffer declines in functioning and a number
of health problems that may cumulatively affect driving ability. When
involved in a motor vehicle accident, elderly people are more likely to
be killed or seriously disabled than younger people.
Lessons from the TAPS study - Communication failures between hospitals and general practices
Meredith A B Makeham, Michael Mira, Michael R Kidd
The Threats to Australian Patient Safety (TAPS) study collected
648 anonymous reports about threats to patient safety from a
representative random sample of Australian general practitioners.
These contained any events the GPs felt should not have happened
and would not want to happen again, regardless of who was at fault
or the outcome of the event. This series of articles presents clinical
lessons resulting from the TAPS study.
AFP in Practice
AFP in Practice questions are designed to get you started in a small group learning (SGL) activity in your practice or with colleagues. Requirements to earn 40 Category 1 CPD points for a SGL activity are: minimum of four and a maximum of 10 people, minimum of 8 hours of discussion in a year, and at least two GPs.
Evaluation of an Australian-Irish general practice registrar exchange
Patrick Kinsella, Jean Wood
Over the past 3 years Gippsland Education and Training for
General Practice (getGP) has piloted the Irish Registrar
Exchange Program, offering general practice registrars the
opportunity to spend 3 months of their general practice
training in rural Ireland, and similarly hosting visits from Irish
registrars.
Clinical Challenge
Questions for this month's clinical challenge are based on articles in this issue. The style and scope of questions is in keeping with the MCQ of the College Fellowship exam. The quiz is endorsed by the RACGP Quality Assurance and Continuing Professional Development Program and has been allocated 4 CPD points per issue.
Indigenous Lifescripts - A tool for modifying lifestyle risk factors for chronic disease
Carole A Reeve, Stephanie De La Rue, Kristin E McBain, Shaun Solomon, Catrina Felton-Busch
A national chronic disease strategy has been described focusing on
health promotion and lifestyle change, screening and evidence based
disease management. The Lifescripts resources complement this
strategy by focusing on health promotion and lifestyle change.
Medicare Australia and the Professional Services Review Scheme
Sara Bird
Medicare Australia's Practitioner Review Program and the
Professional Services Review (PSR) Scheme aim to protect the
integrity of Medicare and pharmaceutical benefits programs by
protecting patients and the community from the risks associated
with 'inappropriate practice' and also protecting the Commonwealth
Government from having to meet the cost of services provided as a
result of inappropriate practice.
An inquiry - Aesthetics of art in hospitals
Jillian Gates
Historically, art has served a significant purpose within hospital
waiting rooms. However, in recent times we have experienced
cuts in funding and less interest in improving the aesthetic of art
displayed in Australian hospitals.
New 45–49 year health checks - GP uptake of MBS item 717
Albert Chan, Cheryl Amoroso, Mark Harris
The Medicare Benefits Schedule item 717 was introduced in
November 2006 for health checks among Australians aged 45–49
years. This study examines current data on Medicare item 717
in order to identify trends in general practitioner and patient
participation.
Journal impact factor and its importance for AFP
Mieke L van Driel, Parker J Magin, Chris B Del Mar, John Furler, Jan De Maeseneer
intro
Integrated GP and allied health care for patients with type 2 diabetes
Karen Grimmer-Somers, Wendy Dolejs, Joanne Atkinson, Anthea Worley
Integrated general practitioner and allied health chronic disease
management (CDM) has been supported by Australian Government
Medicare initiatives since 2005. Practical ways of implementing CDM
have been slow to develop.
Diabetes 'cycles of care' in general practice - Do government incentives help?
Mary Saunders, Peter Schattner, Mary Mathews
In 2001 the Australian government introduced financial incentives
to encourage general practitioners to improve their care of people
with diabetes. This article examines the extent to which GPs are
implementing the diabetes 'cycle of care' for patients, and the
barriers and enablers to its uptake.
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