Paving the way for research excellence

12/08/2021 Written by

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Paving the way for research excellence

The RACGP Foundation awards a suite of research grants to acknowledge excellence in general practice research each year.
Here’s we profile two of its 2021 grant recipients.

Exploring security in the GP−patient relationship: A qualitative study
‘The doctor−patient relationship is foundational to whole-person care, facilitating knowledge of the patient, trust and management.’
In a 2020 Australian Journal of General Practice article, Dr Hayley Thomas explored the doctor–patient relationship based on responses from GPs and GPs in training, reiterating that the relationship’s value is well established and improves patient adherence, satisfaction and health outcomes.
Dr Thomas became interested in the ‘unique nature’ of the GP−patient relationship and how they are cultivated. This formed the impetus for her new project, recently awarded the RACGP Foundation Family Medical Care Education and Research Grant as part of the 2021 round of RACGP Foundation grants.
‘Patients particularly value continuous personal relationships with their GP when they are experiencing vulnerability, such as being seriously unwell or experiencing psychiatric or family problems,’ Dr Thomas said.
‘Some researchers have suggested that this may be explained by our human tendency to seek safety in secure relationships when we are threatened. It is well accepted that supportive doctor−patient relationships can have healing value, particularly in these types of circumstances. 
‘The way we connect with our patients is fundamental to high-quality general practice, now more than ever.’

Dr Thomas’ project will focus on consumerist models of primary care and the reduction in GP−patient contact and continuity, which she believes has resulted in GPs identifying the need for a push for relationship-based care.

‘Concerns have been voiced for some time that an increasingly consumerist model of primary care and systems changes that reduce GP−patient continuity may threaten [that] relationship,’ she said.
‘This has resulted in calls from GPs to advocate for relationship-based care. This research is particularly relevant in this context.’
Dr Thomas believes her team’s research is also timely in the context of primary health system reforms, highlighting that the definition of strong GP−patient relationships is expected to assist in advocating for health systems ‘that are consistent with GPs’ sense that a consumer model should not be expected to yield the full benefits of healing primary care relationships’.
‘It could also underpin future research on whether patients develop attachments to a “practice” or “team” and whether the relationship is similar to other health professional−patient relationships: important questions in the context of current moves towards team-based care,’ she said.
GPs’ knowledge, utilisation of resources and guidelines in understanding prescribing issues with psychotropic medication use in pregnancy and breastfeeding: A mixed-methods study
Dr Jacqueline Frayne is a GP and senior lecturer in general practice at the University of Western Australia. She knows understands the pros and cons of the use of psychotropic medication for pregnant and breastfeeding women.
‘I work in an antenatal clinic for women with severe mental illnesses at the women’s hospital in Perth, and therefore recognise the challenges and impact – both positive and negative − that the prescribing of psychotropic medication can have during this time,’ Dr Frayne said.
‘Additionally, in my general practice I see many women who struggle with the decision-making process regarding the use of medication in pregnancy, and believe that information they receive outlining the best available evidence and discussing the associated risk and benefits helps.’
Dr Frayne research team received the Therapeutic Guidelines Limited (TGL)/RACGP Foundation Research Grant 2021 for a project that explores the role of GPs in prescribing psychotropic medications for women who are pregnant or breastfeeding.
The goal is to improve outcomes for these women and their babies and to guide GPs in what Dr Frayne describes as a ‘complex area’.
According to Dr Frayne, as the prescribing of psychotropic medications is more frequent, the role of GPs in managing these situations within their communities becomes ‘increasingly important’. Equally important is identifying the diversity of GPs’ knowledge and patients’ situations.
‘The research will [also] bring many challenges, including the vast range in clinicians’ experience and knowledge, and access to care and services for women varied throughout Australia,’ she said.
The full list of 2021 RACGP Foundation Grant recipients is available on the RACGP website, and more detailed profiles of Dr Hayley Thomas and Dr Jacqueline Frayne are available on newsGP.
The RACGP Foundation would like to thank funding partners Therapeutic Guidelines, HCF Research Foundation and Diabetes Australia for their ongoing support for general practice research.
They’re are grateful for the generosity of Medibank Better Health Foundation and the RACGP, as well as donations made by Sonic Healthcare, RACGP members and family, friends, colleagues and patients of Dr Harry Nespolon for funding the inaugural RACGP Foundation Harry Nespolon Grant. Donations can be made via mycause.

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