Validity of prescribing indicators for assessing quality of antibiotic use in Australian general practice

2016 ◽  
Vol 25 (1) ◽  
pp. 66-74
Author(s):  
Lisa G. Pont ◽  
Tessa K. Morgan ◽  
Margaret Williamson ◽  
Flora M. Haaijer ◽  
Mieke L. van Driel
Keyword(s):  
General Practice ◽  
Antibiotic Use ◽  
Prescribing Indicators ◽  
Australian General Practice

scholarly journals Updating and validating quality prescribing indicators for use in Australian general practice

2020 ◽  
Vol 26 (1) ◽  
pp. 31
Author(s):  
Cuu Phuong Linh Dang ◽  
Li Shean Toh ◽  
Nick Cooling ◽  
Shane Jackson ◽  
Colin Curtain ◽  
...  
Keyword(s):  
General Practice ◽  
Delphi Technique ◽  
Online Survey ◽  
Delphi Panel ◽  
Medicines Management ◽  
Group Discussions ◽  
Prescribing Indicators ◽  
Australian General Practice ◽  
Two Phases ◽  
Quality Prescribing Indicators

This study aims to update and validate quality prescribing indicators (QPIs) for Australian general practice. The study comprised two phases: (1) developing preliminary potential QPIs based on the 2006 National Prescribing Service (NPS) MedicineWise indicators, published literature, international indicators and guidelines, and through qualitative focus group discussions; and (2) validating the proposed QPIs through a two-round online survey using the Delphi technique. The Delphi panel included four GPs, four pharmacists and two clinical pharmacologists. The Delphi panel rated the potential QPIs for their validity, importance and feasibility using a 1–10 Likert scale. In round one, all proposed QPIs presented as ‘prescribing rules’ achieved high scores regarding validity, importance and feasibility No rule was eliminated and three new rules were introduced. Rules were reworded into ‘prescribing indicators’ for round two, which resulted in 35 indicators being accepted and two indicators being eliminated. The final QPIs also include seven drug–drug interactions, which received high scores in round one. In conclusion, 42 QPIs were nominated for use in Australian general practice, based on their validity, importance and feasibility. If implemented, these QPIs have the potential to assist in efforts to improve the quality and safety of medicines management.

Outcomes and opportunities: a nurse-led model of chronic disease management in Australian general practice

2013 ◽  
Vol 19 (2) ◽  
pp. 150 ◽  
Author(s):  
Diann S. Eley ◽  
Elizabeth Patterson ◽  
Jacqui Young ◽  
Paul P. Fahey ◽  
Chris B. Del Mar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
General Practice ◽  
Chronic Disease ◽  
Disease Management ◽  
Chronic Disease Management ◽  
Models Of Care ◽  
Practice Nurses ◽  
Australian General Practice ◽  
General Practices

The Australian government’s commitment to health service reform has placed general practice at the centre of its agenda to manage chronic disease. Concerns about the capacity of GPs to meet the growing chronic disease burden has stimulated the implementation and testing of new models of care that better utilise practice nurses (PN). This paper reports on a mixed-methods study nested within a larger study that trialled the feasibility and acceptability of a new model of nurse-led chronic disease management in three general practices. Patients over 18 years of age with type 2 diabetes, hypertension or stable ischaemic heart disease were randomised into PN-led or usual GP-led care. Primary outcomes were self-reported quality of life and perceptions of the model’s feasibility and acceptability from the perspective of patients and GPs. Over the 12-month study quality of life decreased but the trend between groups was not statistically different. Qualitative data indicate that the PN-led model was acceptable and feasible to GPs and patients. It is possible to extend the scope of PN care to lead the routine clinical management of patients’ stable chronic diseases. All GPs identified significant advantages to the model and elected to continue with the PN-led care after our study concluded.

scholarly journals Effect of Health Literacy on Quality of Life amongst Patients with Ischaemic Heart Disease in Australian General Practice

PLoS ONE ◽  
2016 ◽  
Vol 11 (3) ◽  
pp. e0151079 ◽  
Author(s):  
David Alejandro González-Chica ◽  
Zandile Mnisi ◽  
Jodie Avery ◽  
Katherine Duszynski ◽  
Jenny Doust ◽  
...  
Keyword(s):  
Quality Of Life ◽  
General Practice ◽  
Heart Disease ◽  
Health Literacy ◽  
Ischaemic Heart Disease ◽  
Australian General Practice

scholarly journals An Observational Study of Gout Prevalence and Quality of Care in a National Australian General Practice Population

2015 ◽  
Vol 42 (9) ◽  
pp. 1702-1707 ◽  
Author(s):  
Philip C. Robinson ◽  
William J. Taylor ◽  
Nicola Dalbeth
Keyword(s):  
General Practice ◽  
Quality Of Care ◽  
Point Of Care ◽  
Serum Urate ◽  
Practice Population ◽  
Australian General Practice ◽  
General Practices ◽  
Low Levels ◽  
Crude Prevalence

Objective.The central strategy for effective gout management is longterm urate-lowering therapy to maintain the serum urate at a level below 0.36 mmol/l. We sought to determine the prevalence of gout and the quality of care in a national Australian general practice population.Methods.Data were from general practice point-of-care electronic records over a 5-year period (n = 1,479,449). Information was collected on patients with gout according to a validated definition. All patients who visited the same general practices over the study period formed the denominator group. We determined the estimated prevalence of gout, the frequency of allopurinol prescription, and serum urate testing, and the percentage of patients achieving a target serum urate level.Results.The crude prevalence of gout in this general practice population was 1.54% (95% CI 1.52–1.56). Prevalence in men was 2.67% and in women 0.53%. Prevalence increased with age in both men and women (4.90%, 95% CI 4.82–4.99, in men > 65 yrs). Allopurinol was prescribed to 57% of patients with gout during the 5 years of the study. Only 55% of patients with gout had their serum urate tested at any time during the 5-year study period. A target serum urate concentration of < 0.36 mmol/l at any time during the 5-year study period was documented in 22.4% of all people with gout.Conclusion.Gout is managed poorly in Australian primary care, with low levels of allopurinol prescribing and serum urate testing. Collectively, these factors probably contribute to low achievement of serum urate targets.

scholarly journals Quality of the Diagnostic Process, Treatment Decision, and Predictors for Antibiotic Use in General Practice for Nursing Home Residents with Suspected Urinary Tract Infection

Antibiotics ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 316
Author(s):  
Stine Dyhl Sommer-Larsen ◽  
Sif Helene Arnold ◽  
Anne Holm ◽  
Julie Aamand Olesen ◽  
Gloria Cordoba
Keyword(s):  
General Practice ◽  
Nursing Home ◽  
Urinary Tract ◽  
Urine Culture ◽  
Treatment Decision ◽  
Antibiotic Use ◽  
Diagnostic Process ◽  
Urinary Tract Symptoms ◽  
Tract Infections

Urinary tract infections (UTIs) are common in nursing home (NH) residents and Denmark is one of the countries with the highest antibiotic use in NHs. The aim of this study was to assess the quality of the diagnostic process and treatment decision on the day of the first contact from NHs to general practice and assess predictors for prescription of antibiotics in NH residents without an indwelling urinary catheter. The study was a prospective observational study in general practice in the Capital Region of Denmark; 490 patients were included; 158 out of 394 (40.1%, 95% CI 35; 45) patients with suspected UTI had urinary tract symptoms; 270 out of 296 (91.2%, 95% CI 87; 94) patients without urinary tract symptoms had a urine culture performed. Performing urine culture in the general practice was inversely associated to prescription of antibiotics on day one (OR 0.27, 95% CI 0.13; 0.56). It is imperative to support the implementation of interventions aimed at improving the quality of the diagnostic process on day one, as less than half of the patients given the diagnosis “suspected UTI” had urinary tract symptoms, and most patients without urinary tract symptoms had a urine culture performed.

Propionibacterium acnes (P. acnes) resistance and antibiotic use in patients attending Australian general practice

2012 ◽  
Vol 53 (2) ◽  
pp. 106-111 ◽  
Author(s):  
Helen Toyne ◽  
Cameron Webber ◽  
Peter Collignon ◽  
Kathryn Dwan ◽  
Marjan Kljakovic
Keyword(s):  
General Practice ◽  
Propionibacterium Acnes ◽  
Antibiotic Use ◽  
Australian General Practice

scholarly journals Exploring patients’ understanding of antibiotic resistance and how this may influence attitudes towards antibiotic use for acute respiratory infections: a qualitative study in Australian general practice

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e026735 ◽  
Author(s):  
Mina Bakhit ◽  
Chris Del Mar ◽  
Elizabeth Gibson ◽  
Tammy Hoffmann
Keyword(s):  
General Practice ◽  
Antibiotic Resistance ◽  
Respiratory Infections ◽  
Antibiotic Use ◽  
Acute Respiratory Infections ◽  
Semistructured Interview ◽  
Child Patients ◽  
Close Proximity ◽  
Australian General Practice ◽  
The Individual

ObjectivesTo explore patients’ or parents of child patients’ understanding of antibiotic resistance and aspects of resistance such as resistance reversibility and its spread among those in close proximity, along with how this may influence attitudes towards antibiotic use for acute respiratory infections (ARIs).DesignQualitative semistructured interview study using convenience sampling and thematic analysis by two researchers independently.SettingGeneral practices in Gold Coast, Australia.Participants32 patients or parents of child patients presenting to general practice with an ARI.ResultsFive themes emerged: (1) antibiotic use is seen as the main cause of antibiotic resistance, but what it is that becomes resistant is poorly understood; (2) resistance is perceived as a future ‘big problem’ for the community, with little appreciation of the individual impact of or contribution to it; (3) poor awareness that resistance can spread between family members but concern that it can; (4) low awareness that resistance can decay with time and variable impact of this knowledge on attitudes towards future antibiotic use and (5) antibiotics are perceived as sometimes necessary, with some awareness and consideration of their harms.ConclusionsPatients’ or parents of child patients’ understanding of antibiotic resistance and aspects of it was poor. Targeting misunderstandings about resistance in public health messages and clinical consultations should be considered as part of a strategy to improve knowledge about it, which may encourage more consideration about antibiotic use for illnesses such as ARIs.

Utilization of the CARDIAB®™ database system to promote quality of care in Australian general practice

2004 ◽  
Vol 10 (3) ◽  
pp. 177-184 ◽  
Author(s):  
Joan R. Burns ◽  
Mary-Ann Bonney ◽  
P. Gawaine Powell Davies ◽  
Mark F. Harris
Keyword(s):  
General Practice ◽  
Quality Of Care ◽  
Database System ◽  
Australian General Practice
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