None listed
Conditions
Brief summary
This is a randomised clinical trial that tests the efficacy of a general practice based intervention to enhance the role of non-GP staff including practice managers, practice nurses and receptionists in chronice diesease management in general practice in terms of its impact on the quality and outcome of care for patients with diabetes and/or ischaemic heart disease and/or hypertension. Key primary measures include an audit of medical records, 20-item patient Assessment of Chronic Illness Care (PACIC), SF-12 (v2), and practice claims of HIC patment for long consultations (Levels C & D), care plans, completed cycles of care, investigations (HbAIc, urinary micro albumin) and eye referral for diabetes and the quality of clinical care measured by clinical care interview. Secondary outcome measures include Team Climate Inventory, the Staff Roles Interview, and a practice profiling survey of practice systems for chronic disease care. These measures will be taken at baseline, 6 and 12 months from baseline.
Interventions
The Study will recruit general practices within participating Divisions of General Practice. Participating practices will be randomly allocated to intervention group (30 practices) which will receive the intervention immediately following randomisation. Study staff collecting data will be blinded. Method: Six-month intervention driven by the practice with assistance from a facilitator (from the research team). The intervention will focus on establishing practice systems and defining roles and pr
The Study will recruit general practices within participating Divisions of General Practice. Participating practices will be randomly allocated to intervention group (30 practices) which will receive the intervention immediately following randomisation. Study staff collecting data will be blinded. Method: Six-month intervention driven by the practice with assistance from a facilitator (from the research team). The intervention will focus on establishing practice systems and defining roles and procedures for non-GP staff for the management of patients with type II diabetes or ischaemic heart disease, or hypertension to ensure: evidence based care is offered; patients return for follow-up; adequate access to appointments and length of consultations or group sessions is available; regular and comprehensive assessment and monitoring is carried out; multidisciplinary care needs are identified and plans to address them are implemented; access to structured patient education sessions and patient education resources is available; appropriate referral is made; financial stability of teamwork is optimised through use of Chronic Disease Management (CDM) Medicare items. Each practice in the intervention group will receive the core intervention, consisting of education sessions, practice visits and ongoing support, with additional customisation for each practice's specific circumstances. Located in the practice, the intervention will be conducted through and with the support of the division, who will support practices beyond the intervention period to maintain the effect of the intervention. At the completion of the study, the intervention will be offered to the control practices.
Sponsors
Centre for GP Integration Studies, University of New South Wales.
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
18 Years to 79 Years
Healthy volunteers
No
Inclusion criteria
The research will take place in partnership with 10 Divisions of General Practice. All general practices that use computerised prescribing, have a minimum of 3 people working in the practice, have a practice manager and/or practice nurse role in the practice and the practice manager role is not carried out solely by a GP, are located in the participating Divisions of General Practice will be eligible for inclusion. Patients in participating practices will be eligible for inclusion in the study if they have type II diabetes and/or ischaemic heart disease and/or hypertension, and have attended the practice in the past 12 months and who have been prescribed medications commonly used to treat the above conditions.
Exclusion criteria
No exclusion criteria
Outcome results
None listed