The focus of this study is to develop innovative and evidence based strategies for implementation with both health care providers and consumers.

Project Short Title

Preventive Evidence into Practice Study (PEP)

Project Number

RM07397

Project Status

Completed Projects

Chief Investigators

Mark Harris, Nick Zwar, John Litt, Danielle Mazza, Mieke van Driel, Richard Taylor, Grant Russell, Josephine Raw, Justine Waters, Jinty Wilson, Gawaine Powell Davies

Associate Investigators

Chris Del Mar, Jane Lloyd, Elizabeth Denny-Wilson, Barbara Booth, Suzanne McKenzie, Jane Smith, Upali Jayasinghe

Other Team Members

Sharon Parker

Rationale

There is no shortage of guidelines to assist general practitioners to work with their patients to prevent chronic disease. However, are these guidelines implemented in practice? A dynamic partnership has been formed to answer that question. The partnership is between the University of New South Wales Centre for Primary Health Care and Equity (CPHCE), the Royal Australian College of General Practitioners (RACGP), the National Heart Foundation of Australia (NHFA), the MBF Foundation, the Flinders University, Monash University, and Bond University. This partnership will develop innovative and evidence based strategies for implementation with both health care providers and consumers.

Aims

This study aims to implement the evidence for preventing chronic disease into practice by identifying the barriers and facilitators of organisational change and developing and evaluating an innovative and flexible model for guideline implementation. The study is funded by the partners and the National Health and Medical Research Council, through their Partnership Grants Program.


The specific objectives of this study are to:

  • Assess current GP practice in the prevention of chronic disease for patients aged 40−69 years.
  • Determine the factors affecting the implementation of these guidelines in general practice.
  • Identify the specific resources, approaches and capacity required for preventing chronic disease among general practice patients living in areas of socio−economic advantage/disadvantage.
  • To develop a response implementation strategy (building upon the RACGP implementation of prevention guidelines), suitable for application in a variety of Australian general practice settings, that is designed to improve implementation of the guidelines.
  • Trial and evaluate the application and effectiveness of this strategy in general practice across four divisions of general practice.

Design and Method

There are four phases to this project:


Phase 1 Assessing current practice
Phase 1 includes interviews with GPs, practices staff, patients and key stakeholders to identify barriers and enablers to preventive care and how barriers might be overcome. Additionally, an audit of clinical records will be conducted to determine current levels of activities related to the assessment and prevention of chronic disease.

Phase 2: Developing and piloting a strategy for implementation
Based on findings from phase 1, an implementation model will be developed and trailed in phase 2. This will include a workshop with general practice staff, Divisions of General Practice, local community health services and consumers.

Phase 3: Evaluating implementation in four Divisions of General Practice
Phase 3 will include a cluster randomised controlled trial to evaluate the effectiveness of the strategy in improving the implementation of the guidelines. 32 general practices from four Divisions of General Practice (in NSW, Vic, Qld, SA) will be recruited to this phase of the study. After baseline data collection has been completed, practices will be randomised to receive the intervention immediately, or after 12 months. For the evaluation of the trial, a survey will be conducted with GPs, practice nurses and patients before and after the intervention. A clinical audit will determine changes in preventive care activities between baseline and 12 months. To evaluate the implementation process qualitative interviews and focus groups will be conducted and field observation notes will be collected.

Phase 4: Evaluation, dissemination and uptake of findings
The project management committee, which includes representatives from all partner organisations and all chief investigators, provides the structure through which the evaluation and dissemination of findings will be coordinated.

Contact

Sharon Parker Email: sharon.parker@unsw.edu.au

Key Partners

RACGP, NHFA, MBF

Funding

NHMRC

Project lead centre
CPHCE
Project stream
Prevention and Management of Long Term Conditions
Project start date
2010
Project end date
2013