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Biomedical subjects

Helena Britt

Publications and source records attributed to Helena Britt.

At least 19 recordsLinked to original sources
PubMed2006

Extent and utilisation of computerisation in Australian general practice.

OBJECTIVE: To assess the availability of computers to general practitioners and individual GPs' use of computers for clinical functions. DESIGN, SETTING AND PARTICIPANTS: A secondary analysis of data from a random sample of 1319 Australian GPs who participated in the Bettering the Evaluation and Care of Health (BEACH) survey, a continuous cross-sectional survey of general practice activity, between November 2003 and March 2005. Participants reported the availability of computers at their major practice address and the clinical functions for which they used the computers. MAIN OUTCOME MEASURES: Proportion of practices with computers available; proportion of individual GPs who used computers for clinical purposes. RESULTS: The proportion of GPs not using a computer was 11.2% (6% did not have a computer at their major practice address and a further 5.2% chose not to use an available computer). The majority of GPs using a computer at work used it for electronic prescribing (94.7%), ordering tests (82.2%) and keeping some patient data in an electronic medical record (79.5%). Of those with clinical software available (n = 1114), 6.6% chose not to use it. A third of GPs (32.8%) kept all patient information in an electronic format. The proportion of GPs keeping all data electronically and using all clinical functions available in their computer was 21.7%. CONCLUSION: While the physical presence of computers has increased significantly over the past decade, GPs are still reluctant to fully embrace the technology.

Attitude of Health Personnel↗
PubMed2006

The independent effect of age of general practitioner on clinical practice.

OBJECTIVE: To establish the extent to which general practitioner age alone explains variations in patient morbidity and treatment patterns. SETTING: An on-going, national survey of general practice activity in Australia. PARTICIPANTS: A random sample of 5013 GPs with a minimum of 375 general practice Medicare items claimed in the previous 3 months. Each GP contributed details of 100 consecutive encounters, with about 1000 GPs sampled each year between 1998 and 2003. MAIN OUTCOME MEASURES: Effect of practitioner age on GP activity after removing the influence of measured confounding factors: doctor, patient and practice characteristics; number of problems; and morbidity managed at encounters. RESULTS: GP age played a significant role in practice style. In comparison with young GPs (< 35 years), older GPs provided more home visits (P < 0.001) and attendances at residential aged-care facilities (P = 0.044); were more likely to manage chronic problems (P < 0.001); had higher prescribing rates (P < 0.001), and lower rates of pathology ordering (P < 0.001) and non-pharmacological treatments (P < 0.001). Individual body system management rates also differed significantly between younger and older GPs. CONCLUSION: A GP's age plays a significant role in determining practice style. Our results have implications in terms of the ageing GP population and in the wider context of the ageing medical labour force.

Adult↗
PubMed2006

Antibiotic prescribing in Australian general practice: how has it changed from 1990-91 to 2002-03?

There is increasing evidence that antibiotics have limited value for many respiratory illnesses. This study investigates changes in overall antibiotic prescribing rates, and rates for specific conditions, by Australian general practitioners (GPs) between 1990-91 and 2002-03. This is a comparative study of two cross-sectional surveys of general practice activity, the Australian Morbidity and Treatment Survey (AMTS) 1990-91 and Bettering Evaluation and Care of Health (BEACH) 2002-03. Both studies used random samples of GPs, each providing data about a cluster of patient encounters. Outcome measures are the antibiotic prescribing rate per 100 encounters or per 100 selected problems managed. Between 1990-91 and 2002-03, the overall antibiotic prescribing rate decreased 24.3% from 18.9 prescriptions per 100 encounters to 14.3 (P<0.001). For children, the decrease for acute upper respiratory tract infection (URTI) was from 39.0 per 100 URTI problems to 24.4 (P<0.001), while the antibiotic prescribing rate increased for acute otitis media, decreased for bronchitis/bronchiolitis, and remained unchanged for other respiratory problems analysed. For adults the antibiotic prescribing rate for URTI decreased from 58.2 per 100 URTI problems to 40.0 (P<0.001), increased significantly for sinusitis and remained unchanged for all other respiratory problems. Antibiotic prescribing decreased significantly between 1990-91 and 2002-03 but the decrease was selective. The decline has been more pronounced among children than adults, and particularly for URTI. While the message of educators may be achieving its goal for URTI, other approaches targeting specific respiratory problems may be required to reduce antibiotic prescribing in these areas.

Acute Disease↗
PubMed2006

The relationship between self-reported alcohol intake and the morbidities managed by GPs in Australia.

BACKGROUND: One in five Australians consume alcohol at risky or harmful levels. Most (85%) attend a general practitioner at least once a year, giving opportunity for detecting and providing brief interventions for reducing alcohol-related harm. Historically, detection rates of problem drinking have been low in general practice, producing lower prevalence estimates of heavy drinking than expected from population surveys. METHOD: The BEACH program collects data from 100 consecutive patient consultations with 1000 GPs annually. For 40 consecutive encounters, GPs ask adult patients three questions on alcohol consumption (AUDIT-C). This paper reports the problems managed and treatments provided at encounters with heavy and non-heavy drinkers, grouped by their response to the 3rd question, and compares the two groups before and after standardisation for age and sex. Heavy drinking was defined as having 6 or more standard drinks at least once a week or more often. RESULTS: Heavy drinking was reported by 7.3% patients overall; more prevalent among men (13.8%) than women (3.9%); and among Indigenous patients (18.5%). Prevalence was highest in young adults (18-24 years)(12.7%) and decreased with age. Patients from a non-English speaking background were less likely to be heavy drinkers. Heavy drinkers had more problems managed at encounters, more chronic problems, physical injuries and psychological problems (particularly depression) managed than non-heavy drinkers. They were less likely to have respiratory complaints, ischaemic heart disease or diabetes managed. CONCLUSION: Heavy drinkers are more likely than non- or light drinkers to see their GP for management of chronic problems, psychological problems and physical injuries. However, the wide range of morbidity managed in heavy drinkers means that relying on clinical impression alone to detect this group will not suffice and should be augmented with routine screening. Given the pressures of general practice, finding efficient methods of screening for alcohol problems remains a priority.

Adult↗
PubMed2006

Trends in clinical encounters for pelvic inflammatory disease and epididymitis in a national sample of Australian general practices.

Trends in the frequency of clinical encounters for pelvic inflammatory disease (PID) and epididymitis in Australian general practice were determined via a national representative study of general practice activity between 1998 and 2003. Information was derived from 502,100 general practice encounters that occurred during the study period. An estimated 59,200 encounters for PID and 54,200 encounters for epididymitis took place in Australian general practice each year. Despite increases in national notification rates for Chlamydia trachomatis, over the study period overall encounter rates did not change significantly for either condition, and a fall in encounter rates for PID of about 50% occurred among women aged 15-34 years (P=0.02). Only 0.3% of encounters for PID and 1.9% of those for epididymitis resulted in hospital referral. On a population level, trends in the incidence of chlamydia-related diseases do not necessarily parallel those of reported chlamydia rates.

Adolescent↗
PubMed2006

Skin excisions in Australian general practice.

The BEACH program, a continuous national study of general practice activity in Australia, gives us an overview of encounters where a skin excision was recorded as a procedure. This provides a backdrop against which the articles in this issue of Australian Family Physician can be further considered.

Adolescent↗
PubMed2006

BMI of Australian general practice patients.

The BEACH program, a continuous national study of general practice activity in Australia, gathers height and weight details of patients at 40% of recorded encounters, enabling their body mass index to be calculated. Details are self reported by the patients, or by their carer in the case of young children, and recorded by the general practitioner at the encounter. This synopsis provides a backdrop against which the articles in this issue of Australian Family Physician can be further considered.

Adolescent↗
PubMed2006

Postnatal depression in Australian general practice.

The BEACH program, a continuous national study of general practice activity in Australia, gives us an overview of encounters at which postnatal depression was managed. This provides a backdrop against which the articles in this issue of Australian Family Physician can be further considered.

Adolescent↗
PubMed2006

Malignant neoplasms--management in Australian general practice.

The BEACH program, a continuous national study of general practice activity in Australia, gives us an overview of encounters at which malignant neoplasms were managed. This synopsis provides a backdrop against which the articles in this issue of Australian Family Physician can be further considered.

Australia↗
PubMed2006

Patient perception of their weight, attempts to lose weight and their diabetes status.

INTRODUCTION: Patients' self perception of weight status is a factor to be considered before an attempt is made by the clinician to initiate weight loss behaviour. METHOD: We compared the weight self assessment of 1973 general practice patients to their body mass index (BMI). Patients also ranked the success of any weight loss methods they had tried. General practitioners recorded the patients' type 2 diabetes status and this was analysed by BMI group. RESULTS: Overweight/obese patients accounted for 56.6% of the sample. Forty percent of overweight and 12.5% of obese patients did not see themselves as overweight. Close to 40% of patients had attempted to lose weight in the previous year. Diet/ exercise was the most common and successful weight loss method. There was a significantly higher prevalence of type 2 diabetes among obese patients. DISCUSSION: Despite some positive results on weight loss attempts, a considerable proportion of overweight and some obese patients do not perceive themselves as being overweight.

Adolescent↗
PubMed2005

Smoking status of Australian general practice patients and their attempts to quit.

This paper seeks to report on smoking rates, quit attempt methods and success rates among adult patients attending Australian general practice. A cluster cross-sectional survey was used to survey adult patients (18+), who attended Australian GPs in during 2002 and 2003. Over a quarter of patients (27.3%; 95% CI: 26.0-28.7) were former smokers and one in five (21.5%; 95% CI: 20.1-22.9) were current smokers. Ninety-two percent of former and 80% of current smokers used only one method in their last quit attempt with cold turkey the most common method used by both former (88%) and current (62%) smokers. Overall, success rates varied from 77% for cold turkey to 23% for bupropion. Success rates were re-analysed to consider quit attempts post-bupropion listing, with success rate for cold turkey reduced to 40% while bupropion remained reasonably constant at 21%. By tailoring smoking cessation interventions to a smokers' preparedness to quit, scope exists to increase the pool of smokers offered strategies that are more effective in achieving abstinence and avoiding relapse rather than relying on less effective self-quitting behaviours such as cold turkey.

Adolescent↗
PubMed2005

The management of alcohol, tobacco and illicit drug use problems by general practitioners in Australia.

The aim of this study was to document the frequency of the management of illicit drug, alcohol and tobacco problems in general practice in Australia. Data from the Bettering the Evaluation and Care of Health (BEACH) study of general practice, April 1998 to March 2003, were analysed. BEACH is an ongoing national study of general practice in Australia. Each year a random sample of approximately 1000 general practitioners (GPs) participate, each providing details of 100 patient encounters. Samples are drawn from the Medicare data held by the Health Insurance Commission. Patient demographic breakdowns, medication, other treatment, referrals and other medical procedures ordered were examined for all problems labelled by GPs as illicit, alcohol and tobacco problems. Annually in Australia, it was estimated that 615,000 GP encounters--or 0.6% of all encounters--involved the management of illicit drug use problems presumably most commonly for problematic heroin use. Despite a much higher population prevalence of use and use disorders, the management of alcohol or tobacco use problems was less common, with 0.4% and 0.3% of encounters, respectively, comprising treatment of these problems. Clear demographic differences existed across the groups. The management of problems also differed, with illicit drug use problems more likely to involve provision of medication, and alcohol and tobacco treatment more likely to involve counselling and/or health advice. Despite higher rates of alcohol and tobacco use problems among patients seeing GPs in Australia, the rate of treatment for such problems was relatively lower than it was for illicit drug use problems. More efforts need to be directed towards assisting GPs to identify and target problematic alcohol and tobacco use among their patients.

Adolescent↗
PubMed2005

Management of infertility in Australian general practice.

The BEACH program, a continuous national study of general practice activity in Australia, gives us an analysis of the management of infertility between April 1998 and March 2004. Subfertility, which accounts for about 10% of the diagnoses analysed here, is included in the label 'infertility'. Because management rates and methods differ markedly between male and female patients, each gender is analysed separately. This provides a backdrop against which relevant articles in this issue of Australian Family Physician can be further considered.

Adult↗
PubMed2005

Presentations of diarrhoea in Australian general practice.

The BEACH program, a continuous national study of general practice activity in Australia, gives us an overview of the consultations in general practice involving a patient presentation of diarrhoea. This provides a backdrop against which articles in this issue of the Australian Family Physician can be further considered.

Adolescent↗
PubMed2005

Management of cardiovascular conditions in Australian general practice.

The BEACH program, a continuous national study of general practice activity in Australia, gives us an analysis of the management of cardiovascular conditions in general practice. This provides a backdrop against which articles in this issue of Australian Family Physician can be further considered.

Adult↗