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Biomedical subjects

Nicholas A Zwar

Publications and source records attributed to Nicholas A Zwar.

12 recordsLinked to original sources
PubMed2006

Weight management in general practice: what do patients want?

OBJECTIVE: To explore patients' views of the role of general practitioners in weight management. DESIGN: Waiting-room questionnaire survey, including measurement of height, weight and waist circumference, May-August 2005. PARTICIPANTS AND SETTING: 227 patients from five general practices located in metropolitan and rural New South Wales. MAIN OUTCOME MEASURES: Patients' views on: the role of GPs in weight management; the usefulness of weight-loss strategies; and the likelihood of following the GP's advice about weight loss. RESULTS: Most patients (78%) felt that GPs had a role in weight management, but only 46% thought that GPs would be able to spend enough time to provide effective weight loss advice. Over 80% of patients perceived advice on healthy eating and physical activity to be useful or very useful, and were likely to follow weight-loss recommendations; 78% were in favour of regular review. Patients indicated they would be less likely to see a dietitian or to attend information sessions, and unlikely to take weight-loss medication. Views of overweight and obese patients were generally similar to those of normal weight patients, but there were significant differences in perceptions of the usefulness of information on weight and weight-related medical conditions, as well as willingness to change lifestyle, possibly reflecting resistance to change among obese or overweight patients. CONCLUSION: These findings have implications for the design of primary care interventions for managing obesity.

Adolescent↗
PubMed2006

Supporting research in primary care: are practice-based research networks the missing link?

Despite the size and importance of primary health care (including general practice) within the health system, traditional research output has been relatively low, both here and overseas. General-practice and primary-care research in Australia has been criticised for the preponderance of small-scale, descriptive and survey-based studies. If we are to conduct larger-scale clinical, epidemiological and health-services research, new structures and processes are needed. The research networks set up under the first phase of the Australian Government's Primary Health Care Research, Evaluation and Development (PHCRED) Strategy have tended to focus on up-skilling, research literacy and dissemination. This is important, but for general-practice research to evolve, a new type of practice-based research network is needed. These new practice-based networks require commitment and funding from policymakers, a base in academic departments, plus active involvement from Divisions of General Practice and the practitioners themselves.

Attitude of Health Personnel↗
PubMed2006

Role of the general practitioner in smoking cessation.

This paper reflects on the role of general practitioners in smoking cessation and suggests initiatives to enhance general practice as a setting for effective smoking cessation services. This paper is one of a series of reflections on key issues in smoking cessation. In this article we highlight the extent that general practitioners (GPs) have contact with the population, evidence for effectiveness of GP advice, barriers to greater involvement and suggested future directions. General practice has an extensive population reach, with the majority of smokers seeing a GP at least once per year. Although there is level 1 evidence of the effectiveness of smoking cessation advice from general practitioners, there are substantial barriers to this advice being incorporated routinely into primary care consultations. Initiatives to overcome these barriers are education in smoking cessation for GPs and other key practice staff; teaching of medical students about tobacco and cessation techniques, clinical practice guidelines; support for guideline implementation; access to pharmacotherapies; and development of referral models. We believe the way forward for the role of the GPs is to develop the practice as a primary care service for providing smoking cessation advice. This will require education relevant to the needs of a range of health professionals, provision of and support for the implementation of clinical practice guidelines, access for patients to smoking cessation pharmacotherapies and integration with other cessation services such as quitlines.

Curriculum↗
PubMed2005

General practitioner views on barriers and facilitators to implementation of the Asthma 3+ Visit Plan.

AIM: The Asthma 3+ Visit Plan is an initiative to promote organised asthma care in general practice. This study aimed to identify factors associated with uptake of the plan by general practitioners, and their views on barriers and facilitators to implementation of the plan. DESIGN: Postal survey sent to a random sample of GPs. PARTICIPANTS AND SETTING: 315 GPs in five Divisions of General Practice in metropolitan Sydney, surveyed sequentially between 1 October 2002 and 31 May 2003. OUTCOME MEASURES: Awareness and use of the Asthma 3+ Visit Plan; GP and practice factors associated with use of the plan; and GP views on barriers and facilitators to implementing the plan. RESULTS: The response rate was 55.7%, and 72.1% of participants were male; participants' mean age was 50.5 years. Most GPs (91.2%) were aware of the plan and and 44.9% had used it. GP and practice factors associated with use of the plan were use of the six-step Australian Asthma Management Plan, confidence in aspects of asthma care, practice accreditation, sign-up for asthma incentives, and computerisation. Major barriers to implementing the plan were workload/paperwork and administrative complexities. Patient factors that influenced completion of the plan were their concept of the severity of their asthma, compliance with follow-up, and patient attitudes towards asthma care. CONCLUSION: The perceived workload and administrative complexity of the asthma incentives are barriers to uptake. Factors relating to the illness rather than social factors are seen as the most important influences on completion of the plan by patients.

Aged↗
PubMed2002

Evaluating general practitioners' views on the enhanced primary care items for care planning and case conferencing. A one year follow up.

BACKGROUND: General practitioners have required support to enable adoption of Enhanced Primary Care Medicare items for care planning and case conferencing. METHODS: A qualitative study of previously interviewed GPs' responses to a semi-structured face-to-face interview conducted between September and November 2001 in their surgeries. RESULTS: Twenty-five GPs predominantly identified several practice and Divisional strategies to facilitate uptake of the items. Practice, Divisional and health service personnel should be involved in identifying suitable patients and initiating care planning and case conferencing. CONCLUSION: Support for care planning and case conferencing requires several organisational and service developments in general practices, Divisions and health services.

Attitude of Health Personnel↗