Research Strength: Primary Health Care

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Introduction


Primary Health Care research is a major strength of the School through staff located at the School’s affiliated Research Centre for Primary Health Care and Equity (CPHCE) and through researchers located within the School. The Primary Health Care Group has research under the following streams:

1. Prevention and management of chronic disease
This theme aims to conduct research on the prevention and management of chronic disease within primary health care. It encompasses research, which focuses on specific chronic diseases especially diabetes, cardiovascular disease, asthma and chronic obstructive pulmonary disease (COPD). The prevention of chronic disease is also a priority, particularly in relation to the SNAP risk factors: Smoking, Nutrition, Alcohol and Physical Activity. Underlying this disease and prevention aspect is a focus on the organisation and capacity required to improve the quality of care in general practice

2. Primary Health Care System Development
This stream is focussed on developing and evaluating the conceptual frameworks, infrastructure and capacity needed for a strong Primary Health Care system; improving integration of services and continuity of care; and access to primary health care including patterns of access and studies on data linkage.

3. Understanding and Intervening to Reduce Health Inequalities
The Equity Stream is primarily located within the Centre for Health Equity Training, Research and Evaluation (CHETRE). There are currently three main program areas within this stream: Early Childhood, Health Impact Assessment (or Healthy Public Policy and Practice) and Disadvantaged Communities and Populations. The focus of this stream is on the development and implementation of interventions that will prevent or redress the impact of health inequalities.

The majority of the work of these streams takes place within the UNSW Research Centre for Primary Health Care and Equity. Details of this work and project descriptions are available at the CPHCE website.

Within the School itself the researchers working on Primary Health Care Research are closely linked to CPHCE and are also involved in collaborations with other members of the School, with others in the Faculty of Medicine and with other Universities. The focus of the work in on: management of chronic disease; and prevention, including intervention of risk factors for chronic illness such as tobacco smoking.

UNSW also provides support for Primary Health Care research capacity building. This program provides basic research skills framing and mentoring through a Primary Health Care research network (PHReNet). A researcher development program is offered to help people with limited research experience develop their skills. The capacity building program has also established a practice based research network to support and facilitate general practice involvement in research.

For more information about the capacity building program see www.cphce.unsw.edu.au.

Management of chronic disease


Primary health care academics within the School are leading or involved in projects on improved care of chronic illness. These projects include:
  • Nurse and general practice partnership for care of chronic obstructive pulmonary disease (COPD)
  • Early diagnosis and intervention for COPD
  • Systematic review of interventions for care of chronic disease in primary health care
  • Multidisciplinary teamwork for chronic disease care
  • Advance care planning
  • Improved care of atrial fibrillation to prevent stroke.
All of these projects address health conditions of high prevalence and impact where improved care in the community has the potential for important health benefit for the population.

The 2009 CPHCE Annual Report including outlines of these projects can be viewed here.

Prevention including intervention of risk factors for chronic disease


Tobacco smoking remains the most common preventable cause of death and illness in Australia today. Smoking cessation programs are some of the most effective and cost effective strategies that can be undertaken in health care settings, including general practice. Nicholas Zwar and Robyn Richmond are leading a project (Quit in General Practice) in collaboration with colleagues at University of Western Sydney, University of Melbourne and the Australian National University to develop and test the role of general practice nurse to provide smoking cessation advice. This project tests a new approach to supporting smoking cessation in general practice. This involves the practice nurse, GP and Quitline working in partnership to provide a flexible program of support to meet the needs of smokers. Academic general practice registrar Nicole Clancy is examining the interaction of depressive illness with quitting smoking in participants in this project.

Primary Care group staff are also involved in projects on absolute cardiovascular risk assessment in general practice, vascular disease prevention, lifestyle risk factor management in the 45-49 year old health check in general practice and implementation of preventive guidelines in general practice.

Prevention of cardiovascular disease is a major focus though uses of absolute risk tools. The impact of absolute risk assessment on quality use of medicines is being explored by Sanjyot Vagholkar. Suzanne McKenzie, who is now at James Cook University but who remains a conjoint academic with the school, is exploring the impact of psychological distress on the prevention of cardiovascular disease.

Primary health care policy


Nick Zwar has led a team to perform a systematic review on optimising skill-mix in the primary health care workforce for care of older Australians. The issue of distribution of roles and responsibilities is an important policy and practice questions given the major problems with health workforce.

Further information and opportunities for Independent Learning Project, Masters and PhD students


For more detailed information about the streams of prevention management of chronic disease, primary health care policy and health equity see the CPHCE website or contact one of the members of the group. For further information about projects in tobacco control contact Professor Robyn Richmond (r.richmond@unsw.edu.au).

A Masters of Public Health in Primary Health Care is available.

For more information this course, view the Postgraduate Program Prospectus.

Research@UNSW

Contact


Professor Nick Zwar
Convenor, School of Public Health
and Community Medicine
Level 3, Samuels Building
Gate 11,
Botany Street, Randwick
Faculty of Medicine
The University of
New South Wales
UNSW Sydney 2052
Australia

T +61 (2) 9385 2515
F +61 (2) 9313 6185
E N.Zwar@unsw.edu.au

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School of Public Health and Community Medicine - UNSW - Faculty of Medicine NSW 2052 Australia | Tel: +61 (2) 9385 2517 Fax: +61 (2) 9313 6185
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