Quality improvement in primary care projects

Quality Use of Medicines for people living with HIV

The aim of the project is to build and deliver a quality improvement intervention for the general practices and sexual health clinics in Australia that treat a significant proportion of people living with HIV, to highlight and address the identified gaps in care for those patients.

A pharmaco-epidemiological study of osteoporosis management in Australian general practice

The aim of this project is to determine the prevalence and patterns of osteoporosis treatment pathways and treatment-associated outcomes. The analysis of MedicineInsight is part of a broader project which will also recruit GPs with high numbers of cases of osteoporosis patients for interview on reasons for treatment pathways.

Iron deficiency and associated conditions in Australian general practice

MedicineInsight will be studied to understand the diagnosis and management of iron deficiency, and characterisation of patients with iron deficiency. It is anticipated that the results of this study may form the basis for future research and potentially inform the development of educational interventions aimed at improving outcomes for patients.

Lung cancer management in primary care: Feasibility project

This program aims to test the feasibility of using MedicineInsight data to gain insights into the primary care provided to patients diagnosed with lung cancer since the time of their first recorded diagnosis. The data analysis will assist the Cancer Institute New South Wales (CINSW) to better understand the impact of lung cancer on general practices and improve development and evaluation in this field, with primary health care.

Hunter Alliance Diabetes Management project

The Diabetes Alliance program objective is to provide knowledge and support to primary care clinicians for them to give best evidenced care to patients with type 2 diabetes. MedicineInsight data will be used for assessing the management and potential improvements in clinical outcomes of patients with affected by this condition within practices. The results will help to improve the development of programs looking to better manage this chronic disease in the Hunter and New England region.

Risk factors for inappropriate prescribing of antibiotics in Australian general practices

This program aims to identify predictors and outcomes as well as to explore the contexts for the inappropriate prescribing of systemic antibiotics in general practices. MedicineInsight data will be used to examine related factors associated with the inappropriate prescribing of antibiotics particularly for tract, ear, skin, urinary tract and eye infections. The data analysis looks to identify the direction, strength and nature of these associations. This program will inform policy and practice in primary care.

Linkage of hospital and primary care data to drive improvements in cancer care

This project is the first large-scale, comprehensive data linkage of primary care and hospital data for cancer patients to create a platform for health services and other cancer research. Hospital clinical, clinical registry, administrative and costing data from 7 VCCC partner hospitals will be linked with Victorian Cancer Registry data. This linkage will allow identification of patients who have had a diagnosis of cancer within the hospital data. The cancer cohort will then be linked to primary care data (MedicineInsight) as well as patient-reported outcomes survey data collected by the VCCC.

Antimicrobial Use and Resistance in Australia (AURA) - 2017 report

The Antimicrobial Use and Resistance in Australia (AURA) Surveillance System objective is to prevent and contain the risk of antimicrobial resistance for human health. This program reports on the use and appropriate prescription of antimicrobials in hospitals, aged care homes and the community. MedicineInsight data is used for the generation of the AURA 2017 report that will be made available on the Australian Commission on Safety and Quality in Health Care webpage.

Hepatitis C educational and quality improvement program for general practice

NPS MedicineWise is undertaking a project in general practice to support general practitioners in the diagnosis and management of patients with chronic hepatitis C infection. The project will focus on the appropriate use of medical tests and medicines, and a quality improvement program designed and developed as a result of the analysis from the MedicineInsight data will be delivered to about 100 general practices across Australia.

Chidwick K, Kiss D, Gray R, Yoo J, Aufgang M, Zekry A. Insights into the management of chronic hepatitis C in primary care using MedicineInsight. Aust  J Gen Pract 2018;47:639-45.

Preventive cardio-metabolic health care in general practice for people living with HIV compared with the general population

Human immunodeficiency virus (HIV) is an important health problem in Australia. People living with HIV have higher risks of developing cardiovascular disease. NPS MedicineWise is aiming to use MedicineInsight data to compare and identify gaps in the management of cardiovascular risk factors of people living with HIV. The results of the analysis will be used to develop an educational program for selected general practices treating people with HIV. Outcomes of the project will be made public on the NPS MedicineWise website.

Optimising early end-of-life conversations and advance care planning in general practice (Stage 1)

This project is investigating the feasibility of using MedicineInsight data to test indicators for patients near end of life, and if this data can be used to identify points for future intervention to improve advanced care planning in general practice.

Osteoporosis feasibility assessment

This project uses MedicineInsight data to better understand the prevalence and management of osteoporosis in general practice. The outputs of the data analysis will be used to inform future education interventions and practice reports delivered independently by NPS MedicineWise.

The impact of My Health Record use in primary care: Qualitative study

This project uses MedicineInsight data to explore the use of the My Health Record in relation to medication management, in particular by determining high users of the My Health Record in NSW and Victoria, to recruit general practitioners and consumers to conduct in-depth interviews. The outcome of this study will also help inform other studies focusing on the impact of My Health Record in primary care.

The impact of My Health Record use in primary care: Quantitative study

This project is a continuation of the qualitative study undertaken by NPS MedicineWise, to explore the use of the My Health Record in relation to whether having a My Health Record reduces duplication of tests and prescriptions for people concurrently attending multiple practices, and the measurement of the proportion of allergy and adverse drug reactions captured in the practice clinical information system and the My Health Record.

Identifying factors and subpopulations associated with high use and high cost of services in general practice. A feasibility study

This project uses MedicineInsight data to determine which demographic factors and comorbidities are associated with high service use and high service costs in the general practice setting. The outputs of the data analysis will generate a report that will be used by NPS MedicineWise and the Menzies Centre for Health Policy to develop a simulation model to identify the impact of interventions to reduce low value care.

How well are people with coronary heart disease managed in primary care?

This study examines how patients are managed in general practice according to clinical guidelines for coronary heart disease CHD, in particular differences in level of treatment and management within the patient cohort.

MedicineInsight expansion in the Hunter New England Central Coast

The project is designed to improve the care of people in the community of the Hunter New England Central Coast PHN area by providing MedicineInsight program products and services to additional general practices which serve these communities. The expansion of MedicineInsight in these communities is funded by an independent grant from NIB Health Funds. MedicineInsight data will also be used to generate an annual report to identify improvements in clinical markets for the patient cohort. Copies of those reports will be published on our website.

Quality use of medicines and tests projects

Pneumococcal immunisation over 65 years

The aim of this study is to better understand who receives the pneumococcal vaccine in Australian general practice. MedicineInsight data will be used to provide a comprehensive longitudinal view of the care patients received.

 A pharmaco-epidemiological study of Pregabalin in Australian general practice

This study describes the pharmaco-epidemiological profile of Pregabalin prescribing in Australian general practice. The results of this study are intended to guide the assessment of safe use of Pregabalin in general practice by the Therapeutic Goods Administration.

Can MedicineInsight support risk management plan evaluation?

This project aims to analyse MedicineInsight data on the use of sodium glucose co-transporter 2 (SGLT2) inhibitors for diabetes. The Therapeutic Goods Administration (TGA) requires post-market monitoring as part of risk management plans for therapeutic goods that are available in the market. The post-market report generated using MedicineInsight data will help to demonstrate the feasibility of using this data for the purpose of medication safety regulations in Australia.

Publication: Gadzhanova S, Pratt N, Roughead E. Use of SGLT2 inhibitors for diabetes and risk of infection: Analysis using general practice records from the NPS MedicineWise MedicineInsight program. Diabetes Res Clin Pract 2017;130:180-185.

Assessing the management of renal toxicity in primary care associated with Stribild™

This project uses MedicineInsight data to assess if Highly Specialised Drugs (s100) prescribers of human immunodeficiency virus (HIV) medicines are managing appropriately the renal toxicity risks associated with Stribild™. The use of MedicineInsight data will provide evidence of the utility of the data to support risk management plans and help to develop strategies to support safety of new pharmaceutical products.

The prevalence of chronic musculoskeletal/ pain conditions in Australian in general practice and their association with vitamin D testing, vitamin D deficiency, vitamin D prescribing, analgesic prescribing and patient sociodemographic characteristics

This project is looking at investigating chronic non-specific musculoskeletal pain (CNMP) and the role of vitamin D testing and supplementation in its management. This project uses MedicineInsight data to explore the estimates of the prevalence of musculoskeletal/ pain conditions in Australia, describe associations with patient characteristics, Vitamin D testing/ supplementation and determine if changes to Medicare rebates affected Vitamin D testing in Australian general practice. The results of the project have the potential to improve practice and contribute to clinicians, policy makers and consumers.

PublicationGonzález-Chica D, Vanlint S, Hoon E, Stocks N. Epidemiology of arthritis, chronic back pain, gout, osteoporosis, spondyloarthropathies and rheumatoid arthritis among 1.5 million patients in Australian general practice: NPS MedicineWise MedicineInsight dataset. BMC Musculoskelet Disord. 2018;19:20. 

Quality use of medicines in chronic kidney disease (CKD)

The aim of this project is to assess the quality use of medicines in patient with CKD. The results of the MedicineInsight data analysis will help to inform discussions regarding the safe and effective prescribing of medications in patients with renal impairment.

PublicationRadford J, Castelino RL, Jose MD, et al. Chronic kidney disease in Australian general practice: its prevalence, and associated patient characteristics and comorbidities, Australian and New Zealand Society of Nephrology Annual Scientific Meeting, Darwin, Australia, 4-6 September 2017, [Conference extract].

Finding improved pathways to diagnosis of mucopolysaccharidoses (MPS) disorders

The objective of this project is to analyse MedicineInsight data to determine if there are any patterns in mucopolysaccharidoses (MPS) disorders cases that may facilitate an earlier diagnosis of these disorders. The MedicineInsight data analysis was used to provide a preliminary report identifying data potential and limitations for this purpose.

Project outcome report: Feasibility study to find improved pathways to diagnosis of mucopolysaccharidoses.

Review of vitamin D, B12 and folate use pre- and post-November 2014

This project uses MedicineInsight data to support discussions around the current appropriateness of requesting vitamin D, vitamin B12 and folate testing in Australia. The analysis of MedicineInsight data will provide a better understanding of the impact of the new Medicare Benefits Schedule (MBS) policy changes for these tests that included restricting use of these tests in certain populations, and subsidy reduction. 

Medication changes in high risk patients with hyperkalaemia in general practice using MedicineInsight data

This project uses MedicineInsight data to characterise and assess medication changes in high-risk patients who experience hyperkalaemia in primary care. The outputs of this project will inform an evidence-based submission to the Pharmaceutical Benefits Advisory Committee (PBAC) by the funder who is also the sponsor for a new potassium-binding medicine for the treatment of hyperkalaemia in adults.

Population health and public policy projects

Improving influenza and influenza like illness surveillance

This study is exploring whether MedicineInsight data can improve existing influenza sentinel surveillance systems on the community burden of disease during the influenza season and for ongoing surveillance throughout the year.

Epidemic thunderstorm asthma analysis in general practice setting

This study aims to describe the impact of past epidemic thunderstorm asthma events on the populations attending general practices. MedicineInsight data will be used to assess health care seeking behaviours and patient management, and input into epidemic thunderstorm asthma forecasting models. The data will also be used to assess the Thunderstorm Asthma Program that followed the epidemic thunderstorm asthma event in Victoria in November 2016.

Potential of MedicineInsight to evaluate the National Immunisation Program

This project will assess the potential for MedicineInsight to be used to evaluate the impact and effectiveness of the National Immunisation Program, including the ability to monitor the burden of vaccine preventable diseases and the impact and effectiveness of vaccines such as influenza, pneumococcal and herpes zoster.

Chronic kidney disease (CKD) prevalence and management in people with type 2 diabetes in Australian general practice

This project uses MedicineInsight data to consider whether there are currently any gaps in the screening and recording of CKD and appropriate prescribing of antihyperglycaemic and cardiovascular medications in general practice and, if so, make recommendations for how these gaps can be addressed in order to optimise the care provided in general practice for this important population by developing interventions to reduce inappropriate prescribing in renal impairment and educating patients on self-management strategies to complement best practice management.

Publication: Prescribing for people with type 2 diabetes and renal impairment in Australian general practice: A national cross sectional study

Evaluation of vaccination coverage data for population subgroups

The primary aim of this project is to assess the suitability of using MedicineInsight data for providing vaccination coverage estimates in particular for subgroups for whom vaccines are funded under the National Immunisation Program. MedicineInsight data is used for estimating influenza vaccination coverage in medically at risk and elderly Australian adults.

Primary Health Network (PHN) Needs Assessment

The population planning project, commissioned by the Western Australia Primary Health Alliance, aims to estimate the need, supply and cost of health services in Western Australia. MedicineInsight data usage looks at demand and utilisation of health services across general practices in the state, and identifies key priority areas and options for addressing population health needs. The results will help to identify potential areas for investment and development, and to design new services.

Preventing obesity in childhood and adolescence: weight and height screening in Australian general practice

This project aims to research if children's and adolescents' weight and height are being measured during medical consultations in Australian general practices. MedicineInsight data provides an overview of the current situation in Australia that may allow improving clinical practice activities, and nutritional status in children and adolescents.

Cardiovascular disease in adults: primary and secondary prevention in Australian general practice

The primary aim of this project is to evaluate if strategies for the prevention of cardiovascular diseases are incorporated among regular activities performed by general practitioners during consultations. MedicineInsight data analysis provides information that can potentially improve clinical practice, health professionals’ training and management of cardiovascular diseases.

Creating a Tasmanian Diabetes Atlas

The project uses MedicineInsight data to explore the pattern and distribution of diabetes in Tasmania with the aim of reducing the impact of diabetes, and improving the management of resources and the care provided to people affected by this health problem in Tasmania.

AusVaxSafety: national vaccine safety surveillance and signal detection

This project uses MedicineInsight data to monitor vaccine safety which is a key priority for the Australian Government. The results of the analysis will be incorporated to the government-funded active vaccines safety surveillance program (AusVaxSafety). The use of MedicineInsight data will support surveillance (pharmacovigilance), policy development and program implementation in the area of vaccine safety.

Improving outcomes with better use of blood pressure and other cardiovascular medicines

This project uses MedicineInsight data to identify opportunities to improve outcomes with better use of cardiovascular (CVD) medicines, including determining the potential for improving use of CVD preventive medicines in Australia.

Influenza-like illness surveillance and influenza vaccine effectiveness estimation using NPS MedicineWise data: A pilot project

This project is aiming to explore if MedicineInsight data could be used to undertake influenza surveillance, in particular vaccine effectiveness in Australian general practices. The benefits of using MedicineInsight data for influenza surveillance include more reliable indicators, and more efficient development of influenza vaccination plans that ultimately will contribute to the improvement of public health.

Prescribing of diabetes medications in patients with type 2 diabetes and renal impairment in Australia

This project uses MedicineInsight data to explore the issue of prescription of medicines for people with type 2 diabetes and renal impairment. The analysis of the data will show whether the non-insulin diabetes medications are appropriately prescribed in general practices in Australia.   

General practice visits for infectious diseases in Australia

The primary aim of this project is to estimate the impact of infectious diseases in general practice settings, and the healthcare resource use and cost linked to these visits. MedicineInsight data is used to evaluate prevention strategies to implement and improve programs such as vaccination initiatives in Australia.

Does continuity of primary care reduce demand on emergency department presentations and hospital admissions?

The primary aim of this project is to evaluate the influence of patterns of primary care contact on emergency departments visits and hospital admissions. MedicineInsight data is used for evaluating the role of primary care in improving health and preventing progression of disease and hospitalisation.  

Study to describe the prevalence and characterisation of aortic stenosis in Australian general practice

This project is examining MedicineInsight data to provide preliminary understanding of prevalence of aortic stenosis in primary care and specific population characteristics, including those used to guide clinical management.

Project outcome report:
Feasibility study to describe the prevalence and characterisation of aortic stenosis in Australian general practice

Other projects

25% MedicineInsight data extract collaboration

This project is a collaboration between University of New South Wales and NPS MedicineWise to improve the quality of MedicineInsight data through validation studies. The project will share a 25% random record data extract that will be used for a range of public health and health services research, subject to approval for each project by the independent Data Governance Committee.

Enriching MedicineInsight data with social determinants of health

This project aims to enrich MedicineInsight data with social research data which would provide holistic consumer behaviours and views, and enable the delivery of more targeted public health campaigns to a more specific audience. The first phase of this project which has been approved is assessing the technical feasibility and utility of enriching MedicineInsight data with social research data.

MedicineInsight report on general practice activity in Australia 2015-2016

This project uses MedicineInsight data to generate a report describing patient’s management including number of encounters and prescriptions for common conditions such as type 2 diabetes mellitus, chronic obstructive pulmonary disease (COPD) and depression. The representative of MedicineInsight data is compared with other data sources such as Australian Medical Publishing Company, General Practice Workforce Statistics, MBS statistics, among other national data sources.

Quality investigation into MedicineInsight data: improving interpretation of MedicineInsight data

This project aims to understand and make other users aware of the uses and limitations of MedicineInsight data; and to collaboratively work on an enduring document that will provide researchers, general practitioners and policy makers with information to help them make the best use of MedicineInsight data to facilitate improved health outcomes in Australia.

Diagnosed conditions for prescribing tiotropium

This project used MedicineInsight data to generate a report showing evidence on diagnosed conditions for prescribing tiotropium (a PBS-listed medicine). The report will be submitted by the funder, as the sponsor of the medicine, to the Pharmaceutical Benefits Advisory Committee (PBAC) to provide evidence- based information about the medicine to support PBAC decision making.

Feasibility of MedicineInsight data to support clinical trials in Australian general practice

This project is testing the feasibility of using MedicineInsight data to setting up clinical trial sites in Australia and identifying potential patients to be recruited into clinical trials.

Effective Quality Incentive Payments in General Practice (EQuIP-GP)

The EQUiP-GP study investigates the impact of an alternate, outcomes based funding model that provides incentives linked to the continuous quality improvement of primary care provision by general practitioners. MedicineInsight data from consenting practices participating in the study will be analysed for pre- and post-intervention measures by a collaborative project team from University of Wollongong, University of Tasmania and Monash University.

Evaluation of the Health Care Homes program

Health Care Homes (HCH) is a new model of primary care where practices receive a periodic bundled payment to provide ongoing chronic disease-related care to patients. MedicineInsight data will be used to support the evaluation of HCH by the independent evaluators. Data from consenting general practices participating in HCH will be shared with the evaluators, as well as de-identified data from non-participating general practices for the purpose of defining a comparator cohort.