Identifying health impacts following a road traffic accident

Morgan Liotta

27/02/2020 2:15:17 PM

Dr Sean Black-Tiong’s research examines what he found to be a gap in primary care.

Sean Black-Tiong
Dr Black-Tiong became aware of a gap in primary care management of people involved in road traffic accidents and proper assessment of what medications are being prescribed.

‘The flow-on effects from what was a “minor” accident with “no major trauma” can have major effects on a patient’s quality of life.’
Dr Sean Black-Tiong is referring to findings as part of his research project, ‘General practice management of physical and psychological trauma resulting from road traffic accidents, 2011–18’, for which he was awarded a Motor Accident Insurance Commission (MAIC)/RACGP Foundation Research Grant in 2019.
Dr Black-Tiong became aware of a gap in primary care management of people involved in road traffic accidents and proper assessment of what medications are being prescribed.
‘Road traffic accidents not requiring hospitalisation are a fairly common occurrence in this day and age, and while there is a great deal of research into major accidents and how these are managed in hospital emergency departments and trauma units, there is a relative scarcity of information in other areas such as primary care,’ he told newsGP.
‘Many of the issues that we manage in general practice are identified days, sometimes weeks, after the initial incident.
‘In order to provide the optimal care for these patients we need to establish what is currently being done and how this fits in with current guidelines and best practice.’
Involvement in a motor vehicle accident places people at increased risk for psychological issues, particularly post-traumatic stress disorder (PTSD). Dr Black-Tiong’s research team used national de-identified patient data from MedicineInsight to investigate the number of consultations related to road traffic accidents.
Possible complications of these accidents were also explored, such as chronic pain, anxiety, depression, PTSD and sleep issues, as well as what medications GPs are prescribing when managing these complications, with a focus on those that may create some form of dependence or addiction, such as tranquilisers and pain medication.
Physical complications identified as most commonly encountered in the general practice setting fall under musculoskeletal injuries that were not immediately apparent after the accident, such as whiplash injuries. Psychological sequelae from road traffic accidents, including PTSD, are also of concern due to the ongoing ‘flow-on effects’.
‘A road traffic accident can also impact patients’ pre-existing medical conditions. For example, worsening of anxiety due to the added stress of having to get the car repaired, being unable to drive to work or do the school pickup,’ he said.
With the rise of problematic use and harm associated with drugs of dependence, a high-quality and comprehensive pain management plan should be made in collaboration with the patient following an accident, Dr Black-Tiong recommends.
‘This plan needs to set clear expectations and goals, and ideally be written down for the patient to hold on to,’ he said.
‘There are great resources available through Pain Australia or the Hunter Integrated Pain Service to assist clinicians and patients with making these plans and managing pain.
‘The involvement of allied health such as physiotherapy and psychology are another part of effective pain management and reducing the need for potentially harmful medications.’
The research team is hoping to utilise their findings to guide conversations with GPs in order to explore their perspectives about drivers and barriers to care in the management of patients following a road traffic accident. The information will then be used to create educational materials for GPs to improve their skills in managing these patients
For Dr Black-Tiong’s individual career plan, general practice remains steadfast.

‘I’ve now received my Fellowship [of the RACGP] so plan on continuing my current clinical work in Adelaide,’ he said. ‘I’ll be continuing my role with the National Faculty for GPs in Training and I’ve also started a new role with the University of Adelaide as a clinical lecturer.’
Applications for the 2020 RACGP Foundation grants open on Monday 2 March.
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