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Research aims to improve ‘neglected’ problems in healthcare

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Investigator Grants is the National Health and Medical Research Council’s (NHMRC) largest funding scheme, with a 40% funding allocation from the Medical Research Endowment Account (MREA).
 
The scheme’s objective is to support the research of outstanding investigators at all career stages, providing five-year funding security for high-performing researchers through its salary and research support packages. The 2019 Investigator Grants funding totals $365.8 million.
 
Professor Glasziou from Bond University is a grant recipient for his research project, ‘Neglected problems in healthcare’, which focuses on four prominent areas in healthcare:

• Over-diagnosis and overtreatment
• Non-drug interventions
• Antibiotic overuse and resistance
• Waste in research 

This is supported by work on the development of methods, tools, implementation and capacity, and grew out of Professor Glasziou’s own clinical work in general practice.
 
‘I found it difficult to use effective non-drug treatments [in general practice] because they are often poorly described in the original trials,’ he told newsGP.
 
‘I was frustrated by the ever-expanding definitions of our diseases, even when there is often poor evidence to justify us treating the lower risk patients included in the expanded definitions, such as chronic kidney disease, gestational diabetes, and PCOS [polycystic ovary syndrome].’
 
Professor Glasziou previously told newsGP that while some recognise the issues, there is a need for further collaboration in primary care to balance specialist interest groups.
 
‘Over-diagnosis is a large and growing problem in Australia and globally,’ he said.
 
‘GPs can help by reducing unnecessary testing, confirming diagnoses, and using lower-dose or less invasive treatments, especially for lower risk and less severe disease.’
 
The Handbook of Non-Drug Interventions (HANDI) is part of Professor Glasziou’s plan to evolve the area of non-drug interventions by integrating it into general practice processes. He cites HANDI as ‘a great example’ of how his research can help GPs and improve patient care.
 
‘I plan to improve and expand HANDI in a number of ways to increase its scope and usefulness,’  
Professor Glasziou said.
 
‘I hope tools such as HANDI will be integrated into undergraduate medical training, general practice registrar training, and resources such as clinical pathways.
 
‘That would increase awareness and findability. Similarly, the work on reducing over-diagnosis and antimicrobial stewardship will hopefully enter general practice training programs – it already is for some areas of Australia but is not yet widespread. 
 
Professor Glasziou’s research team has made some headway in understanding over-diagnosis and antibiotic overuse, and is hopeful to make further advances over the course of the project.
 
‘We hope over the five years of the grant to improve antimicrobial stewardship in primary care and wind back some of the over-diagnosis,’ Professor Glasziou said.
 
Professor Glasziou is also optimistic that HANDI and other areas of his research can be shared beyond Australia’s borders.
 
‘I would like to see international use and translations of HANDI. That would be a major step forward to allow GPs globally to balance the use of drug and non-drug treatments,’ he said.
 
‘Similarly, I would like to see a national and international collaboration on antimicrobial stewardship in primary care.
 
‘We have also commenced plans with the WONCA [World Organization of Family Doctors] and other primary care organisations to increase primary care input into disease definitions to stem the tide of inappropriate expansion.’

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antimicrobial HANDI NHMRC non-drug interventions over-diagnosis research

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