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Paving the way for research excellence: RACGP Foundation


Morgan Liotta


5/08/2021 4:24:24 PM

The GP−patient relationship and prescribing psychotropics for pregnant women are just two research areas being supported by the RACGP.

Dr Jacqueline Frayne and Dr Hayley Thomas
L–R: Dr Jacqueline Frayne and Dr Hayley Thomas.

Each year, the RACGP Foundation awards a suite of research grants to acknowledge excellence in general practice research. newsGP profiles two of its recent 2021 grant recipients.

Exploring security in the GP−patient relationship: A qualitative study
‘The doctor−patient relationship is foundational to whole-person care, facilitating knowledge of the patient, trust and management.’
 
In a 2020 Australian Journal of General Practice article, Dr Hayley Thomas explored the doctor–patient relationship based on responses from GPs and GPs in training, reiterating that the relationship’s value is well established and improves patient adherence, satisfaction and health outcomes.
 
From this study, Dr Thomas became interested in the ‘unique nature’ of the GP−patient relationship and how they are cultivated. This formed the impetus for her new project, recently awarded the RACGP Foundation Family Medical Care Education and Research Grant as part of the 2021 round of RACGP Foundation grants.
 
‘Patients particularly value continuous personal relationships with their GP when they are experiencing vulnerability, such as being seriously unwell or experiencing psychiatric or family problems,’ Dr Thomas told newsGP.
 
‘Some researchers have suggested that this may be explained by our human tendency to seek safety in secure relationships when we are threatened. It is well accepted that supportive doctor−patient relationships can have healing value, particularly in these types of circumstances. 
 
‘The way we connect with our patients is fundamental to high-quality general practice, now more than ever.’

Dr Thomas’ project will focus on consumerist models of primary care and the reduction in GP−patient contact and continuity, which she believes has resulted in GPs identifying the need for a push for relationship-based care.

‘Concerns have been voiced for some time that an increasingly consumerist model of primary care and systems changes that reduce GP−patient continuity may threaten [that] relationship,’ she said.
 
‘This has resulted in calls from GPs to advocate for relationship-based care. This research is particularly relevant in this context.’
 
Dr Thomas believes her team’s research is also timely in the context of primary health system reforms, highlighting that the definition of strong GP−patient relationships is expected to assist in advocating for health systems ‘that are consistent with GPs’ sense that a consumer model should not be expected to yield the full benefits of healing primary care relationships’.
 
‘It could also underpin future research on whether patients develop attachments to a “practice” or “team” and whether the relationship is similar to other health professional−patient relationships: important questions in the context of current moves towards team-based care,’ she said.
 
A New Fellow of the RACGP, Dr Thomas enjoys the combination of clinical practice with research and teaching, having completed her general practice training in 2019.
 
She currently works as a GP in Scarborough, Queensland and is a senior lecturer with the University of Queensland’s Primary Care Clinical Unit, having previously undertaken academic registrar posts there during her general practice training.
 
Dr Thomas is anticipating her research will support the strengthening of doctorpatient relationships, with relevance both to individual practitioners and to health systems. 

‘We hope to discover whether the ways that GPs intend to cultivate relationships align with what their patients’ value, and express [this] need in a health service,’ she said.
 
‘This would enable evaluation of how well patients’ values are reflected in general practice training and professional development, and enhancement of this education. The research may also enable GPs to reflect on “difficult” patient interactions and foster self-care through increased awareness of how individual relational styles affect these interactions.’ 
 
GPs’ knowledge, utilisation of resources and guidelines in understanding prescribing issues with psychotropic medication use in pregnancy and breastfeeding: A mixed-methods study
Dr Jacqueline Frayne is a GP and senior lecturer in general practice at the University of Western Australia. She knows firsthand about the pros and cons of the use of psychotropic medication for pregnant and breastfeeding women.
 
‘I work in an antenatal clinic for women with severe mental illnesses at the women’s hospital in Perth, and therefore recognise the challenges and impact – both positive and negative − that the prescribing of psychotropic medication can have during this time,’ Dr Frayne told newsGP.
 
‘Additionally, in my general practice I see many women who struggle with the decision-making process regarding the use of medication in pregnancy, and believe that information they receive outlining the best available evidence and discussing the associated risk and benefits helps.’
 
Dr Frayne research team received the Therapeutic Guidelines Limited (TGL) / RACGP Foundation Research Grant 2021 for a project that explores the role of GPs in prescribing psychotropic medications for women who are pregnant or breastfeeding.
 
The goal is to improve outcomes for these women and their babies and to guide GPs in what Dr Frayne describes as a ‘complex area’.
 
According to Dr Frayne, as the prescribing of psychotropic medications is more frequent, the role of GPs in managing these situations within their communities becomes ‘increasingly important’. Equally important is identifying the diversity of GPs’ knowledge and patients’ situations.
 
‘The research will [also] bring many challenges, including the vast range in clinicians’ experience and knowledge, and access to care and services for women varied throughout Australia,’ she said.
 
To help meet this need, Dr Frayne is anticipating her research will guide the implementation of enhanced support into the general practice setting.
 
‘I would love to see all GPs have easy access to clear and user-friendly guidelines to assist in their practice of this complex area,’ she said.
 
‘Thereby ensuring the best possible outcomes, for not only women and their babies but also for their families.’  
 
The full list of 2021 RACGP Foundation Grant recipients is available on the RACGP website.
 
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