Research can be ‘vital part’ of GPs’ caring role

Morgan Liotta

29/04/2021 4:32:51 PM

newsGP talks to two previous recipients of RACGP Foundation grants ahead of applications closing on 3 May.

Dr Winnie Chen and Dr Cate Howell
Dr Winnie Chen (left) and Dr Cate Howell were 2020 recipients of RAGGP Foundation research grants.

‘I definitely recommend GPs to apply for the RACGP Foundation Grant. GPs are practical people who want to assist their patients. Research plays a vital part in this.’
That is Dr Cate Howell, recipient of the 2020 RACGP Foundation / ANEDGP Innovation Research Grant for her project, ‘Bridging the gap between primary care and mental health professionals: Scoping review to inform the development of an e-mental health solution’.
A GP with a passion for mental health and wellbeing for many years, Dr Howell first came across the use of e-mental health programs while on a 12-month 2000 Churchill Fellowship to study primary care management of anxiety and depression.
‘I remember being amazed by its [e-mental health] use, and on my return subsequently incorporated use of e-mental health in group mental health programs we were delivering at the Adelaide North East Division of General Practice,’ Dr Howell told newsGP.
She has had a special interest in the use of e-mental health programs in primary care ever since, prompting her to become involved in related research and the grant-funded project to further her knowledge in the field.
‘I was approached by a team of researchers about this project and it resonated with me as a GP, and one who has worked regionally for a number of years,’ Dr Howell said.
‘I saw that this project had the potential to result in findings which could help GPs assist patients experiencing a range of mental health problems … [and was] particularly relevant for GPs working in rural and regional areas.
‘It was also stimulating to work with a research team again and refresh some research skills.’
Acknowledging the existing challenges to access support and services for patients in rural and regional areas, Dr Howell’s research team is working to create a new online self-help intervention for Australians.
The intervention will provide practical, evidence-based strategies to better manage stress, adapt to change and improve mental wellbeing. It aims to address gaps in care identified by GPs, between when people present to primary care and when they can access professional mental health services.
‘It can be challenging for GPs to advise on the most appropriate program for their patients experiencing a mental health issue,’ Dr Howell said.

‘Self-help programs have been shown to be well-received and effective, and they can give patients early access to psycho-education and psychological strategies to assist in their recovery.’ 
The project assessed grant providing an opportunity to conduct a scoping review of existing resources to ensure the intervention adds to, rather than replicates, resources that are already available.
According to Dr Howell, the ability to learn from existing resources will lead to the ‘best possible’ version of the current intervention and increased awareness of available tools.
It aims to benefit patients by incorporating the most up-to-date evidence on e-mental health care and provide GPs an up-to-date summary of existing resources to refer to.
‘I look forward to the results being disseminated and utilising the findings in practice,’ Dr Howell said. 
GP Dr Winnie Chen found many benefits from applying for, and subsequently receiving, her RACGP Foundation Grant.
‘Writing the grant application as principal investigator was a useful experience in itself, and helped me to be more confident in participating in grant applications for subsequent projects,’ she told newsGP.
‘The grant has allowed me to fund a research assistant so that I can broaden the scope of the review to include a variety of chronic diseases, supporting myself and my assistant to attend a week-long systematic review course before commencing the review.’
In contrast, Dr Chen said that previous systematic reviews on clinical decision support systems have primarily focused on a single disease, such as decision support for diabetes, due to time and resource limitations.
‘As GPs, we want to know what the evidence is for decision support overall – not just for a single disease,’ she said.
Dr Chen’s project, ‘Using clinical decision support for chronic diseases? A systematic review of the past decade’ earned her a 2020 RACGP Foundation Chris Silagy Research Scholarship.
‘The ubiquitous use of electronic health records has opened opportunities for increasing interest in data-driven clinical decision support tools,’ she said.
‘Patients often present to their GPs with multiple chronic diseases, [and these] patients have rich information within their electronic health records – held with their GPs or inside their hospital records.
‘This systematic review looks at studies done in the past 10 years to investigate whether decision-support tools actually improve outcomes for patients and clinicians.’
Part of a team at Menzies School of Health Research in Darwin, Dr Chen is developing a clinical decision-support tool for chronic diseases, Territory Kidney Care.
The tool began as a data-driven decision support for chronic kidney disease but has now expanded to assist with diagnosis and management of a broad range of common chronic diseases, including cardiovascular diseases, diabetes, hypertension, and hyperlipidaemia. 
Given the role of primary care in managing chronic disease, Dr Chen is hoping her work will be integrated into general practice to improve outcomes for both GPs and patients.
‘The results of the systematic review help our research team to learn from the successes and failures of similar projects,’ she said. ‘This helps us to improve how we use our decision-support tool in routine workflows for GPs and hospital-based clinicians in the Northern Territory.’
Dr Chen encourages GPs and GPs in training to apply for a Foundation grant.
‘It doesn’t hurt to apply for a grant if you have a suitable research project in mind,’ she said.
Applications for the 2021 RACGP Foundation Grants and Awards close Monday 3 May.
More information and applications are available on the Foundation website.
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