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Dr Smita Shah Director, Primary Health Care Education and Research Unit Primary Care and Community Health Network Clinical Senior Lecturer, School of Public Health Western Clinical School, Poche Centre for Indigenous Health The University of Sydney, Australia Susan Sawyer, Brett Toelle, Craig Mellis, Jenny Peat, Marivic Lagleva, Tim Usherwood, Christine Jenkins  PACE Australia Intervention
Australia
[object Object],Sydney
Overview ,[object Object],[object Object],[object Object],[object Object]
  PACE Australia partners ,[object Object],[object Object],[object Object],[object Object],Funded by the Australian Government Department of Health & Ageing
Phase 1: 2003-04 ,[object Object],[object Object],[object Object],[object Object]
Program comparison ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PACE Australia Session 1 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PACE Australia Session 2 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PACE Australia Doctor’s Kit ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],Phase 1: Feasibility study
Results ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
GPs - communication behaviours 12 months pre workshop 1 month post workshop Difference P value Mean “ How Confident ” score (1= not at all confident to  6 = extremely confident) 4.2   5.03   0.8 < 0.0001 Mean “ How Helpful ” score (1= not at all helpful to  6 = extremely helpful) 5.0   5.5   0.5   0.01   Mean “ How Often ” score  (1= never to 6 = often) 4.6   5.2   0.6   0.0001
Phase 2: 2005 ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Phase 3: 2006 – 2010
PACE Australia Outcomes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Results Variation in baseline study population PACE USA PACE Australia Target Primary Care Paediatricians General Practitioners  Asthma severity Moderate-Severe Mild-Moderate ICS use Suboptimal Inappropriate
Use of ICS by asthma classification
Outcomes: NNT General Practitioners NNT Completion of asthma cycle of care  3.3 Prescribing a spacer device 3.5 Providing written action plan>70% of time  4.3 Patients Child with persistent symptoms using ICS 4.0 Child with infrequent symptoms not using ICS  4.2 Written action plan in last 12 months 5.4
Key differences in results ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Dissemination ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
RE-AIM / PACE Australia How does PACE Australia fit the RE-AIM framework? Reach High - Individual level Efficacy High – Individual level Adoption ? - organisation Implementation Medium - organisation Maintenance High – individual Organisation –low
Questions ,[object Object],[object Object],[object Object]

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PACE Australia Intervention

  • 1. Dr Smita Shah Director, Primary Health Care Education and Research Unit Primary Care and Community Health Network Clinical Senior Lecturer, School of Public Health Western Clinical School, Poche Centre for Indigenous Health The University of Sydney, Australia Susan Sawyer, Brett Toelle, Craig Mellis, Jenny Peat, Marivic Lagleva, Tim Usherwood, Christine Jenkins PACE Australia Intervention
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10.
  • 11.
  • 12.
  • 13. GPs - communication behaviours 12 months pre workshop 1 month post workshop Difference P value Mean “ How Confident ” score (1= not at all confident to 6 = extremely confident) 4.2 5.03 0.8 < 0.0001 Mean “ How Helpful ” score (1= not at all helpful to 6 = extremely helpful) 5.0 5.5 0.5 0.01 Mean “ How Often ” score (1= never to 6 = often) 4.6 5.2 0.6 0.0001
  • 14.
  • 15.
  • 16.
  • 17. Results Variation in baseline study population PACE USA PACE Australia Target Primary Care Paediatricians General Practitioners Asthma severity Moderate-Severe Mild-Moderate ICS use Suboptimal Inappropriate
  • 18. Use of ICS by asthma classification
  • 19. Outcomes: NNT General Practitioners NNT Completion of asthma cycle of care 3.3 Prescribing a spacer device 3.5 Providing written action plan>70% of time 4.3 Patients Child with persistent symptoms using ICS 4.0 Child with infrequent symptoms not using ICS 4.2 Written action plan in last 12 months 5.4
  • 20.
  • 21.
  • 22. RE-AIM / PACE Australia How does PACE Australia fit the RE-AIM framework? Reach High - Individual level Efficacy High – Individual level Adoption ? - organisation Implementation Medium - organisation Maintenance High – individual Organisation –low
  • 23.

Notes de l'éditeur

  1. Thank you My paper today is reporting on our experience
  2. First a little about Australia. Australia and the US are of a similar size , but the US population is fifteen times that of Australia’s 20 million Majority of Australians live along the East coast in cities like Melbourne, Brisbane and Sydney. I live and work in Sydney, which is Australia’s largest city, with a population of nearly 4million
  3. Suggested script The PACE Australia Project is funded by the Department of Health and Ageing. The project has no commercial sponsorship from pharmaceutical companies .
  4. Suggested script Today we will have the first of the two sessions and this will broadly cover clinical aspects of asthma and communication strategies. In particular we will cover….
  5. Suggested script The second session will be held on Saturday September 8 th . This will focus on the broad topic of patient education. We will begin the 2nd session with questions or your own cases for discussion. Then we will hear from you about how you went trying out some of the communication strategies and your use of the self rating questionnaire – yes you have some homework to do between the first and second seminar – but we will come to that later!!! There will be a video demonstration of patient education, a discussion on asthma management plans and case studies. We will briefly present the new Asthma Cycle of Care. Finally we will have a hands-on and fun session for you to learn how to use devices and then to teach your patients the correct use of the various asthma delivery devices.
  6. Suggested script In this folder which you will receive later in the workshop you should have - a copy of the slides - so you don’t have to take too many notes - copies of any educational materials to which a speaker might refer - and also educational material for you to use in your practice.