Research news in brief

Arthritis Australia launches National Strategic Action Plan

Arthritis Australia is calling on government at all levels to invest in implementing the National Strategic Action Plan for Arthritis, which was launched on 21 March 2019. The Action Plan provides an evidence-based blueprint to guide national efforts to improve the health and quality of life for people living with arthritis, reduce the cost and prevalence of the condition, and reduce the impact on individuals, their carers and the community. The development of the Action Plan was led by Arthritis Australia for the Australian Government Department of Health, with input from consumer and medical groups across Australia. At present, two-thirds of Australians with arthritis report that they are faring badly with their condition, with the most common problems being inadequate pain management, lack of information and support, and the high costs of care. Hip and knee replacement for osteoarthritis already cost the health system more than $2.3 billion a year and this is projected to double to over $5.3 billion by 2030. The Action Plan identifies three key priority areas that require urgent, immediate attention: awareness, prevention and education; high value, person-centred care and support; research evidence and data. Recommendations include: awareness campaigns to increase public understanding of arthritis and how it can be prevented and managed; fund arthritis educators to provide personalised care and support; develop and implement a national sports injury prevention program to reduce the risk of developing osteoarthritis; increase funding for specialist and allied health services; provide information, education and tools for health professionals; pilot and evaluate a community-based “one-stop-shop” arthritis clinic to provide a single point of contact for diagnosis, assessment, triage, treatment and referral to other services; fund an arthritis and musculoskeletal research mission from the Medical Research Future Fund to improve arthritis prevention, diagnosis and treatment, and support the search for cures.

New GP qualification to improve support for rural patients

The Royal Australian College of General Practitioners (RACGP) has committed to a new Rural Generalist Fellowship for trainee doctors. The RACGP Fellowship in Rural Generalism will be available for GP registrars from 2020. Transition processes will be developed for experienced GPs and those who already hold a Fellowship in Advanced Rural General Practice or experienced rural GPs who hold a Fellowship with the RACGP. Vice President of the RACGP and Chair of RACGP Rural, Associate Professor Ayman Shenouda, said the new Fellowship will offer a well supported pathway for junior doctors, with the flexibility that would also allow entry and exit from their training at various stages of their career. “[It] will also encourage GPs who want to acquire new skills or to have their existing skills recognised by the RACGP, and better address the shifting needs of rural and remote communities, such as the ever-evolving needs of mental health and palliative care. The specific and appropriate training a Rural Generalist Fellowship will provide registrars and GPs will empower them to care for their rural communities. The evidence is clear that doctors who train and upskill in a rural or remote setting tend to remain in a rural or remote setting caring for their patients.”

National Disability Strategy is “piecemeal” rather than strategic: UNSW report

A report from the UNSW Social Policy Research Centre (SPRC) has found that the National Disability Strategy (NDS) has important goals but it isn’t dealing with the issue of violence, and it is being overshadowed by the National Disability Insurance Scheme (NDIS). The NDS is a plan agreed to by all governments in Australia to make the lives of people with disability better, including improving their accessibility, inclusiveness and participation in society, as well as changing community attitudes towards disability. The Review of implementation of the National Disability Strategy 2010–2020 report comes after the federal government announced it would establish a royal commission into violence and abuse of people with a disability. Lead author of the report, SPRC Senior Research Fellow and Interim Director of the UNSW Disability Innovation Institute, Rosemary Kayess, said: “The NDS tended to be quite piecemeal [in achieving goals]. There would be small pockets of good examples of policy working, but what was being achieved wasn’t strategic; it wasn’t articulated to any broader plan of action”. Ms Kayess said the NDS review report found there was so much government focus on the NDIS that the NDS “just got lost”. She said people with disability would need less support from the NDIS packages if the community were more inclusive and the NDS focused on areas that the NDIS didn’t cover. The report found there was a lack of drive by the federal, state and local governments to implement the NDS as a whole. The national public consultation – Shaping the future of disability policy for 2020 and beyond – is open from April 29 to May 30 2019.

What’s new online at the MJA

Research: Early initiation of antiretroviral therapy for people newly diagnosed with HIV infection in Australia: trends and predictors, 2004–2015
McManus et al; doi: 10.5694/mja2.50006
Further strategies will maximise the benefits of treatment for preventing viral transmission and morbidity … OPEN ACCESS permanently

Podcast: Professor Basil Donovan, Head of the Sexual Health Program at the Kirby Institute, UNSW, talking about early initiation of ART for HIV infections … OPEN ACCESS permanently

Research: Cultural respect in general practice: a cluster randomised controlled trial
Liaw et al; doi: 10.5694/mja2.50031
The complexities of programs that integrate “thinking and doing” cultural respect into primary care require more research … OPEN ACCESS permanently

Research: Evaluating the benefits of a rapid access chest pain clinic in Australia
Black et al; doi: 10.5694/mja2.50021
Assessing people with new onset chest pain in RACPCs may have important benefits to Australian hospitals … OPEN ACCESS permanently

Narrative review: Updates in the management of inflammatory bowel disease during pregnancy
Bell and Flanagan; doi: 10.5694/mja2.50062
As the peak incidence of inflammatory bowel disease overlaps with the prime childbearing years, medication use and disease control in pregnancy are essential for patient wellbeing … PAYWALL