GP role crucial as senior population increases by millions in next 40 years
Sydney, 25 September 2017: Australia’s population is ageing rapidly, with the number of people aged 75 or more expected to increase by four million from 2012 to 2060.1 Annual deaths will also increase over 250 per cent from 147,000 deaths in 2012 to approximately 345,000 in 2061.2
To better support general practitioners as they address the increasing health needs of our ageing population, HCF Research Foundation and The Royal Australian College of General Practitioners (RACGP) are awarding almost $114,000 in research grants to two researchers tackling the growing challenges at a primary-care level of a population that lives longer and dies differently. This year’s grant recipients highlight the increasingly prominent role that general practitioners will play in the health of Australia’s ageing population when it comes to managing those living with multiple health conditions, and providing crucial end-of-life care in a community setting.
HCF Research Foundation Chair, Lisa McIntyre, said the health industry is proactively preparing for the increased challenges of an ageing population.
“We’re pleased the recipients of this year’s grants have a timely focus on improving the health care experiences for the ageing Australian population. It’s more important than ever that we work collaboratively to find solutions for the unique challenges of elderly Australians.”
Mitigating adverse drug events in older Australians
Professor Parker Magin from University of Newcastle is one of the successful HCF Research Foundation and RACGP grant recipients. His research is addressing the challenge of adverse drug effects which is a significant issue for older Australians who are often prescribed a range of medicines to manage multiple health defects.
In Australia, by the age of 70 three out of four people who are hospitalised take five or more medicines every day.3
“Adverse drug events in older Australians are frequently under-recognised, and can be mistaken for symptoms that require further medication. There is now substantial evidence some medicines can be withdrawn safely in older people, with reduction in polypharmacy having survival benefits,” Professor Magin said.4
Over 90 per cent of older people across a range of settings stated that they would like to stop one of their medicines if their doctor said it was possible.5 Professor Magin and his team will be piloting an approach to address the known barriers which doctors and patients face in ‘deprescribing’ medication. They will then evaluate how effective it is to bring together patient priorities and decision support tools, to electronically flag potentially inappropriate medicines.
“We will evaluate the process and acceptability of the ‘deprescribing’ approach qualitatively, and measure changes in emergency presentations or unplanned hospital admissions, patient wellbeing and health system costs,” continued Professor Magin.
Major role for GPs in end-of-life care
The sheer numbers of older people with complex disease highlights the important role of GPs in end-of-life care, working to support a limited specialist palliative care workforce.
The second recipient of the HCF Research Foundation and RACGP grant is Professor Geoffrey Mitchell from University of Queensland. Professor Mitchell’s team has identified that with this elevated role, benchmark data is needed on the nature of end-of-life care at a community level, to better support GPs in managing patients at this stage of illness.
Professor Mitchell’s team will develop and test a questionnaire that can be used to routinely collect data from GPs on end-of-life care.
“GPs have an important role to play in end of life care as they are easily accessible, often have a longstanding relationship with the patient and can carry out home visits. The goal of this research project is to create a viable primary end-of-life care register, which can be used to document quality care needs, as well as track changes in medical practice over time,” said Professor Mitchell.
“The research will also be used to inform the development and implementation of an Australian-first national dataset on primary end-of-life care, so we can use that data to continue to make improvements to the system as the population continues to age,” said Professor Mitchell.
The health care industry is facing an emerging challenge when it comes to the ageing population and HCF is constantly looking at ways to improve systems and better patient outcomes. Along with supporting HCF Research Foundation to find solutions, HCF continues to invest in services like My Health Guardian, and start-ups such as Curo Technologies through our HCF Catalyst accelerator program.
HCF Research Foundation is in its fifth year of co-funding research grants with the RACGP for research that will ultimately improve Australians’ access to health services, and benefit the health care experiences of all Australians now and into the future.
Professor Parker Magin, University of Newcastle
AusTAPER Pilot: Team Approach to Polypharmacy Evaluation and Reduction (AusTaper) pilot study for older General Practice
- Professor Parker Magin, and his team at University of Newcastle will be piloting an approach to address the barriers which doctors and patients face in ‘deprescribing’ medication. For patients, these barriers include fears of the original condition returning, and withdrawal effects. For doctors a lack of guidance and self-efficacy are noted as barriers
- They will then evaluate how effective it is to bring together patient priorities and decision support tools, to then electronically flag potentially inappropriate medicines.
- The project will also provide a clinical pathway for structured assessment and follow up by GPs and pharmacists in a web-based system.
- This will all be executed via the ‘Team Approach to Polypharmacy Evaluation and Reduction’ (AusTaper) app.
Professor Geoffrey Mitchell, University of Queensland
Development of a routine data collection process in community-based end-of-life care
- In Australia, little is known about the quality and how and what palliative and end-of-life care is provided in the community setting.
- Professor Mitchell’s team will develop a questionnaire that can be used to routinely collect data from GPs on end-of-life care - including information on causes of death, co-morbidities, location of care and death, symptom management techniques, service use and advance care planning.
- They will then test the questionnaire to see if this is the most feasible and effective way of capturing this data.
- This project is an essential step in the development of a national primary care minimum dataset, a live registry recording the treatment of patients by GPs at the end of their lives. This has not been achieved in Australia before.
Professor Mitchell’s team includes Dr Claire Johnson PhD, RN, Senior Research Fellow and manager of the Cancer and Palliative Care Research and Evaluation Unit at The University of Western Australia. She and Professor Mitchell have collaborated in primary palliative care research for a decade. Dr Johnson’s initial work was critical to this project being feasible at all.
About the HCF Research Foundation
Now in its 17th year, the HCF Research Foundation’s mission is to encourage the examination and improvement of the provision, administration and delivery of health services to effect positive changes to the health of all Australians. This is achieved by funding research projects that consider the most effective ways to organise, manage, finance and deliver high-quality care; reduce the number of errors; and improve patient safety.
The HCF Research Foundation was originally established with a donation from The Hospitals Contribution Fund of Australia Limited (HCF). While HCF has generously donated money to establish the Foundation’s current corpus of $50 million, the HCF Research Foundation operates independently and with specific focus on funding health services research that can benefit all 24 million Australians.
Visit the HCF Research Foundation website: www.hcf.com.au/about-us/hcf-foundation/.
About the RACGP
The Royal Australian College of General Practitioners (RACGP) was established in 1958 and is Australia’s peak general practice representative organisation.
The RACGP has more than 35,000 members working in or towards a career in general practice across metropolitan, regional and rural areas of the country. Almost 9 in every 10 GPs are with the RACGP.
More than 134 million general practice consultations take place annually in Australia.
Visit the RACGP website: www.racgp.org.au or foundation.racgp.org.au
Issued on behalf of HCF Research Foundation by WE Buchan. Media inquiries to:
- Ellen McIver
Ph: (02) 9237 2814
M: 0414 137 686
- Sophia Brockman
Ph: (02) 9237 2815
M: 0416 558 002
HCF, Australia’s largest not-for-profit health fund protecting people since 1932, covers around 1.5 million members with health and life insurance, community care, travel and pet insurance. On average over the last five years, HCF has paid out more cents in every dollar in premiums to members as benefits than the industry average. With over 35,000 specialists participating in its Medical Gap Cover Scheme and approximately 10,000 providers participating in its 100% back More for You programs, HCF gives members access to quality healthcare with no gaps or minimal costs compared to non-participating providers. To empower members to put their health first, HCF also offers a range of health and lifestyle services including its My Health Guardian health management program, mobile Victor Chang Heart Health Checks and My Global Specialist second opinion service. HCF’s national network of retail outlets and Australian-based call centres have earned multi-award winning status. HCF members also have access to low cost, high quality services at HCF Dental Centres. Having contributed $50 million to support the health services research funded by the HCF Research Foundation, HCF is devoted to investing in the future of Australia’s health. To learn more about HCF go to hcf.com.au/about-us
1Productivity Commission 2013, An Ageing Australia: Preparing for the Future, Commission Research Paper Overview, Canberra.
2Australian Bureau of Statistics. 3222.0 – Population Projections, Australia, 2012 (base) to 2101. Canberra, Australia 2012.
3Hubbard RE, Peel NM, Scott IA, et al. Polypharmacy among inpatients aged 70 years or older in Australia. Medical Journal of Australia 2015
4Polypharmacy describes the use of four or more medications by a patient, generally adults aged over 65 year
5Qi K, Reeve E, Hilmer SN, et al. Older peoples’ attitudes regarding polypharmacy, statin use and willingness to have statins deprescribed in Australia. International Journal of Clinical Pharmacy 2015.