MEDICINEINSIGHT Using health record data to explore the provision - - PowerPoint PPT Presentation
MEDICINEINSIGHT Using health record data to explore the provision of care in primary care Melissa Chapman BPharm MPH(PP) Clinical Product Specialist 14 October 2019 OVERVIEW Aim: To show how health record data can be used to explore general
Melissa Chapman BPharm MPH(PP) Clinical Product Specialist 14 October 2019
Aim: To show how health record data can be used to explore general practitioners’(GPs’) management of patients with certain conditions. Use MedicineInsight data to gain insights about the use of psychological treatments for the management of anxiety by GPs.
Large-scale Australian primary care data set De-identified patient data routinely extracted from the clinical information software (CIS) of participating practices Data can be used to support quality improvements Data validation in practice
Commercial in confidence
MEDICINEINSIGHT PRACTICES ACROSS AUSTRALIA
4
722
general practices
3.5 M
regular patients
5,074
GPs
83 12 122 262 11 144 50 21
A resource that… uses practice level data to start a conversation between GPs and educational visitors enables general practices to review and reflect on clinical activity and plan for areas of improvement is evidence-based
Affects 2.3 million Australians Second most common mental health presentation in primary care Psychological treatments, including cognitive behavioural therapy (CBT) are first line treatments for mild or moderate and in combination with antidepressants for severe anxiety disorders What data could help GPs understand their use of psychological treatments to manage patients with specific subtypes of anxiety disorders? Mental Health Treatment Plans (MHTP): proxy to explore psychological (non-pharmacological) treatments
PSYCHOLOGICAL INTERVENTIONS FOR ANXIETY SUBTYPES
Coded and free-text condition information were analysed Subtype Related term
AGORAPHOBIA Agoraphobia GENERALISED ANXIETY DISORDER GAD Generalised Anxiety Disorder SOCIAL ANXIETY DISORDER Social Anxiety Disorder Social phobia PANIC ATTACKS Panic attacks Panic disorder OBSESSIVE COMPULSIVE DISORDER Obsessive compulsive disorder OCD POST TRAUMATIC STRESS DISORDER Post Traumatic Stress Disorder PTSD
HOW IS THE DATA DISPLAYED?
5 10 15 20 25 30
16-34 35-44 45-54 55-64 65+ 16-34 35-44 45-54 55-64 65+ Male Female
% of patients aged ≥ 16 years with anxiety in last 24 months
Your practice (n=)
5 10 15 20 25 30 35 40
Post traumatic stress disorder [b] Obsessive compulsive disorder [b] Panic disorder Agoraphobia General anxiety disorder Social anxiety disorder
% of patients aged ≥ 16 years with anxiety in the last 24 months
Your practice (n=) All practices
Number of patients ≥ 16 years with anxiety % of patients ≥ 16 years with anxiety Number of patients ≥ 16 years with anxiety currently prescribed > 1 antidepressant % of patients ≥ 16 years with anxiety currently prescribed > 1 antidepressant All practices Your practice Dr 1 Dr 2 Dr 3 Dr 4 Other Doctors
Condition coding (coded vs free text) of anxiety symptoms/ anxiety disorder Data can not be extracted from progress notes Tick box for psychological treatments is NOT available for use in the CIS
Information about non-pharmacological management of patients with anxiety can be extracted even where data appeared to be limited. Data shows that psychological treatments are being used, and recorded in routinely collected data There may be some potential underuse for patients with anxiety:(approx.1/3 patients had a MHTP across the broad cohort of patients with anxiety symptoms) Build upon this data parameter for other condition in future programs
ACKNOWLEDGEMENTS We thank the patients, general practitioners and general practices who allow the use of their de-identified information for MedicineInsight We thank the advisory group (GPs and specialists) and NPS MedicineWise contributors: Rob Mina, Chris Gianacas, Josephine Belcher, Claire Green and Jeannie Yoo Funding was provided by the Department of Health as part
educational programs in primary care