The 3-Domains toolkit for assessing older drivers: pilot study in general practices and validation study in driving assessment clinic
Assessing fitness to drive in older drivers is an increasingly important but challenging role for general practice. General practitioners (GPs) are often the first port of call for concerned family or friends, and some Australian states and territories require older drivers to have an annual assessment of their health and fitness to drive. Some GPs are not comfortable in this role, citing concern to maintain relationships with older patients, concern about the impact driving cessation can have on an older person and poor access to on-road driving assessments.
The 3-Domains toolkit is a screening toolkit for use in general practice to inform clinical judgment when assessing fitness to drive in older drivers (>75 years). The toolkit comprises visual acuity using a Snellen chart; the functional reach test; and the road signs recognition test. The toolkit generates a score predicting the likelihood an older driver would pass an on-road driving test.
This project is to determine whether the 3-Domains toolkit is acceptable and useful to GPs and older drivers in Australia; to evaluate the effectiveness of the toolkit in predicting on-road driving test outcome in older drivers in Australia. If the toolkit is found to be effective, useful, acceptable to both GPs and older drivers, it could be used regularly in practices to inform clinical judgment, and as a communication tool to facilitate discussions about the need to plan for eventual driving cessation or for on-road testing.
Funded by: Motor Accident Insurance Commission and the RACGP Foundation grant.
Research team: A/Prof Katharine Wallis, Dr Geoff Spurling, Dr James Matthews, Dr Theresa Scott, Dr Rory Melville.
Access the 3-Domains toolkit.
Assessing fitness to drive in older people: the need for an evidence-based toolkit in general practice.
A crisis is also an opportunity: GP teachers' views on continuing clinical placements in general practice during an evolving pandemic
Associate Professor Katharine Wallis, Associate Professor Jane Smith, Dr. Rory Melville, Associate Professor Deborah Askew, Associate Professor Nancy Sturman, Dr. Margaret Henderson, Dr. Kim Jackson
Background: Early in the COVID-19 pandemic, some universities suspended student placements in general practice.
Objective: To explore the views of GP clinical teachers.
Methods: Semi-structured interviews with 15 GP teachers in southeast Queensland from June to August 2020.
Results: Challenges included lack of masks and space, and concerns around infection control, medicolegal liability and student learning. Telehealth created more time for reflection and accessing information, increased student access to sensitive consultations, and opportunities to think-through rather than rote-do physical examinations. Students could be an extra pair of hands, also accessing and implementing the latest public health advice. GP teachers wanted clear communication and guidance from universities and for students to be trained in infection control and telehealth skills.
Discussion: Findings suggest that many GP teachers can be supported to continue clinical placements during an evolving crisis. The pandemic presented many challenges for general practice, but also new opportunities for students to learn and contribute in practice.
RELEASE: REdressing Long-tErm Antidepressant uSE in general practice
Our aim is to improve Australian health outcomes by decreasing unnecessary and potentially harmful long-term (>12 months) prescribing of antidepressants in general practice. Unpleasant withdrawal symptoms make stopping antidepressants difficult for many people. The outcomes of our research will include a validated antidepressant discontinuation model and proven implementation strategies, including practical resources where currently there are none, to foster sustainable improvement in primary mental health care, including for urban and rural general practice.
Projects are updated as approved and funded.
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