David has been part of the HANDI team for over 2 years, assisting in reviewing and preparing entries for inclusion on the HANDI website. He is a senior lecturer in General Practice at the University of Queensland. In 1995 he started teaching Evidence-Based Medicine with Professor Paul Glasziou, Centre for Research in Evidence-Based Practice, Bond University, which has influenced his application of the best evidence and a critical approach to his own clinical work situations. Current clinical work encompasses student health and a refugee clinic at the Mater hospital in Brisbane. He has designed and overseen a number of clinical trials in general practice, and had some involvement in developing clinical pathways for divisions of general practice and PHNs.
Improving use of effective nondrug treatments in primary care: HANDI in HealthPathways
Sunday 2 September | View program for more details
Effective non-drug methods are less well known, less well promoted, and less well used than their pharmaceutical cousins. Advances in non-drug treatments in the past few decades have been substantial and diverse: exercise for heart failure and COPD, ‘mirror’ therapy for poststroke pain, the Epley manoeuvre for benign paroxysmal positional vertigo, cognitive therapy for depression (and almost everything else!), ‘bibliotherapy’ (specific guided self-help books), to name just a few. Indeed, nearly half the thousands of clinical trials conducted each year are for non-drug treatments. However, these simple, cheap, effective nondrug treatments are underused in primary care. To address one barrier to using non-drug interventions, in 2013 the RACGP launched of the Handbook of Non-Drug Intervention (HANDI), which aims to make ‘prescribing’ a non-drug therapy almost as easy prescribing a drug. However, many barriers remain to making better use of effective non-drug treatments, including poor support for clinical trials, poor reporting of such trials, and better awareness and uptake by clinicians and patients (https://www.racgp.org.au/handi). Currently, HANDI has over 65 effective non-drug interventions including exercises, procedures, devices, and diet each with easy-to-follow instructions for their use, with about 8,000 views/month. To improve the use of HANDI topics, the Mackay HealthPathways is introducing links to relevant HANDI items, and will provide education sessions to GPs focusing on these clinical pathways and HANDI items. To evaluate their impact, we will conduct a crossover designed study to assess the uptake and outcomes of HANDI interventions for 5 common conditions (osteoarthritis, back/neck pain, COPD/pulmonary rehabilitation, diabetes, and depression). We will embed links to the HANDI website in Mackay HealthPathways and compare outcomes with a neighbouring Hospital and Health Service as a control. By positioning HANDI within the Mackay HealthPathways, we aim to reduce patient costs, improve their care and create a more sustainable healthcare system.