Data presented in the report Healthy Communities: GP care for patients with chronic conditions in 2009–2013 were sourced from the Bettering the Evaluation and Care of Health (BEACH) program conducted by the Family Medicine Research Centre (FMRC) at the University of Sydney. Analysis of data was provided by FMRC.
About the BEACH program
The BEACH program, which began in April 1998, is a continuous national cross-sectional study of GP activity in Australia. Each year, approximately 1,250 active GPs are recruited from a random sample drawn by the Australian Government Department of Health, with approximately 1,000 GPs participating in the study. Each participating GP records details of 100 consecutive encounters with consenting patients on paper recording forms. These encounters are termed GP consultations in the report. These forms collect information on patient characteristics, encounter details, the health problems managed at the encounter (GP management occasion) and the clinical actions undertaken (actively managed) by the GP to manage these problems. The types of clinical actions recorded include: medications prescribed/supplied or advised for over-the-counter purchase; clinical treatments; procedural treatments; imaging and pathology tests ordered; and referrals provided. See Appendix 1 for an example of the BEACH survey form.1
About the BEACH substudies
In addition to the BEACH encounter data collected, the BEACH program simultaneously conducts substudies to collect information about aspects of patients’ health or health care provided to patients on specific topics that are not covered in the encounter data. These patient substudies are referred to as SAND (Supplementary Analysis of Nominated Data). For more information about the SAND substudies see General practice activity in Australia 2012–13.1
A series of BEACH SAND substudies used in the report examined the prevalence of chronic conditions in Australian general practice patients. See Box 1 for more information about these chronic disease substudies.
Box 1: BEACH SAND chronic disease substudies
Three BEACH SAND chronic disease substudies were used to provide information on the prevalence of selected chronic conditions among patients and how often GPs see patients who have chronic conditions. These substudies were conducted between July 2005 and June 2013. In total, the studies provided a sample of 861 GPs recording information for 25,855 patients.
While the response categories in the three chronic disease substudies differed slightly, all of the studies asked GPs, ‘Does the patient have any of the following chronic diseases/problems?’ Common chronic conditions were listed (tick boxes) with additional blank spaces allowing free text descriptions of other unlisted chronic conditions. A ‘no chronic conditions’ option was also provided. GPs were instructed to ‘use your own knowledge, patient knowledge and health records as you see fit, in order to answer these questions’. Chronic conditions listed were primarily those most frequently managed among Australian general practice.1
There were 18 common chronic conditions selected in all three studies. These same conditions are used in Healthy Communities: GP care for patients with chronic conditions in 2009–2013. The conditions are in order based on prevalence at GP consultation:
- Osteoarthritis (OA)
- Gastro-oesophageal reflux disease (GORD)
- Chronic back pain
- Ischaemic heart disease
- Type 2 diabetes
- Cancer (malignant neoplasm)
- Sleep disorder
- Chronic obstructive pulmonary disease (COPD)
- Cerebrovascular disease/ cerebrovascular accident (CVD/CVA)
- Congestive heart failure
- Peripheral vascular disease
- Rheumatoid arthritis (RA)
- Type 1 diabetes.
International Classification of Primary Care
Information provided on the BEACH survey and BEACH SAND substudy survey forms are classified according to the International Classification of Primary Care, 2nd edition (ICPC‑2).2 This is a classification designed for primary care, including general practice.2 It is accepted by the World Health Organization (WHO) in the WHO Family of International Classifications3, and is the declared national standard in Australia for reporting of health data from general practice and patient self-reported health information.4 It allows for the classification of three elements of a health care encounter: patient reasons for encounter; diagnoses or problems managed; and the process of care. The linked METeOR specifications refer to ICPC-2.
Classification of medications
Information on medications prescribed by GPs provided on the BEACH survey forms are classified to the Anatomical Therapeutic Chemical (ATC) classification index.5 The ATC divides medications into different groups according to the organ or system on which they act and their therapeutic, pharmacological and chemical properties.
Percentage of GP management occasions where depression or anxiety was managed in which psychotropic medication were prescribed refers to medications in ATC categories N05 (psycholeptics), which include antipsychotics, anxiolytics and hypnotics and sedatives, and N06 (psychoanaleptics) which include antidepressants, psychostimulates, agents used for attention deficit hyperactivity disorder (ADHD) and nootropics, psycholeptics and psychoanaleptics in combination and anti-dementia drugs. The linked METeOR specifications refer to ATC.
1. Britt H, Miller GC, et al. General practice activity in Australia 2012–13. General practice series no. 33. Sydney: Sydney University Press; 2013.
2. Classification Committee of the World Organization of Family Doctors. ICPC-2: International Classification of Primary Care. Oxford: Oxford University Press; 1998.
3. World Health Organization (WHO). Family of international classifications [Internet]. Geneva: WHO; 2004 [cited 2013 Jul 30]. Available from: http://www.who.int/classifications/en/WHOFICFamily.pdfExternal link, opens in a new window.
4. Australian Institute of Health and Welfare (AIHW). Australian family of health and related classifications matrix [Internet]. Canberra: AIHW; 2013 [cited 2013 Jul 30]. Available from: http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442475388&libID=6442475369
5. World Health Organization Collaborating Centre for Drug Statistics Methodology. Anatomical Therapeutic Chemical (ATC) classification index with Defined Daily Doses (DDDs). Oslo: WHO; 2009.