Care of patients with chronic disease: the challenge for general practice

Mark F Harris and Nicholas A Zwar
Med J Aust 2007; 187 (2): 104-107.
  • Mark F Harris1
  • Nicholas A Zwar2

  • School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW.



Our research referred to in this article was funded by the Australian Government Department of Health and Ageing.

Competing interests:

None identified.

  • 1. Australian Institute of Health and Welfare. Chronic disease and associated risk factors in Australia 2006. Canberra: AIHW, 2006. (AIHW Cat. No. PHE 81.) (accessed Jun 2007).
  • 2. Pegram R, Daniel J, Harris M, et al. General practice in Australia 2004. Canberra: Australian Government Department of Health and Ageing, 2005.
  • 3. Overland J, Mira M, Yue DK. Diabetes management: shared care or shared neglect. Diabetes Res Clin Pract 1999; 44: 123-128.
  • 4. Griffin S. Diabetes care in general practice: meta-analysis of randomised control trials. BMJ 1998; 317: 390-396.
  • 5. Greenfield S, Rogers W, Mangotich M, et al. Outcomes of patients with hypertension and non-insulin dependent diabetes mellitus treated by different systems and specialities. Results from the medical outcomes study. JAMA 1995; 274: 1436-1444.
  • 6. Oakeshott P, Kerry S, Austin A, Cappuccio F. Is there a role for nurse-led blood pressure management in primary care? Fam Pract 2003; 20: 469-473.
  • 7. Baker R, Sanderson-Mann J, Longworth S, et al. Randomised controlled trial to compare GP-run orthopaedic clinics based in hospital outpatient departments and general practices. Br J Gen Pract 2005; 55: 912-917.
  • 8. Drummond N, Abdalla M, Buckingham JK, et al. Grampian Asthma Study of Integrated Care (GRASSIC). Integrated care for asthma: a clinical, social and economic evaluation. BMJ 1994; 308: 559-564.
  • 9. Meulepas MA, Jacobs JE, Lucas AE, et al. The feasibility of a primary care model for the management of COPD. Prim Care Respir J 2006; 15: 337-341.
  • 10. Ahmed A, Allman RM, Kiefe CI, et al. Association of consultation between generalists and cardiologists with quality and outcomes of heart failure care. Am Heart J 2003; 145: 1086-1093.
  • 11. Ezekowitz JA, van Walraven C, McAlister FA, et al. Impact of specialist follow-up in outpatients with congestive heart failure. CMAJ 2005; 172: 189-194.
  • 12. Starfield B, Lemke KW, Herbert R, et al. Comorbidity and the use of primary care and specialist care in the elderly. Ann Fam Med 2005; 3: 215-222.
  • 13. Lafata JE, Martin S, Morlock R, et al. Provider type and the receipt of general and diabetes-related preventive health services among patients with diabetes. Med Care 2001; 39: 491-499.
  • 14. Overland J, Yue DK, Mira M. Continuity of care in diabetes: to whom does it matter? Diabetes Res Clin Pract 2001; 52: 55-61.
  • 15. Haby MM, Powell CV, Oberklaid F, et al. Asthma in children: gaps between current management and best practice. J Paediatr Child Health 2002; 38: 284-289.
  • 16. Wan Q, Harris MF, Jayasinghe UW, et al. Quality of diabetes care and coronary heart disease absolute risk in patients with type 2 diabetes mellitus in Australian general practice. Qual Saf Health Care 2006; 15: 131-135.
  • 17. Briganti EM, Shaw JE, Chadban SJ, et al. Untreated hypertension among Australian adults: the 1999–2000 Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Med J Aust 2003; 179: 135-139. <MJA full text>
  • 18. Wagner E, Austin B, Von Korff M. Organizing care for patients with chronic illness. Milbank Q 1996; 74: 511-544.
  • 19. World Health Organization. Innovative care for chronic conditions: building blocks for action. Geneva: WHO, 2002.
  • 20. Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness. JAMA 2002; 288: 1775-1779.
  • 21. Bodenheimer T, Wagner EH, Grumbach K. Improving primary care for patients with chronic illness: the chronic care model, part 2. JAMA 2002; 288: 1909-1914.
  • 22. Australian Government Department of Health and Ageing. National Primary Care Collaboratives [website]. (accessed May 2007).
  • 23. Zwar NA, Comino EJ, Hasan I, Harris MF. General practitioner views on barriers and facilitators to implementation of the Asthma 3+ Visit Plan. Med J Aust 2005; 183: 64-67. <MJA full text>
  • 24. Medicare Australia. Statistics. (accessed Apr 2007).
  • 25. Kmietowicz Z. New GP contract: modernisation or miscalculation? BMJ 2006; 333: 1192.
  • 26. Georgiou A, Burns J, McKenzie S, et al. Monitoring change in diabetes care using diabetes registers: experience from Divisions of General Practice. Aust Fam Physician 2006, 35: 77-80.
  • 27. Zwar NA, Hermiz O, Comino EJ, et al. Do multidisciplinary care plans result in better care for type 2 diabetes? Aust Fam Physician 2007; 36: 85-89.
  • 28. Farmer L, Knight A, Ford D. Systems change in Australian general practice: early impact of the National Primary Care Collaboratives. Aust Fam Physician 2005; 34: 44-46.
  • 29. Comino EJ, Harris MF, Harris E, et al. The National Health Survey 2001: usefulness to inform a discussion on access to and use of quality primary health care using type 2 diabetes mellitus as an example. Aust Health Rev 2006; 30: 496-506.
  • 30. Jordon JE, Osborne RH. Chronic disease self-management education programs: challenges ahead. Med J Aust 2007; 186: 84-87. <MJA full text>
  • 31. Centre for General Practice Integration Studies, University of New South Wales; Department of General Practice, Adelaide University; Australian Divisions of General Practice; Collaborative Centre for eHealth, University of Ballarat; Centre for Health Informatics, UNSW. Chronic disease functionality project — final report. Sydney: CGPIS UNSW, 2004. (accessed Apr 2007).
  • 32. Schoen C, Osborn R, Trang Huynh P, et al. On the front lines of care: primary care doctors’ office systems, experiences, and views in seven countries [web exclusive]. Health Aff (Millwood) 2006; 25: w555–w571.
  • 33. Sutton M, McLean G. Determinants of primary medical care quality measured under the new UK contract: cross sectional study. BMJ 2006; 332: 389-390.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Responses are now closed for this article.