Evidence map›Paper›PMID 34585377›Full record

Trial reportThe Medical journal of Australia2021

OPTIMISE: a pragmatic stepped wedge cluster randomised trial of an intervention to improve primary care for refugees in Australia.

Grant M Russell, Katrina Long, Virginia Lewis, Joanne C Enticott, Nilakshi Gunatillaka, I-Hao Cheng, Geraldine Marsh, Shiva Vasi, Jenny Advocat, Shoko Saito and 4 more

Open access · hybridAbstract readPragmatic Clinical TrialRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The Medical journal of Australia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Towards System Changes: Experiences of General Practitioners and Nurses in Facilitating Appointments and Referrals for Africans from Refugee Backgrounds in Australia.Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals · 2026
    Article
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors at 6 institutions in 4 countries.

Grant M RussellMonash University, Melbourne, VIC.ORCID https://orcid.org/0000-0003-3773-2355
Katrina LongMonash University, Melbourne, VIC.
Virginia LewisAustralian Institute for Primary Care and Ageing, La Trobe University, Melbourne, VIC.
Joanne C EnticottMonash Centre for Health Research and Implementation, Monash University, Melbourne, VIC.ORCID https://orcid.org/0000-0002-4480-5690
Nilakshi GunatillakaAustralian Institute for Primary Care and Ageing, La Trobe University, Melbourne, VIC.
I-Hao ChengMonash University, Melbourne, VIC.
Geraldine MarshAustralian Institute for Primary Care and Ageing, La Trobe University, Melbourne, VIC.
Shiva VasiMonash University, Melbourne, VIC.
Jenny AdvocatMonash University, Melbourne, VIC.
Shoko SaitoCentre for Primary Health Care and Equity, UNSW, Sydney, NSW.
Hyun SongCentre for Primary Health Care and Equity, UNSW, Sydney, NSW.
Sue CaseyVictorian Foundation for Survivors of Torture, Melbourne, VIC.
Mitchell SmithNSW Refugee Health Service, South Western Sydney Local Health District, Sydney, NSW.
Mark F HarrisCentre for Primary Health Care and Equity, UNSW, Sydney, NSW.
Monash University · AULa Trobe University · AUUNSW Sydney · AUMoscow University «Synergy» · RUMyer Foundation · AUSydney Local Health District · AU

Funding

AMES AustraliacoHealthenlivenMonash HealthNational Health and Medical Research Council APP1106372North Western Melbourne Primary Health NetworkRoyal Australian College of General PractitionersSettlement Services InternationalSouth Western Sydney Primary Health NetworkVictorian Department of Health and Human ServicesVictorian Refugee Health Network
6 · The paper itself

Abstract

objectivesTo examine whether primary care outreach facilitation improves the quality of care for general practice patients from refugee backgrounds.

designPragmatic, cluster randomised controlled trial, with stepped wedge allocation to early or late intervention groups. SETTING,

participants31 general practices in three metropolitan areas of Sydney and Melbourne with high levels of refugee resettlement, November 2017 - August 2019.

interventionTrained facilitators made three visits to practices over six months, using structured action plans to help practice teams optimise routines of refugee care. MAJOR OUTCOME MEASURE: Change in proportion of patients from refugee backgrounds with documented health assessments (Medicare billing). Secondary outcomes were refugee status recording, interpreter use, and clinician-perceived difficulty in referring patients to appropriate dental, social, settlement, and mental health services.

resultsOur sample comprised 14 633 patients. The intervention was associated with an increase in the proportion of patients with Medicare-billed health assessments during the preceding six months, from 19.1% (95% CI, 18.6-19.5%) to 27.3% (95% CI, 26.7-27.9%; odds ratio, 1.88; 95% CI, 1.42-2.50). The impact of the intervention was greater in smaller practices, practices with larger proportions of patients from refugee backgrounds, recent training in refugee health care, or higher baseline provision of health assessments for such patients. There was no impact on refugee status recording, interpreter use increased modestly, and reported difficulties in refugee-specific referrals to social, settlement and dental services were reduced.

conclusionsLow intensity practice facilitation may improve some aspects of primary care for people from refugee backgrounds. Facilitators employed by local health services could support integrated approaches to enhancing the quality of primary care for this vulnerable population.

trial registrationAustralian New Zealand Clinical Trials Registry, ACTRN12618001970235 (retrospective).

Indexed as

RefugeesAmbulatory Care FacilitiesAustraliaDelivery of Health CareHumansPrimary Health CareQuality ImprovementReferral and ConsultationGeneral practicePrimary careQuality of health careRandomized controlled trial as topicRefugees

Identifiers

PMID34585377
PMCPMC9292802
OpenAlexW3202312604

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.