Evidence map›Paper›PMID 35729493›Full record

Trial reportBMC primary care2022

Utilisation of government-subsidised chronic disease management plans and cardiovascular care in Australian general practices.

Genevieve Coorey, Anna Campain, John Mulley, Tim Usherwood, Julie Redfern, Mark Harris, Nicholas Zwar, Sharon Parker, Enrico Coiera, David Peiris

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC primary care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Genevieve CooreyThe George Institute for Global Health, University of New South Wales, Sydney, Australia. gcoorey@georgeinstitute.org.au.
Anna CampainThe George Institute for Global Health, University of New South Wales, Sydney, Australia.
John MulleyThe George Institute for Global Health, University of New South Wales, Sydney, Australia.
Tim UsherwoodThe George Institute for Global Health, University of New South Wales, Sydney, Australia.
Julie RedfernThe George Institute for Global Health, University of New South Wales, Sydney, Australia.
Mark HarrisCentre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia.
Nicholas ZwarFaculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia.
Sharon ParkerCentre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia.
Enrico CoieraAustralian Institute for Health Innovation, Faculty of Medical and Health Sciences, Macquarie University, Sydney, Australia.
David PeirisThe George Institute for Global Health, University of New South Wales, Sydney, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGovernment-subsidised general practice management plans (GPMPs) facilitate chronic disease management; however, impact on cardiovascular disease (CVD) is unknown. We aimed to determine utilisation and impact of GPMPs for people with or at elevated risk of CVD.

methodsSecondary analysis of baseline data from the CONNECT randomised controlled trial linked to Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) claims. Multivariate regression examining the association of GPMP receipt and review with: (1) ≥ 1 MBS-subsidised allied health visit in the previous 24 months; (2) adherence to dual cardioprotective medication (≥ 80% of days covered with a dispensed PBS prescription); and (3) meeting recommended LDL-cholesterol and blood pressure (BP) targets concurrently.

resultsOverall, 905 trial participants from 24 primary health care services consented to data linkage. Participants with a GPMP (46.6%, 422/905) were older (69.4 vs 66.0 years), had lower education (32.3% vs 24.7% high school or lower), lower household income (27.5% vs 17.0% in lowest bracket), and more comorbidities, particularly diabetes (42.2% vs 17.6%) compared to those without a GPMP. After adjustment, a GPMP was strongly associated with allied health visits (odds ratio (OR) 14.80, 95% CI: 9.08-24.11) but not higher medication adherence rates (OR 0.82, 95% CI: 0.52-1.29) nor meeting combined LDL and BP targets (OR 1.31, 95% CI: 0.72-2.38). Minor differences in significant covariates were noted in models using GPMP review versus GPMP initiation.

conclusionsIn people with or at elevated risk of CVD, GPMPs are under-utilised overall. They are targeting high-needs populations and facilitate allied health access, but are not associated with improved CVD risk management, which represents an opportunity for enhancing their value in supporting guideline-recommended care.

Indexed as

Cardiovascular DiseasesNational Health ProgramsAgedAustraliaDisease ManagementGovernmentHumansUnited StatesAllied healthCardiovascular diseaseChronic conditionsIncentive schemeMedication adherencePrimary health care

Identifiers

PMID35729493
PMCPMC9210726

What OpenQuestion holds

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Registered trials

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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.