NHMRC Health Priority Areas

NHMRC Health Priority Areas

(In my mind, this means areas to know inside-out)

see http://www.nhmrc.gov.au/grants/research-funding-statistics-and-data/nhpas

These areas will be addressed in detail over the coming months:

Arthritis and Osteoporosis

Osteoarthritis, rheumatoid arthritis and gout - account for more than 95 per cent of arthritis in Australia.

see "Think Osteoporosis!" GP guide to Osteoporosis

Asthma

Asthma is Australia's most widespread chronic health problem. It affects 1 in 7 primary school-aged children, 1 in 8 teenagers and 1 in 9 adults.

See National Asthma Council Australia. Asthma Management Handbook 2006. Melbourne, 2006
An excellent  (essential) resource if you can get a copy.
Download one from the Asthma council: http://www.nationalasthma.org.au/handbook

Cancer

It is estimated that more than 43,000 people will die of cancer in 2010

The most commonly diagnosed cancer (excluding non-melanoma skin cancer) is prostate cancer, followed by colon cancer, then breast cancer, melanoma and lung cancer. There are more than 100 different types of cancer, but these five most common types account for 60% of all cases. While lung cancer is the fifth most common type of cancer overall, it is the leading cause of cancer death in Australians.

Under this heading comes "cancer screening" which will be addressed in detail.

Cardiovascular Disease

Cardiovascular disease (CVD) is (macro and microvascular) is the leading cause of death in Australia, accounting for 34% of all deaths in Australia in 2006. Cardiovascular disease kills one Australian nearly every 10 minutes.
For resources on lipid management, hypertension and absolute risk see http://www.heartfoundation.org.au/information-for-professionals/Clinical-Information/Pages/default.aspx

Diabetes

Diabetes is Australia’s fastest growing chronic disease and is the sixth leading cause of death in Australia. For every person diagnosed, it is estimated that there is another who is not yet diagnosed. Indigenous Australians are four time more likely to develop diabetes than non-indigenous Australians.
Norman Swan has an excellent series on diabetes, the audiofiles of which can be freely downloaded from the Rural Health Education Foundation. See http://www.rhef.com.au/programs/
The booklet "Diabetes Management in General Practice 2011/12" is crucial reading. An electronic version of these guidelines is available at www.racgp.org.au or www.diabetesaustralia.com.au. For a hard copy of the 2011-12 publication, contact your State or Territory diabetes office on 1300 136 588.
Of note there are charts in both Murtagh  (John Murtagh's General Practice 5th edition) and the diabetes guidelines which are identical and which also appear in RACGP learning modules....so it would be helpful to learn these.

Obesity

Results from the 2007-08 National Health Survey, the first since 1995, reveal that in 2007-08, 61.4%of the Australian population were either overweight or obese.

42.1% of adult males and 30.9% of adult females were classified as overweight (Body Mass Index between 25.0 and 30.0 kg/m2). 25.6% of males and 24% of females were classified as obese (Body Mass Index > 30.0 kg/m2). For children and adolescents, results indicate that 24.9% of children aged 5 – 17 years are overweight or obese - 25.8% of boys and 24.0% girls.

Injury Related Issues

Injuries were responsible for 7% of the total burden of disease and injury in Australia in 2003, with suicide, self-inflicted injuries, road traffic injuries and falls accounting for nearly two thirds of this burden.

Mental Health
The National Survey of Mental Health and Wellbeing 2007 found that one in five (20%) Australian adults experience some form of mental illness in any year. One in four of these people may experience more than one mental disorder. Based on these prevalence rates, over 3.2 million Australians had a mental disorder in the previous 12 months. This means that:

• one in seven (14.4%) Australians had an anxiety disorder;
• one in 16 (6.2%) had an depressive disorder; and
• one in 20 (5.1%) had a substance use disorder.

Almost half of the Australian population (45.5%) will experience mental illness at some point in their lifetime.

The RANZP have some very helpful clinical practice guidelines which can be accessed at: http://www.ranzcp.org/Publications/Clinical-Practice-Guidelines-2.aspx  including

• Clinical guidance on the use of antidepressants medications in children and adolescents
• Guidance on the use of SSRIs and SNRI in late pregnancy

I had trouble locating the clinical practice guidelines for depression on their website but here is a link from another Australian site to the RANZCP Clinical Practice Guidelines for Treatment of Depression 2004 http://smileyaustralia.org/images/downloads/CPG_Clinician_Full_Depression.pdf



NB although not specifically mentioned as a health priority area, Chronic Kidney Disease is a cause of major morbidity and mortality and is closely tied to hypertension, cardiovascular risk and diabetes. This will also be an area I will cover in detail in the coming months. "Timely identification and treatment of CKD can reduce the risks of cardiovascular disease and CKD progression by up to 50%"--See www.kidney.org.au for a copy of Chronic Kidney Disease Management in General Practice in 2012. Ive found this booklet exceptionally clear and a great resource in day-to-day medical practice.

Other areas that connect with the above health priority areas include smoking cessation, preventative health and lifestyle modification (see Smoking Cessation pharmacotherapy: an update for health professionals; available from www.racgp.org.au.)