Research publications on neurological conditions, discussing opioid monitoring for safe prescribing, and outlining the significant rise in patients seeking help from their GP to stop smoking and vaping feature in the latest issue of the Australian Journal of General Practice (AJGP).
As the peer-reviewed journal of the Royal Australian College of GPs (RACGP), the AJGP keeps GPs updated on the latest research and provides information to assist them in providing high quality care.
A new study by Dr Daniel Bogale Odo, Professor Tanya Buchanan, Megan Varlow, and Associate Professor Raglan Maddox revealed a 16-fold rise in Australians seeing their GP for help to quit smoking or vaping over just two years.
Between July 2021 and December 2023, when funding ceased, GPs provided 188,904 nicotine and smoking cessation counselling sessions.
Dr Odo, an Australian National University epidemiologist who led the research, said: "The number of nicotine and smoking cessation counselling services by GPs funded by Medicare skyrocketed while funding was available. Despite this, funding ceased on 31 December 2023, with the assumption this counselling was embedded in routine practice.
"But one of the frequently reported barriers to providing nicotine and smoking cessation support in clinical settings is a lack of time. The increase in the use of these temporarily funded Medicare items could be due to the allocation of adequate time and payment to provide this care.
"The cessation of these services might have had a regressive impact on people who want to quit seeking support from their GP at a time when many changes were occurring in respect of nicotine and tobacco control measures."
RACGP President Dr Michael Wright said: "Almost 9000 people still die of lung cancer in Australia each year, and it is still our most common cancer death. Most of these deaths are preventable. Australia has been a world leader in strategies to reduce smoking in the community, but smoking cessation must remain an urgent public health priority.
"GPs have a critical role to play in helping people to stop smoking and vaping. This study shows the difference embedding smoking and vaping cessation in routine care makes in people's lives.
"Smoking cessation is only one area where patients may need longer consults with their GP.
"Australia should have a health system that supports our patients to access affordable long consults with their GP when they need them."
This edition of the AJGP also:
- updates GPs on assessing and managing sudden hearing loss due to damage to the inner ear
- provides a concise framework for assessing patients with low back pain and radiculopathy (a 'pinched nerve')
- discusses whether GPs should prescribe levodopa to improve quality of life for patients with probable Parkinson's disease while they wait for diagnostic confirmation.
A paper by Dr Hester Wilson, Dr Louisa Picco, and Professor Suzanne Nielsen gives GPs guidance on supporting patients living with chronic pain who have been prescribed long-term opioids through a structured and validated opioid review process using the Routine Opioid Outcome Monitoring (ROOM) tool and the patient-led Opioid Safety Toolkit.
Dr Wilson, a GP who is Chief Addiction Medicine Specialist for NSW and Chair of the RACGP Specific Interests Addiction Medicine group, said the publication seeks to support GPs and patients to use opioids safely where they are needed.
"Opioids are essential medicines, and although they play an important role in severe pain management, it's become clear that their role in chronic pain is limited and can cause harms," she said.
"Most people would be surprised to know that Australia had a higher per-capita rate of opioid prescribing in 2019 than the US. A range of policies have been implemented to reduce harms such as rising overdose rates, risk of dependence, hospitalisations, and deaths.
"While it might be tempting to simply reduce or cease opioids for a patient, collaborative patient care, shared decision making, and careful assessment are vital parts of quality use of opioid medicines.
"In the paper, we aim to provide GPs with a framework to support chronic pain and opioid use reviews with their patients, identify where support and referral are needed using a patient self-reported tool, and raise awareness of the Opioid Safety Toolkit as a resource for GPs to promote increased health literacy with patients who are prescribed opioids."
Given the risk of accidental opioid overdose, Dr Wilson also emphasised the need for greater awareness of naloxone, a drug that can temporarily reverse the effects of an opioid overdose among GPs and patients.
Naloxone is available free of charge and without a prescription at participating pharmacies all across Australia under the national Take Home Naloxone program.
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