PhD Scholarship Opportunity: Upscaling the Management of Hypertension in GP practices in Australia

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We currently have a scholarship available for a suitably qualified candidate to undertake a 3 year, full-time PhD. The successful student will be enrolled in the School of Population Health at UNSW, Sydney however will be based at The George Institute for Global Health. 'The George' hosts a thriving program for PhD students, including development opportunities as well as exposure to some of the world’s leading research minds in the field of noncommunicable disease research.

In 2017-2019, the Australian Institute of Health and Welfare reported that a third of Australians over the age of 18 had high blood pressure (measured systolic ≥140mmHg and/or diastolic ≥90mmHg), of whom two-thirds were uncontrolled.

What is also of significant concern is that community-based blood pressure data from the Australian May Measurement Month collected in 2018 showed that only half of those with high blood pressure were aware of it, indicating poor awareness in the community.

We know from Australian data that uncontrolled blood pressure is directly responsible for major cardiovascular events including 65% of the burden of hypertensive heart disease, 43% of coronary heart disease, 41% of stroke, 38% of chronic kidney disease, 32% of atrial fibrillation and flutter and 3.6% of dementia. It is therefore entirely unsurprising that cardiovascular disease remains the leading cause of death in Australia for both men and women. Not only is it the leading cause of mortality, over half a million Australians are living with coronary heart disease and just under 400,000 have had a stroke, creating a high-risk cohort at significant risk of a further event, and this is not to even mention the thousands more with prevalent chronic kidney disease, atrial fibrillation and dementia.

This PhD aims to use large-scale datasets to comprehensively evaluate key elements of hypertension management practices in Australia, compare these to current evidence-based ‘best practice’ and model their impact on the cardiovascular health of Australians. It will also evaluate training programmes in Medical School curricula and other training programs and ascertain the views of general practitioners and primary care experts on how to improve hypertension care.

Methods:

1. Quantitative analysis of the 10% PBS representative dataset as well as either the Medicine Insight or POLAR datasets (longitudinal datasets of patient level data from General Practice) to determine current practices related to management of hypertension in Australia including subgroups to evaluate equitable access for disadvantaged or minority populations. Concepts to be explored include treatment inertia, time to first use of pharmacological therapy and its relationship to blood pressure levels and other patient characteristics, use of combination therapy, time at target and others.
2. Qualitative interviews with general practitioners, primary care experts and opinion leaders and public health nurses. Anecdotal evidence has shown that GPs do not follow guidelines for hypertension management but tend to just believe that they know what to do. However, it is unclear how representative this view is. Qualitative methodology, which may include focus groups, individual interviews, or Discrete Choice Experiments, potentially supplemented by national panel surveys, will be used to ascertain GPs views on specific aspects of hypertension management including its place within management of overall CVD risk.
3. Scoping exercise to identify how hypertension management is addressed in Australian Medical Schools’ curriculum and/or GP Synergy program (General Practitioner registrar training program). All medical schools in Australia as well as the GP Synergy program administration will be approached and asked for any information on how hypertension is taught within the curriculum.

Supervisory Team:

Professor Schutte is the Principal Theme Lead of Cardiac, Vascular and Metabolic Medicine at UNSW, Sydney and Professorial Fellow at The George Institute for Global Health. She has extensive experience in working in the field of hypertension and cardiovascular disease.

Associate Professor Webster (Centre for Health Economics Research and Evaluation, UTS, Sydney) has expertise in the epidemiology of cardiovascular risk with a particular interest in the use of combination therapy in the prevention of cardiovascular disease.

Eligibility

Applicants should hold an appropriate undergraduate or Masters degree in a related discipline. Professional experience in the Australian health sector, health research, or other related health disciplines would be an advantage.

Australian citizens, New Zealand citizens or Australian permanent residents are eligible to apply.

Award Amount

The stipend for the scholarship is $30k per annum for up to 3 years.

Students will be supported to apply for competitive scholarship funding.

Application Guide

Applications must include a cover letter, current CV, copy of academic transcripts, proof of citizenship or permanent residency, and the names and contact details of at least two referees.

Please include in your cover letter:

• Why you are interested in this opportunity
• Prior relevant research or relevant health sector experience
• Ability to work as part of a team
• Evidence of excellent written and verbal communication skills

Closing Date - Sunday 11th July 2021

If you are interested in undertaking this research project and require further information, please contact Professor Alta Schutte - a.schutte@unsw.edu.au