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Welcome to the second issue of the "Clinical guideline for the diagnosis and management of work-related mental health conditions" project newsletter. 

                                
        Danielle Mazza                                                     Bianca Brijnath
        Chief Investigator                                                   Co-Investigator
Project Update

Background

During phase one of the project we explored in detail the clinical dilemmas that GPs face when caring for patients with work-related mental health problems.  We utilised a case-study approach to explore the patient trajectory over a period of 12 months. 

Study 1 has commenced!
In July this year, the project team invited over 240 GPs throughout Australia from Remoteness Area's (RA) 1-5 to participate in a short telephone interview. 25 GPs, 5 psychiatrists and 6 compensation scheme workers participated. Two case-studies were presented to them. Participants were asked to respond to the management of the patient in each scenario, focussing on areas of difficulty for GPs. 

Data analysis
Once individual dilemmas were identified, these dilemmas were organised into key clinical problems and these key problem areas were transformed into draft key clinical questions, using a traditional Population Intervention Comparator Outcome (PICO) approach that can be addressed in the guideline. Issues regarding diagnosis, assessment and referral are just some of the key themes that have emerged. These draft questions were provided to the Guideline Development Group for their review and determination of the clinical questions that will be addressed in the guidelines.
Guideline Development Group
The Guideline Development Group (GDG) was recently established to oversee the development of the guidelines according to National Health and Medical Research Council (NHMRC) standard. The GDG will, therefore, act as an advisory group for the project team, providing advice about the strength of existing evidence and formulating recommendations for inclusion in the guidelines.

The GDG had its initial meeting in December. At this meeting the GDG were provided with an overview of the project, introduced to GRADE (a standard method used to assess the quality of evidence for guidelines), decided upon clinical questions for inclusion in the guideline and discussed the timeline for the project in accordance with the NHMRC process.


The NHMRC process consists of five key stages:

1.  Register intention to seek NHMRC approval
2.  Develop the guideline in accordance with NHMRC requirements 
3.  Release the draft guideline for public consultation
4.  Submit the final draft guideline to NHMRC for review and approval
5.  Publish and disseminate the NHMRC approved clinical practice guideline.

The GDG will meet several times throughout the project period.
What's next?
Study 2
The project team will shortly commence phase two of the project being the development of a clinical guideline using both, traditional best practice approaches such as the GRADE tool to turn evidence into recommendations as well as newer technology in the form of MagicAPP (https://www.magicapp.org/app#/guidelines), an online tool used to develop and publish guidelines.
Other news

We are pleased to host visiting researcher A/Prof Silje Maeland, Bergen University College, Norway between November and January at Monash University, Notting Hill (in Melbourne). A/Prof Maeland will also spend some time with Dr Bianca Brijnath at Curtin University in Western Australia.

On Tuesday, 29 November, A/Prof Maeland presented on recent research comparing sick leave decisions by GPs, insurance physicians and occupational physicians in several different countries (Norway, Sweden, Denmark, France, The Netherlands). She introduced work currently underway in Norway evaluating the impact of independent medical examinations on return to work, using an unusual RCT design. 
Publications of interest

Physicians' assessments of work capacity in patients with severe subjective health complaints: a cross - sectional study on differences between five European countries. Werner EL, Merkus SL, Maeland S, et al. BMJ Open. 2016 Jun 22.


Meet the team
Project Manager, Dr Samantha Chakraborty
Samantha is a primary health care researcher with a focus on developing and implementing research that makes a difference. Samantha has a unique combination of skills comprising implementation science, research management, and quantitative and qualitative research in primary health care. She is currently overseeing the development of evidence-based and implementable clinical practice guidelines for the management of work-place related mental health conditions.
Project Officer, Jacinta Clements
Jacinta joined the Department of General Practice four months ago as a Project Officer and will primarily be working on the ‘Work-Related Mental Health Guidelines’. Prior to this, she has worked across various health related projects, predominantly in government. 
Summer scholar student, Eli Ivey
Eli is a third year MBBS student from Monash University’s Clayton campus. Over the next eight weeks, Eli will work alongside the team on the ‘Work-Related Mental Health Guidelines’ project. He will be involved in further data analysis and research.

The team are delighted to have Eli on board.
Contact details:
For more information please contact the Project Manager:
Dr Samantha Chakraborty
E: samantha.chakraborty@monash.edu 
T: (03) 9902 9698.
                 






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