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This study aimed to identify strategies to improve the management of hypertension in general practice.Four focus groups (25 general practitioners and general practice registrars) were conducted, recorded and transcribed. Common emerging themes were analysed by an iterative thematic process.Four main themes were identified: uncertainty about blood pressure measurement, achieving consensus in practice, accommodating patient differences and addressing systematic barriers. General practitioners want a more standardised approach to measuring and interpreting blood pressure with consistent, valid readings taken on one device that accurately measures patients blood pressure in the 'real world'. General practitioners want to be upskilled in specific areas related to hypertension management.To facilitate improvements in blood pressure management, the most pressing needs of this group of GPs is to reduce the uncertainty surrounding the measurement and interpretation of blood pressure readings. This study has identified that sections of existing hypertension guidelines need to be reviewed and implemented.

Guidelines advise chronic obstructive pulmonary disease (COPD) should be diagnosed and managed by using spirometry to demonstrate irreversible airflow limitation and monitor change in smokers and ex-smokers aged over 35 years.A cross-sectional study of patients and their general practitioners investigating use of spirometry in COPD in two practices by lung function assessment, review of practice records, interviews and focus groups.Sixteen GPs, and 38 patients with a diagnosis of COPD participated. At diagnosis, although 72% had spirometry, this occurred in only 41% of 17 patients diagnosed by a GP; but in all 19 cases when a specialist was involved. Diagnosis often occurred late, despite all patients having previously recorded symptoms typical of COPD. General practitioners expressed a preference to diagnose COPD on clinical grounds. Although 58% of patients had recent spirometry for current management, only 32% were performed by their GP. There were organisational and technical barriers to spirometry and poor recognition of the essential role of spirometry in the diagnosis of COPD.There are a number of potentially reversible factors that hinder practice recommendations regarding the use of spirometry in general practice to diagnose and manage COPD.

Current initiatives are aimed at building the capacity within Australian primary care to undertake high quality research and evaluation, including clinicians who are not primarily researchers.To provide a simple guide to encourage practice based research projects. TIPS AND ADVICE: Be parsimonious with the amount of data collected, ensure the literature is searched first, keep the project as simple as possible, invest time in planning and managing the project, readily ask for help and advice, and make every effort to publish the results.A modest, carefully supported and systematic approach is recommended for increasing the chance of success and quality of the research.