Teaching & Research
Manning Health Hub doctors are keen contributors to current teaching and research resources to help achieve the best quality of care for their patients and the wider community. See below a range of resources developed by Manning HealthHub doctors
General practitioner attitudes towards systems-level opioid prescribing interventions
This paper looked at how GPs feel about initiatives by regulators designed to reduce opioid overprescribing
Prescribing practices that can create iatrogenic addiction 3rd March 2021
Two webinars from the series “Alcohol and Other Drug Assessment and Withdrawal” arranged by Hunter Primary Care and by Hunter New England and Central Coast Primary Health Network.
Managing Alcohol and Other Drug (AOD) Presentations in the GP Setting 3rd February 2021
A bridge too small: A case series of microdosing transfers from oral methadone to depot buprenorphine
This was about transferring patients on long-term opioids (prescribed or illicit) to an opioid less likely to cause overdose or death. Also the first patient information handout on this topic to our knowledge.
Presentation to International Medicine in Addiction Conference
Beyond the black stump: rapid reviews of health research issues affecting regional, rural and remote Australia
Chapter 6 looked at the evidence about deprescribing prescription opioids in Australian rural, remote and indigenous populations in the context of chronic non-cancer pain.
Presentation for the PAIN20 conference 14 November 2020: Update on identifying and managing opioid dependent pain patients
Patterns of oxycodone controlled release use in older peoplewith cancer following public subsidy of oxycodone/naloxoneformulations: An Australian population-based study
Here we looked at how the subsidisation of a strong opioid designed to minimise constipation changed the rate it was used for cancer patients in Australia. Prescribing increased at the same rate as in those without cancer.Increased consumption of this medication, regardless of the presence of a cancer diagnosis, suggests cancer patients may face similar harms for opioids as non-cancer patients.
Prescribers or Multidisciplinarians? An Evaluation of Brief Education for General Practitioners on Chronic Pain Management
This study evaluates an innovative model of GP training to upskill them in using non-pharmacological management techniques for chronic pain and other long-term conditions. Additionally it was able to increase the reported use of safety strategies when addictive medications were provided for pain, anxiety or insomnia (e.g. opioids or benzodiazepines).
Risk of opioid misuse in people with cancer and pain and related clinical considerations: a qualitative study of the perspectives of Australian general practitioners
This is the first study to explore the perspectives of Australian GPs regarding the risk and context of opioid misuse in people with cancer and pain.
The vision of the founder of the Newcastle Medical School
Dr Simon Holliday studied medicine at the Newcastle Medical School. When researching for his speech at the HealthHub launch, he came across Professor David Maddison’s speech to the first entrants to the Newcastle Medical School on their first day (the year before I started). It is really worth listening for half an hour.
Prof Maddison had been practicing medicine about 3½ decades. He had consulted for the World Health Organisation and previously been the dean of the Sydney University Medical Faculty. This launch was the cumulation of much of his academic and clinical (and human) experience: his vision for the medical profession.
Opening address by Professor David Maddison to first intake of University of Newcastle Medical students on 6th of March 1978.
HealthHub Opening Speech
Bruggink L, Hayes C, Lawrence G, Brain K, Holliday S. Chronic pain: Overlap and specificity in multimorbidity management. Australian Journal for General Practitioners. 2019;48(10):689-692.
This paper outlines how GPs’ excellent chronic pain management is also the model of care for many chronic diseases and individual patients who suffer multiple chronic problems.
Holliday S. Ben has chronic flank pain: Case 4. Check. 2018;553 (September):25-9.
This reports a case in a question and answer format about a de-identified chap and his pain care prior to his attending our surgery
Magin, P., Tapley, A., Dunlop, A.J. et al. (Holliday last author) Changes in Australian Early-Career General Practitioners’ Benzodiazepine Prescribing: a Longitudinal Analysis J Gen Intern Med (2018) 33: 1676.
This paper shows that over the years, GP registrars (trainees) as a whole are prescribing less sedatives & hypnotics but each registrar does not change their prescribing rate during their training years.
Holliday S, Hayes C, Jones L, Gordon J, Harris N, Nicholas M. Prescribing wellness: comprehensive pain management outside specialist services. Australian Prescriber June 2018;41(3):86-91.
This paper outlines how GPs should manage chronic pain and legacy opioid-consuming patients.
Holliday S, Hayes C, Dunlop A et al Protecting pain patients. The evaluation of a chronic pain educational intervention. Pain Med. 2017 Mar 13; PMID: 28340143
This paper showed brief education for GPs improved their knowledge and theoretical care of pain patients.
Holliday SM, Hayes C, Dunlop AJ, Morgan S, Tapley A, Henderson KM, et al. Does brief chronic pain management education change opioid prescribing rates? A pragmatic trial in Australian early-career general practitioners. PAIN. 2017 Feb;158(2):278-88.
This paper showed the same training did not change total opioid prescribing. However, there was a suggestion that after training opioids may have been initiated less often for chronic pain.
Holliday, S. M., Morgan, S., Tapley, A., et.al. 2017 The pattern of anxiolytic and hypnotic management by Australian general practice trainees. Drug and Alcohol Review, 36: 261–269.
This paper describes Who gets What sedative or hypnotic and in what geographical and clinical context.
Bennett AA, Holliday S, Cohen M. Using opioids in general practice for chronic non-cancer pain: an overview of current evidence. Med J Aust. 2016 Oct 3;205(7):334
This was a letter from the NSW guideline working group in reply to a paper published in the MJA disagreeing with their suggested approach.
Dushan Jayaweera, Shawkat Islam, Naren Gunja, Chris Cowie, James Broska, Latesh Poojara, Michael S. Roberts & Geoffrey K. Isbister Chloroform ingestion causing severe gastrointestinal injury, hepatotoxicity and dermatitis confirmed with plasma chloroform concentrations.
Chloroform poisoning is now very rare, but Dr Shawkat wrote up a patient who he looked after who suffered this.
Holliday S, Wilson H. How to minimise drug and alcohol-related harms. Part I. Australian Doctor. 2015 4 Dec 2015:19-26.
Holliday S, Wilson H. How to minimise drug and alcohol-related harms. Part 2. Australian Doctor. 2015. 11 Dec 2015
This is a two-part primer for GP on how to deal with drug and alcohol issues
Holliday S, Magin P, Morgan S, Tapley A, Henderson K, Dunlop A, et al. The pattern of opioid analgesic management by Australian General Practice trainees. Pain Medicine 2015 Sep;16(9):1720-31
This paper describes Who gets What opioid and in what geographical and clinical context.
Holliday S, Jammal W. The analgesia tango: chronic pain cases from a general practice. Medicine Today 2015 June;16 (6):Suppl 26-32.
This paper explores the clinical and medico-legal aspects of the opioid management of chronic pain
Holliday S, Wilson H. How to Treat: Risky alcohol consumption Australian Doctor 2015, 6 February p21-28.
This is a brief primer for GP on how to deal with alcohol issues.
Holliday S, Magin P, Oldmeadow C, Dunbabin J, Attia J, Henry J, et al. An examination of the influences on New South Wales general practitioners regarding the provision of Opioid Substitution Therapy. Drug and Alcohol review. 2013;32(5):495-503
This paper showed fear and stigma was the greatest barrier towards providing evidence based treatments to those dependent on opioids.
Holliday S, Hayes C, Dunlop A. Opioid use in chronic non-cancer pain: Part 1: Known knowns and known unknowns. Australian Family Physician. 2013 March 42(3):98-102. (plus author’s reply e-letter)
This paper summarised the evidence base (or lack of it) regarding the safety and effectiveness of opioids in chronic pain
Holliday S, Hayes C, Dunlop A. Opioid use in chronic non-cancer pain: Part 2: Prescribing issues and alternatives. Australian Family Physician. 2013 March 42(3):104-11.
This the second paper tried to describe how to implement the then expert-recommended management guidelines for opioids in chronic pain. Many of these guideline developers had conflicts of interests.
Holliday S, Magin P, Oldmeadow C, Dunbabin J, Attia J, Henry J, et al. An evaluation of the prescription of opioids for chronic non malignant pain by Australian General Practitioners Pain Medicine. 2013;14(1):62-74
This paper surveyed over 400 GPs and found none followed all the then guideline items for the opioid management of chronic pain and under a third used most items on most patients.
We made some brief videos in 2013. They described the guideline
These were based more on expert opinion than evidence. They remain current policy but now have been superseded by evidence.
Holliday SM, Magin PJ, Dunbabin JS, Ewald BD, Henry J-M, Goode SM, et al. Waiting room ambience and provision of opioid substitution therapy in general practice. Med J Aust 2012;196(6):391-4
This paper revealed how patients want to keep a distance from people with certain problems eg mental health or drug and alcohol problems.
Holliday S: Equipping patients for a time of helplessness: an educational intervention. Aust J Rural Health; 2009 Oct;17(5):232-5
This paper describes how GPs can simply incorporate End-of-Life planning into routine clinical care.