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https://www.readbyqxmd.com/read/28524255/enablers-and-barriers-to-the-use-of-antibiotic-guidelines-in-the-assessment-and-treatment-of-community-acquired-pneumonia-a-qualitative-study-of-clinicians-perspectives
#1
Antoine Sedrak, Mahesan Anpalahan, Karen Luetsch
BACKGROUND: Community-acquired pneumonia (CAP) is a common condition and a number of guidelines have been developed for its assessment and treatment. Adherence to guidelines by clinicians varies and particularly the prescribing of antibiotics often remains suboptimal. OBJECTIVE: The aim of this study was to elucidate potential barriers and enablers to the adherence to antibiotic guidelines by clinicians treating CAP in an Australian hospital. METHODS: Semi-structured interviews were conducted with purposively recruited senior prescribers who regularly treat CAP in an Australian hospital...
May 19, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28521194/preconception-care-for-women-with-type-2-diabetes-mellitus-a-mixed-methods-study-of-provider-knowledge-and-practice
#2
J Klein, J A Boyle, R Kirkham, C Connors, C Whitbread, J Oats, F Barzi, D McIntyre, I Lee, M Luey, J Shaw, A D H Brown, L J Maple-Brown
AIMS: Preconception care may decrease adverse pregnancy outcomes associated with pre-existing diabetes mellitus. Aboriginal Australians are at high risk of type 2 diabetes mellitus (T2DM), with earlier onset. We explored practitioner views on preconception care delivery for women with T2DM in the Northern Territory, where 31% of births are to Aboriginal women. METHODS: Mixed-methods study including cross-sectional survey of 156 health practitioners and 11 semi-structured interviews...
May 5, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28520865/impact-of-an-integrated-antibiotic-allergy-testing-program-on-antimicrobial-stewardship-a-multicenter-evaluation
#3
Jason A Trubiano, Karin A Thursky, Andrew J Stewardson, Karen Urbancic, Leon J Worth, Cheryl Jackson, Wendy Stevenson, Michael Sutherland, Monica A Slavin, M Lindsay Grayson, Elizabeth J Phillips
Background.: Despite the high prevalence of patient-reported antibiotic allergy (so-called antibiotic allergy labels [AALs]) and their impact on antibiotic prescribing, incorporation of antibiotic allergy testing (AAT) into antimicrobial stewardship (AMS) programs (AAT-AMS) is not widespread. We aimed to evaluate the impact of an AAT-AMS program on AAL prevalence, antibiotic usage, and appropriateness of prescribing. Methods.: AAT-AMS was implemented at two large Australian hospitals during a 14-month period beginning May 2015...
May 18, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28516333/risk-of-hip-fracture-in-older-people-using-selective-serotonin-reuptake-inhibitors-and-other-psychoactive-medicines-concurrently-a-matched-case-control-study-in-australia
#4
Michael J Leach, Nicole L Pratt, Elizabeth E Roughead
BACKGROUND: Few studies have assessed the risk of hip fracture following concurrent use of psychoactive medicines, and none has investigated combinations with selective serotonin reuptake inhibitors. OBJECTIVES: To assess the risk of hip fracture in older people as a result of concurrent use of selective serotonin reuptake inhibitors and other psychoactive medicines. METHODS: A matched case-control design was employed. Cases were Australian Government Department of Veterans' Affairs beneficiaries aged over 65 years who experienced a hip fracture between 2009 and 2012...
May 17, 2017: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/28514013/antimicrobial-prescribing-in-dogs-and-cats-in-australia-results-of-the-australasian-infectious-disease-advisory-panel-survey
#5
L Y Hardefeldt, S Holloway, D J Trott, M Shipstone, V R Barrs, R Malik, M Burrows, S Armstrong, G F Browning, M Stevenson
BACKGROUND: Investigations of antimicrobial use in companion animals are limited. With the growing recognition of the need for improved antimicrobial stewardship, there is urgent need for more detailed understanding of the patterns of antimicrobial use in this sector. OBJECTIVES: To investigate antimicrobial use for medical and surgical conditions in dogs and cats by Australian veterinarians. METHODS: A cross-sectional study was performed over 4 months in 2011...
May 17, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28512920/an-audit-of-adherence-to-heart-failure-guidelines-in-an-australian-hospital-a-pharmacist-perspective
#6
Viviane Khalil, Melanie Danninger, Wei Wang, Hanan Khalil
RATIONALE, AIMS, AND OBJECTIVES: The Australian National Heart Foundation Guidelines have been developed to guide clinicians on how to best manage chronic heart failure (CHF) patients according to the current best available evidence. The primary aim of this study is to evaluate the proportion of patients prescribed evidence-based therapy (EBT) for CHF on discharge at this Australian metropolitan hospital and factors affecting its prescribing. The secondary aims are to examine the proportion of patients prescribed EBT on discharge on cardiac wards compared to medical wards and to explore the role of the pharmacist in the management of these patients...
May 17, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28503879/impact-of-an-antimicrobial-stewardship-intervention-on-appropriateness-of-prescribing-for-community-acquired-pneumonia-in-an-australian-regional-hospital
#7
Stuart E Bond, Craig S Boutlis, Wilfred W Yeo, Spiros Miyakis
Community-acquired pneumonia (CAP) is the second commonest indication for antibiotic use in Australian hospitals and is therefore a frequent target for antimicrobial stewardship. A single-centre prospective study was conducted in a regional referral hospital comparing management of adult patients with CAP before and after an educational intervention. We demonstrated a reduction in duration of therapy and reduced inappropriate use of ceftriaxone-based regimens for non-severe CAP.
May 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28489479/biologics-and-dermatology-life-quality-index-dlqi-in-the-australasian-psoriasis-population
#8
Diana Norris, Louise Photiou, Mark Tacey, Con Dolianitis, George Varigos, Peter Foley, Chris Baker
BACKGROUND/OBJECTIVES: Psoriasis is a chronic condition that may require long-term treatment for disease control. This analysis utilises data from the Australasian Psoriasis Registry with particular attention to the impact of biologic therapy on DLQI, and the differences between the biologics in terms of DLQI score change. METHODS: A retrospective review of patients enrolled in the Australasian Psoriasis Registry from April 2008 to August 2016 was conducted. All subjects from the registry that had DLQI and Psoriasis Assessment Severity Index (PASI) scores recorded at a baseline timepoint of treatment commencement, in addition to week 12 and 24 post commencement were included in the study...
May 10, 2017: Journal of Dermatological Treatment
https://www.readbyqxmd.com/read/28468629/a-methodological-protocol-for-selecting-and-quantifying-low-value-prescribing-practices-in-routinely-collected-data-an-australian-case-study
#9
Jonathan Brett, Adam G Elshaug, R Sacha Bhatia, Kelsey Chalmers, Tim Badgery-Parker, Sallie-Anne Pearson
BACKGROUND: Growing imperatives for safety, quality and responsible resource allocation have prompted renewed efforts to identify and quantify harmful or wasteful (low-value) medical practices such as test ordering, procedures and prescribing. Quantifying these practices at a population level using routinely collected health data allows us to understand the scale of low-value medical practices, measure practice change following specific interventions and prioritise policy decisions. To date, almost all research examining health care through the low-value lens has focused on medical services (tests and procedures) rather than on prescribing...
May 3, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28450898/a-single-blinded-randomized-parallel-group-superiority-trial-investigating-the-effects-of-footwear-and-custom-foot-orthoses-versus-footwear-alone-in-individuals-with-patellofemoral-joint-osteoarthritis-a-phase-ii-pilot-trial-protocol
#10
Narelle Wyndow, Kay M Crossley, Bill Vicenzino, Kylie Tucker, Natalie J Collins
BACKGROUND: Patellofemoral joint osteoarthritis is a common condition, yet information regarding conservative management is lacking. Foot orthoses are an effective intervention for improving pain and function in younger individuals with patellofemoral pain and may be effective in those with patellofemoral osteoarthritis. This pilot study will seek to establish the feasibility of a phase III randomised controlled trial to investigate whether foot orthoses worn in prescribed motion controlled footwear are superior to prescribed motion control footwear alone in the management of patellofemoral osteoarthritis...
2017: Journal of Foot and Ankle Research
https://www.readbyqxmd.com/read/28448326/design-of-an-online-medication-safety-module-for-clinicians
#11
Hanan Khalil, Kirsten Schliephake
BACKGROUND: In Australia, there are very few online courses addressing medication safety issues. Educating clinicians about medication safety is paramount given the increased responsibility of clinicians in advanced practice roles including nurses at several key points throughout the medication process that encompass prescribing, dispensing, administering and monitoring medications. METHOD: The model used for the course design is based on adult teaching principles...
April 26, 2017: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/28447363/tobacco-packaging-design-for-reducing-tobacco-use
#12
REVIEW
Ann McNeill, Shannon Gravely, Sara C Hitchman, Linda Bauld, David Hammond, Jamie Hartmann-Boyce
BACKGROUND: Tobacco use is the largest single preventable cause of death and disease worldwide. Standardised tobacco packaging is an intervention intended to reduce the promotional appeal of packs and can be defined as packaging with a uniform colour (and in some cases shape and size) with no logos or branding, apart from health warnings and other government-mandated information, and the brand name in a prescribed uniform font, colour and size. Australia was the first country to implement standardised tobacco packaging between October and December 2012, France implemented standardised tobacco packaging on 1 January 2017 and several other countries are implementing, or intending to implement, standardised tobacco packaging...
April 27, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28407747/antipsychotic-prescribing-for-vulnerable-populations-a-clinical-audit-at-an-acute-australian-mental-health-unit-at-two-time-points
#13
Sara S McMillan, Sara Jacobs, Louise Wilson, Theo Theodoros, Gail Robinson, Claire Anderson, Gabor Mihala, Amanda J Wheeler
BACKGROUND: Antipsychotics are recognised as a critical intervention for schizophrenia and bipolar disorder. Guidelines globally endorse the routine practice of antipsychotic monotherapy, at the minimum effective dose. Even in treatment-resistant schizophrenia, clozapine use is endorsed before combining antipsychotics. This aim of this study was to review antipsychotic polytherapy alone, high-dose therapy alone, polytherapy and high-dose prescribing patterns in adults discharged from an inpatient mental health unit at two time-points, and the alignment of this prescribing with clinical guideline recommendations...
April 13, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28402570/prescription-opioid-access-patterns-and-factors-associated-with-increasing-number-of-prescribers-pharmacies-and-dispensings-an-observational-study-using-pharmaceutical-claims
#14
Bianca Blanch, Louisa Degenhardt, Nicholas A Buckley, Natasa Gisev, Timothy Dobbins, Emily A Karanges, Briony Larance, Sarah Larney, Sallie-Anne Pearson
Objective. : To examine associations between patient factors and increasing opioid access measured by three metrics: number of unique prescribers, pharmacies, and dispensings in 12 months. Methods. : We used pharmaceutical claims for a random 10% sample of Australians age 18 years or older initiating or reinitiating strong opioid treatment (≥90 days of no strong opioid dispensing) between July 2010 and December 2012. We report the distribution of opioid access by metric...
April 10, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28395092/travellers-diarrhoea-a-survey-of-practice
#15
Christian M McGrath, Karin Leder
Background.: Travellers' diarrhoea (TD) is a common problem, affecting millions of tourists each year and creating a large economic burden. Risk factors for TD are known and guidelines exist to assist practitioners in advising travellers on how to prevent and treat TD. However, data are lacking regarding actual prescribing practices or approaches used in TD management. This study aims to establish a baseline which identifies uniformities and diversities in practice. Methods...
March 1, 2017: Journal of Travel Medicine
https://www.readbyqxmd.com/read/28379046/knowledge-and-attitudes-of-health-professionals-regarding-menopausal-hormone-therapies
#16
L Yeganeh, J Boyle, H Teede, A Vincent
OBJECTIVE: To evaluate the knowledge and attitudes of Australian health professionals (HPs) including general practitioners (GPs), gynecologists and endocrinologists, to menopausal hormone therapy (MHT). METHODS: Participants were recruited from medical societies/colleges and a national GP conference. An online survey containing devised and previously published questions was used. Data analysis included frequencies, ANOVA, χ(2) and regression analysis. RESULTS: A total of 745/888 responses were analyzed...
April 5, 2017: Climacteric: the Journal of the International Menopause Society
https://www.readbyqxmd.com/read/28377092/interdisciplinary-medication-decision-making-by-pharmacists-in-pediatric-hospital-settings-an-ethnographic-study
#17
Ellie Rosenfeld, Sharon Kinney, Carlye Weiner, Fiona Newall, Allison Williams, Noel Cranswick, Ian Wong, Narelle Borrott, Elizabeth Manias
OBJECTIVE: Children are particularly vulnerable to experiencing medication incidents in hospitals. Making sound medication decisions is therefore of paramount importance. Prior research has principally described pharmacists' role in reducing medication errors. There is a dearth of information about pharmacists' interactions with pediatric hospital staff across disciplines in resolving medication issues. The aim of this study was to examine interdisciplinary medication decision making by pharmacists in pediatric hospital settings...
March 22, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28351159/implementation-fidelity-of-a-computer-assisted-intervention-for-children-with-speech-sound-disorders
#18
Jane McCormack, Elise Baker, Sarah Masso, Kathryn Crowe, Sharynne McLeod, Yvonne Wren, Sue Roulstone
BACKGROUND: Implementation fidelity refers to the degree to which an intervention or programme adheres to its original design. This paper examines implementation fidelity in the Sound Start Study, a clustered randomised controlled trial of computer-assisted support for children with speech sound disorders (SSD). METHOD: Sixty-three children with SSD in 19 early childhood centres received computer-assisted support (Phoneme Factory Sound Sorter [PFSS] - Australian version)...
March 29, 2017: International Journal of Speech-language Pathology
https://www.readbyqxmd.com/read/28347319/applying-the-theoretical-domains-framework-to-identify-barriers-and-targeted-interventions-to-enhance-nurses-use-of-electronic-medication-management-systems-in-two-australian-hospitals
#19
Deborah Debono, Natalie Taylor, Wendy Lipworth, David Greenfield, Joanne Travaglia, Deborah Black, Jeffrey Braithwaite
BACKGROUND: Medication errors harm hospitalised patients and increase health care costs. Electronic Medication Management Systems (EMMS) have been shown to reduce medication errors. However, nurses do not always use EMMS as intended, largely because implementation of such patient safety strategies requires clinicians to change their existing practices, routines and behaviour. This study uses the Theoretical Domains Framework (TDF) to identify barriers and targeted interventions to enhance nurses' appropriate use of EMMS in two Australian hospitals...
March 27, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28339847/telephone-delivered-exercise-advice-and-behavior-change-support-by-physical-therapists-for-people-with-knee-osteoarthritis-protocol-for-the-telecare-randomized-controlled-trial
#20
Rana S Hinman, Belinda J Lawford, Penny K Campbell, Andrew M Briggs, Janette Gale, Caroline Bills, Simon D French, Jessica Kasza, Andrew Forbes, Anthony Harris, Stephen J Bunker, Clare M Delany, Kim L Bennell
Background.: Exercise and physical activity are a core component of knee osteoarthritis (OA) care, yet access to physical therapists is limited for many people. Telephone service delivery models may increase access. Objective.: Determine the effectiveness of incorporating exercise advice and behaviour change support by physical therapists into an existing Australian nurse-led musculoskeletal telephone service for adults with knee OA. Design.: Randomized controlled trial with nested qualitative studies...
March 1, 2017: Physical Therapy
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