The Australian journal of rural health
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Aust J Rural Health · Aug 2013
Multicenter StudyThey've given me that many tablets, I'm bushed. I don't know where I'm going: Aboriginal and Torres Strait Islander peoples' experiences with medicines.
To explore Aboriginal and Torres Strait Islander patients' experiences with medicines and the barriers and facilitators to their effective use of medicines. ⋯ Many Aboriginal and Torres Strait Islander patients take multiple medicines and often find managing their medicines difficult and worrying. These patients require more comprehensive information, verbal and written, and more effective communications from doctors and pharmacists about medication indications, mechanisms, side effects, drug interactions and duration of treatment. Pharmacists have an opportunity to play a greater role in improving understanding of medicines and treatment choices.
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Aust J Rural Health · Apr 2012
Randomized Controlled Trial Multicenter StudyDo clinical pathways enhance access to evidence-based acute myocardial infarction treatment in rural emergency departments?
The objective of this study is to measure the impact of a five-step implementation process for an acute myocardial infarction (AMI) clinical pathway (CPW) on thrombolytic administration in rural emergency departments. ⋯ The lack of impact of the implementation process for a chest pain CPW on thrombolytic delivery or time to electrocardiogram in these rural hospitals can be explained by a ceiling effect in outcome measures but was also compromised by the small sample. Results suggest that quality of AMI treatment in rural emergency departments (EDs) is high and does not contribute to the worse mortality rate reported for AMIs in rural areas.
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Aust J Rural Health · Dec 2007
Multicenter StudyRecruitment and retention of rural general practitioners: a marketing approach reveals new possibilities.
This paper repositions the challenge of attracting and retaining rural GPs in a marketing context as a new focus for future research and policy development. ⋯ A marketing orientation to the GP challenge emphasises individual's perceptions of value, GP expectations and practice offerings. Failure to acknowledge benefits of this marketing approach means that solutions such as those developed in the Limestone Coast region are unlikely. Research is now required to define GP satisfaction and value for long-term viability of general practices.
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Aust J Rural Health · Dec 2000
Multicenter Study Comparative StudyDifferences in cardiac procedures among patients in metropolitan and non-metropolitan hospitals in New South Wales after acute myocardial infarction and angina.
An observational cohort study examined the difference in use of cardiac procedures during and after hospital admission for acute chest pain in 47 metropolitan or non-metropolitan hospitals across New South Wales (NSW). There were 3836 patients, represented by 4151 admissions to hospital after acute myocardial infarction (AMI), unstable angina or other angina. Follow up at 22 months was completed on 1695 patients. ⋯ Odds ratios (95% confidence intervals) for the use of exercise stress tests, echocardiograms, nuclear studies and coronary angiography were 3.30 (1.38, 7.90), 9.34 (4.07, 21.44), 4.87 (2.08, 11.39) and 68.64 (17.29, 272.49), respectively, for patients with AMI and 1.93 (0.91, 4.12), 5.60 (1.60, 19.57), 3.51 (1.48, 8.33) and 38.57 (9.36, 158.94), respectively, for patients with unstable angina. Rates were similar between hospital types during the 22 months after discharge. The appropriateness of this large variation in resource use between metropolitan and non-metropolitan hospitals requires examination.