The Medical journal of Australia
-
Multicenter Study
Impact of an ultrabroadband emergency department telemedicine system on the care of acutely ill patients and clinicians' work.
To evaluate whether introduction of an emergency department (ED) telemedicine system changed patient management and outcome indicators and to investigate clinicians' perceptions of the impact of the system on care provided and on their work. ⋯ The ViCCU appears most effective for moderate trauma patients, with associated reductions in admissions and transfers. Large-scale trials of telemedicine systems that include measurements of both patient care and impact on clinicians' work are required.
-
Randomized Controlled Trial
Impact of an educational intervention on general practitioners' skills in cognitive behavioural strategies: a randomised controlled trial.
To evaluate the impact of an educational intervention on general practitioners' skills in cognitive behavioural strategies (CBS). ⋯ Competency in CBS in highly motivated GPs can be improved by a brief training intervention.
-
Multicenter Study
Invasive management and late clinical outcomes in contemporary Australian management of acute coronary syndromes: observations from the ACACIA registry.
To describe the impact of invasive management on 12-month survival among patients with suspected acute coronary syndrome (ACS) in Australia. ⋯ A substantial burden of late morbidity and mortality persists among patients with ACS within contemporary Australian clinical practice. Under-use of invasive management may be associated with an excess in 12-month mortality, suggesting the need for more use of invasive management among these patients.
-
Comparative Study
What can alert the general practitioner to people whose common mental health problems are unrecognised?
To assess the characteristics of people with common mental health problems who are recognised by their general practitioner, and those who are not. ⋯ Low rates of recognition of psychological problems by GPs, and infrequent treatment for those presenting with somatic symptoms, indicate a need for building GPs skills in the assessment and management of somatisation. The SPHERE-12 may be a useful screening tool for primary care if followed by further questioning and other methods to assess diagnosis and severity to target appropriate treatment.
-
To report the baseline characteristics of the Diagnosis, Management and Outcomes of Depression in Primary Care (diamond) study cohort and discuss the implications for depression care in general practice. ⋯ This method of screening for depressive symptoms in general practice identifies a group of patients with substantial multiple comorbidities -- psychiatric, physical and social problems coexist with depressive symptoms, raising challenges for the management of depression in general practice.