The Medical journal of Australia
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To compare changes in the costs of statins following patent expiry in Australia and England, and to estimate projected savings for Australia based on the government and consumers paying prices equivalent to those in England and increased use of generics. ⋯ The current arrangement for pricing statins places a considerable burden on the Australian community. Alternative pricing arrangements that provide incentives to lower statin prices and increase the proportion of generic prescriptions could be highly advantageous.
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Reach Out Central (ROC) is a serious game drawing on the principles of cognitive behaviour theory that has been designed to improve the mental health and wellbeing of young people, particularly men. ROC was developed over a 3-year period from 2003 to 2006, in consultation with young people aged 16-25 years who use the Reach Out mental health website http://www.reachout.com). ROC was launched online in September 2007. ⋯ Young women reported reduced psychological distress and improved life satisfaction, problem solving and help seeking; however, no significant changes were observed for young men. Although ROC was successful in attracting young men, demonstrating that the concept resonates with them, the service failed to keep them engaged. Further research is needed to explore how (or what changes need to be made) to sustain young men's engagement in the game.
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Self-help delivered through online websites has been found to be beneficial for people with mental health problems, and consumers find internet support groups helpful. The Australian National University e-hub group delivers automated web interventions (BluePages, MoodGYM, e-couch) and an online bulletin board (BlueBoard) to the public for mental health self-help. The evidence-based web interventions require no direct therapist or other human involvement, while the bulletin board is moderated by trained consumers under the supervision of a clinical psychologist. ⋯ These services provide programs for prevention and early intervention and are particularly suited to people who prefer anonymous services, live in rural and remote areas, or have a preference for self-help methods, as well as for use in school and workplace settings. A range of best-practice measures have been developed and put in place to ensure high-quality service delivery. Evaluation and quality control are enabled by a database and associated software.
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Traditional clinic-based service delivery systems remain inaccessible to many Australians with mental health problems. If we are to substantially reduce the burden of mental illness, we need to develop more accessible, empowering and sustainable models of mental health care. E-health technologies have specific efficiencies and advantages in the domains of health promotion, prevention, early intervention and prolonged treatment. It is timely to use the best features of these technologies to start to build a more responsive and efficient mental health care system.
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Internet treatment programs for anxiety and depressive disorders are becoming available and offer cost-effective alternatives to face-to-face treatment with medication or cognitive behaviour therapy. The Clinical Research Unit for Anxiety and Depression at St Vincent's Hospital, Sydney, offers internet treatment courses at the VirtualClinic (http://www.virtualclinic.org.au) for people who meet diagnostic criteria for major depression, social phobia, panic disorder and generalised anxiety disorder. ⋯ The four treatment programs that have been successfully evaluated in the VirtualClinic have been made available on a not-for-profit basis ($5 service fee) at the CRUfADclinic (http://www.crufadclinic.org) for general practitioners and other clinicians to use with their patients. These programs could be the first level of treatment in a stepped-care environment, where patients who do not benefit sufficiently could then receive face-to-face treatment from their clinician or be referred for specialist treatment.