Internal medicine journal
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Internal medicine journal · Oct 2020
Recent trends in cardiac electrophysiology and catheter ablation in New Zealand.
Catheter ablation has rapidly become an integral part of the management of many arrhythmias. ⋯ There has been a substantial increase in EP procedure and AF ablation rates in NZ and international trends suggest this growth will continue. However, there is considerable variation in procedure rates and growth trends between EP centres, highlighting inequities in access within the country.
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Internal medicine journal · Oct 2020
Quality of care in inflammatory bowel disease: actual health service experiences fall short of the standards.
Quality of care in inflammatory bowel disease (IBD) has received much attention internationally; however, the available surveys focus on health professionals rather than patients. ⋯ These data show discordance between expectations of patients and national standards with current levels of service provision, which fail to deliver equitable and comprehensive IBD care.
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Internal medicine journal · Oct 2020
Clinical decision support in a hospital electronic prescribing system informed by local data: experience at a tertiary New Zealand centre.
An electronic prescribing and administration (ePA) system has been progressively rolled out to Canterbury District Health Board (CDHB, Christchurch, New Zealand) public hospitals since 2014, and is currently used for around 1300 tertiary beds. ePA data can be used to monitor user behaviour, and to evaluate and inform the local customisation of clinical decision support (CDS) tools within the ePA system. ⋯ Local data extracts from ePA systems can inform iterative configuration of the software and monitor user behaviour.
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Internal medicine journal · Oct 2020
ReviewDeprescribing long-term opioid therapy in patients with chronic pain.
Proposed regulatory changes will limit the access to opioids by Australian patients with chronic pain, many of whom are under the care of consultant physicians. This review summarises points of consensus on opioid deprescribing that emerged from the interaction of an expert panel and the audience at a symposium on the topic held in Sydney in 2019. Each of these consensus points speaks to the need for an individualised, patient-centred approach. In other words, 'treat the patient, not the pill count'.
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Internal medicine journal · Oct 2020
Observational StudyComplications of cardiac implantable electronic device placement in public and private hospitals.
Few safety data exist comparing clinical outcomes in Australian public and private hospitals. We hypothesised that differences could exist between public and private hospitals due to differences in acuity and patient-level co-morbidities. ⋯ These data identify important similarities and differences in safety outcomes of CIED implantation between Australian public and private hospitals.