Internal medicine journal
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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.
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Internal medicine journal · Oct 2020
Anticoagulant prescribing in patients with ischaemic stroke: what has changed over a decade?
A study at our institution conducted 10 years ago identified that warfarin was under-utilised in patients with atrial fibrillation. We replicated this study and compared the results. ⋯ Seventy-two percent of treated patients were prescribed a direct oral anticoagulant. Of these, 10% were discharged with a sub-therapeutic dose without obvious explanation.
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Internal medicine journal · Oct 2020
Towards new models of cancer care in Australia: lessons from Victoria's response to the COVID-19 pandemic.
In response to the COVID-19 pandemic, the Department of Health and Human Services Victoria (DHHS), the Monash Partners Comprehensive Cancer Consortium (MPCCC) and Victorian Comprehensive Cancer Centre (VCCC) pooled their combined infrastructure to establish the Victorian COVID-19 Cancer Network (VCCN) backed by a Taskforce of expert members. In a few short months, this state-wide clinical network implemented a number of new models of care including clinics to manage acutely presenting cancer patients away from emergency departments, chemotherapy in the home, telehealth models and addressing sustainability of clinical trials.
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Internal medicine journal · Oct 2020
Addressing the challenges of artificial intelligence in medicine.
The application of artificial intelligence in medicine, particularly in relation to screening and diagnosis of disease through imaging analysis, will have a profound impact over the next decade. This communication discusses regulatory challenges that should be considered by physicians and how potential issues may be mitigated using a collaborative approach, drawing on the combined expertise of relevant stakeholders.