Internal medicine journal
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Internal medicine journal · Sep 2020
Randomized Controlled TrialEffectiveness of patient-oriented education and medication management intervention in people with decompensated cirrhosis.
People with chronic disease often have poor comprehension of their disease and medications, which can negatively affect health outcomes. In a randomised-controlled trial, we found that patients with decompensated cirrhosis who received a pharmacist-led, patient-oriented education and medication management intervention (n = 57) had greater knowledge of cirrhosis and key self-care tasks compared with usual care (n = 59). Intervention patients also experienced improved quality of life. Dedicated resources are needed to support implementation of evidence-based measures at local centres to improve outcomes.
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Internal medicine journal · Jul 2020
Randomized Controlled TrialModel-based analysis on systemic availability of co-administered cannabinoids after controlled vaporised administration.
The most important two medicinal cannabinoids are Δ9 -tetrahydrocannabinol (THC) and cannabidiol (CBD). Vaporised administration is superior due to its higher systemic availability, lower individual variability and faster drug delivery. Although it is common THC is co-administered with CBD, the influence of CBD on the pharmacokinetics, especially the systemic availability of THC after vaporised administration, is unknown. ⋯ The results observed in this study are useful for guiding future pharmacokinetic studies of medicinal cannabinoids, and for development of dosing guidelines for medical use of cannabis in the 'real-world' setting.
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Internal medicine journal · Sep 2018
Randomized Controlled TrialMusic reduces state anxiety scores in patients undergoing pleural procedures: a randomised controlled trial.
Patient anxiety is an often overlooked complication of pleural diagnostic and therapeutic procedures. Listening to music is effective in reducing patient anxiety in some endoscopy procedures but has not yet been evaluated in pleural procedures. ⋯ Listening to music appears to be beneficial in reducing anxiety in patients undergoing pleural procedures.
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Internal medicine journal · Dec 2017
Randomized Controlled Trial Comparative Study Pragmatic Clinical TrialSIRCLE: a randomised controlled cost comparison of self-administered short-course isoniazid and rifapentine for cost-effective latent tuberculosis eradication.
Currently, treatment of latent tuberculosis infection (LTBI) in Australia consists most commonly of a 9-month course of isoniazid (9H). A 3-month course of weekly isoniazid and rifapentine (3HP) has been shown to be as effective as 9 months of daily isoniazid, and associated with less hepatotoxicity; however, rifapentine is not currently available in Australia. Introduction of this regimen would have apparent advantages for people with LTBI in Victoria by safely shortening duration of LTBI therapy. However, the cost benefit of this new therapeutic approach is uncertain. ⋯ This study provides cost analysis evidence to support the use of 3HP for the treatment of LTBI in Australia.
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Internal medicine journal · Jul 2016
Randomized Controlled Trial Multicenter StudyNew oral anticoagulants: appropriateness of prescribing in real-world setting.
The new oral anticoagulants (NOAC) have been extensively studied in the clinical trial setting; however, concerns remain about the safety of prescribing in the elderly and patients with renal impairment. ⋯ Our findings imply that there remains considerable uncertainty about appropriate prescribing and dosing of NOAC, particularly in patients with impaired renal function. We recommend judicious prescribing and regular monitoring of renal function in patients at high risk of complications from NOAC therapy.