Internal medicine journal
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Internal medicine journal · Oct 2024
Active deprescribing attitudes and practices in a large regional tertiary health service: a mixed methods study.
In this pilot study, we explored current attitudes and deprescribing practices of clinicians in a large regional health service through a mixed methods approach. Respondents included doctors, pharmacists and nurse practitioners, who outlined three themes including professional and organisational contexts, disconnect between goals and practices and factors influencing deprescribing.
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Internal medicine journal · Oct 2024
Identify, screen and treat via electronic pathway: a semiautomated approach to retriaging a liver clinic waitlist.
Long specialist outpatient waiting lists are a source of clinical risk. Triage assignment is based on subjective assessment of referrals and fails to account for dynamic changes in disease status while patients await clinical review. ⋯ This study successfully implemented a semiautomated strategy that prioritises patients with probable advanced liver disease or active HCV, demonstrating enhanced patient engagement with LCG support. It highlights the burden of patients referred for specialist care and the need for innovative strategies for monitoring and objective risk stratification.
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Internal medicine journal · Oct 2024
Clinical outcomes and risk factors in patients with COVID-19 and autoimmune rheumatic diseases: insights from a major Australian hospital study.
Patients with autoimmune inflammatory rheumatic disease (AIIRD) are at higher risk of severe infections because of their underlying diseases and immunosuppression. Our objective was to elucidate the epidemiological and clinical characteristics of patients with AIIRD presenting with COVID-19 and their relation to disease severity. We explored whether variables, including underlying diagnosis, disease-modifying antirheumatic drugs (DMARDs) and COVID-19 vaccine status, were associated with more severe forms of COVID-19 infection. ⋯ Severity of COVID-19 infection in patients with AIIRD is affected by age, background steroid use and vaccination status. Factors including sex, comorbidity, diagnosis of AIIRDs and use of DMARDs, including conventional synthetic, biologics and targeted DMARDs, were not significantly associated with COVID-19 severity.
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Internal medicine journal · Oct 2024
Navigating high-cost medicines: summary of the Guiding Principles for the governance of high-cost medicines in Australian hospitals.
High-cost medicines (HCMs) can be clinically impactful for individual patients but are also subject to variable funding mechanisms. Public hospitals and health services are often asked to fund HCMs, but inconsistent processes frequently create large variations in care. CATAG (Council of Australian Therapeutic Advisory Groups) is the Australian peak national advisory body for the quality use of medicines in hospitals and health services, with all states and territories collaborating to support Drug and Therapeutics Committees (DTCs). ⋯ The final version was approved by the EAG and CATAG members. This document represents a summary of the seven Guiding Principles developed, covering the areas of governance, application and assessment, communication, training and resourcing. Although many outstanding priorities still exist, including the development of national coordination regarding HCM assessment, these Guiding Principles offer a basis to navigate this complex area.
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Internal medicine journal · Oct 2024
Use of glucose sensors for post-discharge care triaging of insulin-treated patients with type 2 diabetes: a feasibility study.
The use of glucose sensors to triage post-discharge follow-up was investigated among hospital inpatients with type 2 diabetes. Feasibility, utility and patient satisfaction with this model of care were studied. ⋯ Follow-up plans were altered in 76.3% of the patients able to use the sensor technology. Patient satisfaction was high and was improved on follow-up after 6 months.