Internal medicine journal
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Internal medicine journal · Dec 2014
Randomized Controlled Trial Multicenter StudyMetoclopramide for patients with intractable hiccups: a multicentre, randomised, controlled pilot study.
Limited data exist regarding the efficacy of metoclopramide in the treatment of intractable hiccups. ⋯ Metoclopramide appears to be a promising candidate for the treatment of patients with intractable hiccups, with mild adverse events. However, further clinical trials are required to confirm these results.
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Internal medicine journal · Sep 2014
Randomized Controlled TrialEffect of hospital-based telephone coaching on glycaemic control and adherence to management guidelines in type 2 diabetes, a randomised controlled trial.
Failure to achieve treatment targets is common among people with type 2 diabetes. Cost-effective treatments are required to delay the onset and slow the progression of diabetes-related complications. ⋯ Telephone coaching improved glycaemic control and adherence to complication screening in people with type 2 diabetes, for the duration of its delivery, but these effects were not maintained on withdrawal of the intervention. Strategies that assist patients to sustain these benefits are required.
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Internal medicine journal · Sep 2014
Randomized Controlled TrialEffect of a patient-directed discharge letter on patient understanding of their hospitalisation.
Poor patient understanding of their diagnosis and treatment plan can adversely impact clinical outcome following hospital discharge. Discharge summaries are primarily written for the doctor rather than the patient. We determined patient understanding of the reasons for hospitalisation, in-hospital tests, treatments and post-discharge recommendations, and whether a brief patient-directed discharge letter (PADDLE) delivered during a brief discussion prior to discharge would improve understanding. ⋯ A simple patient-directed letter delivered during a brief discussion improves patient understanding of their hospitalisation and post-discharge recommendations, which is otherwise limited. Further evaluation of this brief and well-received intervention is indicated, with the goal of improving patient understanding, satisfaction and clinical outcomes.
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Internal medicine journal · Apr 2014
Randomized Controlled Trial Comparative StudyProcalcitonin, a valuable biomarker assisting clinical decision-making in the management of community-acquired pneumonia.
Community-acquired pneumonia (CAP) is a leading cause of mortality, morbidity and hospital admission, which places strain on our healthcare system. Procalcitonin (PCT) is a biomarker of bacterial infection which may help gauge the severity and prognosis of patients with CAP. In addition to clinical predictors, PCT may assist in decisions pertaining to timing of discharge from hospital and the discontinuation of antibiotics. This study aimed to determine the predictive role of PCT measurement in reducing hospital admissions, length of stay (LOS) and antibiotic (AB) usage in patients with CAP. ⋯ Our study supports the hypothesis that by incorporation of PCT levels, hospital admission and LOS in patients with CAP can be reduced. A randomised prospective clinical trial is planned in an attempt to help confirm these findings.
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Internal medicine journal · Apr 2014
Randomized Controlled Trial Multicenter Study Comparative StudyEvidence-based prescribing of drugs for secondary prevention of acute coronary syndrome in Aboriginal and non-Aboriginal patients admitted to Western Australian hospitals.
To assess the level of evidence-based drug prescribing for acute coronary syndrome (ACS) at discharge from Western Australian (WA) hospitals and determine predictors of such prescribing in Aboriginal and non-Aboriginal patients. ⋯ Opportunity exists to improve prescribing of recommended drugs for ACS patients at discharge from WA hospitals in both Aboriginal and non-Aboriginal patients. Attention regarding pharmaceutical management post-ACS is particularly required for patients from rural and remote areas, and those attending district and private hospitals.