24 April 2014

Chronic pain toolkit for clinicians

The NSW Agency for Clinical Innovation's Pain Management Network has made available a Chronic pain toolkit for cliniciansdesigned to help gain a better understanding of pain.  Early assessment and effective management of pain is essential to prevent its progression to chronic pain.   The site advocates that best evidence for effective management and prevention of chronic pain is to use an interdisciplinary bio-psychosocial approach, and various resources are provided to help guide management.  There are links to assessment tools and practice guidelines as well as to other websites, factsheets and other evidence related to the management of chronic pain.

Play safe - sexual health website

NSW Health's new sexual health website, Play Safe, was developed in consultation with the NSW Youth Advisory Council and aims to connect young people aged 15-24 years old with sexual health information and sexually transmissible infection (STI) testing, treatment and prevention services via an online platform. 

Medicare locals under review

Across Australia 61 Medicare Locals currently plan and fund extra health services in local communities. The operation of these primary healthcare organisations has been under review, with changes expected after the Federal Budget in May. Listen to Dr Arn Sprogis' interview with Norman Swan on ABC's Saturday Extra online. [Duration 23:35]
See: www.abc.net.au/radionational/programs/saturdayextra/medicare-locals-under-review/5392030

Wound care panel discussion

Out of the three billion dollars spent on wound care in Australia annually, 2.8 billion are used caring for chronic wounds. The ABC Health Report recently aired a panel discussion on wound care, sponsored by the Wounds Cooperative Research Centre and featuring some of Australia's expert researchers in the field of wound management practice and research. Held at Parliament House in Canberra and chaired by Robyn Williams, panelists included Professor Helen Edwards from Queensland University of Technology and Professor Karyln Carville from Curtin University.  Also taking part in the discussion was a patient who had a 17 year old wound healed in a few weeks once he got the correct treatment.

Read the transcript or download the audio here.

Time to move: Arthritis

Arthritis affects more than three million people in Australia and costs our health and welfare systems more Time to move: Arthritis, a national strategy to reduce a costly burden.  Components of the strategy are awareness raising campaigns, health promotion and prevention, education and self-management support, multidisciplinary arthritis clinics, workforce capacity building and research.
than $5.6 billion each year.  Arthritis Australia has published a series of reports as a road map for improving care for Australian arthritis sufferers.  The details are summarised in

Three other documents support the overall strategy:

17 April 2014

Evolution of nursing in general practice

"The evolution of nursing in general practice: a comparative analysis of workforce surveys ten years on" is an article recently published in BMC Family Practice by Elizabeth Halcomb et al.  It describes the current demographic and employment characteristics of Australian nurses working in general practice, and trends over time.

Government initiatives to strengthen primary care has seen an expansion of the role of nurses in general practice over the last decade, but this study identified continuing barriers that impact practice nurse role development. "Understanding and addressing these issues is vital to optimise the effectiveness of the primary care nursing workforce."

BMC Family Practice, 2014, 15:52 http://www.biomedcentral.com/1471-2296/15/52 (open access).

Unlocking Skills in Hospitals - report from the Grattan Institute

The Grattan Institute - an Australian public policy think tank - has just released a report, "Unlocking Skills in Hospitals: better jobs more care" by Stephen Duckett and Peter Breadon.  The authors argue that enabling less highly-trained hospital workers to play a bigger role could improve jobs for doctors and nurses, save public hospitals nearly $430 million a year and fund treatment for more than 85,000 extra people.

The report suggests ways that hospitals can get a better match between workers and their work.  For example, AINs could free up nurses’ time by providing basic care to patients, specialist nurses could free up doctors’ time by doing common, low-risk procedures now done by doctors and more assistants could be employed to support physiotherapists and occupational therapists. The authors suggest that barriers of culture, tradition, industrial relations and vested interest stand in the way of change and current  workforce roles are outdated.

Peter Breadon wrote a commentary piece in The Conversation earlier this week which summarises the report's findings, Hospital Work Reform, which was answered in the same publication today by Rhian Parker from the University of Canberra who in, Leave Prescribing to Doctors and Nurse Practitioners, urges caution in adopting the recommendations from the Grattan report.

Global guideline for Type 2 diabetes in older people

The International Diabetes Federation as published its Global Guideline for Managing Older People with Type 2 Diabetes.  The guideline has been developed to provide clinicians with recommendations that assist in clinical management of older adults who are both relatively well and active and those who are functionally dependent.  Topics covered include assessment measures, cardiovascular risk, education, renal impairment, diabetic foot disease and sexual health. Also included is a section of 'special consideration' where areas such as pain and end of life care are addressed.

11 April 2014

Alzheimer's Australia reports on incidence and medication

Alzhiemer's Australia publishes regular reports and discussion papers on this disease.  The most recent are:

Paper 39 - Is the Incidence of Dementia Declining?  - a joint report from Alzheimer's Australia and the Centre for Healthy Brain Ageing, suggesting that action on preventative health could lower the risk of dementia for future generations.  If Australians change the way they think about dementia, the growth of the disease could be reduced.

Paper 38 - The Use of Restraint and Psychotropic Medication in People with Dementia - describes how up to 80% of people with dementia and nearly half of people in residential aged care facilities are receiving psychotropic medications that in some cases are inappropriately prescribed.

National Aged Care Data Clearinghouse

The new National Aged Care Data Clearinghouse, at the Australian Institute of Health and Welfare, is an useful repository of national aged care data. It is a component of the Australian Government’s package of aged care reform measures and was developed to provide aged care data to policy makers, researchers, service providers and consumers. It provides statistical information on clients and services within a range of national programs and services, including residential aged care, aged care packages provided in the community, the Transition Care Program, the National Respite for Carers Program and the Aged Care Assessment Program.

Rare Cancers report

Rare Cancers Baseline Report: 2014from Rare Cancers Australia, calls on the Australian government to take action to improve research, diagnostics and access to medicines for rare and less common cancer patients. 
‘Rare cancers’ are defined as those with an incidence of less than 6 per 100,000 Australians per annum and ‘less common’cancers as those with an incidence of between 6 and 12 per 100,000 Australians per annum.
This accounts for over 42,000 diagnoses of rare and less common (RLC) cancers and around 22,000 deaths in Australia.

The report describes a failing in research funding and support for patients with RLC cancers and their families.  The survival rates are very low compared to rates for the more common cancers. 

09 April 2014

NHMRC homeopathy review

The National Health and Medical Research Council has today released its draft information paper, Evidence on the effectiveness of homeopathy for treating health conditions.  It summarises the findings of an assessment of homeopathy which included an overview of published systematic reviews, evaluation of information provided by homeopathy interest groups and the public, and consideration of clinical practice guidelines and government reports on homeopathy published in other countries. Their overall finding was "NHMRC concludes that the assessment of the evidence from research in humans does not show that homeopathy is effective for treating the range of health conditions considered."

An assessment of the paper and discussion of the issues can be found in an article by Ian Musgrave from the University of Adelaide in The Conversation.  No evidence homeopathy is effective.

Breast cancer screening debate

The ABC Health and Wellbeing website has included a precis of the current debate from researchers about whether or when to screen for breast cancer.  Breast cancer: to screen or not to screen gives a good summary of the prevalence of the disease, the problems of over-diagnosis and the importance of early diagnosis.  It seems the research is mixed, and a recent Canadian study published in the BMJ concluded that annual mammography in women aged 40-59 did not reduce mortality from breast cancer and 22% (106/484) of screen detected invasive breast cancers were over-diagnosed.

Quality of allied health - evidence based framework

In this research paper the Australian-based authors propose a framework for measuring the quality of allied health (AH). A systematic review of the literature since 1980 led to the development of a “realist synthesis framework" to describe what AH does, how it does it, and what is achieved. The literature review identified 24 measures of quality which can be used to address the complexity of AH therapies. This reveiw should assist in better evaluation of AH processes and outcomes, costs, and evidence-based engagement of AH providers in healthcare teams.  The article is available freely on open access.

An evidence-based framework to measure quality of allied healthcare  Grimmer K, Lizarondo L, Kumar S, Bell E, Buist M, Weinstein P. Health Research Policy and Systems 2014;12(1):10.

04 April 2014

Indigenous health check data tool

This innovative tool from the Australian Institute of Health and Welfare, draws together MBS billing data and Indigenous population data to produce readily-accessible information about use of MBS-rebated regular health checks for Aboriginal and Torres Strait Islander people. It shows quarterly and financial year data on numbers of health checks and usage rates (the proportion of Indigenous people who have had a health check) across Medicare Locals. It also links data to map displays and shows trends over time. Policy makers, program officers, researchers and Aboriginal and Torres Strait Islander consumers can now easily track progress and identify priority areas for action.