Get it Right! Taking a Best Possible Medication History.

Obtaining a best possible medication history, or BPMH, is an important step in medication reconciliation. The Australian Commission on Safety and Quality in Healthcare recently released a training video that guides clinicians on how to obtain an accurate and complete BPMH. By the end of the video, clinicians should be able to:

•  explain how to obtain and record a BPMH
•  explain why at least two sources of information are used to obtain the BPMH
•  understand how medication history taking techniques can influence the accuracy of the BPMH
•  recognise when medication reconciliation should occur and why it is important.

Designed for medical, nursing and pharmacy staff, the video includes a short, role play scenario which highlights the steps in taking a BPMH and provides important tips when reviewing sources of medicines information.
The video can be accessed via the Commission’s YouTube channel.

Asthma Management

The Victorian Government Better Health Channel website have produced a fact sheet on Asthma Management which you can download for free. Asthma is a big health problem in Australia. with over two million having the condition. Managing your asthma properly can help you lead a normal, active life. An asthma action plan is an individual plan created by you and your doctor to help you manage your asthma.
An asthma plan includes:

• how to care for your day-to-day asthma
• key things that tell you when your asthma is getting worse and the steps your should take to manage it
• symptoms that are serious enough to need urgent medical help.

Patient Safety. It takes a team

The American Academy of Orthopaedic Surgeons has produced this page on their site to aid patients in understanding and being engaged in their care. The "Patient Safety: It Takes a Team" campaign promotes the “cooperation between doctor, patient, nurses, and hospital staff that is necessary for safe, successful surgeries. For the patient this includes:

·         Ask questions — be sure to speak up when you need more information from your doctor

·         Involve a friend or family member in your care

·         Be able to discuss your medical history — such as past surgeries, major illnesses, and family history of medical problems

·         Keep a complete, accurate list of all your medications, including over-the-counter medications, vitamins, and nutritional supplements

·         Tell your healthcare team about your allergies and any past reactions to anesthesia or medications

The Trans Pacific Partnership Agreement negotiations and the health of Australians

The Trans Pacific Partnership Agreement has the potential to negatively impact the health of Australians by raising the cost of medicine and limiting the government's ability to regulate tobacco and alcohol, argues this paper, based on publicly available and recently leaked negotiating documents. The purpose of this policy brief, by the Centre for Health Equity Training, Research and Evaluation at the University of New South Wales, is to inform the debate from a health perspective in the final stages of the negotiations on the Trans Pacific Partnership Agreement (TPPA) in February 2014. The brief focuses on two specific issues: the cost of medicines, and the ability of government to take major steps to improve the health of Australians by regulating the areas of tobacco and alcohol policy.

The authors conclude that while there is some potential for the TPPA to contribute to economic development, there is also significant risk that the economic gains and the health of the Australian community, will be threatened if certain proposed provisions are adopted for the TPPA. These include increased direct costs in terms of providing health care and increased use of hospitals, higher costs of obtaining pharmaceuticals, indirect costs associated with lost productivity across society, continuing or exacerbating inequalities in society, and the worsening health of Australia’s already vulnerable communities.
Authored by: Katie Hirono, Deborah Gleeson, Fiona Haigh, Patrick Harris  (APO 19/2/14)

Clinical Practice Guidelines for the Management of Hypertension in the Community

About one third of adults in most communities in the developed and developing world have hypertension.  It is the most common chronic condition dealt with by primary care physicians and other health practitioners, however treatment success is often limited.

The American Society of Hypertension and the International Society of Hypertension in the United States have produced a clinical guideline with the goal being to give sufficient information to enable health care practitioners, wherever they are located, to provide professional care for people with hypertension.

Measuring the Burden - Alcohol’s Evolving Impact on Individuals, Families, and Society

 

Alcohol use is associated with tremendous costs to the drinker, those around him or her, and society as a whole. These costs result from the increased health risks (both physical and mental) associated with alcohol consumption as well as from the social harms caused by alcohol. Alcohol Research: Current Reviews Volume 25, Issue 2 examines the public health impact of alcohol consumption in America, looking at the full burden of disease that can be attributed to drinking.

This Alcohol Research: Current Reviews volume is now freely available to read or download online or as an e-book for your favorite e-reader.

Integrated care for older people with complex needs

Providing integrated care for older people with complex needs: lessons from seven international case studies around the world, is a recent report from the King's Fund.  Rapidly ageing populations are resulting in increased demand for health and social care services, which presents significant challenges for national health care systems. Many have adopted an integrated care approach to meet the needs of older people with chronic or multiple conditions. using a single care manager to co-ordinate multiple caregivers and share information between them. This report synthesises evidence from seven international case studies - Australia, Canada, the Netherlands, New Zealand, Sweden, the UK and the USA. It identifies lessons for policy-makers and service providers to help them address the challenges ahead. 

Goodwin N, Dixon A, Anderson G, Wodchis W, The King’s Fund (2014).  

Immunotherapy for peanut allergy

A randomised controlled trial recently published in The Lancet showed that giving children and adolescents with peanut allergies increasing doses of the peanut protein over time built up their tolerance in most cases.  Allergic reactions became less severe, and tolerance of more than an accidental quantity of peanuts became significantly improved.  "Assessing the efficacy of oral immunotherapy for the desensitisation of peanut allergy in children (STOP II): a phase 2 randomised controlled trial" by Katherine Anagnostou et al, trialled 99 medically supervised children between 7 and 16 years and found that most of them experienced a "clinically meaningful increase in peanut threshold. Quality of life improved after intervention and there was a good safety profile."

A useful summary of the study can be found on The Conversation, "Small doses therapy shows promise for peanut allergy". 

The Lancet, Early Online Publication, 30 January 2014 doi:10.1016/S0140-6736(13)62301-6.  Ask your librarian if you have trouble accessing the full text.

Closing the Gap report 2014

Prime Minister Tony Abbott has recently delivered the 6th annual Closing the Gap report, outlining mixed results in the quest to minimise indigenous disadvantage.  Some of the key findings included:

• there has been a small improvement in indigenous life expectancy, but progress needs to accelerate in order to meet the target to close this gap by 2031
• child mortality targets are on track
• progress on the reading, writing and numeracy gaps are disappointing
• no progress has been made against the target to halve the employment gap within a decade. 

New Australian physical activity guidelines

The Australian government's Department of Health has just published its latest Physical Activity and Sedentary Behaviour Guidelines. Separate guidelines are available for different aged children, adolescents, adults and those people 65 and over. For the first time, adult Australians are being encouraged to sit less and are encouraged to partake in 60 minutes per day of activity, double the previous recommendation. Another change is the inclusion of muscle strengthening activity, which should be undertaken at least twice weekly.

WHO World Cancer Report 2014

The International Agency for Research on Cancer, part of the World Health Organisation, has published the World Cancer Report 2014. The report provides a global view of cancer patterns, causes and prevention.  At 630 pages it is not freely available but can be purchased in print or electronic format for US$60.

This 2014 report is the first of its type since 2008 and shows that cancer is now the world’s biggest killer. In 2012, there were 8.2 million cancer deaths (including 40,000 Australians) and 14.1 million new cancer cases worldwide. These numbers are predicted to rise to 13 million deaths and 22 million cases per year by 2025.  Several useful summaries and commentaries about the report contents can be found, including from the ABC, Cancer now biggest killer in Australia and in The Conversation, Cancer, the world's biggest killer.  

Alzheimer mapping and memory - Health Report

A recent Health Report on ABC RN focused on Alzheimer Disease and memory.  In Mapping Alzhiemer, Norman Swan interviewed researchers at Columbia University who have mapped the path of a distorted protein known as 'tau' which hits the area of the brain where memories are made and stored as it jumps from cell to cell.  It is hoped that this knowledge will lead to the development of a way to stop this happening.

Another study from the University of Minnesota trialed Vitamin E and Alzheimer and trial leader, Mark Dysken, described how a marked benefit on functional ability in people with mild to moderate Alzheimer disease was demonstrated when treated with quite a high dose of Vitamin E.

Finally, in Active Memory, cognitive psychologist Professor Bob Wood explains his scepticism about the brain training industry as a preventive measure for staving off dementia.  He discusses the importance of accumulated knowledge as a balance to cognitive fluidity in younger people and suggests that doing tasks like crosswords and Sudoku make you better at those specific tasks, but don't improve your everyday performance as a whole.

Working beyond 65 - what's realistic?

This report from the National Seniors Productive Ageing Centre explores the relationship between health and remaining in the workforce past the age of 65 in Australia. It shows that people in good health are almost twice as likely to be employed as those with a chronic health condition. The report also finds that 80% of people working with a chronic health condition earn $500 or less per week, compared to 54% of those without a health condition. The most common conditions affecting people in this age group are arthritis and related disorders, hypertension, back problems, diabetes and heart disease. A concerning finding from the study is that many employed people with a chronic health condition believe that the income they earn is not enough to allow them to retire.

Working beyond 65—what’s realistic? The influence of health on longer working lives was written by D Schofield, E. Callander, S. Kelly and R. Shrestha for the NSPAC.

Work health and safety statistics booklet

In 2010-11 there were 132 570 workers’ compensation claims for serious work-related injuries or illnesses in Australia, according to the Key Work Health and Safety Statistics Booklet Australia 2014, published by Safe work Australia. This equates to an incidence rate of 13.1 serious claims per 1000 employees. Preliminary figures from 2011-12 show that this figure has most likely improved. Some of the key findings were that males have a 25% higher rate of claims for serious injury than females, that claims increase with age, and that labourers and related workers have over double the rate of claims as other occupations.

A typical serious workers’ compensation claim involves four weeks absence from work and one-quarter of serious claims required 12 or more weeks off work. 58 out of every 1000 workers experienced an injury or illness in the workplace in 2009–10 but half of these incidents involved less than one day or shift absent from work.

Medical workforce 2012

The medical workforce is continuing to grow, with increased supply across all regions of Australia, according to the recent Australian Institute of Health and Welfare report, Medical Workforce 2012.  The report shows that in 2012 there were 91,504 medical practitioners registered in Australia, a rise of approximately 16% since 2008.  The supply of medical practitioners across Australia compared to the population rose by almost 9% in that time, from 344 to 374 full-time equivalent medical practitioners employed per 100,000 people.