Christopher J. Poulos
University of New South Wales
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Publication
Featured researches published by Christopher J. Poulos.
Journal of the American Geriatrics Society | 1992
Brian Draper; Christopher J. Poulos; Andrew Cole; Roslyn G. Poulos; Frederick Ehrlich
To compare elderly co‐resident caregivers of stroke and dementia patients on measures of burden and psychological morbidity.
International Journal of Geriatric Psychiatry | 1996
Brian Draper; Roslyn G. Poulos; Christopher J. Poulos; Frederick Ehrlich
This cross‐sectional study examined 99 elderly coresident stroke and dementia caregivers who had been in the caregiving role for at least 6 months, to identify risk factors for subjective burden and psychological morbidity. A worsening in the quality of relationship between the caregiver and patient, being a spouse, shorter length of caregiving, poor caregiver self‐rated health, greater physical disability and behaviour/mood disturbance in the patient were found to be risk factors for burden. For psychological morbidity, risk factors also included behaviour/mood disturbance as well as female gender and low participation in life activities. These results demonstrate the multifactorial nature of caregiver stress in the elderly.
Pain Medicine | 2009
Michael Yelland; Christopher J. Poulos; Peter I. Pillans; Guy Bashford; C. J. Nikles; J. Sturtevant; Norma Vine; Chris Del Mar; Philip J. Schluter; Meng Tan; Jonathan Chan; Fraser D Mackenzie; R. Brown
OBJECTIVE The objective of this study was to compare the efficacy of gabapentin with placebo for neuropathic pain at the individual and population levels. DESIGN This study used an n-of-1 trial methodology with three double-blind, randomized, crossover comparisons of gabapentin with placebo. SETTING This study was carried out at specialist outpatient clinics at two Australian hospitals. Patients. The patients are adults with chronic neuropathic pain. INTERVENTIONS Following a dose-finding period, participants underwent three comparisons of 2-week periods on gabapentin (600-1,800 mg per day) and placebo. The dose-finding period was commenced by 112 patients, of whom 39 had no response so they did not enroll, leaving 73 trial participants. Of these, 48 completed and 7 partially completed their trials, and 18 withdrew. OUTCOME MEASURES The five outcome measures were the visual analog scale (0-10) of pain, sleep interference and functional limitation; frequency of adverse events and medication preference. The aggregate response was determined by weighting the response to each measure equally. RESULTS Of the 55 participants who completed at least one cycle, the aggregate response to gabapentin was better than placebo in 16 (29%), of whom 15 continued gabapentin posttrial. No difference was shown in 38 (69%), and 1 (2%) showed a better response to placebo. Fifteen of these 39 continued gabapentin posttrial. Meta-analysis of the mean scores showed lower mean (standard deviation) scores for gabapentin by 0.8 (0.2) for pain, 0.6 (0.2) for sleep interference, and 0.6 (0.2) for functional limitation. CONCLUSIONS The response rate and mean reduction in symptoms with gabapentin were small. Gabapentin prescribing posttrial was significantly influenced by the trial results.
Australian Health Review | 2007
Christopher J. Poulos; Boris M Gazibarich; Kathy Eagar
Providing information technology solutions to clinicians to support their work practices benefits clinicians, administrators and patients. We present our 8-year experience with an inexpensive information management system which provides clinical and business process support for clinicians and bed managers. The system has been used by an area rehabilitation and aged care service to manage inpatient consultations and patient flow across nine hospitals. Performance monitoring of the time from referral to consultation, the number, type and outcome of consultations, and the time taken to access a rehabilitation or subacute bed is also provided. Read-only access to the system for clinicians and bed managers outside the rehabilitation and aged care service allows greater transparency.
Journal of Rehabilitation Medicine | 2010
Christopher J. Poulos
OBJECTIVE To evaluate inpatient rehabilitation in public facilities in Australia against a utilization review tool used in the USA. DESIGN Prospective cohort study. SUBJECTS Patients identified in the acute wards of a regional referral hospital and subsequently transferred to a public inpatient rehabilitation facility. METHODS The InterQual utilization review criteria were applied to days of stay in the rehabilitation wards. Reasons for variance and actual therapy time were recorded. RESULTS Data on 267 patient episodes (7359 days) are available. Only 48% of patient days met utilization review criteria, with reasons for variance including insufficient therapy, awaiting discharge to long-term care or to home and being more appropriate for acute medical care. Therapy time data (available on 208 patient episodes) show that therapy was received on 50% of calendar days and for an average of 37 min per weekday (56 min for stroke patients). Allied health staffing levels were below recommended levels, but consistent with other Australian public hospital rehabilitation facilities. CONCLUSION Patients in these facilities seem to be receiving less therapy than their American counterparts; however, therapists often viewed their rehabilitation as appropriate. Findings also suggest inefficiencies in care delivery. Utilization review may help in the assessment of level of care appropriateness in the rehabilitation setting.
Clinical Rehabilitation | 2017
Jane Wu; Steven Faux; John Estell; Stephen Wilson; Ian A. Harris; Christopher J. Poulos; Linda Klein
Objective: To investigate the impact of an in-reach rehabilitation team for patients admitted after road trauma. Design: Randomised control trial of usual care versus early involvement of in-reach rehabilitation team. Telephone follow-up was conducted by a blind assessor at three months for those with minor/moderate injuries and six months for serious/severe injuries. Setting: Four participating trauma services in New South Wales, Australia. Subjects: A total of 214 patients admitted during 2012-2015 with a length of stay of at least five days. Intervention: Provision of rehabilitation services in parallel with ward based therapy using an in-reach team for the intervention group. The control group could still access the ward based therapy (usual care). Main measures: The primary outcome was acute length of stay. Secondary outcomes included percentage requiring inpatient rehabilitation, function (Functional Independence Measure and Timed Up and Go Test), psychological status (Depression Anxiety and Stress Score 21), pain (Orebro Musculoskeletal Pain Questionnaire) and quality of life (Short Form-12 v2). Results: Median length of stay in acute care was 13 days (IQR 8-21). The intervention group, compared to the control group, received more physiotherapy and occupational therapy sessions (median number of sessions 16.0 versus 11.5, P=0.003). However, acute length of stay did not differ between the intervention and control groups (median 15 vs 12 days, P=0.37). There were no significant differences observed in the secondary outcomes at hospital discharge and follow-up. Conclusion: No additional benefit was found from the routine use of acute rehabilitation teams for trauma patients over and above usual care.
Alzheimer's & Dementia: Translational Research & Clinical Interventions | 2017
Christopher J. Poulos; Antony James Bayer; Lauren A. Beaupre; Linda Clare; Roslyn G. Poulos; Rosalie H. Wang; Sytse U. Zuidema; Katherine S. McGilton
As society grapples with an aging population and increasing prevalence of disability, “reablement” as a means of maximizing functional ability in older people is emerging as a potential strategy to help promote independence. Reablement offers an approach to mitigate the impact of dementia on function and independence. This article presents a comprehensive reablement approach across seven domains for the person living with mild‐to‐moderate dementia. Domains include assessment and medical management, cognitive disability, physical function, acute injury or illness, assistive technology, supportive care, and caregiver support. In the absence of a cure or ability to significantly modify the course of the disease, the message for policy makers, practitioners, families, and persons with dementia needs to be “living well with dementia”, with a focus on maintaining function for as long as possible, regaining lost function when there is the potential to do so, and adapting to lost function that cannot be regained. Service delivery and care of persons with dementia must be reoriented such that evidence‐based reablement approaches are integrated into routine care across all sectors.
Australian and New Zealand Journal of Public Health | 2016
Jane Wu; Steven Faux; Ian A. Harris; Christopher J. Poulos; Tara L Alexander
Objectives: 1) Describe probabilistic linkage (PL) for road trauma and rehabilitation records in New South Wales (NSW) Australia. 2) Determine the accuracy of linkage for these records.
Archives of Gerontology and Geriatrics | 1994
Frederick Ehrlich; Roslyn G. Poulos; Christopher J. Poulos; B. Burraston; Stephen R. Lord; Raja Salgado
This paper looks at two surveys of bed rest, conducted in a general hospital. The first survey, conducted early one afternoon, assessed the prevalence of bed rest within the hospital. It was found that most of the patients (67%) were in bed, and nearly half of those (42%) were in bed for reasons other than being too sick or unsafe to be up, or because bed rest was part of their treatment. A second survey, in which a sample of general hospital patients was repeatedly observed throughout the day, found that patients with no requirements for bed rest spent 63% (95% confidence limits: 51-75%) of the active part of the day in bed. It may be that because of the nature of hospital design, many patients are unnecessarily confined to bed because there is simply nowhere else to go. Inappropriate use of bed rest has implications for patient health and the utilization of scarce hospital resources.
Archive | 2018
Kirsty Beilharz; Christopher J. Poulos; Roslyn G. Poulos; Janette Fodera; Andrew Cole; Roderick MacLeod
This chapter has an intentionally broad title to convey the breadth of ways that arts (with an emphasis on visual arts but also performative, poetic, tactile, and narrative art forms) contribute to whole-person wellness, hope, and engagement, across a range of stages encountered in palliative care services. This chapter looks at participatory arts, community and creative art facilitation, and art therapy. While there is considerable overlap in the utility of art and its benefits, such as creative enabling and expression for the patient, the range of approaches to art in palliative care herald from different disciplines, with different objectives, and are usually practised by people with distinctive professional backgrounds. It will also be clear that aspects of art facilitation in palliative care overlap substantially with approaches found in mental healthcare, dementia care, aged care, rehabilitation, and wellness initiatives in the general population. Specific to palliative care are the needs of the individual patient. Arts in palliative care now cross a range of settings, from hospital or hospice to residential care homes and community settings, variously with a dedicated studio space or a relatively mobile setup provided by the practitioner in any venue, even at the bedside. There is also some degree of nexus between arts in palliative care discussed here and psychotherapy and psychoanalysis, music engagement, “social clubs,” and initiatives for art appreciation offered by art organizations, galleries, or museums and communityrun art-making courses. However, this chapter focuses on the art experience tailored to people with palliative care needs.