Margaret Williamson

A national census of medicines use: a 24-hour snapshot of Australians aged 50 years and older.

Objective: To explore the current use of conventional and complementary medicines in Australians aged ≥ 50 years.

Impact of asthma on self-reported health status and quality of life: a population based study of Australians aged 18–64

Background: The impact of asthma has traditionally been measured in terms of the prevalence of the disease, mortality rates, and levels of healthcare utilisation, particularly hospital admissions. However, the impact of asthma extends beyond these outcomes to include effects on lifestyle, well being, and perceived health status. Methods: Information on self-reported current asthma status, arthritis and diabetes as well as measures of life satisfaction, self-assessed health status, psychological distress, and interference with usual activities was obtained for 14 641 respondents aged 18–64 years in the 2001 National Health Survey of the general population in all states and territories in Australia. Log linear models were fitted separately for each of the dichotomised quality of life measures as dependent variables. The estimates of the adjusted rate ratio obtained from each model were used to compute the population attributable fraction (PAF) of self-reported asthma, arthritis, and diabetes for each of the health status and quality of life measures. Results: The presence of asthma accounted for 3.18% (95% CI 2.13 to 4.23) of people reporting poor life satisfaction, 8.12% (95% CI 6.57 to 9.67) of people reporting poor health status, 5.90% (95% CI 4.19 to 7.61) of people reporting high psychological distress, and 3.58% (95% CI 2.16 to 5.01) of people reporting any reduced activity days. The proportions of people with these adverse health states attributable to asthma were higher than the proportions attributable to diabetes but lower than the proportions attributable to arthritis. Conclusion: Asthma is an important contributor to the burden of ill health and impaired quality of life in the community. A strategic approach is needed to develop and implement strategies to address the impact of asthma on quality of life.

Drug interaction alerts in software--what do general practitioners and pharmacists want?

Objective: To explore Australian general practitioners’ and pharmacists’ preferences in relation to content, format and usability of drug interaction alerts in prescribing and dispensing software.

Reattendance at hospital for asthma in two Australian states, 2000–2003

Objective and background:  Reattendance rates at hospitals and emergency departments (ED) can provide a valuable marker of the quality and effectiveness of clinical care. Linked hospital and ED data from New South Wales and Victoria, Australia, were used to examine reattendances for asthma.

Hospital readmissions for asthma: a feasibility study comparing strategies for linking hospital morbidity data

Objective: To investigate whether the variables in the National Hospital Morbidity Database (NHMD) provide sufficient information to validly link hospital admission records for the same person so that persons admitted and re‐admissions for a specified disease can be enumerated.

Who Benefits from Aggressive Rapid Response System Treatments Near the End of Life? A Retrospective Cohort Study

BACKGROUND Many patients near the end of life are subject to rapid response system (RRS) calls. A study was conducted in a large Sydney teaching hospital to identify a cutoff point that defines nonbeneficial treatment for older hospital patients receiving an RRS call, describe interventions administered, and measure the cost of hospitalization. METHODS This was a retrospective cohort of 733 adult inpatients with data for the period three months before and after their last placed RRS call. Subgroup analysis of patients aged ≥ 80 years was conducted. Log-rank, chi-square, and t-tests were used to compare survival, and logistic regression was used to examine predictors of death. RESULTS Overall, 65 (8.9%) patients had a preexisting not-for-resuscitation (NFR) or not-for-RRS order; none of those patients survived to three months. By contrast, patients without an NFR or not-for-RRS order had three-month survival probability of 71% (log-rank χ2 145.63; p < 0.001). Compared with survivors, RRS recipients who died were more likely to be older, to be admitted to a medical ward, and to have a larger mean number of admissions before the RRS. The average cost of hospitalization for the very old transferred to the ICU was higher than for those not requiring treatment in the ICU (US

Validity of prescribing indicators for assessing quality of antibiotic use in Australian general practice

33,990 vs. US

6. Development of methods

14,774; p = 0.045). CONCLUSION Identifiable risk factors clearly associated with poor clinical outcomes and death can be used as a guide to administer less aggressive treatments, including reconsideration of ICU transfers, adherence to NFR orders, and transition to end-of-life management instead of calls to the RRS team.

2. Executive summary

The aim of this study was to assess the validity of a set of European quality indicators for assessing antimicrobial prescribing in Australian General Practice.

Asthma in Australia 2005.

The New South Wales Child Health Survey was conducted in the NSW Department of Healths 19-station computer assisted telephone interviewing (CATI) facility, which was used to administer the 1997, and 1998 NSW Health Surveys of adults, and 1999 Older Peoples Survey. More than 95 per cent of people in NSW have a telephone in their household, making CATI interviewing an efficient, reliable, and safe method of collecting information for population surveys. Methods were mostly consistent with previous NSW Health Surveys, except for methods of sampling of children, use of proxy respondents, introductory questions, and bi-lingual interviews.