Sabrina Pit

Accuracy of Telephone Self-Report of Drug Use in Older People and Agreement with Pharmaceutical Claims Data

ObjectiveTo determine the agreement between two measures of medication use, namely telephone interview self-report and pharmaceutical claims data, in an elderly population.MethodsAn agreement study of 566 community-dwelling, general practice patients aged ≥65 years was conducted to compare self-reported use of medicines with pharmaceutical claims data for different retrieval periods. Classes of drugs commonly used in the elderly were selected for comparison.Results1094 people were eligible for the main study. Of these, 697 people completed a follow-up survey and 625 of these patients consented to the release of pharmaceutical claims data. A further 59 participants were excluded from the analysis because they had a home visit instead of a telephone interview. The proportion of observed agreement between the telephone self-report and the various retrieval periods was consistently high. Kappa coefficients showed good to very good agreement (≥0.75) with retrieval periods of 30, 60 and 90 days for benzodiazepines, low-risk NSAIDs, thiazide diuretics and most other drugs. The specificity of self-reported medication use compared with claims data was consistently high across all drug classes, suggesting that people usually did not mention drugs that were not included in the claims data. Sensitivity values varied according to drug class and retrieval period, and were lower for NSAIDs than for benzodiazepines and thiazide diuretics. Decline in sensitivity with increased retrieval periods was most marked for benzodiazepines, NSAIDs and low-risk NSAIDs, which are often used on an as-needed basis. Positive predictive values increased with longer retrieval periodsConclusionHigh agreement and accuracy were demonstrated for self-reported use of medicines when patients were interviewed over the telephone compared with pharmaceutical claims data. The telephone inventory method can be used in future studies for accurately measuring drug use in older people when claims data are not available.

Health problems and retirement due to ill-health among Australian retirees aged 45-64 years

OBJECTIVE To examine which health problems are associated with retirement due to ill-health among Australians aged 45-64 years. METHODS Cross-sectional analysis of self-reported data of 1933 retired men and 3160 retired women aged 45 and over, living in NSW in 2008, who took part in the 45 and Up Study. MAIN OUTCOME MEASURE retirement due to ill-health versus retirement for other reasons. RESULTS Among retired women, those who reported ever having been told by a doctor that they had thrombosis, depression, osteoarthritis or cancer (except melanoma and skin and breast cancer), were twice as likely to have retired early due to ill-health as those without these health problems. The number of health problems associated with early retirement due to ill-health appeared to be slightly greater for men than for women. From most to least significant stroke, cancer (except melanoma and skin and prostate cancer), osteoarthritis, depression, anxiety and heart disease had significant associations with early retirement. In men and women, the strongest association with retirement due to ill-health was in self-reported health status. CONCLUSION Legislators, decision-makers, and health policymakers should be aware that several health problems are associated with early retirement due to ill-health among men and women aged 45-64 years. Interventions to prevent or treat these health problems would not only bring immediate health gains to the individuals themselves but would increase their ability to participate in the workforce and/or be otherwise productive in society. Interventions would need to be tailored for men and women separately, given the gender differences in disease profiles and social roles.

The Association of Health and Employment in Mature Women: A Longitudinal Study

BACKGROUND Despite a reduction in income inequalities between men and women, there is still a large gap between income and retirement savings of Australian men and women. This is especially true for women who have health or disability problems. Mature age women are closest to retirement and, therefore, have less chance than younger women to build up enough retirement savings and may need to continue working to fund their older age. Continued workforce participation may be particularly difficult for women who are less healthy. Understanding which health problems lead to a decrease in workforce participation among mature age women is crucial. Therefore, this longitudinal study sought to identify which health problems are associated with employment among midage women over time. METHODS Data were analyzed from the midage cohort of the Australian Longitudinal Study on Womens Health (ALSWH), which involved 14,200 midage women (aged 45-50 years in 1996). The women have been surveyed four additional times, in 1998, 2001, 2004, and 2007. Generalized estimating equations (GEE) were used to conduct nested multivariate longitudinal analyses. RESULTS The percentages of women who were employed in the years 2001, 2004, and 2007 were 77%, 72%, and 68%, respectively. Results were adjusted for sociodemographic variables. Being employed decreased as physical and mental health deteriorated and with self-reported conditions: diabetes, high blood pressure, depression, anxiety, and other psychiatric conditions. Back pain, arthritis, cancer, obesity, and being a current smoker are associated with employment but not when quality of life is added to the model. CONCLUSIONS There were significant associations between health and employment. Understanding these relationships could inform policies and guidelines for preventing declines in employment in mature age women.

Factors influencing early retirement intentions in Australian rural general practitioners

BACKGROUND The Australian general practice workforce is ageing. This and a trend towards higher exit intentions and earlier retirement make it increasingly important to identify those work and personal factors affecting intention to leave, which are amenable to change. AIMS To assess the various work, occupational and individual health factors associated with early retirement intentions among Australian rural general practitioners (GPs) that may be amenable to intervention. METHODS A cross-sectional study of GPs practising in rural Australia. Odds ratios of early retirement intentions across work, occupational and individual health factors were calculated. RESULTS There were 92 participants (response rate 56%), and 47% of responders intended to retire before 65. GPs with medium to high burnout levels had higher odds of intending to retire. Increased job satisfaction and work ability scores were associated with decreased retirement intentions, whereas increased physical and mental work ability demands were associated with an increase in retirement intentions. Absenteeism was not related to retirement intentions but presenteeism was. GPs reporting any work-related sleep problems were found to have a 3-fold increase in the odds of early retirement intentions. The odds of early retirement intentions also increased with higher psychological distress, worsening general health and longer working hours. CONCLUSIONS From a health policy reform perspective, the greatest impact on reducing early retirement intentions among ageing GPs could potentially be made by intervening in areas of working hours, burnout and work-related sleep issues, followed by job satisfaction, psychological distress, health, general workability and mental and physical work ability.

The relationship between lifestyle, occupational health, and work-related factors with presenteeism amongst general practitioners

ABSTRACT There is evidence that general practitioners (GPs) are more likely to exhibit sickness presenteeism than other health professional groups or other high-income earners and less likely to take sick leave. This study aims to examine the relationship between lifestyle, occupational health, and work-related factors with presenteeism amongst GPs. A cross-sectional study was conducted amongst GPs in 2011. Logistic regression was used to determine crude and adjusted odds ratios between lifestyle, occupational health, and work-related factors with presenteeism. Whilst adjusting for age and gender, exercising 1 to 3 times a week (odds ratio [OR] = 4.88), not having a good work-life balance (OR = 4.2), work-related sleep problems (OR = 2.55), moderate psychological distress (OR = 3.94), and poor or fair health (OR = 6.22) were associated with presenteeism. Increased burnout and reduced job satisfaction and workability due to the physical demands of the job were also associated with presenteeism. In conclusion, presenteeism amongst GPs can be addressed by implementing interventions in relation to physical activity, stress reduction, and sleep hygiene and improving work-life balance and the physical demands of the job.

Local infiltration analgesia versus standard analgesia in total knee arthroplasty

Purpose. To compare outcome and cost following local infiltration analgesia (LIA) versus standard analgesia in total knee arthroplasty (TKA). Methods. 13 men and 33 women (mean age, 67.5 years) underwent TKA by a single surgeon and received LIA (n=24) or standard analgesia (n=22), depending on the availability of the senior anaesthetist. Results. The 2 groups were comparable at baseline in terms of age, gender, body mass index, American Society of Anesthesiologists score, and range of motion. Compared with the standard analgesia group, the LIA group resulted in a shorter mean length of hospital stay (4.9 vs. 2.7 days, p<0.0001) and higher proportion of patients able to straight leg raise on discharge (38% vs. 86%, p=0.0011), as well as lower pain scores in the first 3 days and greater range of motion at all time points. Respectively in the standard analgesia and LIA groups, the mean cost per patient for all analgesic medication was A

Integrated solutions for sustainable fall prevention in primary care, the iSOLVE project: a type 2 hybrid effectiveness-implementation design

129.25 and A

A small unconditional non-financial incentive suggests an increase in survey response rates amongst older general practitioners (GPs): a randomised controlled trial study

153.63, the mean cost per patient for all nights spent in hospital was A

Errors and Predictors of Confidence in Condom Use amongst Young Australians Attending a Music Festival.

1600.36 and A

Intention to Stay and Intention to Leave: Are They Two Sides of the Same Coin? A Cross-sectional Structural Equation Modelling Study among Health and Social Care Workers

901.50, and thus the mean total cost per patient was A