Z. Johnson

National survey of MRSA: Ireland, 1995

The objective of this survey was to obtain an indication of the size of the methicillin-resistant Staphylococcus aureus (MRSA) problem in Ireland prior to introducing national MRSA control guidelines. A survey of all microbiology laboratories in Ireland was carried out over two weeks in Spring 1995. For patients from whom MRSA was isolated during the study period standard demographic and clinical data were requested and period prevalence/1000 discharges was calculated. All 45 microbiology laboratories surveyed responded. MRSA was isolated from 448 patients during the two-week period. The period prevalence of MRSA was 16.5/1000 discharges. Males aged > or = 65 had the highest rate (50/1000 discharges). Half of all isolates were from patients in surgical or medical wards, but 4% were from community-based sources such as GPs, nursing homes and hospices. Thirty-two percent of MRSA patients were infected rather than colonized. MRSA is clearly a significant problem in Ireland. While it is largely a hospital problem at present, the increasing trend towards day procedures and shorter hospital stay means that infection will increase in the community.

The standardized prescribing ratio—a new method for comparing prescribing between GPs, controlling for patient age and sex

Objectives—To develop a method for comparing the proportion of patients on any drug or group of drugs for individual GP patient panels in Ireland, taking account of the age and sex structure of the panel.

The impact of reminder letters on attendance for breast cancer screening

ObjectiveThe aims of this investigation was to analyse the response to second and third postal invitations from a group of patients previously invited for mammographic screening and to identify any demographic differences between responders and non-responders.SubjectsThe subjects were females aged 50–64 yr resident in 6 adjacent District Electoral Divisions (DEDs) in North Dublin where screening had not been carried out prior to the study.MethodNon-responders to an invitation for screening were re-invited by computer-generated letter to attend for screening 6 weeks after issue of the first invitation and a final invitation was issued at 12 weeks. Data sources used for the project register were the Eastern Health Board General Medical Services data base (GMS), Voluntary Health Insurance Board (VHI) data and self-registration.ResultsThere were 1,310 females in the target age group who were eligible for screening. The response rate to the first invitation was 60.7 per cent. Issue of second invitation increased the response rate by 17.9 per cent. A third invitation increased the response rate by a further 7.6 per cent. Those with private medical insurance were more likely to respond to the first and third invitations. The was no difference in response rate to the second invitation for those with and without private insurance. Women aged 55–64 were more likely to respond to first, second or third invitations than those aged less than 55 yr.ConclusionsIssue of second mailed invitations to women in the target age for mammography screening is cost-effective and should be incorporated into routine policy. Response to third invitations is not cost-effective.

A survey of psychotropic drug use in elderly psychiatric inpatients

Objective: The objective of the present study was to examine the use of medication in an elderly psychiatric inpatient population. Method: This was a retrospective survey of medication prescribed to the total elderly inpatient population of a single psychiatric hospital. Data collected included basic sociodemographic information, length of stay, number of admissions, frequency of psychiatric disturbance, diagnosis and medication prescribed. Results: A total of 340 cases were studied, 229 (67%) were female, 324 (95%) had been inpatients for more than one year, 111 (33%) suffered from dementia, while the remainder were in the functional category. In 57% more than one psychotropic drug was used. Over half (56%) of those with dementia were on neuroleptic medication. Conclusion: Psychotropic polypharmacy was found in this population of elderly patients. Management issues emphasised include the risk of polypharmacy in this age group, the need for staff education, an active pharmacy committee and alternative methods of managing behavioural disturbance in elderly patients in particular those with dementia.

Feasibility of population based screening in Ireland

Population registers have formed the basis for computerised call/recall registers for screening programmes in many countries and have been important in achieving high uptakes in targeted populations. The absence of a population register for the ECCLES (European Campaign against Cancer, Localisation, Evaluation & Screening) Breast Screening Project necessitated the development of a special register of women in the target age group. The data sources used to build the project register were the Eastern Health Board and North Eastern Health Board General Medical Services database, Voluntary Health Insurance data and self-registration with the project. The register captured 86.3 per cent of the target population. A debate on the merits and difficulties associated with the setting up of a population register in Ireland is now timely.