Australian Health Review最新文献

{"title":"Healthcare practitioner use of real-time prescription monitoring tools: an online survey.","authors":"Dimi Hoppe,&nbsp;Chaojie George Liu,&nbsp;Hanan Khalil","doi":"10.1071/AH22257","DOIUrl":"https://doi.org/10.1071/AH22257","url":null,"abstract":"<p><p>Objective The aim of this study is to investigate how healthcare practitioners use real-time prescription monitoring tools in clinical practice. Methods An online survey was distributed to Australian prescribers and pharmacists who use a real-time prescription monitoring tool. Data were analysed and descriptive statistics summarised participant characteristics and responses. A Chi-squared test was conducted to test the difference between prescribers and pharmacists. Results The majority of participants agreed that real-time prescription monitoring (RTPM) information is useful (92.2%) and the tool is valuable for informing clinical decisions (90.2%); however, just over half reported that they had changed their prescribing or dispensing practices as a result of RTPM information (51.0%), and they employed evidence-based clinical interventions to varying degrees. No statistically significant differences were detected between pharmacists and prescribers and perceptions on tool use. Conclusions This is the first known study to investigate practitioner use of RTPM tools in Australia, and is a starting point for further research. What constitutes 'success' in the clinical application of RTPM tools is yet to be realised.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9609483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The financial implications of investigating false-positive and true-positive mammograms in a national breast cancer screening program.","authors":"Jason Soon,&nbsp;Nehmat Houssami,&nbsp;Michelle Clemson,&nbsp;Darren Lockie,&nbsp;Rachel Farber,&nbsp;Alexandra Barratt,&nbsp;Adam Elshaug,&nbsp;Kirsten Howard","doi":"10.1071/AH22120","DOIUrl":"https://doi.org/10.1071/AH22120","url":null,"abstract":"<p><p>Objectives To determine the total annual screening and further-investigation costs of investigating false-positive and true-positive mammograms in the Australian population breast-screening program. Methods This economic analysis used aggregate-level retrospective cohort data of women screened at a breast-screening clinic. Counts and frequencies of each diagnostic workup-sequence recorded were scaled up to national figures and costed by estimating per-patient costs of procedures using screening clinic cost data. Main outcomes and measures estimated were percentage share of total annual screening and further-investigation costs for the Australian population breast-screening program of investigating false-positive and true-positive mammograms. Secondary outcomes determined were average costs of investigating each false-positive and true-positive mammogram. Sensitivity analyses involved recalculating results excluding subgroups of patients below and above the screening age range of 50-74 years. Results Of 8235 patients, the median age was 60.35 years with interquartile range of 54.17-67.17 years. A total of 15.4% (ranging from 13.4 to 15.4% under different scenarios) of total annual screening and further-investigation costs were from investigating false-positive mammograms. This exceeded the share of costs from investigating true-positives (13%). Conclusions We have developed a transparent and non-onerous approach for estimating the costs of false-positive and true-positive mammograms associated with the national breast-screening program. While determining an optimal balance between false-positives and true-positive rates must rely primarily on health outcomes, costs are an important consideration. We recommend that future research adopts and refines similar approaches to facilitate better monitoring of these costs, benchmark against estimates from other screening programs, and support optimal policy development.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9253996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting the personal importation of therapeutic goods: recent legislative amendments to advertising regulations may impact consumer access and understanding.","authors":"Christopher Rudge,&nbsp;Narcyz Ghinea","doi":"10.1071/AH22209","DOIUrl":"https://doi.org/10.1071/AH22209","url":null,"abstract":"<p><p>Objective The personal importation scheme is a legislative mechanism that allows health consumers to import unapproved medicines under certain conditions. This article analyses the legal and policy basis for the scheme and considers how reforms to advertising laws for therapeutic goods may restrict communications about it. The article represents the first published analysis of the personal importation scheme's interaction with the communications of health professionals and buyer's clubs. It considers how these communications may be affected by legal amendments, particularly where unapproved medicines may be accessed through the scheme. Methods An examination of Australian therapeutic goods law concerning the personal importation scheme was conducted, including both the historical law and recent regulatory reforms. Illustrative tables were prepared to identify scheme-related advertising that may contravene therapeutic goods law. Risk estimates were allocated to several new legal rules to indicate whether health professionals or buyer's clubs would contravene these laws when promoting the scheme to health consumers for unapproved medicines. Results Representations made directly to the public by health practitioners or on buyer's clubs websites about accessing unapproved therapeutic goods through the personal importation scheme are likely to contravene one or more advertising laws. Conclusions The Therapeutic Goods Administration has very strong powers to initiate compliance or enforcement action for advertising breaches in Australia for many promotional practices. Arguably, in the age of the internet and in the context of emerging expensive medicines, these powers should not be used to restrict health practitioners or buyer's clubs from sharing information about the lawful personal importation scheme to health consumers in need. Nevertheless, the study finds that health practitioners who promote or refer to the availability of unapproved medicines through the personal importation scheme outside of a consultation are likely to contravene the law and may be subject to disciplinary or enforcement action.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9255643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with Pharmaceutical Benefits Advisory Committee decisions for listing medicines for diabetes and its associated complications.","authors":"Mohammad M Haque,&nbsp;Mutsa Gumbie,&nbsp;Megan Gu,&nbsp;Gnanadarsha Dissanayake","doi":"10.1071/AH22198","DOIUrl":"https://doi.org/10.1071/AH22198","url":null,"abstract":"<p><p>Objective To retrospectively analyse the key factors associated with listing decisions by the Pharmaceutical Benefits Advisory Committee (PBAC) for medicines for diabetes and its complications on the Pharmaceutical Benefits Scheme. Methods The clinical and economic evidence were retrieved from public summary documents (PSD) of all major submissions between July 2005 and March 2020. A multivariate binary logit regression analysis was conducted to assess the relationship between the categorical explanatory variables and PBAC recommendations. Results We identified a total of 211 PSD of which 118 (56%) were recommended for listing. Clinical and economic uncertainty were significantly and inversely associated with the PBAC recommendation. Submissions with high clinical and economic uncertainty were less likely to be recommended. Conclusion Our findings will enhance the understanding of medical professionals, pharmaceutical companies, and other stakeholders about the rationale of PBAC reimbursement decisions for these medicines and assist prospective applicant sponsor companies in preparing their submissions.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9308750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use and cost of Medicare Benefits Schedule and Pharmaceutical Benefits Scheme services following inpatient rehabilitation for acquired disability in Australia.","authors":"Samantha J Borg,&nbsp;David N Borg,&nbsp;Michele M Foster,&nbsp;Ryan Bell,&nbsp;Jessica Bowley,&nbsp;Timothy Geraghty","doi":"10.1071/AH22118","DOIUrl":"https://doi.org/10.1071/AH22118","url":null,"abstract":"<p><p>Objectives This study explored publicly funded health system and patient expenditure in the post-acute phase following discharge from inpatient acquired brain injury (ABI) or spinal cord injury (SCI) rehabilitation. The secondary aim was to explore sociodemographic and injury characteristics associated with high costs. Methods This was a prospective cohort study. 153 patients (ABI: n  = 85; SCI: n  = 68) who consented to the use of their Medicare data were recruited between March 2017 and March 2018, at the point of discharge from ABI or SCI specialist rehabilitation units. The main outcome measure involved linkage of the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) data for the 12 months following discharge from rehabilitation. Bayesian penalised regression was used to determine characteristics associated with high costs. Results The median number of MBS items used in the 12 months after discharge was 33 (IQR: 21-52). General practitioners and allied health services were accessed by 100% and 41% of the cohort, respectively. The median MBS system cost (in Australian dollars) was $2006 (IQR: $162-$3090). Almost half (46%) of the participants had no MBS patient expenditure. The median PBS system cost was $541 (IQR: $62-$1574). For people with ABI, having a traumatic injury or one comorbidity was associated with lower PBS system costs by on average $119 and $134, respectively. We also found that hospitalisation in ABI was associated with higher PBS system costs, by on average $669. Conclusion There was evidence of high and variable MBS and PBS costs, raising concerns about financial hardship. Future research should focus on identifying any unmet service and prescription needs in the post-acute rehabilitation phase for these populations.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9308752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accurate calculations of out-of-pocket costs for mental healthcare consultations.","authors":"Jeffrey C L Looi,&nbsp;Stephen J Robson","doi":"10.1071/AH22294","DOIUrl":"https://doi.org/10.1071/AH22294","url":null,"abstract":"<p><p>What is known about the topic? When assessing real growth in costs, it is important to adjust for inflation through indexation to the Consumer Price Index (CPI). The change in prices or costs over time can be calculated in constant currency amounts by adjusting by a ratio of the CPI in the year of interest to the CPI in the baseline year. What does this paper add? Rosenberg et al. (2022) did not calculate out-of-pocket costs in constant currency, which does not give an accurate estimation of costs adjusted for inflation. What are the implications for practitioners? We calculated examples to illustrate the impact of such adjustments, which substantially impact the results of the study.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9260990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary challenges for primary care.","authors":"Stephen Duckett,&nbsp;Jeremy Hunt","doi":"10.1071/AH23042","DOIUrl":"https://doi.org/10.1071/AH23042","url":null,"abstract":"","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9257571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential therapeutic value of new drugs approved in Australia: a retrospective cohort study.","authors":"Joel Lexchin","doi":"10.1071/AH22280","DOIUrl":"https://doi.org/10.1071/AH22280","url":null,"abstract":"<p><p>Objective To examine the potential therapeutic value of new medicines approved in the US and both approved and not approved in Australia. Methods A list of new medicines approved by the US Food and Drug Administration (FDA) between 1 January 2015 and 31 December 2020 was assembled and it was determined which of these medicines were also approved in Australia. Three metrics - first in class, priority review and therapeutic rating by two independent organisations - were used to determine the potential therapeutic value of the medicines. The percent of medicines with and without potential significant therapeutic value was compared using each of the three metrics. Results A total of 273 drugs were approved by the FDA, of which 147 (53.8%) were approved by the Therapeutic Goods Administration, the Australian regulator. For each of these three metrics, the percent of medicines with and without potential significant therapeutic value approved in Australia was the same: first in class (yes vs no: Chi-squared P  = 0.8562), priority review (yes vs no: Chi-squared P  = 0.4593), therapeutic rating (major/moderate vs little/no: Chi-squared P  = 0.9006). Some of the 126 drugs not approved may be therapeutically important. Conclusions New medicines approved in the US between 2015 and 2020 without potential significant therapeutic value are as likely to be introduced into Australia as drugs with potential significant therapeutic value. Some potentially valuable drugs may not have been submitted for approval in Australia by the companies making them.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9260989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contents and Advertisements","authors":"","doi":"10.1071/ahv47n1toc","DOIUrl":"https://doi.org/10.1071/ahv47n1toc","url":null,"abstract":"","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46493153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the COVID-19 pandemic on access and use of health services by middle-aged and older Australians.","authors":"Lorraine Ivancic,&nbsp;Diana M Bond,&nbsp;Natasha Nassar","doi":"10.1071/AH22183","DOIUrl":"https://doi.org/10.1071/AH22183","url":null,"abstract":"<p><p>Objectives To examine: the impact of the coronavirus disease 2019 (COVID-19) pandemic on access to health services by middle-aged and older Australians; and the use of telehealth services during the COVID-19 pandemic and its ongoing usefulness. Methods A cross-sectional survey was conducted among participants who completed the COVID-19 supplement in the 45 and Up Study 2020 Survey. Multivariable logistic regression analysis was used to examine the association between socio-demographic characteristics and health conditions with missed/delayed access to health services, changes in health outcomes resulting from missed/delayed access, and use of telehealth services. Results Data for 45 071 participants were analysed (56% female, 72% aged ≥65 years). Almost half (42.2%) reported they had missed/delayed access to health care due to COVID-19; mainly for dental services (26.1%), visits to a general practitioner (GP) (16.3%) and specialists (12.6%). Missed/delayed visits to GPs and specialists were more likely among females, participants from non-English-speaking backgrounds, with disability/illness, living in outer regional/remote areas or with chronic health conditions. People with a disability or high/very high psychological distress were twice as likely to report worse health as a result of missed/delayed care. Half (48.0%) the study participants used telehealth during the COVID-19 pandemic and 81.9% indicated telehealth would be useful post-pandemic. Conclusions The COVID-19 pandemic impacted access to healthcare services, particularly for people with a disability, and chronic or mental health issues who also reported worse health. This may account for their higher use of telehealth services as an alternate way of accessing health care. Ongoing evaluation of telehealth services for vulnerable groups post-pandemic is required.</p>","PeriodicalId":55425,"journal":{"name":"Australian Health Review","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9218822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}