2020 |
Gibson C, Goeman D, Pond D, 'What is the role of the practice nurse in the care of people living with dementia, or cognitive impairment, and their support person(s)?: A systematic review', BMC Family Practice, 21 (2020) [C1]
© 2020 The Author(s). Background: The potential value of expanding the Practice Nurse role to include the recognition and management of dementia has been acknowledged. Practice Nu... [more]
© 2020 The Author(s). Background: The potential value of expanding the Practice Nurse role to include the recognition and management of dementia has been acknowledged. Practice Nurses are well-positioned to provide comprehensive dementia information and support so that people living with dementia are better equipped to self-manage their health and live well with dementia. The purpose of this review was to systematically examine published literature to identify existing and potential roles of Practice Nurse's in the delivery of care to people affected by dementia and to describe the characteristics and effectiveness of nurse interventions in dementia models of care. Methods: The PRISMA statement guided the systematic review of the quantitative and qualitative evidence for roles and characteristics of the Practice Nurse in the delivery of dementia care. A comprehensive literature search of seven electronic databases and Google scholar identified relevant original research published in English between January 2000 and January 2019. Thirteen articles met the inclusion criteria and were extracted into the Covidence software for analysis. Results: The heterogeneity of the included studies purpose, design and outcomes measures and the diversity in health systems and primary care nurses scope of practice made it difficult to synthesise the findings and draw conclusions. The heterogeneity did, however, provide important insights into the characteristics of roles undertaken by nurses working in the general practice setting, which were potentially beneficial to people living with dementia and their support person. These included patient accessibility to the Practice Nurse, early recognition and management of cognitive changes, care management and collaboration with the General Practitioner. Limitations of the provision of dementia care by Practice Nurses included a lack of definition of the role, inadequate dementia specific training, time constraints and poor communication with General Practitioners. Conclusions: Embedding an evidence-based model that describes the role of the Practice Nurse in dementia care provision has the potential to increase early recognition of cognitive impairment and more appropriate primary care management of dementia. Systematic review registration: PROSPERO 2018 CRD42018088191.
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2020 |
Bruce R, Murdoch W, Kable A, Palazzi K, Hullick C, Pond D, et al., 'Evaluation of Carer Strain and Carer Coping with Medications for People with Dementia after Discharge: Results from the SMS Dementia Study', HEALTHCARE, 8 (2020) [C1]
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2020 |
Chong TWH, Curran E, Ellis KA, Southam J, You E, Cox KL, et al., 'Physical activity for older Australians with mild cognitive impairment or subjective cognitive decline A narrative review to support guideline development', Journal of Science and Medicine in Sport, 23 913-920 (2020)
© 2020 Sports Medicine Australia Objectives: This review informed development of the first national Physical Activity (PA) Guidelines for Older Australians with Mild Cognitive Imp... [more]
© 2020 Sports Medicine Australia Objectives: This review informed development of the first national Physical Activity (PA) Guidelines for Older Australians with Mild Cognitive Impairment (MCI) or Subjective Cognitive Decline (SCD) (http://www.dementiaresearch.org.au/images/dcrc/output-files/1567-pa_guidelines_for_mci_or_scd_full_report_final.pdf). These guidelines are directed at healthcare professionals and aim to encourage older adults with SCD/MCI to engage in PA to enhance cognitive, mental and physical health. Design: A narrative review was undertaken to inform the guideline adaptation process. Methods: A systematic search of existing PA guidelines for older adults was performed and evaluated using the Appraisal of Guidelines for Research and Evaluation II Instrument. The guideline assessed as most appropriate was adapted to the population with SCD/MCI using the Guideline Adaptation Resource Toolkit, supported by the narrative review. Results: The search for existing PA guidelines for older adults yielded 22 guidelines, none of which specifically considered older adults with SCD/MCI. The Canadian Physical Activity Guidelines for Older Adults were selected for adaptation to the population with SCD/MCI. The narrative review found 24 high-quality randomised controlled trials and 17 observational studies. These supported the four guideline recommendations that address aerobic PA, progressive resistance training, balance exercises and consultation with healthcare professionals to tailor PA to the individual. Conclusions: This review found evidence to support the four guideline recommendations. These recommendations provide specific guidance for older adults with SCD/MCI, their families, health professionals, community organisations and government to obtain benefits from undertaking PA. The review also highlights important future research directions, including the need for targeted translation and implementation research for diverse consumers.
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2020 |
Anstey KJ, Cherbuin N, Kim S, McMaster M, D'Este C, Lautenschlager N, et al., 'An internet-based intervention augmented with a diet and physical activity consultation to decrease the risk of dementia in at-risk adults in a primary care setting: Pragmatic randomized controlled trial', Journal of Medical Internet Research, 22 (2020)
© Kaarin J Anstey, Nicolas Cherbuin, Sarang Kim, Mitchell McMaster, Catherine D'Este, Nicola Lautenschlager, George Rebok, Ian McRae, Susan J Torres, Kay L Cox, Constance Dim... [more]
© Kaarin J Anstey, Nicolas Cherbuin, Sarang Kim, Mitchell McMaster, Catherine D'Este, Nicola Lautenschlager, George Rebok, Ian McRae, Susan J Torres, Kay L Cox, Constance Dimity Pond. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 24.09.2020. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on http://www.jmir.org/, as well as this copyright and license information must be included. Background: There is a need to develop interventions to reduce the risk of dementia in the community by addressing lifestyle factors and chronic diseases over the adult life course. Objective: This study aims to evaluate a multidomain dementia risk reduction intervention, Body Brain Life in General Practice (BBL-GP), targeting at-risk adults in primary care. Methods: A pragmatic, parallel, three-arm randomized trial involving 125 adults aged 18 years or older (86/125, 68.8% female) with a BMI of =25 kg/m2 or a chronic health condition recruited from general practices was conducted. The arms included (1) BBL-GP, a web-based intervention augmented with an in-person diet and physical activity consultation; (2) a single clinician¿led group, Lifestyle Modification Program (LMP); and (3) a web-based control. The primary outcome was the Australian National University Alzheimer Disease Risk Index Short Form (ANU-ADRI-SF). Results: Baseline assessments were conducted on 128 participants. A total of 125 participants were randomized to 3 groups (BBL-GP=42, LMP=41, and control=42). At immediate, week 18, week 36, and week 62 follow-ups, the completion rates were 43% (18/42), 57% (24/42), 48% (20/42), and 48% (20/42), respectively, for the BBL-GP group; 71% (29/41), 68% (28/41), 68% (28/41), and 51% (21/41), respectively, for the LMP group; and 62% (26/42), 69% (29/42), 60% (25/42), and 60% (25/42), respectively, for the control group. The primary outcome of the ANU-ADRI-SF score was lower for the BBL-GP group than the control group at all follow-ups. These comparisons were all significant at the 5% level for estimates adjusted for baseline differences (immediate: difference in means -3.86, 95% CI -6.81 to -0.90, P=.01; week 18: difference in means -4.05, 95% CI -6.81 to -1.28, P<.001; week 36: difference in means -4.99, 95% CI -8.04 to -1.94, P<.001; and week 62: difference in means -4.62, 95% CI -7.62 to -1.62, P<.001). Conclusions: A web-based multidomain dementia risk reduction program augmented with allied health consultations administered within the general practice context can reduce dementia risk exposure for at least 15 months. This study was limited by a small sample size, and replication on a larger sample with longer follow-up will strengthen the results.
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2020 |
Wang H, Abbas KM, Abbasifard M, Abbasi-Kangevari M, Abbastabar H, Abd-Allah F, et al., 'Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019: a comprehensive demographic analysis for the Global Burden of Disease Study 2019', LANCET, 396 1160-1203 (2020)
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2020 |
Abbafati C, Abbas KM, Abbasi M, Abbasifard M, Abbasi-Kangevari M, Abbastabar H, et al., 'Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019', LANCET, 396 1204-1222 (2020)
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2020 |
Murray CJL, Aravkin AY, Zheng P, Abbafati C, Abbas KM, Abbasi-Kangevari M, et al., 'Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019', LANCET, 396 1223-1249 (2020)
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2020 |
Abbafati C, Abbas KM, Abbasi M, Abbasifard M, Abbasi-Kangevari M, Abbastabar H, et al., 'Five insights from the Global Burden of Disease Study 2019', LANCET, 396 1135-1159 (2020)
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2020 |
Teng C, Loy CT, Sellars M, Pond D, Latt MD, Waite LM, et al., 'Making Decisions About Long-Term Institutional Care Placement Among People With Dementia and Their Caregivers: Systematic Review of Qualitative Studies.', The Gerontologist, 60 e329-e346 (2020)
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2020 |
Kable A, Hullick C, Palazzi K, Oldmeadow C, Searles A, Ling R, et al., 'Evaluation of a safe medication strategy intervention for people with dementia with an unplanned admission: Results from the Safe Medication Strategy Dementia Study.', Australas J Ageing, (2020)
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2020 |
Mate KE, Barnett M, Kerr KP, Pond CD, Magin PJ, 'Stability of anticholinergic load in Australian community-dwelling older people: a longitudinal analysis', Family practice, 37 314-320 (2020) [C1]
© The Author(s) 2019. Published by Oxford University Press. All rights reserved.For permissions, please e-mail: journals.permissions@oup.com. BACKGROUND: It is recommended that an... [more]
© The Author(s) 2019. Published by Oxford University Press. All rights reserved.For permissions, please e-mail: journals.permissions@oup.com. BACKGROUND: It is recommended that anticholinergic medication is avoided in older people, especially those with cognitive impairment. OBJECTIVE: To investigate anticholinergic load (ACL) over time in older primary care patients with and without cognitive impairment. METHODS: Community-dwelling general practice patients at baseline (n = 1768), at year one (n = 1373) and a restricted cohort (with possible or definite cognitive impairment) at year two (n = 370) had medication regimens documented by a research nurse during a home visit. Anticholinergic medicines were categorized as levels 1-3 (low-high potency) and summed for each participant as a measure of their ACL. RESULTS: Most participants had no change in ACL over time, but there was some turnover in the anticholinergic medications used. The mean change in ACL was 0.012 ± 0.99 from baseline to 12 months and -0.04 ± 1.3 from baseline to 24 months. Cardiovascular drugs were the most commonly used level 1 anticholinergics, followed by antidepressants and opioids. Antidepressants and urologicals were the most commonly used level 3 anticholinergics. The rate of anticholinergic deprescribing was equivalent to the rate of anticholinergic initiation, and commonly involved the level 1 drugs warfarin, furosemide and temazepam, and the level 3 drugs amitriptyline and oxybutynin. People with dementia had a higher ACL at baseline and year one compared with other participants. CONCLUSION: ACL of community-dwelling older people was very stable over time. This may represent lost opportunities for deprescribing as well as potentially inappropriate prescribing, particularly in those with cognitive impairment.
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2019 |
Sellars M, Chung O, Nolte L, Tong A, Pond D, Fetherstonhaugh D, et al., 'Perspectives of people with dementia and carers on advance care planning and end-of-life care: A systematic review and thematic synthesis of qualitative studies', Palliative Medicine, 33 274-290 (2019) [C1]
© The Author(s) 2018. Background: Advance care planning aims to ensure that care received during serious and chronic illness is consistent with the person¿s values, preferences an... [more]
© The Author(s) 2018. Background: Advance care planning aims to ensure that care received during serious and chronic illness is consistent with the person¿s values, preferences and goals. However, less than 40% of people with dementia undertake advance care planning internationally. Aim: This study aims to describe the perspectives of people with dementia and their carers on advance care planning and end-of-life care. Design: Systematic review and thematic synthesis of qualitative studies. Data sources: Electronic databases were searched from inception to July 2018. Results: From 84 studies involving 389 people with dementia and 1864 carers, five themes were identified: avoiding dehumanising treatment and care (remaining connected, delaying institutionalisation, rejecting the burdens of futile treatment); confronting emotionally difficult conversations (signifying death, unpreparedness to face impending cognitive decline, locked into a pathway); navigating existential tensions (accepting inevitable incapacity and death, fear of being responsible for cause of death, alleviating decisional responsibility); defining personal autonomy (struggling with unknown preferences, depending on carer advocacy, justifying treatments for health deteriorations); and lacking confidence in healthcare settings (distrusting clinicians¿ mastery and knowledge, making uninformed choices, deprived of hospice access and support at end of life). Conclusion: People with dementia and their carers felt uncertain in making treatment decisions in the context of advance care planning and end-of-life care. Advance care planning strategies that attend to people¿s uncertainty in decision-making may help to empower people with dementia and carers and strengthen person-centred care in this context.
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2019 |
Thomas R, Sims R, Beller E, Scott AM, Doust J, Le Couteur D, et al., 'An Australian community jury to consider case-finding for dementia: Differences between informed community preferences and general practice guidelines', Health Expectations, 22 475-484 (2019) [C1]
© 2019 The Authors. Health Expectations published by John Wiley & Sons Ltd. Background: Case-finding for dementia is practised by general practitioners (GPs) in Australia bu... [more]
© 2019 The Authors. Health Expectations published by John Wiley & Sons Ltd. Background: Case-finding for dementia is practised by general practitioners (GPs) in Australia but without an awareness of community preferences. We explored the values and preferences of informed community members around case-finding for dementia in Australian general practice. Design, setting and participants: A before and after, mixed-methods study in Gold Coast, Australia, with ten community members aged 50-70. Intervention: A 2-day citizen/community jury. Participants were informed by experts about dementia, the potential harms and benefits of case-finding, and ethical considerations. Primary and secondary outcomes: We asked participants, ¿Should the health system encourage GPs to practice ¿case-finding¿ of dementia in people older than 50?¿ Case-finding was defined as a GP initiating testing for dementia when the patient is unaware of symptoms. We also assessed changes in participant comprehension/knowledge, attitudes towards dementia and participants¿ own intentions to undergo case-finding for dementia if it were suggested. Results: Participants voted unanimously against case-finding for dementia, citing a lack of effective treatments, potential for harm to patients and potential financial incentives. However, they recognized that case-finding was currently practised by Australian GPs and recommended specific changes to the guidelines. Participants increased their comprehension/knowledge of dementia, their attitude towards case-finding became less positive, and their intentions to be tested themselves decreased. Conclusion: Once informed, community jury participants did not agree case-finding for dementia should be conducted by GPs. Yet their personal intentions to accept case-finding varied. If case-finding for dementia is recommended in the guidelines, then shared decision making is essential.
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2019 |
Sopina E, Chenoweth L, Luckett T, Agar M, Luscombe GM, Davidson PM, et al., 'Health-related quality of life in people with advanced dementia: a comparison of EQ-5D-5L and QUALID instruments', Quality of Life Research, 28 121-129 (2019) [C1]
© 2018, Springer Nature Switzerland AG. Background: Assessing health-related quality of life (HRQOL) in people with advanced dementia is challenging but important for informed dec... [more]
© 2018, Springer Nature Switzerland AG. Background: Assessing health-related quality of life (HRQOL) in people with advanced dementia is challenging but important for informed decision-making. Proxy measurement of this construct is difficult and is often rated lower than self-report. Accurate proxy rating of quality of life in dementia is related to identification of concepts important to the person themselves, as well as the sensitivity of the measures used. The main aim of this study was to compare the performance of two instruments¿QUALID and EQ-5D-5L¿on measuring HRQOL in people with advanced dementia. Methods: In a sub-study nested within a cluster-RCT we collected proxy(nurse)-completed EQ-5D-5L and QUALID measures at baseline, 3, 6, 9 and 12¿months¿ follow-up for people with advanced dementia, residing in 20 nursing homes across Australia. Spearman¿s rank correlations, partial correlations and linear regressions were used to assess the relationship between the HRQOL instrument scores and their changes over time. Results: The mean weight from 284 people for the EQ-5D-5L and QUALID at baseline were 0.004 (95% CI - 0.026, 0.033) and 24.98 (95% CI 24.13, 25.82), respectively. At 12¿months¿ follow-up, 115 participants remained alive. EQ-5D-5L weights and QUALID scores at baseline and at follow-up were moderately correlated (r = - 0.437; p < 0.001¿at 12¿months). Changes within QUALID and EQ-5D-5L across the same follow-up periods were also correlated (r = - 0.266; p = 0.005). The regression analyses support these findings. Conclusion: Whilst these quality of life instruments demonstrated moderate correlation, the EQ-5D-5L does not appear to capture all aspects of quality of life that are relevant to people with advanced dementia and we cannot recommend the use of this instrument for use within this population. The QUALID appears to be a more suitable instrument for measuring HRQOL in people with severe dementia, but is not preference-based, which limits its application in economic evaluations of dementia care.
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2019 |
Kable A, Fullerton A, Fraser S, Palazzi K, Hullick C, Oldmeadow C, et al., 'Comparison of Potentially Inappropriate Medications for People with Dementia at Admission and Discharge during An Unplanned Admission to Hospital: Results from the SMS Dementia Study.', Healthcare, 7 (2019) [C1]
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2019 |
Nichols E, Szoeke CEI, Vollset SE, Abbasi N, Abd-Allah F, Abdela J, et al., 'Global, regional, and national burden of Alzheimer's disease and other dementias, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016', LANCET NEUROLOGY, 18 88-106 (2019) [C1]
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2019 |
Pond CD, Regan C, 'Improving the delivery of primary care for older people', Medical Journal of Australia, 211 60-62.e1 (2019) [C1]
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2019 |
Tan ACW, Clemson L, Mackenzie L, Sherrington C, Roberts C, Tiedemann A, et al., 'Strategies for recruitment in general practice settings: the iSOLVE fall prevention pragmatic cluster randomised controlled trial', BMC MEDICAL RESEARCH METHODOLOGY, 19 (2019) [C1]
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2019 |
Luckett T, Luscombe G, Phillips J, Beattie E, Chenoweth L, Davidson PM, et al., 'Australian long-term care personnel's knowledge and attitudes regarding palliative care for people with advanced dementia', DEMENTIA-INTERNATIONAL JOURNAL OF SOCIAL RESEARCH AND PRACTICE, (2019)
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2019 |
Kable A, Baker A, Pond D, Southgate E, Turner A, Levi C, 'Health professionals perspectives on the discharge process and continuity of care for stroke survivors discharged home in regional Australia: A qualitative, descriptive study', Nursing and Health Sciences, 21 253-261 (2019) [C1]
© 2018 John Wiley & Sons Australia, Ltd Many stroke patients are discharged home due to advances in treatment approaches and reduced residual disability. The aim of this stu... [more]
© 2018 John Wiley & Sons Australia, Ltd Many stroke patients are discharged home due to advances in treatment approaches and reduced residual disability. The aim of this study was to understand health professionals¿ perspectives on the discharge process and continuity of care during the transition between hospital and home for stroke survivors. In this qualitative, descriptive study, we used focus groups with 25 health professionals involved in discharge processes for transition from hospital to home in 2014, in a regional area of Australia. Discontinuity in the discharge process was affected by pressure to discharge patients, discharge medications and associated risks, inadequate or late discharge summaries, and challenges involving carers. Discontinuity in post-discharge services and follow up was affected by availability of post-discharge services, number of services arranged at the time of discharge, general practitioner follow up after discharge, delays and waiting lists, carer problems, and long-term follow up. There were complex organizational barriers to the continuity of care for stroke survivors discharged home. It is important to address these deficits so that stroke survivors and their carers can make the transition home with minimal risk and adequate support following a stroke.
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2019 |
Kable A, Pond D, Hullick C, Chenoweth L, Duggan A, Attia J, Oldmeadow C, 'An evaluation of discharge documentation for people with dementia discharged home from hospital A cross-sectional pilot study', Dementia, 18 1764-1776 (2019) [C1]
© The Author(s) 2017. This study evaluated discharge documentation for people with dementia who were discharged home, against expected discharge criteria and determined relationsh... [more]
© The Author(s) 2017. This study evaluated discharge documentation for people with dementia who were discharged home, against expected discharge criteria and determined relationships between compliance scores and outcomes. This cross-sectional study audited discharge documentation and conducted a post discharge survey of carers. There were 73 eligible discharges and clinically significant documentation deficits for people with dementia included: risk assessments of confusion (48%), falls and pressure injury (56%); provision of medication dose-decision aids (53%), provision of contact information for patient support groups (6%) and advance care planning (9%). There was no significant relationship between compliance scores and outcomes. Carer strain was reported to be high for many carers. People with dementia and their carers are more vulnerable and at higher risk of poor outcomes after discharge. There are opportunities for improved provision of medications and risk assessment for people with dementia, provision of information for patient support groups and advanced care planning.
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2018 |
Pond D, Mate K, Stocks N, Gunn J, Disler P, Magin P, et al., 'Effectiveness of a peer-mediated educational intervention in improving general practitioner diagnostic assessment and management of dementia: a cluster randomised controlled trial.', BMJ open, 8 1-12 (2018) [C1]
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2018 |
Pond D, 'Office-based assessment of cognitive impairment.', Australian journal of general practice, 47 602-605 (2018) [C1]
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2018 |
Dicker D, Nguyen G, Abate D, Abate LH, Abay SM, Abbafati C, et al., 'Global, regional, and national age-sex-specific mortality and life expectancy, 1950-2017: a systematic analysis for the Global Burden of Disease Study 2017', LANCET, 392 1684-1735 (2018) [C1]
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2018 |
Page AT, Cross AJ, Elliott RA, Pond D, Dooley M, Beanland C, Etherton-Beer CD, 'Integrate healthcare to provide multidisciplinary consumer-centred medication management: report from a working group formed from the National Stakeholders Meeting for the Quality Use of Medicines to Optimise Ageing in Older Australians', Journal of Pharmacy Practice and Research, 48 459-466 (2018) [C1]
© 2018 The Society of Hospital Pharmacists of Australia A National Stakeholders¿ Meeting on Quality use of Medicines to Optimise Ageing in Older Australians was held in Sydney 201... [more]
© 2018 The Society of Hospital Pharmacists of Australia A National Stakeholders¿ Meeting on Quality use of Medicines to Optimise Ageing in Older Australians was held in Sydney 2015 with the aim of setting an agenda to improve the quality use of medicines for older Australians. Multidisciplinary working groups were formed to address each of the eight key challenges identified. The aim of Working Group 2 was to develop recommendations to integrate the health care of older Australians across settings and practitioners to provide multidisciplinary consumer-centred care. A systems map was proposed to better understand the complex pathways older Australians take through health care. Working Group 2 members (consumer representatives and health professionals) met via teleconference and email, and contributed relevant literature identified during their work. They identified challenges to optimal medication management that were used to develop a systems map to illustrate the complex medication management pathways for older Australians. The working group generated 10 recommended strategies to facilitate multidisciplinary consumer-centred care that could improve the quality use of medicines. Medication management in Australia is complex, as highlighted by the systems map. Working Group 2 identified concrete strategies to improve the quality use of medicines by older adults through systemic policy and practice-based strategies.
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2018 |
Bohatko-Naismith J, Guest M, James C, Pond D, Rivett DA, 'Australian general practitioners' perspective on the role of the workplace Return-to-Work Coordinator', Australian Journal of Primary Health, 24 502-509 (2018) [C1]
© 2018 La Trobe University. General practitioners (GPs) play a key role in the return-to-work process, and yet their experiences working with workplace Return-to-Work Coordinators... [more]
© 2018 La Trobe University. General practitioners (GPs) play a key role in the return-to-work process, and yet their experiences working with workplace Return-to-Work Coordinators (RTWCs) have rarely been studied. The aim of this paper is to provide insights from the GP perspective about their experiences with workplace RTWCs and their preparedness for the role. GPs from Australian states and territories where legislation mandates workplaces employ a RTWC were requested to complete a questionnaire on their experiences with workplace RTWCs. Fifty GPs completed a questionnaire on the preparedness of RTWCs in relation to their role, with 58% (n = 29) indicating RTWCs require more training. A total of 78% (n = 39) of respondents considered RTWCs were important in assisting injured workers return to work, with 98% (n = 49) ranking trustworthiness, respectfulness and ethicalness as the most important or an important trait for a RTWC to possess. Interestingly, 40% (n = 20) of respondents themselves reported having no training in the return-to-work process. GPs acknowledge the importance of the workplace RTWC in the return-to-work process, and the results highlight the need for RTWCs to possess specific traits and undergo appropriate training for the facilitation of a successful return to work for injured workers.
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2018 |
Lozano R, Fullman N, Abate D, Abay SM, Abbafati C, Abbasi N, et al., 'Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017', The Lancet, 392 2091-2138 (2018) [C1]
© 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: Efforts to establish the 2015 baseline and monitor early im... [more]
© 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of ¿leaving no one behind¿, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990¿2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0¿100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59·4 (IQR 35·4¿67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6¿14·0) to a high of 84·9 (83·1¿86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed...
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2018 |
Dickins M, Goeman D, O'Keefe F, Iliffe S, Pond D, 'Understanding the conceptualisation of risk in the context of community dementia care', Social Science and Medicine, 208 72-79 (2018) [C1]
© 2018 Elsevier Ltd Risk has become a ubiquitous presence in modern society. For individuals diagnosed with dementia this preoccupation with risk can affect their day-to-day life ... [more]
© 2018 Elsevier Ltd Risk has become a ubiquitous presence in modern society. For individuals diagnosed with dementia this preoccupation with risk can affect their day-to-day life in many ways. Maintaining autonomy while balancing risks is a continual struggle not only for those living with the disease, but also their carers, family and health professionals. To understand how these different groups of individuals conceptualise the issue of risk for those living with dementia, 83 semi-structured interviews were conducted with people living with dementia, carers, older people without significant experience of dementia, and registered nurses, and staff from a community nursing organisation. These interviews were analysed using Thematic Analysis, which suggested that the risks identified by each group were grounded in their experiences and perspective on dementia. Furthermore, context and understanding of the individual living with dementia and their preferences was central to effectively managing risk in a balanced way, ensuring that ¿acceptable risks¿ were taken to ensure an acceptable quality of life for all involved. These findings highlight that there is no single approach to risk which can be applied to all individuals; rather, a negotiation needs to take place that takes into account the individual's preferences alongside their available resources and means.
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2018 |
Kim S, McMaster M, Torres S, Cox KL, Lautenschlager N, Rebok GW, et al., 'Protocol for a pragmatic randomised controlled trial of Body Brain Life-General Practice and a Lifestyle Modification Programme to decrease dementia risk exposure in a primary care setting', BMJ OPEN, 8 (2018)
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2018 |
Kable AK, Pond C, 'Evaluation of discharge documentation after hospitalization for stroke patients discharged home in Australia: A cross-sectional, pilot study', Nursing and Health Sciences, 20 24-30 (2018) [C1]
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2018 |
Fullman N, Yearwood J, Abay SM, Abbafati C, Abd-Allah F, Abdela J, et al., 'Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: A systematic analysis from the Global Burden of Disease Study 2016', The Lancet, 391 2236-2271 (2018) [C1]
Copyright © 2018 The Author(s). Published by Elsevier Ltd. Background A key component of achieving universal health coverage is ensuring that all populations have access to qualit... [more]
Copyright © 2018 The Author(s). Published by Elsevier Ltd. Background A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97·1 (95% UI 95·8-98·1) in Iceland, followed by 96·6 (94·9-97·9) in Norway and 96·1 (94·5-97·3) in the Netherlands, to values as low as 18·6 (13·1-24·4) in the Central African Republic, 19·0 (14·3-23·7) in Somalia, and 23·4 (20·2-26·8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91·5 (89·1-93·6) in Beijing to 48·0 (43·4-53·2) in Tibet (a 43·5-point difference), while India saw a 30·8-point disparity, from 64·8 (59·6-68·8) in Goa to 34·0 (30·3-38·1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4·8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20·9-point to 17·0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17·2-point to 20·4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher...
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2018 |
Disalvo D, Luckett T, Luscombe G, Bennett A, Davidson P, Chenoweth L, et al., 'Potentially Inappropriate Prescribing in Australian Nursing Home Residents with Advanced Dementia: A Substudy of the IDEAL Study.', Journal of palliative medicine, 21 1472-1479 (2018) [C1]
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2018 |
Aghajafari F, Pond D, Catzikiris N, Cameron I, 'Quality assessment of systematic reviews of vitamin D, cognition and dementia.', BJPsych open, 4 238-249 (2018) [C1]
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2017 |
Barber RM, Fullman N, Sorensen RJD, Bollyky T, McKee M, Nolte E, Abajobir AA, 'Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990-2015: a novel analysis from the Global Burden of Disease Study 2015', LANCET, 390 231-266 (2017) [C1]
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2017 |
Luckett T, Chenoweth L, Phillips J, Brooks D, Cook J, Mitchell G, et al., 'A facilitated approach to family case conferencing for people with advanced dementia living in nursing homes: perceptions of palliative care planning coordinators and other health professionals in the IDEAL study', INTERNATIONAL PSYCHOGERIATRICS, 29 1713-1722 (2017)
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2017 |
Pond CD, 'The role of primary care in identification and ongoing management of dementia: a time of transition', INTERNATIONAL PSYCHOGERIATRICS, 29 1409-1411 (2017)
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2017 |
Laver K, Cumming R, Dyer S, Agar M, Anstey KJ, Beattie E, et al., 'Evidence-based occupational therapy for people with dementia and their families: What clinical practice guidelines tell us and implications for practice', AUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, 64 3-10 (2017)
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2017 |
Agar M, Luckett T, Luscombe G, Phillips J, Beattie E, Pond D, et al., 'Effects of facilitated family case conferencing for advanced dementia: A cluster randomised clinical trial', PLOS ONE, 12 (2017) [C1]
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2017 |
Mate KE, Magin PJ, Brodaty H, Stocks NP, Gunn J, Disler PB, et al., 'An evaluation of the additional benefit of population screening for dementia beyond a passive case-finding approach', International Journal of Geriatric Psychiatry, 32 316-323 (2017) [C1]
Copyright © 2016 John Wiley & Sons, Ltd. Objective: General practitioners (GPs) fail to identify more than 50% of dementia cases using the existing passive case-finding appr... [more]
Copyright © 2016 John Wiley & Sons, Ltd. Objective: General practitioners (GPs) fail to identify more than 50% of dementia cases using the existing passive case-finding approach. Using data from the ¿Ageing in General Practice¿ study, we sought to establish the additional benefit of screening all patients over the age of 75 for dementia beyond those patients already identified by passive case-finding. Method: Patients were classified as ¿case-finding¿ (n = 425) or ¿screening¿ (n = 1006) based on their answers to four subjective memory related questions or their GP's clinical judgement of their dementia status. Cognitive status of each patient was formally assessed by a research nurse using the Cambridge Cognition Examination (CAMCOG-R). Patients then attended their usual GP for administration of the GP assessment of Cognition (GPCOG) dementia screening instrument, and follow-up care and/or referral as necessary in light of the outcome. Results: The prevalence of dementia was significantly higher in the case-finding group (13.6%) compared to the screening group (4.6%; p < 0.01). The GPCOG had a positive predictive value (PPV) of 61% in the case-finding group and 39% in the screening group; negative predictive value was >95% in both groups. GPs and their patients both found the GPCOG to be an acceptable cognitive assessment tool. The dementia cases missed via case-finding were younger (p = 0.024) and less cognitively impaired (p = 0.020) than those detected. Conclusion: There is a very limited benefit of screening for dementia, as most people with dementia could be detected using a case-finding approach, and considerable potential for social and economic harm because of the low PPV associated with screening.
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2017 |
Clemson L, Mackenzie L, Roberts C, Poulos R, Tan A, Lovarini M, et al., 'Integrated solutions for sustainable fall prevention in primary care, the iSOLVE project: a type 2 hybrid effectivenessimplementation design', IMPLEMENTATION SCIENCE, 12 (2017)
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2017 |
Goeman DP, Dickins M, Iliffe S, Pond D, O'Keefe F, 'Development of a discussion tool to enable well-being by providing choices for people with dementia: a qualitative study incorporating codesign and participatory action research.', BMJ open, 7 (2017) [C1]
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2016 |
Forouzanfar MH, Afshin A, Alexander LT, Biryukov S, Brauer M, Cercy K, et al., 'Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015', Lancet (London, England), 388 1659-1724 (2016) [C1]
Copyright © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved. BACKGROUND: The... [more]
Copyright © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license. Published by Elsevier Ltd.. All rights reserved. BACKGROUND: The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context.METHODS: We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors-the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI).FINDINGS: Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6-58·8) of global deaths and 41·2% (39·8-42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa.INTERPRETATION: Declin...
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2016 |
Parkinson L, Moorin R, Peeters G, Byles J, Blyth F, Caughey G, et al., 'Incident osteoarthritis associated with increased allied health services use in baby boomer Australian women', Australian and New Zealand Journal of Public Health, 40 356-361 (2016) [C1]
© 2016 Public Health Association of Australia Objective: To explore impact of incident osteoarthritis (OA) on health services use by Australian women born 1946¿51. Methods: Second... [more]
© 2016 Public Health Association of Australia Objective: To explore impact of incident osteoarthritis (OA) on health services use by Australian women born 1946¿51. Methods: Secondary analysis of Australian Longitudinal Study on Women's Health survey data linked to Medicare Australia databases (2002 to 2011). Medicare services use was compared for two groups: OA group (n=761) ¿ reported incident OA in 2007; Never group (n=4346) ¿ did not report arthritis in time frame. Interrupted time series regression compared health services use over time. Results: The OA group had higher health services use than the Never group. Rate of services use increased over time for both groups. Rate of increase in quarterly doctor attendances was significantly lower for the OA group after onset of OA, with no corresponding change for the Never group. Conclusions: A pre-existing higher use of health services is associated with reporting incident OA, compared to those who never report arthritis. After onset of OA, rate of doctor use reduced and allied health use increased, consistent with recommended Australian treatment guidelines. Implications: This study provides a rare insight into change in healthcare use for people reporting incident OA, against an appropriate comparison group, highlighting the importance of early diagnosis of OA to optimise effective use of health services.
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2016 |
Laver K, Cumming RG, Dyer SM, Agar MR, Anstey KJ, Beattie E, et al., 'Clinical practice guidelines for dementia in Australia', MEDICAL JOURNAL OF AUSTRALIA, 204 1-+ (2016)
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2016 |
Laver K, Cumming RG, Dyer SM, Agar MR, Anstey KJ, Beattie E, et al., 'Clinical practice guidelines for dementia in Australia', MEDICAL JOURNAL OF AUSTRALIA, 204 191-193 (2016)
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2016 |
Brodaty H, Connors MH, Loy C, Teixeira-Pinto A, Stocks N, Gunn J, et al., 'Screening for Dementia in Primary Care: A Comparison of the GPCOG and the MMSE', Dementia and Geriatric Cognitive Disorders, 42 323-330 (2016) [C1]
© 2016 S. Karger AG, Basel. Background/Aims: The General Practitioner Assessment of Cognition (GPCOG) is a brief cognitive test. This study compared the GPCOG to the Mini-Mental S... [more]
© 2016 S. Karger AG, Basel. Background/Aims: The General Practitioner Assessment of Cognition (GPCOG) is a brief cognitive test. This study compared the GPCOG to the Mini-Mental State Examination (MMSE), the most widely used test, in terms of their ability to detect likely dementia in primary care. Methods: General practitioners across three states in Australia recruited 2,028 elderly patients from the community. A research nurse administered the GPCOG and the MMSE, as well as the Cambridge Examination for Mental Disorders of the Elderly Cognitive Scale-Revised that we used to define likely dementia. Results: Overall, the GPCOG and the MMSE were similarly effective at detecting likely dementia. The GPCOG, however, had a higher sensitivity than the MMSE when using published cutpoints. Conclusion: The GPCOG is an effective screening tool for dementia in primary care. It appears to be a viable alternative to the MMSE, whilst also requiring less time to administer.
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2016 |
Pond CD, 'After-hours medical deputising services for older people', MEDICAL JOURNAL OF AUSTRALIA, 205 395-396 (2016)
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2016 |
Cumming R, Agar M, Anstey K, Beattie E, Brodaty H, Broe T, et al., 'Clinical Practice Guidelines for Dementia in Australia: A step towards improving uptake of research findings in health- and aged-care settings', AUSTRALASIAN JOURNAL ON AGEING, 35 86-89 (2016)
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2016 |
Magin P, Juratowitch L, Dunbabin J, McElduff P, Goode S, Tapley A, Pond D, 'Attitudes to Alzheimer's disease testing of Australian general practice patients: A cross-sectional questionnaire-based study', International Journal of Geriatric Psychiatry, 31 361-370 (2016) [C1]
Copyright © 2015 John Wiley & Sons, Ltd. Objective In view of proposed screening for presymptomatic Alzheimer's disease (AD) with advanced imaging, and blood and cerebr... [more]
Copyright © 2015 John Wiley & Sons, Ltd. Objective In view of proposed screening for presymptomatic Alzheimer's disease (AD) with advanced imaging, and blood and cerebral spinal fluid analysis, we aimed to establish levels, and associations, of acceptance of AD testing modalities by general practice patients. Methods A cross-sectional questionnaire-based study of consecutive patients (aged 50 years and over) of general practices of an Australian practice-based research network was used. The questionnaire elicited demographic data and attitudes to screening for other diseases and included the screening acceptance domain of the Perceptions Regarding Investigational Screening for Memory in Primary Care (PRISM-PC) instrument. This assesses receptivity to modalities of testing for AD: short questionnaire, blood test, cerebral imaging, and annual physician examination. Reflecting speculation of possible future AD diagnostic methods, an item regarding testing cerebral spinal fluid was also included. Associations of PRISM-PC scores were analyzed with multiple linear regression. Results Of 489 participants (response rate 87%), 66.2% would like to know if they had AD. Participants were more accepting of testing modalities that were noninvasive or familiar (questionnaire, physician's examination, and blood test) as opposed to cerebral imaging or lumbar puncture. Attitudes to AD testing are influenced by a positive attitude to disease screening in general. Patients with a self-perceived higher risk of AD were less accepting of testing, as were participants with an educational level of junior high school (10 school years) or less. Conclusions This study demonstrates that a majority of patients would like to know if they have AD. Acceptability of testing modalities, however, varies. Noninvasive, familiar methods are more acceptable.
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2016 |
Vos T, Allen C, Arora M, Barber RM, Brown A, Carter A, et al., 'Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990 2015: a systematic analysis for the Global Burden of Disease Study 2015', The Lancet, 388 1545-1602 (2016) [C1]
© 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license Background Non-fatal outcomes of disease and injury increasingly detract fr... [more]
© 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY license Background Non-fatal outcomes of disease and injury increasingly detract from the ability of the world's population to live in full health, a trend largely attributable to an epidemiological transition in many countries from causes affecting children, to non-communicable diseases (NCDs) more common in adults. For the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015), we estimated the incidence, prevalence, and years lived with disability for diseases and injuries at the global, regional, and national scale over the period of 1990 to 2015. Methods We estimated incidence and prevalence by age, sex, cause, year, and geography with a wide range of updated and standardised analytical procedures. Improvements from GBD 2013 included the addition of new data sources, updates to literature reviews for 85 causes, and the identification and inclusion of additional studies published up to November, 2015, to expand the database used for estimation of non-fatal outcomes to 60¿900 unique data sources. Prevalence and incidence by cause and sequelae were determined with DisMod-MR 2.1, an improved version of the DisMod-MR Bayesian meta-regression tool first developed for GBD 2010 and GBD 2013. For some causes, we used alternative modelling strategies where the complexity of the disease was not suited to DisMod-MR 2.1 or where incidence and prevalence needed to be determined from other data. For GBD 2015 we created a summary indicator that combines measures of income per capita, educational attainment, and fertility (the Socio-demographic Index [SDI]) and used it to compare observed patterns of health loss to the expected pattern for countries or locations with similar SDI scores. Findings We generated 9·3 billion estimates from the various combinations of prevalence, incidence, and YLDs for causes, sequelae, and impairments by age, sex, geography, and year. In 2015, two causes had acute incidences in excess of 1 billion: upper respiratory infections (17·2 billion, 95% uncertainty interval [UI] 15·4¿19·2 billion) and diarrhoeal diseases (2·39 billion, 2·30¿2·50 billion). Eight causes of chronic disease and injury each affected more than 10% of the world's population in 2015: permanent caries, tension-type headache, iron-deficiency anaemia, age-related and other hearing loss, migraine, genital herpes, refraction and accommodation disorders, and ascariasis. The impairment that affected the greatest number of people in 2015 was anaemia, with 2·36 billion (2·35¿2·37 billion) individuals affected. The second and third leading impairments by number of individuals affected were hearing loss and vision loss, respectively. Between 2005 and 2015, there was little change in the leading causes of years lived with disability (YLDs) on a global basis. NCDs accounted for 18 of the leading 20 causes of age-standardised YLDs on a global scale. Where rates were decreasing, the rate of decrease for YLDs was slower than that of years of life lost (YLLs) for nearly every cause included in our analysis. For low SDI geographies, Group 1 causes typically accounted for 20¿30% of total disability, largely attributable to nutritional deficiencies, malaria, neglected tropical diseases, HIV/AIDS, and tuberculosis. Lower back and neck pain was the leading global cause of disability in 2015 in most countries. The leading cause was sense organ disorders in 22 countries in Asia and Africa and one in central Latin America; diabetes in four countries in Oceania; HIV/AIDS in three southern sub-Saharan African countries; collective violence and legal intervention in two north African and Middle Eastern countries; iron-deficiency anaemia in Somalia and Venezuela; depression in Uganda; onchoceriasis in Liberia; and other neglected tropical diseases in the Democratic Republic of the Congo. Interpretation Ageing of the world's population is...
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2016 |
Magin PJ, Morgan S, Tapley A, McCowan C, Parkinson L, Henderson KM, et al., 'Anticholinergic medicines in an older primary care population: a cross-sectional analysis of medicines levels of anticholinergic activity and clinical indications', Journal of Clinical Pharmacy and Therapeutics, 41 486-492 (2016) [C1]
© 2016 John Wiley & Sons Ltd What is known and objectives: Adverse clinical outcomes have been associated with cumulative anticholinergic burden (to which low-potency as wel... [more]
© 2016 John Wiley & Sons Ltd What is known and objectives: Adverse clinical outcomes have been associated with cumulative anticholinergic burden (to which low-potency as well as high-potency anticholinergic medicines contribute). The clinical indications for which anticholinergic medicines are prescribed (and thus the ¿phenotype¿ of patients with anticholinergic burden) have not been established. We sought to establish the overall prevalence of prescribing of anticholinergic medicines, the prevalence of prescribing of low-, medium- and high-potency anticholinergic medicines, and the clinical indications for which the medicines were prescribed in an older primary care population. Methods: This was a cross-sectional analysis of a cohort study of Australian early-career general practitioners¿ (GPs¿) clinical consultations ¿ the Registrar Clinical Encounters in Training (ReCEnT) study. In ReCEnT, GPs collect detailed data (including medicines prescribed and their clinical indication) for 60 consecutive patients, on up to three occasions 6 months apart. Anticholinergic medicines were categorized as levels 1 (low-potency) to 3 (high-potency) using the Anticholinergic Drug Scale (ADS). Results: During 2010¿2014, 879 early-career GPs (across five of Australia's six states) conducted 20 555 consultations with patients aged 65 years or older, representing 35 506 problems/diagnoses. Anticholinergic medicines were prescribed in 10·4% [95% CIs 9·5¿10·5] of consultations. Of the total anticholinergic load of prescribed medicines (¿community anticholinergic load¿) 72·7% [95% CIs 71·0¿74·3] was contributed by Level 1 medicines, 0·8% [95% CIs 0·5¿1·3] by Level 2 medicines and 26·5% [95% CIs 24·8¿28·1] by Level 3 medicines. Cardiac (40·0%), Musculoskeletal (16·9%) and Respiratory (10·6%) were the most common indications associated with Level 1 anticholinergic prescription. For Level 2 and 3 medicines (combined data), Psychological (16·1%), Neurological (16·1%), Musculoskeletal (15·7%) and Urological (11·1%) indications were most common. What is new and conclusion: Anticholinergic medicines are frequently prescribed in Australian general practice, and the majority of the ¿community¿ anticholinergic burden is contributed by ¿low¿-anticholinergic potency medicines whose anticholinergic effects may be largely ¿invisible¿ to prescribing GPs. Furthermore, the clinical ¿phenotype¿ of the patient with high anticholinergic burden may be very different to common stereotypes (patients with urological, psychological or neurological problems), potentially making recognition of risk of anticholinergic adverse effects additionally problematic for GPs.
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2016 |
Dyer SM, Laver K, Pond CD, Cumming RG, Whitehead C, Crotty M, 'Clinical practice guidelines and principles of care for people with dementia in Australia', Australian Family Physician, 45 884-889 (2016) [C1]
© The Royal Australian College of General Practitioners 2016. Background Dementia is a national health priority in Australia. Most people with dementia are over the age of 65 year... [more]
© The Royal Australian College of General Practitioners 2016. Background Dementia is a national health priority in Australia. Most people with dementia are over the age of 65 years, have a number of comorbidities and experience a trajectory of functional decline. General practitioners (GPs) have an important role in the diagnosis and management of people with dementia. The Cognitive Decline Partnership Centre's Clinical practice guidelines and principles of care for people with dementia (Guidelines) was recently approved by the National Health and Medical Research Council (NHMRC). Objective This article describes the recommendations within the Guidelines that are of greatest relevance to GPs, including those addressing diagnosis, living well, managing behavioural and psychological symptoms, supporting carers, and the palliative approach. Discussion The Guidelines synthesise current evidence in dementia care and emphasise: timely diagnosis; encouraging the person with dementia to exercise, eat well and keep doing as much for themselves as possible; supporting and training carers to provide care; and reducing prescription of potentially harmful medications where possible.
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2015 |
Forouzanfar MH, Alexander L, Bachman VF, Biryukov S, Brauer M, Casey D, et al., 'Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013', The Lancet, 386 2287-2323 (2015) [C1]
Background: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, partic... [more]
Background: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution. Methods: Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk-outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990-2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian metaregression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol. Findings: All risks combined account for 57·2% (95% uncertainty interval [UI] 55·8-58·5) of deaths and 41·6% (40·1-43·0) of DALYs. Risks quantified account for 87·9% (86·5-89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa. Interpretation: Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and pri...
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2015 |
Plakiotis C, Simon Bell J, Simon Bell J, Pond D, O Connor DW, 'Deprescribing psychotropic medications in aged care facilities: The potential role of family members', Advances in Experimental Medicine and Biology, 821 29-43 (2015) [C1]
© Springer International Publishing Switzerland 2015. There is widespread concern in Australia and internationally at the high prevalence of psychotropic medication use in residen... [more]
© Springer International Publishing Switzerland 2015. There is widespread concern in Australia and internationally at the high prevalence of psychotropic medication use in residential aged care facilities. It is difficult for nurses and general practitioners in aged care facilities to cease new residents¿ psychotropic medications when they often have no information about why residents were started on the treatment, when and by whom and with what result. Most existing interventions have had a limited and temporary effect and there is a need to test different strategies to overcome the structural and practical barriers to psychotropic medication cessation or deprescribing. In this chapter, we review the literature regarding psychotropic medication deprescribing in aged care facilities and present the protocol of a novel study that will examine the potential role of family members in facilitating deprescribing. This project will help determine if family members can contribute information that will prove useful to clinicians and thereby overcome one of the barriers to deprescribing medications whose harmful effects often outweigh their benefits. We wish to understand the knowledge and attitudes of family members regarding the prescribing and deprescribing of psychotropic medications to newly admitted residents of aged care facilities with a view to developing and testing a range of clinical interventions that will result in better, safer prescribing practices.
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2015 |
Kable A, Chenoweth L, Pond D, Hullick C, 'Health professional perspectives on systems failures in transitional care for patients with dementia and their carers: A qualitative descriptive study', BMC Health Services Research, 15 (2015) [C1]
© 2015 Kable et al. Background: Healthcare professionals engage in discharge planning of people with dementia during hospitalisation, however plans for transitioning the person in... [more]
© 2015 Kable et al. Background: Healthcare professionals engage in discharge planning of people with dementia during hospitalisation, however plans for transitioning the person into community services can be patchy and ineffective. The aim of this study was to report acute, community and residential care health professionals' (HP) perspectives on the discharge process and transitional care arrangements for people with dementia and their carers. Methods: A qualitative descriptive study design and purposive sampling was used to recruit HPs from four groups: Nurses and allied health practitioners involved in discharge planning in the acute setting, junior medical officers in acute care, general practitioners (GPs) and Residential Aged Care Facility (RACF) staff in a regional area in NSW, Australia. Focus group discussions were conducted using a semi-structured schedule. Content analysis was used to understand the discharge process and transitional care arrangements for people with dementia (PWD) and their carers. Results: There were 33 participants in four focus groups, who described discharge planning and transitional care as a complex process with multiple contributors and components. Two main themes with belonging sub-themes derived from the analysis were: Barriers to effective discharge planning for PWD and their carers - the acute care perspective: managing PWD in the acute care setting, demand for post discharge services exceeds availability of services, pressure to discharge patients and incomplete discharge documentation. Transitional care process failures and associated outcomes for PWD - the community HP perspective: failures in delivery of services to PWD; inadequate discharge notification and negative patient outcomes; discharge-related adverse events, readmission and carer stress; and issues with medication discharge orders and outcomes for PWD. Conclusions: Although acute care HPs do engage in required discharge planning for people with dementia, participants identified critical issues: pressure on acute care health professionals to discharge PWD early, the requirement for JMOs to complete discharge summaries, the demand for post discharge services for PWD exceeding supply, the need to modify post discharge medication prescriptions for PWD, the need for improved coordination with RACF, and the need for routine provision of medication dose decision aids and home medicine reviews post discharge for PWD and their carers.
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2015 |
Bonney A, Knight-Billington P, Mullan J, Moscova M, Barnett S, Iverson D, et al., 'The telehealth skills, training, and implementation project: an evaluation protocol.', JMIR Res Protoc, 4 e2 (2015) [C3]
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2015 |
Chenoweth L, Kable A, Pond D, 'Research in hospital discharge procedures addresses gaps in care continuity in the community, but leaves gaping holes for people with dementia: A review of the literature', Australasian Journal on Ageing, 34 9-14 (2015) [C1]
© 2015 AJA Inc. Aim: To examine the literature on the impact of the discharge experience of patients with dementia and their continuity of care. Methods: Peer-reviewed and grey li... [more]
© 2015 AJA Inc. Aim: To examine the literature on the impact of the discharge experience of patients with dementia and their continuity of care. Methods: Peer-reviewed and grey literature published in the English language between 1995 and 2014 were systematically searched using Medline, CINAHL, PubMed, PsycINFO and Cochrane library databases, using a combination of the search terms Dementia, Caregivers, Integrated Health Care Systems, Managed Care, Patient Discharge. Also reviewed were Department of Health and Ageing and Alzheimer's Australia research reports between 2000 and 2014. Results: The review found a wide range of studies that raise concerns in relation to the quality of care provided to people with dementia during hospital discharge and in transitional care. Conclusion: Discharge planning and transitional care for patients with dementia are not adequate and are likely to lead to readmission and other poor health outcomes.
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2015 |
Mate KE, Kerr KP, Pond D, Williams EJ, Marley J, Disler P, et al., 'Impact of Multiple Low-Level Anticholinergic Medications on Anticholinergic Load of Community-Dwelling Elderly With and Without Dementia', Drugs and Aging, 32 159-167 (2015) [C1]
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2015 |
Parkinson L, Magin PJ, Thomson A, Byles JE, Caughey GE, Etherton-Beer C, et al., 'Anticholinergic burden in older women: not seeing the wood for the trees?', MEDICAL JOURNAL OF AUSTRALIA, 202 91-+ (2015) [C1]
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2015 |
Ranasinghe WKB, Kim SP, Papa NP, Sengupta S, Frydenberg M, Bolton D, et al., 'Prostate cancer screening in Primary Health Care: the current state of affairs', SpringerPlus, 4 (2015) [C1]
© 2015, Ranasinghe et al.; licensee Springer. This study aims to examine the current practice of General practitioners (GPs)/primary care physicians in opportunistic screening for... [more]
© 2015, Ranasinghe et al.; licensee Springer. This study aims to examine the current practice of General practitioners (GPs)/primary care physicians in opportunistic screening for prostate cancer (PC) by digital rectal examination(DRE) and Prostate Specific Antigen(PSA) testing and identify any difference in screening practice. Printed copies and/or electronic versions of a survey was distributed amongst 438 GPs throughout Australia in 2012. Statistical analyses (Wilcoxon rank-sum test, Fisher¿s exact test or Pearson chi-square test)were performed by outcomes and GP characteristics.There were a total of 149 responses received (34%), with similar gender distribution in rural and metropolitan settings. 74% GPs believed PSA testing was at least ¿somewhat effective¿ in reducing PC mortality with annual PSA screening being conducted by more GPs in the metropolitan setting compared to the rural GPs (35% vs 18.4%), while 25% of rural GPs would not advocate routine PSA screening. When examining the concordance between DRE and PSA testing by gender of GP, the male GPs reported performing PSA testing more frequently than DRE in patients between ages 40 to 69 (p = 0.011). Urology Society guidelines (77.2%) and College of GPs (73.2%) recommendations for PC screening were thought to be at least ¿somewhat useful¿. Although reference ranges for PSA tests were felt to be useful, the majority (65.8%) found it easier to refer to an urologist due to the disagreements in guidelines. In conclusion, the current guidelines for PSA screening appear to cause more confusion due to their conflicting advice, leaving GPs to formulate their own practice methods, calling for an urgent need for uniform collaborative guidelines.
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2015 |
Agar M, Beattie E, Luckett T, Phillips J, Luscombe G, Goodall S, et al., 'Pragmatic cluster randomised controlled trial of facilitated family case conferencing compared with usual care for improving end of life care and outcomes in nursing home residents with advanced dementia and their families: The IDEAL study protocol Palliative care in other conditions', BMC Palliative Care, 14 (2015) [C3]
© 2015 Agar et al. Background: Care for people with advanced dementia requires a palliative approach targeted to the illness trajectory and tailored to individual needs. However, ... [more]
© 2015 Agar et al. Background: Care for people with advanced dementia requires a palliative approach targeted to the illness trajectory and tailored to individual needs. However, care in nursing homes is often compromised by poor communication and limited staff expertise. This paper reports the protocol for the IDEAL Project, which aims to: 1) compare the efficacy of a facilitated approach to family case conferencing with usual care; 2) provide insights into nursing home-and staff-related processes influencing the implementation and sustainability of case conferencing; and 3) evaluate cost-effectiveness. Design/Methods: A pragmatic parallel cluster randomised controlled trial design will be used. Twenty Australian nursing homes will be randomised to receive either facilitated family case conferencing or usual care. In the intervention arm, we will train registered nurses at each nursing home to work as Palliative Care Planning Coordinators (PCPCs) 16 h per week over 18 months. The PCPCs' role will be to: 1) use evidence-based 'triggers' to identify optimal time-points for case conferencing; 2) organise, facilitate and document case conferences with optimal involvement from family, multi-disciplinary nursing home staff and community health professionals; 3) develop and oversee implementation of palliative care plans; and 4) train other staff in person-centred palliative care. The primary endpoint will be symptom management, comfort and satisfaction with care at the end of life as rated by bereaved family members on the End of Life in Dementia (EOLD) Scales. Secondary outcomes will include resident quality of life (Quality of Life in Late-stage Dementia [QUALID]), whether a palliative approach is taken (e.g. hospitalisations, non-palliative medical treatments), staff attitudes and knowledge (Palliative Care for Advanced Dementia [qPAD]), and cost effectiveness. Processes and factors influencing implementation, outcomes and sustainability will be explored statistically via analysis of intervention 'dose' and qualitatively via semi-structured interviews. The pragmatic design and complex nature of the intervention will limit blinding and internal validity but support external validity. Discussion: The IDEAL Project will make an important contribution to the evidence base for dementia-specific case conferencing in nursing homes by considering processes and contextual factors as well as overall efficacy. Its strengths and weaknesses will both lie in its pragmatic design. Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12612001164886. Registered 02/11/2012.
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2015 |
Magin P, Goode S, Pond D, 'GPs, medications and older people: A qualitative study of general practitioners' approaches to potentially inappropriate medications in older people', Australasian Journal on Ageing, 34 134-139 (2015) [C1]
© 2014 ACOTA. Aim: To explore the prescribing, and the rationale for this prescribing, of potentially inappropriate medications (PIMs) in older persons by Australian general pract... [more]
© 2014 ACOTA. Aim: To explore the prescribing, and the rationale for this prescribing, of potentially inappropriate medications (PIMs) in older persons by Australian general practitioners (GPs). Methods: This was a qualitative study employing semistructured interviews and thematic analysis. GPs who had patients taking at least one PIM were invited to participate. PIMs were defined by the Beers criteria. Results: Twenty-two GPs from four regions in three Australian states participated. While none were aware of the Beers criteria, participant GPs displayed good knowledge of the potential adverse effects of these medications. They were comfortable with the continued prescription of the medications. This was based on often quite complex harm-benefit considerations of the biopsychosocial contexts of individual patients. Conclusions: The concept of 'appropriate' versus 'inappropriate' medications implicit in classification systems such as the Beers criteria is at odds with complex considerations informing decision-making prescribing PIMs in older persons.
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2014 |
Kerr KP, Mate KE, Magin PJ, Marley J, Stocks NP, Disler P, Pond CD, 'The prevalence of co-prescription of clinically relevant CYP enzyme inhibitor and substrate drugs in community-dwelling elderly Australians', JOURNAL OF CLINICAL PHARMACY AND THERAPEUTICS, 39 383-389 (2014) [C1]
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2014 |
Dabson AM, Magin PJ, Heading G, Pond D, 'Medical students' experiences learning intimate physical examination skills: A qualitative study', Acta Veterinaria Scandinavica, 39-39 (2014) [C1]
Background: Intimate physical examination skills are essential skills for any medical graduate to have mastered to an appropriate level for the safety of his or her future patient... [more]
Background: Intimate physical examination skills are essential skills for any medical graduate to have mastered to an appropriate level for the safety of his or her future patients. Medical schools are entrusted with the complex task of teaching and assessing these skills for their students. The objectives of this study were to explore a range of medical students' experiences of learning intimate physical examination skills and to explore their perceptions of factors which impede or promote the learning of these skills. Methods: Individual semi-structured interviews (N = 16) were conducted with medical students in years two to five from the University of Newcastle, as part of a larger research project investigating how medical students develop their attitudes to gender and health. This was a self-selected sample of the entire cohort who were all invited to participate. A thematic analysis of the transcribed data was performed. Results: Students reported differing levels of discomfort with their learning experiences in the area of intimate physical examination and differing beliefs about the helpfulness of these experiences. The factors associated with levels of discomfort and the helpfulness of the experience for learning were: satisfaction with teaching techniques, dealing with an uncomfortable situation and perceived individual characteristics in both the patients and the students. The examination causing the greatest reported discomfort was the female pelvic examination by male students. Conclusions: Student discomfort with the experience of learning intimate physical examination skills may be common and has ongoing repercussions for students and patients. Recommendations are made of ways to modify teaching technique to more closely match students' perceived needs.
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2014 |
Wurtman R, Pond D, 'Rethinking nutrition and early Alzheimer's disease', Australian Journal of Pharmacy, 95 14-16 (2014) |
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2013 |
Johnson DA, Frank O, Pond D, Stocks N, 'Older people with mild cognitive impairment: Their views about assessing driving safety', Australian Family Physician, 42 317-320 (2013) [C1]
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2013 |
Pond CD, Mate KE, Phillips J, Stocks NP, Magin PJ, Weaver N, Brodaty H, 'Predictors of agreement between general practitioner detection of dementia and the revised Cambridge Cognitive Assessment (CAMCOG-R)', INTERNATIONAL PSYCHOGERIATRICS, 25 1639-1647 (2013) [C1]
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2013 |
Brodaty H, Connors M, Pond D, Cumming A, Creasey H, 'Dementia 14 essentials of assessment and care planning', Medicine Today, 14 18-27 (2013) [C2]
Many GPS report a lack of time and confidence in diagnosing dementia. Fourteen practical points are described to guide the assessment and care of patients with cognitive decline.... [more]
Many GPS report a lack of time and confidence in diagnosing dementia. Fourteen practical points are described to guide the assessment and care of patients with cognitive decline.
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2013 |
Brodaty H, Connors M, Pond D, Cumming A, Creasey H, 'Dementia: 14 Essentials of management', Medicine Today, 14 29-41 (2013) [C2]
Dementia places a great burden on patients and their families and the challenges vary considerably over the course of the illness. We describe 14 practical points to guide managem... [more]
Dementia places a great burden on patients and their families and the challenges vary considerably over the course of the illness. We describe 14 practical points to guide management.
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2013 |
Boughtwood D, Shanley C, Adams J, Santalucia Y, Kyriazopoulos H, Rowland J, Pond D, 'The role of the bilingual/bicultural worker in dementia education, support and care', Dementia, 12 7-21 (2013) [C1]
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2013 |
Brodaty H, Gibson LH, Waine ML, Shell AM, Lilian R, Pond CD, 'Research in general practice: a survey of incentives and disincentives for research participation.', Ment Health Fam Med, 10 163-173 (2013) [C1] |
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2012 |
Pond CD, 'Dementia: An update on management', Australian Family Physician, 41 936-939 (2012) [C2]
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2012 |
Joyce T, Higgins IJ, Magin PJ, Goode SM, Pond CD, Stone TE, et al., 'The experiences of nurses with mental health problems: Colleagues' perspectives', Archives of Psychiatric Nursing, 26 324-332 (2012) [C1]
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2012 |
Magin PJ, Pond CD, Smith WT, Goode SM, Paterson NE, 'Reliability of skin-type self-assessment: Agreement of adolescents' repeated Fitzpatrick skin phototype classification ratings during a cohort study', Journal of the European Academy of Dermatology and Venereology, 26 1396-1399 (2012) [C1]
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2012 |
Phillips J, Pond CD, Paterson NE, Howell C, Shell A, Stocks NP, et al., 'Difficulties in disclosing the diagnosis of dementia: A qualitative study in general practice', British Journal of General Practice, 62 e546-e553 (2012) [C1]
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2012 |
Boughtwood D, Shanley C, Adams J, Santalucia Y, Kyriazopoulos H, Pond CD, Rowland J, 'Dementia information for culturally and linguistically diverse communities: Sources, access and considerations for effective practice', Australian Journal of Primary Health, 18 190-196 (2012) [C1]
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2012 |
Greenway-Crombie A, Snow P, Disler P, Davis S, Pond CD, 'Influence of rurality on diagnosing dementia in Australian general practice', Australian Journal of Primary Health, 18 178-184 (2012) [C1]
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2012 |
Pond CD, Brodaty H, Stocks NP, Gunn J, Marley JE, Disler P, et al., 'Ageing in general practice (AGP) trial: A cluster randomised trial to examine the effectiveness of peer education on GP diagnostic assessment and management of dementia', BMC Family Practice, 13 1-9 (2012) [C3]
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2012 |
Shanley C, Boughtwood D, Adams J, Santalucia Y, Kyriazopoulos H, Pond CD, Rowland J, 'A qualitative study into the use of formal services for dementia by carers from culturally and linguistically diverse (CALD) communities', BMC Health Services Research, 12 354 (2012) [C1]
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2012 |
Mate KE, Pond CD, Magin PJ, Goode SM, McElduff P, Stocks NP, 'Diagnosis and disclosure of a memory problem is associated with quality of life in community based older Australians with dementia', International Psychogeriatrics, 24 1962-1971 (2012) [C1]
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2011 |
Magin PJ, Pond CD, Smith WT, Watson AB, Goode SM, 'Correlation and agreement of self-assessed and objective skin disease severity in a cross-sectional study of patients with acne, psoriasis, and atopic eczema', International Journal of Dermatology, 50 1486-1490 (2011) [C1]
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2011 |
Magin PJ, Marshall MJ, Goode SM, Cotter GL, Pond CD, Zwar NA, 'How generalisable are results of studies conducted in practice-based research networks? A cross-sectional study of general practitioner demographics in two New South Wales networks', Medical Journal of Australia, 195 210-213 (2011) [C1]
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2011 |
Broughtwood D, Shanley C, Adams J, Santalucia Y, Kyriazopoulos H, Pond CD, Rowland J, 'Culturally and linguistically diverse (CALD) families dealing with dementia: An examination of the experiences and perceptions of multicultural community link workers', Journal of Cross-Cultural Gerontology, 26 365-377 (2011) [C1]
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2011 |
Joyce TA, Higgins IJ, Magin PJ, Goode SM, Pond CD, Stone TE, et al., 'Nurses' perceptions of a mental health education programme for Australian nurses', International Journal of Mental Health Nursing, 20 247-252 (2011) [C1]
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2011 |
Magin PJ, Adams J, Heading G, Pond CD, ''Perfect skin', the media and patients with skin disease: A qualitative study of patients with acne, psoriasis and atopic eczema', Australian Journal of Primary Health, 17 181-185 (2011) [C1]
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2010 |
Pond CD, Brodaty H, Gunn J, Stocks N, Disler P, Mate KE, et al., 'GP identification of dementia: effect of gender, age and size of practice', Alzheimer's & Dementia, 6 S364-S365 (2010) [C3]
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2010 |
Sweeney KP, Magin PJ, Pond CD, 'Patient attitudes: Training students in general practice', Australian Family Physician, 39 676-682 (2010) [C1]
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2010 |
Magin PJ, Pond CD, Smith WT, Goode SM, 'Acne's relationship with psychiatric and psychological morbidity: Results of a school-based cohort study of adolescents', Journal of the European Academy of Dermatology and Venereology, 24 58-64 (2010) [C1]
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2010 |
Magin PJ, Heading G, Adams J, Pond CD, 'Sex and the skin: A qualitative study of patients with acne, psoriasis and atopic eczema', Psychology, Health and Medicine, 15 454-462 (2010) [C1]
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2009 |
Brodaty H, Pond CD, Draper B, Seeher K, 'Assisting general practitioners to screen for cognitive impairment: The General Practitioner Assessment of Cognition website', Alzheimer's and Dementia, 5 e15-e16 (2009) [C3]
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2009 |
Paterson NE, Pond CD, 'Early diagnosis of dementia and diagnostic disclosure in primary care in Australia: A qualitative study into the barriers and enablers', Alzheimer's and Dementia, 5 e15 (2009) [C3]
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2009 |
Magin PJ, Adams J, Heading GS, Pond CD, 'Patients with skin disease and their relationships with their doctors: A qualitative study of patients with acne, psoriasis and eczema', Medical Journal of Australia, 190 62-64 (2009) [C1]
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2009 |
Sturmberg JP, Pond CD, 'Impacts on clinical decision making: Changing hormone therapy management after the WHI', Australian Family Physician, 38 249-255 (2009) [C1]
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2009 |
Magin PJ, Adams J, Heading G, Pond CD, Smith WT, 'The psychological sequelae of psoriasis: Results of a qualitative study', Psychology, Health and Medicine, 14 150-161 (2009) [C1]
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2008 |
Pond CD, 'Med student entry: Putting our future GPs to the test', Australian Doctor, 18 (2008) [C3] |
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2008 |
Gunn JM, Gilchrist GP, Chondros P, Ramp M, Hegarty KL, Blashki GA, et al., 'Who is identified when screening for depression is undertaken in general practice? Baseline findings from the Diagnosis, Management and Outcomes of Depression in Primary Care (diamond) longitudinal study', Medical Journal of Australia, 188 S119-S125 (2008) [C1]
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2008 |
Magin PJ, Adams J, Heading G, Pond CD, Smith WT, 'Experiences of appearance-related teasing and bullying in skin diseases and their psychological sequelae: Results of a qualitative study', Scandinavian Journal of Caring Sciences, 22 430-436 (2008) [C1]
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2008 |
Magin PJ, Pond CD, Smith WT, Watson AB, Goode SM, 'A cross-sectional study of psychological morbidity in patients with acne, psoriasis and atopic dermatitis in specialist dermatology and general practices', Journal of the European Academy of Dermatology and Venereology, 22 1435-1444 (2008) [C1]
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2007 |
Rumsey S, Hokin B, Magin PJ, Pond CD, 'Macrocytosis: An Australian general practice perspective', Australian Family Physician, 36 571-572 (2007) [C1]
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2007 |
Pond CD, 'Why research will never replace clinical judgment (Editorial)', Australian Doctor, 20 (2007) [C3] |
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2007 |
Cook IF, Pond CD, Hartel G, 'Comparative reactogenicity and immunogenicity of 23 valent pneumococcal vaccine administered by intramuscular or subcutaneous injection in elderly adults', Vaccine, 25 4767-4774 (2007) [C1]
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2006 |
Magin PJ, Pond CD, Baines SK, Goode SM, 'Hyperlipidaemia: a pilot of a multidisciplinary intervention in general practice', Asia Pacific Family Medicine, 5 online (2006) [C1]
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2006 |
Cook IF, Barr I, Hartel G, Pond CD, Hampson AW, 'Reactogenicity and immunogenicity of an inactivated influenza vaccine administered by intramuscular or subcutaneous injection in elderly adults', Vaccine, 24 2395-2402 (2006) [C1]
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2006 |
Cook IF, Williamson M, Pond CD, 'Definition of needle length required for intramuscular deltoid injection in elderly adults: an ultrasonographic study', Vaccine, 24 937-940 (2006) [C1]
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2006 |
Magin PJ, Adams J, Pond CD, Smith WT, 'Topical and oral CAM in acne: A review of the empirical evidence and a consideration of its context', Complementary Therapies in Medicine, 14 62-76 (2006) [C1]
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2006 |
Magin PJ, Adams J, Heading GS, Pond CD, Smith WT, 'Complementary and alternative medicine therapies in acne, psoriasis, and atopic eczema: results of a qualitative study of patients' experiences and perceptions', Journal of Alternative and Complementary Medicine, 12 451-457 (2006) [C1]
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2006 |
Magin PJ, Adams J, Heading G, Pond CD, Smith WT, 'The causes of acne: a qualitative study of patient perceptions of acne causation and their implications for acne care', Dermatology Nursing, 18 344-349, 370 (2006) [C1]
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2006 |
Magin PJ, Adams J, Heading G, Pond CD, Smith WT, 'Psychological sequelae of acne vulgaris: Results of a qualitative study', Canadian Family Physician, 52 978-979 (2006) [C1]
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2005 |
Barnard A, Pond CD, Usherwood TP, 'Asthma and older people in general practice.', The Medical journal of Australia, 183 (2005)
WHAT WE NEED TO KNOW: Why is there undiagnosed and untreated asthma in older people in the community and in general practice? What patient, general practitioner and organisational... [more]
WHAT WE NEED TO KNOW: Why is there undiagnosed and untreated asthma in older people in the community and in general practice? What patient, general practitioner and organisational factors contribute to this? Are current best practice guidelines appropriate for older people with asthma? WHAT WE NEED TO DO: Undertake broad community and general practice screening to identify characteristics of older people with undiagnosed asthma. Analyse GPs' perspectives and decision-making processes for older people with dyspnoea. Undertake targeted research in general practice, trialling decision-making frameworks for older patients with dyspnoea. Undertake appropriate and relevant community and GP awareness campaigns about the prevalence of asthma in older people. Analyse current best practice management of asthma, including self-management and the Asthma 3+ Visit Plan, in older people.
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2005 |
Magin PJ, Adams J, Heading GS, Pond CD, Smith WT, 'Patients' perceptions of isotretinoin, depression and suicide--a qualitative study', Australian Family Physician, 34 795-797 (2005) [C1]
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2005 |
Magin PJ, Pond CD, Smith WT, Watson A, 'A systematic review of the evidence for 'myths and misconceptions' in acne management: diet face-washing and sunlight', Family Practice, 22 62-70 (2005) [C1]
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2005 |
Magin PJ, Pond CD, Smith WT, 'Isotretinoin, depression and suicide: a review of the evidence', British Journal of General Practice, 55 134-138 (2005) [C1]
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2005 |
Nicholas L, Pond CD, Roberts DCK, 'The effectiveness of nutrition counselling by Australian General Practitioners', European Journal of Clinical Nutrition, 59 S140-S145 (2005) [C1]
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2005 |
Barnard A, Pond CD, Usherwood TP, 'Asthma and older people in general practice', Medical Journal of Australia, 183 S41-S43 (2005) [C1] |
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2005 |
Magin PJ, Shah NC, Regan CM, Pond CD, Bissett KE, 'A literature in medicine elective: undergraduate medical students' performance of a literature in medicine elective task during a general practice clinical attachment', Focus on Health Professional Education, 6 19-20 (2005) [C1]
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2004 |
Nicholas L, Pond CD, Roberts DC, 'GPs' views on active nutrition management for their patients', Australian Family Physician, 33 957-960 (2004) [C1]
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2004 |
Pond D, Brodaty H, 'Diagnosis and Management of Dementia in General Practice', Australian Family Physician, 33 789-793 (2004) [C1]
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2004 |
Joy E, Pond CD, Cotteril GF, 'Coping with redundancy: a mentorship program for men', Australian Journal of Primary Health, 10 124-129 (2004) [C1]
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2003 |
Bridges-Webb C, Wolk J, Britt H, Pond D, 'The management of dementia in general practice. A field test of guidelines.', Australian family physician, 32 283-285 (2003)
INTRODUCTION: Guidelines for the management of dementia in non-institutionalized patients living in the community were developed by a broadly representative group. We assessed the... [more]
INTRODUCTION: Guidelines for the management of dementia in non-institutionalized patients living in the community were developed by a broadly representative group. We assessed their usefulness. METHOD: The draft guidelines included emphasis on psychosocial issues. They were field tested by 17 general practitioners with 119 dementia patients. RESULTS: There was a high prevalence of comorbidity in the patients and frequent psychosocial issues in their management that were often not addressed. The guidelines were rated as very helpful for at least one aspect of care for 50% of the patients. DISCUSSION: The guidelines were found to be useful to GPs.
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2003 |
Nicholas L, Pond CD, Roberts DC, 'Dietitian - general practitioner interface: a pilot study on what influences the provision of effective nutrition management', American Journal of Clinical Nutrition, 1039S-42S (2003) [C1]
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2003 |
Pond CD, 'Priority setting and Australian general practice research', Australian Family Phusician, 32 376-377 (2003) [C1]
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2003 |
Bridges-Webb C, Wolk J, Britt H, Pond CD, 'The management of dementia in general practice', Australian Family Physician, 32 283-285 (2003) [C1] |
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2003 |
Nicholas L, Roberts DC, Pond CD, 'The role of the general practitioner and the dietitian in patient nutrition management', Asia Pacific Journal of Clinical Nutrition, 12 3-8 (2003) [C1]
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2002 |
Shah NC, Pond CD, Heaney SE, 'Research capacity building in general practice', Australian Family Physician, 31(2) 201-204 (2002) [C1]
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2002 |
Shah NC, Pond D, Heaney S, 'Research capacity building in general practice. The new Australian scene.', Australian family physician, 31 201-204 (2002)
BACKGROUND: Primary care research needs strengthening. The Commonwealth Government Department of Health and Aged Care has recently funded the university departments of general pra... [more]
BACKGROUND: Primary care research needs strengthening. The Commonwealth Government Department of Health and Aged Care has recently funded the university departments of general practice and rural health to build research capacity in primary care. OBJECTIVE: To explore issues surrounding building primary care research capacity, as well as looking at barriers to research capacity building and ways of overcoming them. DISCUSSION: New funding provides many opportunities for increasing research capacity in primary health care areas. Different institutions will select those methods that are best suited to their skills and the requirements of their area.
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2002 |
Kemp NM, Brodaty H, Pond D, Luscomb G, 'Diagnosing dementia in primary care: the accuracy of informant reports', Alzheimer Disease and Associated Disorders, 16 171-176 (2002) [C1]
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2002 |
Brodaty H, Pond CD, Kemp N, Luscombe G, Harding L, Berman K, Huppert F, 'The GPCOG: A New Screening Test for Dementia Designed for General Practice', The Journal of American Geriatrics Society, 50(3) 530-534 (2002) [C1]
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2001 |
Llewellyn-Jones RH, Baikie A, Castell S, Andrews CL, Pond CD, Willcock S, et al., 'How to help depressed older people in residential care:A multi-faceted shared-care intervention for late-life depression', International Psychogeriatrics, 13 477-492 (2001) [C1]
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2001 |
Smith M, Pond D, Webster P, Acheson T, 'Gp''s Attitudes to pharmacists medication review of nursing home patients', Medicine Today, (2001) [C3] |
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2000 |
Pond CD, 'The Upskilling of General Practitioners in Australia', IPA Bulletin, 17 1 (2000) [C3] |
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1997 |
Berglund CA, Pond CD, Harris MF, McNeill PM, Gietzelt D, Comino E, et al., 'Research in progress: The formation of professional and consumer solutions: Ethics in the general practice setting', Health Care Analysis, 5 164-167 (1997)
A general practice research project on ethics is underway at the University of New South Wales, funded by GPEP (General Practice Evaluation Program, Commonwealth Department of Hum... [more]
A general practice research project on ethics is underway at the University of New South Wales, funded by GPEP (General Practice Evaluation Program, Commonwealth Department of Human Services and Health, GPEP 386). Ethical issues, as defined and explored by general practitioners and consumers, are being examined across four areas of Sydney. So far, telephone interviews have been conducted (64% response rate) with a random sample of general practitioners (GPs). Face-to-face interviews have been conducted with 107 consumers, randomly sampled using ABS collection district information. Focus groups have been formed to discuss acceptable solutions to GP and consumer identified ethical issues. This report will report on some preliminary findings to date and will explore professional and consumer roles in the formation of ethical solutions.
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1997 |
Berglund CA, Pond CD, Harris MF, McNeill PM, Gietzelt D, Comino E, et al., 'The formations of professional and consumer solutions: Ethics in the general practice setting', HEALTH CARE ANALYSIS, 5 164-167 (1997) |
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1996 |
Pond D, Knowlden S, Harris M, 'News from the divisions: diabetes shared care.', Australian family physician, Suppl 1 (1996)
It is not surprising that diabetes care has been a very active area for divisional projects and activities. Diabetes is prevalent in the community (up to one million Australians) ... [more]
It is not surprising that diabetes care has been a very active area for divisional projects and activities. Diabetes is prevalent in the community (up to one million Australians) and in general practice (1% of GP encounters). Optimal cost-effective diabetes management involves collaboration between general practice and public and private health services--one of the purposes for which divisions were created. Because diabetes is a multisystem chronic disease requiring multi-disciplinary interventions, it has also been a model for applying the health outcomes approach in general practice, especially in New South Wales.
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1996 |
Harris MF, Silove D, Kehag E, Barratt A, Manicavasagar V, Pan J, et al., 'Anxiety and depression in general practice patients: Prevalence and management', MEDICAL JOURNAL OF AUSTRALIA, 164 526-529 (1996)
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1995 |
MANT A, KING M, SAUNDERS NA, POND CD, GOODE E, HEWITT H, '4-YEAR FOLLOW-UP OF MORTALITY AND SLEEP-RELATED RESPIRATORY DISTURBANCE IN NONDEMENTED SENIORS', SLEEP, 18 433-438 (1995)
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1994 |
WARD J, POND D, LLEWELLYNJONES R, ANDREWS C, 'FLU VACCINATION OF THE ELDERLY - ROOM TO IMPROVE', MEDICAL JOURNAL OF AUSTRALIA, 160 454-454 (1994)
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1994 |
POND CD, MANT A, KEHOE L, HEWITT H, BRODATY H, 'GENERAL-PRACTITIONER DIAGNOSIS OF DEPRESSION AND DEMENTIA IN THE ELDERLY - CAN ACADEMIC DETAILING MAKE A DIFFERENCE', FAMILY PRACTICE, 11 141-147 (1994)
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1992 |
PEARSE PAE, HAYS RB, POND CD, 'DEPRESSION IN GENERAL-PRACTICE', MEDICAL JOURNAL OF AUSTRALIA, 157 38-& (1992)
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1992 |
HAYWARD L, MANT A, EYLAND A, HEWITT H, PURCELL C, TURNER J, et al., 'SLEEP DISORDERED BREATHING AND COGNITIVE FUNCTION IN A RETIREMENT VILLAGE POPULATION', AGE AND AGEING, 21 121-128 (1992)
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1992 |
MANT A, EYLAND EA, HEWITT H, FOX M, GOODE E, LECOUNT A, et al., 'SLEEP-DISORDERED BREATHING IN ELDERLY PEOPLE AND SUBJECTIVE SLEEP WAKE DISTURBANCE', AGE AND AGEING, 21 262-268 (1992)
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1992 |
HAYWARD LB, MANT A, EYLAND EA, HEWITT H, POND CD, SAUNDERS NA, 'NEUROPSYCHOLOGICAL FUNCTIONING AND SLEEP PATTERNS IN THE ELDERLY', MEDICAL JOURNAL OF AUSTRALIA, 157 51-52 (1992)
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1991 |
LORD S, SAWYER B, OCONNELL D, KING M, POND D, EYLAND A, et al., 'NIGHT-TO-NIGHT VARIABILITY OF DISTURBED BREATHING DURING SLEEP IN AN ELDERLY COMMUNITY SAMPLE', SLEEP, 14 252-258 (1991)
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1990 |
Mant A, Kehoe L, Eyland A, Purcell C, Pond CD, Hewitt H, Saunders NA, 'Use of medications by the elderly.', Australian family physician, 19 1405-1411 (1990)
Our study confirms that multiple medications are frequently taken by relatively healthy residents of a retirement village, the more so when they are less socially active during th... [more]
Our study confirms that multiple medications are frequently taken by relatively healthy residents of a retirement village, the more so when they are less socially active during the day, and when they are living in hostel accommodation. There were few drug combinations that caused a potential interaction, suggesting that safe use of medication by the elderly should be an achievable goal.
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1990 |
POND CD, MANT A, BRIDGESWEBB C, PURCELL C, EYLAND EA, HEWITT H, SAUNDERS NA, 'RECOGNITION OF DEPRESSION IN THE ELDERLY - A COMPARISON OF GENERAL-PRACTITIONER OPINIONS AND THE GERIATRIC DEPRESSION SCALE', FAMILY PRACTICE, 7 190-194 (1990)
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1990 |
POND CD, MANT A, EYLAND EA, SAUNDERS NA, 'DEMENTIA AND ABNORMAL BREATHING DURING SLEEP', AGE AND AGEING, 19 247-252 (1990)
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1989 |
LORD S, SAWYER B, POND D, OCONNELL D, EYLAND A, MANT A, et al., 'INTERRATER RELIABILITY OF COMPUTER-ASSISTED SCORING OF BREATHING DURING SLEEP', SLEEP, 12 550-558 (1989)
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1988 |
MANT A, EYLAND EA, POND DC, SAUNDERS NA, CHANCELLOR AHB, 'RECOGNITION OF DEMENTIA IN GENERAL-PRACTICE - COMPARISON OF GENERAL-PRACTITIONERS OPINIONS WITH ASSESSMENTS USING THE MINI-MENTAL STATE EXAMINATION AND THE BLESSED DEMENTIA RATING-SCALE', FAMILY PRACTICE, 5 184-188 (1988)
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1988 |
SAUNDERS NA, SAWYER BJ, LORD S, POND D, MANT A, EYLAND A, et al., 'RELATION BETWEEN SLEEP COMPLAINTS AND BREATHING DISTURBANCE IN THE ELDERLY', AUSTRALIAN AND NEW ZEALAND JOURNAL OF MEDICINE, 18 540-540 (1988)
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1988 |
LORD S, SAWYER B, POND D, MANT A, EYLAND A, HOLLAND T, et al., 'INTER-RATER RELIABILITY (IRR) OF SCORING SLEEP RECORDS FROM A MICROPROCESSOR-BASED PORTABLE MONITORING-SYSTEM', AUSTRALIAN AND NEW ZEALAND JOURNAL OF MEDICINE, 18 541-541 (1988) |
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1988 |
MANT A, SAUNDERS NA, EYLAND AE, POND CD, CHANCELLOR AH, WEBSTER IW, 'SLEEP-RELATED RESPIRATORY DISTURBANCE AND DEMENTIA IN ELDERLY FEMALES', JOURNALS OF GERONTOLOGY, 43 M140-M144 (1988)
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1987 |
GYULAY S, GOULD D, SAWYER B, POND D, MANT A, SAUNDERS N, 'EVALUATION OF A MICROPROCESSOR-BASED PORTABLE HOME MONITORING-SYSTEM TO MEASURE BREATHING DURING SLEEP', SLEEP, 10 130-142 (1987)
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1986 |
SAUNDERS NA, GYULAY S, GOULD D, POND D, MANT A, 'PORTABLE MONITORING OF BREATHING DURING SLEEP - EVALUATION OF THE VITALOG PMS-8', AUSTRALIAN AND NEW ZEALAND JOURNAL OF MEDICINE, 16 635-635 (1986) |
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