31 January 2018

Dr Malcolm Dobbin on codeine misuse and dependency

Dr Malcolm Dobbin and Dr Jill Thistlethwaite discuss codeine misuse disorder and the diagnosis of codeine dependency in a podcast. Malcolm is a Public Health Physician with a special interest in the misuse of medicines, including over-the-counter codeine, and Jill is a GP and NPS MedicineWise Medical Advisor.

Included on this page by NPS Medicinewise along with the podcast, are many FAQs and patient resources.  

Diabetes and Cognitive Decline

A new study of some 5,000 older people in the UK has shown that rates of long-term cognitive decline are steeper in those who have diabetes compared with people with normal blood sugar control, and that efforts to delay the onset of diabetes and/or control blood sugar levels might prevent subsequent progression of brain function decline.

The study, based on the English Longitudinal Study of Ageing, is by Dr Wuxiang Xie, School of Public Health, Imperial College London, London, UK, and Peking University Clinical Research Institute, Beijing, China, and colleagues, and is published in Diabetologia, the journal of the European Association for the Study of Diabetes (EASD).

Zheng, F., Yan, L., Yang, Z. et al. HbA1c, diabetes and cognitive decline: the English Longitudinal Study of Ageing, Diabetologia (2018). (open access)

You can read the full text article here.  

Shifting the Dial: Healthier Australians

In October last year the report " Shifting the Dial: 5 year productivity review" was released by the Australian Productivity Commission with chapter 2 focusing on Healthier Australians. Main topics covered were integrated, patient-centred care to treat today’s chronic diseases; interlinked policy initiatives required; regional flexibility crucial; funding models should encourage integration; financial incentives for quality needed; and better data collection and information-sharing.

You can read the full chapter here.

03 January 2018

Overweight and Obese: a public health issue

Young people today are much more likely to be obese than their parents were when they were the same age, according to new analysis released by the Australian Institute of Health and Welfare (AIHW).
This report provides an overview of overweight and obesity in Australia-a major public health issue that has significant health and financial costs. Almost one-quarter of children and two-thirds of adults are overweight or obese, and rates continue to rise, largely due to a rise in obesity, which cost the economy $8.6 billion in 2011-12.  

Download the report here.   

Caring for Cognitive Impairment

People with cognitive impairment in hospital are at increased risk of preventable complications as they have difficulty with communication, speech or understanding language, memory, attention, thinking or judgment.
The Caring for Cognitive Impairment campaign is about providing better outcomes and experiences for patients with cognitive impairment in hospitals, and for their loved ones and staff who care for them. The campaign website has a wealth of information, tools, stories and resources aimed at those working in hospitals caring for people with cognitive impairment.

Staphylococcus Aureus Bacteraemia in Australian Hospitals 2016–17

In 2016-17, Australian public hospitals reported 1,502 cases of hospital-associated Staphylococcus aureus bacteraemia (SAB) at a rate of 0.76 cases per 10,000 days of patient care. SAB is a type of infection often associated with healthcare. It occurs when Staphylococcus aureus bacteria (‘Golden staph’) cause an infection of the bloodstream (bacteraemia). When associated with healthcare procedures, these infections are considered to be potentially preventable. This new report from AIHW is free to download.

Staphylococcus aureus bacteraemia in Australian hospitals 2016–17. AIHW, Cat. no: HSE 198

Obsessive Compulsive Disorder

Obsessions are more than just worries about real life problems. They are excessive and illogical, and can cause distress to both the person affected and those caring for them.
This guide from SANE Australia provides an in-depth exploration of OCD, its causes and treatments, coping strategies and support for people living with OCD and their families, friends and carers.

Obsessive Compulsive Disorder (OCD)      

27 December 2017

Antimicrobial Resistance Website

The Government has launched an online resource for industry and the community as part of ongoing work to tackle the rise of antimicrobial resistance.
The main cause of antibiotic resistance is antibiotic use, the more we use antibiotics, the more chance bacteria have to develop resistance to them. As a result of antibiotic resistance, standard medical and veterinary treatments may become ineffective and infections may persist and spread to others. Australia is one of the developed world’s highest users of antibiotics – one of the main causes of AMR.

The new AMR website has information for the community, health professionals, animal health professionals, farmers, animal owners and the broader agriculture industry.

Using appreciative inquiry as a framework to enhance the patient experience

The following case depicts the journey of a non-profit hospital in the US and its attempts to turn around suffering patient experience. The Hospital turned to the theories of Appreciative Inquiry and the power of a strengths-based approach to create a framework to support the patient experience initiatives. Hospital leadership led the formation of a Patient Experience Team to implement ten initiatives in order increase the top box score in the domain of willingness to recommend the hospital, as that was selected as a global measure of success for the overall improvement project.

Moorer, Kerry [et al] (2017). Using appreciative inquiry as a framework to enhance the
patient experience, Patient Experience Journal,  4(3), Article 18. 

A productive workplace is built on teamwork and a shared vision

An interesting blog post from Jane Collins on the KingsFund blog where the author considers how managers and clinicians can work together to improve productivity and reduce waste in healthcare. Although the post relates to the NHS, improving productivity in the UK has become a national priority as it is in Australia.

Collins, Jane (2017) 'A productive workplace is built on teamwork and a shared vision', 8 November. Available at: (Accessed 27 December 2017)

Hospital care for Australian sports injury 2012-13

This report focuses on acute care services provided by hospitals for sports injuries treated in Australian hospitals in 2012-13. Cases of sports injury are examined in terms of the body region injured with ten types of injury are described in some detail. 7500 people were hospitalised for sport-related head injury and 5500 for knee injury.

Hospital care for Australian sports injury 2012–13, AIHW 2017.  

Work-related hospitalised injuries, Australia 2006-07 to 2013-14

AIHW has recently published a report on work related injuries requiring hospitalisation. There were 617,755 hospitalised cases funded by workers' compensation in Australia in the period from 2006-07 to 2013-14, with 72% being male and 96% aged 15-64. Almost 38% of these cases were hospitalised primarily due to a musculoskeletal-related condition while 32% were hospitalised primarily due to injury and poisoning. There were 234,104 hospitalised cases reported as work related over this period, with 61% being funded by workers' compensation.

Download report: Work-related hospitalised injuries, Australia 2006-07 to 2013-14  

Strengthening safety statistics: How to make hospital safety data more useful

Australia needs to reform how it collects and uses information about patient safety, to reduce the risk of more scandals and tragedies in our hospitals, according to Grattan Institute’s latest report, Strenghtening safety statistics: How to make hospital safety data more useful. The system is awash with data, but the information is poorly collated, not shared with patients, and often not given to doctors, explains Health Program Director Stephen Duckett in this podcast. Inexcusably, private hospitals are left outside state safety monitoring of hospitals. The performance of private hospitals should be analysed in the same way as public hospitals, and the results fed back to them and reported widely.
To ensure hospital safety data is more useful, it must be more trustworthy, relevant and accessible. The many different data sets should be linked, and the information should be presented more clearly so doctors can act on it and patients can understand it.

You can listen to the podcast or download the report here. 

Yoga for Improving Health and Well-being

This Cochrane Library Special Collection of systematic reviews on yoga focuses on reviews evaluating the effectiveness of yoga for improving physical or mental symptoms and quality of life in a range of health conditions. It has been developed to bring the best available evidence on the health-related effects of yoga to the attention of the general public, patients, health professionals, and other decision makers, and to inform choices on the use of yoga to improve health and well-being.

Yoga for improving health and well-being. Cochrane Library Special Collection. Nov. 2017. 

Opioid Dependence in Older Adults

A literature review of relevant material was conducted in November 2015 to assess current outcome research among older adults treated for opioid dependence. Most research conducted on older adults involves alcohol and prescription medications. Older drug users are growing in number and have a unique profile, with many presenting for treatment for the first time aged 50–70 years. Findings reveal that opioid treatment numbers are decreasing, however the average age of treatment admissions is increasing, older clients achieve better treatment outcomes than younger counterparts, and older women achieve better treatment outcomes than men.
Addiction and healthcare services must anticipate and prepare for increased demand by this group.

Carew, A.M., Comiskey, C. M. (2018).Treatment for opioid use and outcomes in older adults: a systematic literature review. Drug and Alcohol Dependence, 182(Jan), 48-57. [open access]