Academic literature on the topic 'Patient compliance Victoria'

ABSTRACTThe H1N1 (swine influenza) 2009 outbreak in Victoria, Australia, provided a unique opportunity to review the prehospital response to a public health emergency. As part of Ambulance Victoria’s response to the outbreak, relevant emergency response plans and pandemic plans were instigated, focused efforts were aimed at encouraging the use of personal protective equipment (PPE), and additional questions were included in the call-taking script for telephone triage of emergency calls to identify potential cases of H1N1 from the point of call. As a result, paramedics were alerted to all potential cases of H1N1 influenza or any patient who met the current case definition before their arrival on the scene and were advised to use appropriate PPE. During the period of May 1 to July 2, Ambulance Victoria telephone triaged 1598 calls relating to H1N1 (1228 in metropolitan areas and 243 in rural areas) and managed 127 calls via a referral service that provides specific telephone triage for potential H1N1 influenza cases based on the national call-taking script. The referral service determines whether a patient requires an emergency ambulance or can be diverted to other resources such as flu clinics. Key lessons learned during the H1N1 outbreak include a focused need for continued education and communication regarding infection control and the appropriate use of PPE. Current guidelines regarding PPE use are adequate for use during an outbreak of infectious disease. Compliance with PPE needs to be addressed through the use of intra-agency communications and regular information updates early in the progress of the outbreak. (Disaster Med Public Health Preparedness. 2009;3(Suppl 2):S154–S159)

1 Department of Microbiology, The Royal Women's Hospital, Victoria, 2 Menzies School of Health Research, Rocklands Drive, Tiwi, 3 Department of Epidemiology and Preventive Medicine, Alfred Hospital, Monash University, Prahran, Victoria and 4 AIDS/STD Unit, Centre for Disease Control, Territory Health Services, Darwin, Australia Summary: Self-administered sampling techniques for the detection of sexually transmitted diseases (STDs) are particularly useful due to their ease of collection and better patient compliance. Urine specimens, and recently tampons, have been described as methods of specimen collection for the detection of some STDs in women. In this study, 660 women had both first-void urine (FVU) and tampon specimens analysed by polymerase chain reaction (PCR) for the detection of Chlamydia trachomatis , Neisseria gonorrhoeae and Trichomonas vaginalis . Overall 6.5%, 10.1% and 17.9% of urine samples were positive whereas 7%, 21.2% and 22% of tampon specimens were positive for C. trachomatis , N. gonorrhoeae and T. vaginalis respectively. Tampon-collected specimens tested by PCR were more sensitive than urine specimens for the detection of N. gonorrhoeae and T. vaginalis ( P 0.001) and equally sensitive for the detection of C. trachomatis ( P =0.45). <

In Australia, compulsory microchipping legislation requires that animals are microchipped before sale or prior to 3 months in the Australian Capital Territory, New South Wales, Queensland and Victoria, and by 6 months in Western Australia and Tasmania. Describing the implementation of microchipping in animals allows the data guardians to identify individual animals presenting to differing veterinary practices over their lifetimes, and to evaluate compliance with legislation. VetCompass Australia (VCA) collates electronic patient records from primary care veterinary practices into a database for epidemiological studies. VCA is the largest companion animal clinical data repository of its kind in Australia, and is therefore the ideal resource to analyse microchip data as a permanent unique identifier of an animal. The current study examined the free-text ‘examination record’ field in the electronic patient records of 1000 randomly selected dogs and cats in the VCA database. This field may allow identification of the date of microchip implantation, enabling comparison with other date fields in the database, such as date of birth. The study revealed that the median age at implantation for dogs presented as individual patients, rather than among litters, was 74.4 days, significantly lower than for cats (127.0 days, p = 0.003). Further exploration into reasons for later microchipping in cats may be useful in aligning common practice with legislative requirements.

IntroductionIn Australia, general practitioners usually are the first point of contact for patients with non-urgent medical conditions. Appropriate and efficient utilisation of pathology tests by general practitioners forms a key part of diagnosis and monitoring. However overutilisationand underutilisation of pathology tests have been reported across several tests and conditions, despite evidence-based guidelines outlining best practice in pathology testing. There are a limited number of studies evaluating the impact of these guidelines on pathology testing in general practice. The aim of our quantitative observational study is to define how pathology tests are used in general practice and investigate how test ordering practices align with evidence-based pathology guidelines.Methods and analysisAccess to non-identifiable patient data will be obtained through electronic health records from general practices across three primary health networks in Victoria, Australia. Numbers and characteristics of patients, general practices, encounters, pathology tests and problems managed over time will be described. Overall rates of encounters and tests, alongside more detailed investigation between subcategories (encounter year, patient’s age, gender, and location and general practice size), will also be undertaken. To evaluate how general practitioner test ordering coincides with evidence-based guidelines, five key candidate indicators will be investigated: full blood counts for patients on clozapine medication; international normalised ratio measurements for patients on warfarin medication; glycated haemoglobin testing for monitoring patients with diabetes; vitamin D testing; and thyroid function testing.Ethics and disseminationEthics clearance to collect data from general practice facilities has been obtained by the data provider from the RACGP National Research and Evaluation Ethics Committee (NREEC 17–008). Approval for the research group to use these data has been obtained from Macquarie University (5201700872). This study is funded by the Australian Government Department of Health Quality Use of Pathology Program (Agreement ID: 4-2QFVW4M). Findings will be reported to the Department of Health and disseminated in peer-reviewed academic journals and presentations (national and international conferences, industry forums).

Background Accurate pre-operative imaging plays a vital role in patient selection for surgery and in allocating stage-appropriate therapies to patients diagnosed with pancreatic cancer (PC). This study aims to: (1) understand the current diagnosis and staging practices for PC; and (2) explore the factors (barriers and enablers) that influence the use of a pancreatic protocol computed tomography (PPCT) or magnetic resonance imaging (MRI) to confirm diagnosis and/or accurately stage PC. Methods Semi-structured interviews were conducted with radiologists, surgeons, gastroenterologists, medical and radiation oncologists from the states of New South Wales (NSW) and Victoria, Australia. Interviews were conducted either in person or via video conferencing. All interviews were recorded, transcribed verbatim, de-identified and data were thematically coded according to the 12 domains explored within the Theoretical Domains Framework (TDF). Common belief statements were generated to compare the variation between participant responses. Findings In total, 21 clinicians (5 radiologists, 10 surgeons, 2 gastroenterologists, 4 medical and radiation oncologists) were interviewed over a four-month-period. Belief statements relevant to the TDF domains were generated. Across the 11 relevant domains, 20 themes and 30 specific beliefs were identified. All TDF domains, with the exception of social influences were identified by participants as relevant to protocol-based imaging using either a PPCT or MRI, with the domains of knowledge, skills and environmental context and resources being offered by most participants as being relevant in influencing their decisions. Conclusions To maximise outcomes and personalise therapy it is imperative that diagnosis and staging investigations using the most appropriate imaging modalities are conducted in a timely, efficient and effective manner. The results provide an understanding of specialists’ opinion and behaviour in relation to a PPCT or MRI and should be used to inform the design of future interventions to improve compliance with this practice.

Abstract Purpose: Esophageal Adenocarcinoma (EAC) is the second most lethal (&lt;20% five-year survival) and fastest growing (&gt;500% increase in incidence over 40 years) cancer in the U.S. All EAC is believed to arise from a metaplastic esophageal precancer, Barrett’s Esophagus (BE), in at-risk patients with gastroesophageal reflux disease (GERD). Non-dysplastic BE can be monitored for progression to dysplastic BE, which can be ablated endoscopically, reliably halting progression to EAC. Since mortality is high even in early stage EAC (&lt;50% five-year survival), clinical practice guidelines recommend BE screening in GERD patients with multiple risk factors. Since, endoscopic BE screening has failed (&lt;10% compliance with guidelines), recently updated guidelines from both the American College of Gastroenterology and American Gastroenterological Association now support non-endoscopic biomarker screening as an acceptable alternative to endoscopy. EsoCheck®, a noninvasive swallowable balloon capsule catheter device, is the only FDA 510(k)-cleared esophageal cell collection device which permits anatomically targeted and protected sampling of distal esophageal mucosal cells. The sample is collected in a less than five-minute office procedure, without sedation or anesthesia, and sent to a central laboratory for molecular biomarker testing. We report our initial clinical experience using EsoCheck® for collection of esophageal cells in outpatient test centers. Experimental Design: 687 patients underwent EsoCheck® distal esophageal cell sampling by a trained nurse practitioner (average sampled length 5 cm). Patient tolerance was rated on a five-point scale for gag reflex (GR) severity: 1 = no GR; 2 = minimal GR; 3 = mild GR; 4 = severe GR; and 5 = worst GR therefore collection could not be completed. DNA was extracted using the QIAamp DNA Mini kit and quantitated using Qubit™ dsDNA Assay kit. Cytologic assessment using H&E staining was performed on 15 samples. Results: 98% of patients successfully completed the procedure. 88% tolerated it well (rating ≤ 3); 10% experienced severe gagging (rating 4); and only 2% were unable to complete the procedure (rating 5). Average procedure time was 3.5 min (range: 1 min to 15 min). Average DNA yield was 868 ng (range: 0 ng to 19 µg) and 92% yielded at least 100 ng. The samples undergoing cytologic assessment averaged 500,000 cells (range: 100,000 to 2.5 million). Conclusion: Rapid, noninvasive, office-based, anatomically-targeted, and protected sampling of distal esophageal mucosal cells using EsoCheck® can be successfully performed in nearly all patients and is broadly well-tolerated. Cellular and DNA yields were very good and are expected to improve with clinical experience and assay optimization. When combined with a highly sensitive molecular biomarker test, the EsoCheck® device has the potential to significantly improve BE screening compliance and prevent EAC deaths. Citation Format: Suman M. Verma, Ivy T. Le, Abhisek B. Ghosal, Marci L. Hageman, Victoria T. Lee, Brian J. deGuzman, Lishan Aklog. Rapid, noninvasive, office-based, esophageal cell collection for early detection of esophageal precancer and cancer. [abstract]. In: Proceedings of the AACR Special Conference: Precision Prevention, Early Detection, and Interception of Cancer; 2022 Nov 17-19; Austin, TX. Philadelphia (PA): AACR; Can Prev Res 2023;16(1 Suppl): Abstract nr P058.

Background: Compliance with ART treatment is an important indication to improve the quality of life of people dliving with HIV / AIDS (PLWHA), prevent drug resistance, and reduce mortality. One factor that can influence the level of adherence to ART treatment is the self-efficacy of ARV treatment levels.Objectives: To determine the relationship of self-efficacy with adherence to taking medication in men with HIV / AIDS at Victoria Plus Foundation Yogyakarta. Methods: This research is a quantitative correlation with cross sectional approach. The research sample of 35 respondents was determined by probability sampling technique. The research instrument was in the form of a self-efficacy questionnaire and medication adherence. Data analysis techniques using the Kendall Tau test. Results: Self-efficacy in people with HIV / AIDS was in the confident category of 97.1%. Treatment adherence in people with HIV / AIDS is in the category of non-compliance by 80.0%. There is a relationship between self-efficacy and medication adherence in male patients with HIV / AIDS based on pvalue = 0.023. Conclusion: There is a relationship between self-efficacy and medication adherence in male patients with HIV / AIDS at the Victori Plus Foundation in Yogyakarta.

BackgroundThere is an unmet need for new treatments for hand osteoarthritis (OA). Symptomatic hand OA is more common in women and its incidence increases round the age of menopause. Pre-clinical, epidemiological and post hoc studies in Hormone Replacement Therapy (HRT) trials implicate estrogen deficiency as of likely importance in OA aetiopathogenesis. No clinical trials of HRT have been carried out in hand OA to date. The licensed HRT Duavive (conjugated estrogens + SERM bazedoxifene) was selected on its potential for efficacy and tolerability.ObjectivesWe set out to determine the feasibility and acceptability of this form of HRT in post-menopausal women with hand OA, to generate proof of concept data and refine methods for a full study.MethodsISRCTN12196200. Females aged 40-65 yrs and 1-10yrs after final menstrual period with hand OA fulfilling ACR criteria and 2+ painful hand joints were recruited. Eligibility incorporated best practice for HRT prescription but did not require menopausal symptoms. Recruitment was at 3 sites in primary/secondary care, including directly from the community. Design was parallel group, double-blind 1:1 randomisation of Duavive or placebo, orally once daily for 24 weeks, then weaning for 4 weeks before stopping. Routes and rates of recruitment and the acceptability of randomisation, medication (compliance, retention), and proposed outcomes were measured, and the likelihood of unblinding. Measures related to hand pain and function, menopause symptoms and joint appearance. Patient and Public Involvement actively informed study rationale, design and materials. An end of study questionnaire and 2 participant focus groups provided further acceptability data.ResultsRecruitment was for 12/possible 18 months, interrupted due to COVID-19. Some study procedures were modified to allow reopening whilst collecting all primary outcomes. 434 enquiries/referrals were received, leading to 96 telephone pre-screens, of which 33 gave written informed consent and attended face to face screening. 28/33 screened (85%) were eligible and randomised. The highest number of randomisations was from study web presence (n=7) followed by SMS text from GP surgeries (n=5). Of 401 not proceeding, 250 (62%) were ineligible, most commonly due to contraindicated medication, followed by medical contraindication, whilst 55 (14%) decided not to take part, for reasons including not wanting to take a hormone-based drug or difficulty attending study visits. Retention and compliance were excellent. All 28 participants completed all study follow ups, with only 3 withdrawals from treatment due to AEs, 2 of these at week 24 and all in the placebo arm. There were no serious AEs. High levels of completeness of all study outcome measures were achieved. Bang’s blinding index suggested that participants/investigators were well blinded. There were overall high/good levels of satisfaction with taking part in the study. 26/28 (92%) would recommend taking part to others with hand OA (irrespective of study arm). Many found the flexibility offered by a combination of remote and face to face visits (due to the pandemic) attractive. Additional insights from focus groups were to include hand stiffness as well as pain measures but to reduce the overall number of questions.ConclusionDespite COVID-19 and a reduced recruitment period, this study recruited sufficient numbers to assess feasibility outcomes. Randomisation of eligible people and retention rates were high. A mixture of remote and face to face visits due to COVID-19 probably improved recruitment and retention and was supported by participants, who were generally satisfied with the study design and medication. The study provided useful insight and improvements that would be incorporated into a future study. Overall, this feasibility study showed that with clear messaging on eligibility and a defined recruitment strategy, recruitment and retention to a study testing this treatment is possible.AcknowledgementsThis research was funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0416-20023). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. The study team thank the sites and the participants who made this research possible.Disclosure of InterestsJennifer A.E. Williams: None declared, Mae Chester-Jones: None declared, Anne Francis: None declared, Ioana Marian: None declared, Megan Goff: None declared, Gretchen Brewer: None declared, Malvika Gulati: None declared, Lucy Eldridge: None declared, Patrick Julier: None declared, Catherine Minns Lowe: None declared, Vicki Barber: None declared, Victoria Glover: None declared, Charles Mackworth-Young: None declared, Tonia Vincent Consultant of: Pfizer, Grant/research support from: Grant support from Fidia, Biosplice, Novartis, Pfizer as part of their contribution to an international consortium., Sarah E Lamb: None declared, Katy Vincent: None declared, Susan J Dutton: None declared, Fiona E Watt Consultant of: Pfizer, Grant/research support from: Pfizer and from Astellas Pharma (> 3 years ago)

The prevalence of blood-borne viruses (BBV) continues to increase in Australia, as does the need for vigilant infection control. Despite this, some Australian health practitioners demonstrate poor compliance with recommended infection control practices. The aim of this study was to examine the experiences and attitudes of dentists regarding infection control, patients with BBV, occupational risk, and related matters, and identify reasons for non-compliance with infection control guidelines. A purposive sample of 25 Victorian dentists took part in semi-structured interviews between November 2003 and November 2004. Interviews were taped, transcribed and coded for thematic analysis. The majority of participants expressed compliance with standard precautions; however, many admitted to changing their routine infection control practices for patients known or assumed to have a BBV. Approximately half disclosed minor changes, such as double gloving; a small minority reported having treated people with a BBV at the end of a session. Most participants experienced apprehension about the risk of occupational exposure to BBV and admitted this as the reason for changing infection control practices. Reasons offered by participants for poor compliance included ignorance of either the effectiveness of standard precautions or BBV transmission, or confusion and frustration regarding inadequate or impractical infection control guidelines. It is suggested that infection control guidelines be specifically designed for dental practice, and that these be promoted in both undergraduate dental education and professional development.

Patient rehabilitation advice (PRA) is commonly used amongst a variety of health care practitioners to aid and enhance the recovery of their patients. Research has demonstrated a positive relationship between the level of adherence to PRA recovery from a variety of musculoskeletal conditions, and has shown non-compliance to home-based exercise programs reduces the probability of successful outcome for therapeutic intervention. No previous research has focused on compliance to prescription and methods of prescription used in the osteopathic medicine setting. As exercise has shown to augment treatment efficacy and speed of recovery, it is important that osteopaths are informed of the current likely adherence rate to PRA and all factors that may cause non-compliance to their exercise prescription. The overall compliance rate to PRA at VUOMC is comparable with previous studies, with the use of diagrams being the least utilised but most effective method of prescription in the VUOMC setting. This study provides a basis for understanding exercise prescription implications that are important both to osteopaths and osteopathic patients in enhancing treatment results in terms of speed and efficacy, as well as potentially reducing treatment costs to both patients and third party payers. This minor thesis was written by a post-graduate student as part of the requirements of the Master of Health Science (Osteopathy) program.

Patient rehabilitation advice (PRA) is commonly used amongst a variety of health care practitioners to aid and enhance the recovery of their patients. Research has demonstrated a positive relationship between the level of adherence to PRA recovery from a variety of musculoskeletal conditions, and has shown non-compliance to home-based exercise programs reduces the probability of successful outcome for therapeutic intervention. No previous research has focused on compliance to prescription and methods of prescription used in the osteopathic medicine setting. As exercise has shown to augment treatment efficacy and speed of recovery, it is important that osteopaths are informed of the current likely adherence rate to PRA and all factors that may cause non-compliance to their exercise prescription. The overall compliance rate to PRA at VUOMC is comparable with previous studies, with the use of diagrams being the least utilised but most effective method of prescription in the VUOMC setting. This study provides a basis for understanding exercise prescription implications that are important both to osteopaths and osteopathic patients in enhancing treatment results in terms of speed and efficacy, as well as potentially reducing treatment costs to both patients and third party payers. This minor thesis was written by a post-graduate student as part of the requirements of the Master of Health Science (Osteopathy) program.

The prescription of patient rehabilitation advice (PRA) encompassing exercises or stretches prescribed for completion external to a manual therapy consultation time is often condition specific and varies in accordance to a patient's diagnosis in order to produce a more successful outcome over a shorter duration. Previous research has investigated this problem in physiotherapy fields, but as yet has not been undertaken in an osteopathic setting. This study attempted to compare verbal and diagrammatic PRA prescription in the Victoria University Osteopathic Medicine Clinic (VUOMC) to new patients at this clinic. This study demonstrated that diagrammatic PRA prescription was more successful than verbal presricption when used at the VUOMC. The use of the diagrammatic PRA modality should assist the osteopathic practitioner to gain greater compliance and potentially better outcomes for the patient. This minor thesis was written by a post-graduate student as part of the requirements of the Master of Health Science (Osteopathy) program.

The prescription of patient rehabilitation advice (PRA) encompassing exercises or stretches prescribed for completion external to a manual therapy consultation time is often condition specific and varies in accordance to a patient's diagnosis in order to produce a more successful outcome over a shorter duration. Previous research has investigated this problem in physiotherapy fields, but as yet has not been undertaken in an osteopathic setting. This study attempted to compare verbal and diagrammatic PRA prescription in the Victoria University Osteopathic Medicine Clinic (VUOMC) to new patients at this clinic. This study demonstrated that diagrammatic PRA prescription was more successful than verbal presricption when used at the VUOMC. The use of the diagrammatic PRA modality should assist the osteopathic practitioner to gain greater compliance and potentially better outcomes for the patient. This minor thesis was written by a post-graduate student as part of the requirements of the Master of Health Science (Osteopathy) program.