Internal medicine journal
-
Inappropriate polypharmacy and its associated harm pose a significant threat to older patients. The prescribing decisions of physicians greatly influence what other practitioners prescribe. Minimising medication-related harm requires physicians to adopt a systematic approach to the deliberate and judicious deprescribing of potentially inappropriate medicines in at-risk individuals.
-
Internal medicine journal · Mar 2015
Thromboprophylaxis in patients undergoing total hip and knee arthroplasty: a review of current practices in an Australian teaching hospital.
Venous thromboembolism (VTE) remains a cause of significant morbidity and mortality following total hip arthroplasty (THA) and total knee arthroplasty (TKA). Prophylaxis significantly reduces the rate of VTE following these procedures. Previous studies report suboptimal uptake of guideline recommended thromboprophylaxis. ⋯ The proportion of study patients receiving thromboprophylaxis compares favourably with prior research. The overall incidence of VTE is higher than that demonstrated in major orthopaedic trials. Inadequate duration of chemoprophylaxis remains a potential area of improvement. Extended prophylaxis should be prescribed as per current guidelines. Comparison between efficacy and safety of various agents is the subject of future research.
-
Internal medicine journal · Mar 2015
ReviewTreatment of patients with multiple myeloma who are not eligible for stem cell transplantation: position statement of the myeloma foundation of Australia Medical and Scientific Advisory Group.
Options for treatment of elderly patients with multiple myeloma have expanded substantially following the development of immunomodulatory drugs (IMiD), proteasome inhibitors and with enhancement in safety of high-dose therapy and autologous stem cell transplant (HDT + ASCT). The recognition of biological heterogeneity among elderly patients has made delivery of therapy more challenging. An individualised approach to treatment selection is recommended in an era in which highly efficacious treatment options are available for transplant-ineligible patients. Here, we summarise recommendations for patients who are considered unsuitable for HDT + ASCT, including pretreatment considerations, and induction, maintenance and supportive care therapies.