Internal medicine journal
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Internal medicine journal · Dec 2023
Polypharmacy in older patients presenting to a tertiary regional health service: identifying correlations between demographics, presentations and length of stay.
This study aimed to describe hospital admissions in patients experiencing polypharmacy and evaluate the effects of demographic factors on length of stay (LOS) and polypharmacy. We found that increasing age is associated with increasing polypharmacy rates but decreasing LOS. ⋯ First Nations peoples had higher rates of polypharmacy and longer LOS. Future projects investigating deprescribing methods are critical.
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Internal medicine journal · Dec 2023
Mixed insulin can improve control of prednisolone-induced hyperglycaemia.
Hyperglycaemia is a common side effect of prednisolone, although there are no widely accepted guidelines for the management of glucocorticoid-induced hyperglycaemia (GIH). Our institution uses mixed insulin in a pre-breakfast or pre-breakfast and pre-lunch regimen, with the rationale that this profile of insulin action matches the physiological effect of prednisolone on blood glucose levels (BGLs). ⋯ Mixed insulin as a pre-breakfast or pre-breakfast and pre-lunch regimen can target the hyperglycaemic pattern induced by prednisolone and minimise overnight hypoglycaemia. However, higher doses of insulin than those used in our study are likely required for optimal BGL control.
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Internal medicine journal · Dec 2023
Understanding the contribution of general medical services to acute inpatient care in Victorian public hospitals.
General medicine is an integral part of health services, yet there is little data highlighting their contribution to acute hospital care in Australia. ⋯ Both DRG-based data and discharge unit-based data indicate that general medicine is the largest provider of acute multiday inpatient care in Victorian hospitals. The estimate of contribution of general medicine differed between the two datasets as DRG data likely over-represents the role of other specialties possibly due to assumptions regarding specialty management of varying groups of diagnoses.
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Internal medicine journal · Dec 2023
The characteristics and perceptions to utilising Telehealth of predominantly middle-aged to older, metropolitan-based general medical patients.
Effective post-pandemic telehealth (TH) requires understanding patients' characteristics and perceptions, which have not been established in broader clinical services and are independent of TH appointments. ⋯ From predominantly middle-aged to older, metropolitan-based general medical patients completing the survey, most patienpreferred face-to-face appointments to TH. Health services should subsidise those in need of TH and target the patients' barriers to effective TH use.
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Internal medicine journal · Dec 2023
DKA/HHS insulin infusion protocol adherence and patient outcomes in Shellharbour Hospital.
Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS) are medical emergencies requiring prompt assessment and management to avoid complications. ⋯ This audit highlights areas in DKA/HHS management requiring improvement. These include fluid and potassium replacement and appropriate overlap between subcutaneous insulin and insulin infusion.