Internal medicine journal
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Internal medicine journal · Nov 2024
Comparative StudyEnvironmental impact of pressurised metered dose inhalers versus dry powder and soft mist inhalers at a tertiary Melbourne hospital.
The carbon footprint of devices to deliver inhaled respiratory medications has come into focus as climate change has been identified as a worldwide emergency. Metered dose inhalers (MDIs) contain hydrofluorocarbons that have significant global warming potential compared to dry powder inhalers (DPIs) and soft mist inhalers (SMIs), which do not use a propellant gas. A 12-month pharmacy inpatient dispensing audit demonstrated that inpatient MDI use significantly outweighed that of DPIs and SMIs and accounted for approximately 99% of inhaler-related greenhouse gas emissions at our hospital.
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Internal medicine journal · Nov 2024
Observational StudyOutcomes of a patient support programme for subcutaneous immunoglobulin therapy in patients with primary or secondary immunodeficiencies or chronic inflammatory demyelinating polyneuropathy.
Subcutaneous immunoglobulin (SCIg) therapy is important in the treatment of primary (PID) and secondary immunodeficiencies (SID) and chronic inflammatory demyelinating polyneuropathy (CIDP). Patient support programmes (PSPs) help patients self-administer medication regimens and play a more active role in the self-management of their medical conditions. ⋯ This is the largest real-world evidence study that describes the effectiveness of SCIg PSPs across three therapeutic disease states. These PSPs can optimise hospital resources such as infusion nurse time and allocation of infusion chairs that were once used for intravenous immunoglobulin infusions, improve patient access to SCIg therapy and enable patients self-administer SCIg outside a hospital environment.
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Internal medicine journal · Nov 2024
Are our patients becoming more complex? Trends in comorbidity and functional dependence in General Medicine 2011-2019.
Anecdotally, patients don't seem to be more unwell than they were 10 years ago, yet they still seem more 'complex'. ⋯ Despite a stable level of comorbidity, our finding of a decreasing BS score may suggest that patients are becoming more dependent. This increase in dependency rather than a change in chronic disease burden may be the cause of apparent increasing patient complexity.
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Internal medicine journal · Nov 2024
Medicine Access Programmes: what do patients think - a patient-reported outcome study on ribociclib in metastatic breast cancer in Australia.
This study evaluated patient-reported outcomes (PROs) of Medicine Access Programmes (MAPs) for Australian metastatic breast cancer patients on ribociclib. Limited patient awareness of MAP enrolment was identified, emphasising the need for improved education and consent processes. Most patients expressed gratitude for accessing non-funded medications and perceived enhanced medication adherence as a key benefit. Integrating PRO data with real-world registry data provides comprehensive insight for future MAP development.
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Internal medicine journal · Nov 2024
Pregnancy outcomes in Australian patients with systemic lupus erythematosus.
Systemic lupus erythematosus (SLE) affects women, with the onset of disease typically around the childbearing years. ⋯ This study shows a considerable incidence of APO in patients with SLE, emphasising the need for pre-pregnancy counselling and collaboration between maternal-foetal medicine specialists and rheumatologists, especially for women diagnosed with SLE at a younger age.