Internal medicine journal
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Internal medicine journal · Oct 2020
Anticoagulant prescribing in patients with ischaemic stroke: what has changed over a decade?
A study at our institution conducted 10 years ago identified that warfarin was under-utilised in patients with atrial fibrillation. We replicated this study and compared the results. ⋯ Seventy-two percent of treated patients were prescribed a direct oral anticoagulant. Of these, 10% were discharged with a sub-therapeutic dose without obvious explanation.
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Internal medicine journal · Oct 2020
Ecologically enhanced healthcare at the Mater hospitals: the intersection between sustainable delivery, Pope Francis' care of the common home and indigenous land care in an era of climate challenges.
The changes we are causing to our global environment now threaten everyone's health. As such, health systems and professionals should consider environmental sustainability as part of good health and care. ⋯ High-quality healthcare depends on addressing the social and environmental determinants of health and disease, more so in rural and indigenous areas. The Mater Hospital's reconciling Francis' global holistic approach to local Aboriginal expertise addresses both needs at the same time.
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Internal medicine journal · Oct 2020
ReviewDeprescribing long-term opioid therapy in patients with chronic pain.
Proposed regulatory changes will limit the access to opioids by Australian patients with chronic pain, many of whom are under the care of consultant physicians. This review summarises points of consensus on opioid deprescribing that emerged from the interaction of an expert panel and the audience at a symposium on the topic held in Sydney in 2019. Each of these consensus points speaks to the need for an individualised, patient-centred approach. In other words, 'treat the patient, not the pill count'.
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Internal medicine journal · Oct 2020
Planning and clinical role of acute medical home care services for COVID-19 - consensus position statement by the Hospital-in-the-Home Society Australasia.
During a pandemic when hospitals are stretched and patients need isolation, the role of hospital-in-the-home (HITH) providing acute medical care at home has never been more relevant. We aimed to define and address the challenges to acute home care services posed by the COVID-19 pandemic. ⋯ Planning for clinical care involves maximising cohorts of patients without COVID-19 and new clinical pathways for patients with COVID-19. The risk of SARS-CoV-2 transmission, specific COVID-19 clinical pathways and the well-being of patients and staff should be addressed in advance.