Internal medicine journal
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Internal medicine journal · Apr 2014
Randomized Controlled Trial Multicenter Study Comparative StudyEvidence-based prescribing of drugs for secondary prevention of acute coronary syndrome in Aboriginal and non-Aboriginal patients admitted to Western Australian hospitals.
To assess the level of evidence-based drug prescribing for acute coronary syndrome (ACS) at discharge from Western Australian (WA) hospitals and determine predictors of such prescribing in Aboriginal and non-Aboriginal patients. ⋯ Opportunity exists to improve prescribing of recommended drugs for ACS patients at discharge from WA hospitals in both Aboriginal and non-Aboriginal patients. Attention regarding pharmaceutical management post-ACS is particularly required for patients from rural and remote areas, and those attending district and private hospitals.
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Internal medicine journal · Apr 2014
ReviewMedicine's inconvenient truth: the placebo and nocebo effect.
Placebo and nocebo effects are often regarded by clinicians as either a quaint reminiscence from the pre-therapeutic era, or simply as a technique for establishing the efficacy of therapeutic interventions within the locus of evidence-based practice. However, neither of these explanations sufficiently account for their complexity or their persistence and impact in clinical medicine. ⋯ We describe how recent biological and neuropsychiatric data have clarified the operation of placebo and nocebo effects in clinical practice - demonstrating the ability of the therapeutic context to modulate endogenous biological processes in a targeted manner. This, in turn, illustrates the potent philosophical and sociocultural aspects of medical praxis.
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Internal medicine journal · Apr 2014
ReviewKnowledge and attitudes regarding the personally controlled electronic health record: an Australian national survey.
The personally controlled electronic health record (PCHER) was designed to bring important information together to facilitate effective communication between clinicians and so improve patient care. This national cross-sectional survey of 405 healthcare providers and consumers found that they had relatively low awareness and knowledge about the PCEHR; that 62% of respondents believed that healthcare providers with access to the PCEHR would be able to provide better quality of care but only 50% of respondents would sign up to have a PCEHR.
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Internal medicine journal · Apr 2014
Internal medicine in the bush: a clinical audit of a rural and remote outreach programme.
Provision of internal medicine services in rural Australia is always problematic. ⋯ In providing an outreach service to a mixed community, flexibility in both setting and personnel are essential. Diabetes and liver disease are highly prevalent in indigenous patients, but the low numbers presenting for hepatitis C requires further study.
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Internal medicine journal · Apr 2014
Multicenter StudyCare of the dying cancer patient in the emergency department: findings from a National survey of Australian emergency department clinicians.
Patients with cancer are presenting to emergency departments (ED) for end-of-life care with increasing frequency. Little is known about this experience for patients and ED clinicians in Australia. ⋯ Our findings provide important new insights into a growing area of care for ED. Barriers and enablers to optimal care of the dying patient in ED were identified, and especially the reported high occurrence of futile care, likely a result of these barriers, is detrimental to both optimal patient care and allocation of valuable healthcare resources.