Internal medicine journal
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Internal medicine journal · Nov 2023
Aspirin deprescribing in primary prevention of cardiovascular disease: a prospective risk-benefit approach.
Current evidence and practice guidelines do not recommend aspirin for primary prevention of cardiovascular disease (CVD). Insufficient all-cause mortality benefits juxtaposed to increased gastrointestinal bleeding rates are well established. Pharmacists are well placed to assess the clinical appropriateness of aspirin in CVD and initiate deprescribing as required with medical colleagues. ⋯ This study described an impactful pharmacist-led initiative utilising a validated aspirin-specific tool to conduct risk-benefit analysis to reduce potential major bleeding associated with inappropriate aspirin use.
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Internal medicine journal · Nov 2023
Tunnelled central venous catheters for incident haemodialysis patients - a Victorian survey exploring reasons for use.
Tunnelled central venous catheters (T-CVCs) are used globally as vascular access for patients on haemodialysis (HD) but are associated with increased sepsis, mortality, cost and length of hospitalisation compared with more permanent HD vascular access. The reasons for using T-CVC are varied and poorly understood. A significant and increasing proportion of incident HD patients in Victoria, Australia, have required T-CVC over the last decade. ⋯ These survey results provide an opportunity for quality improvement initiatives with respect to dialysis access planning and care.