Ten Terms in the Realm of Quaternary Prevention
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Depression and Antidepressants in Australia and Beyond - a Critical Public Health Analysis Melissa Raven University of Wollongong
University of Wollongong Research Online University of Wollongong Thesis Collection University of Wollongong Thesis Collections 2012 Depression and antidepressants in Australia and beyond - a critical public health analysis Melissa Raven University of Wollongong Recommended Citation Raven, Melissa, Depression and antidepressants in Australia and beyond - a critical public health analysis, Doctor of Philosophy thesis, Faculty of Arts, University of Wollongong, 2012. http://ro.uow.edu.au/theses/3686 Research Online is the open access institutional repository for the University of Wollongong. For further information contact the UOW Library: [email protected] Depression and antidepressants in Australia and beyond A critical public health analysis A thesis submitted in fulfilment of the requirements for the award of the degree Doctor of Philosophy from UNIVERSITY OF WOLLONGONG by Melissa Raven BA(Hons), MPsych(Clin), MMedSci(ClinEpid) Faculty of Arts 2012 ii Certification I, Melissa Raven, declare that this thesis, submitted in fulfilment of the requirements for the award of Doctor of Philosophy, in the Faculty of Arts, University of Wollongong, is wholly my own work unless otherwise referenced or acknowledged. The document has not been submitted for qualifications at any other academic institution. Melissa Raven 5 July 2012 iii iv Concise table of contents List of acronyms .................................................................................... xiii Abstract .................................................................................................. -
Polypharmacy and the Senior Citizen: the Influence of Direct-To-Consumer Advertising
2021;69:19-25 CLINICAL GETRIATRICS - ORIGINAL INVESTIGATION doi: 10.36150/2499-6564-447 Polypharmacy and the senior citizen: the influence of direct-to-consumer advertising Linda Sperling, DHA, MSN, RN1, Martine B. Fairbanks, Ed.D, MA, BS2 1 College of nursing, University of Phoenix, Arizona, USA; 2 College of doctoral studies, University of Phoenix, Arizona, USA Background. Polypharmacy, or taking five or more medications dai- ly, can lead to poor medication compliance and an increased risk for adverse drug-to-drug interactions that may eventually lead to death. The study was designed to explore the questions of how age, the re- lationship between the physician and patient, and television, radio, magazines and modern electronic technology, such as the Internet, affect patients’ understanding of their medical care. Two main areas addressed in this research study included the pharmaceutical indus- try’s influence on consumer decisions to ask a physician for a particular medication, and the prescribing practices of the physician. Methods. This qualitative phenomenological study began with pre- screening volunteer residents in a nursing home to discover poten- tial participants who met the criteria of using five or more medicines daily. We then interviewed 24 participants who met the criteria, using semi-structured interview questions. Results. Four core themes emerged from this study: professional trust, professional knowledge, communication deficit, and direct-to-consum- Received: April 30, 2020 er advertising. Participants reported trusting their doctors and taking Accepted: November 2, 2020 medications without question, but most knew why they were taking the Correspondence medications. Participants also reported seeing ads for medications, but Linda Sperling DHA, MSN, RN only one reported asking a physician to prescribe the medication. -
2019 Abstract Book
2019 NATIONAL MEETING / ÉDITION 2019 DU CONGRÈS ANNUEL: TAKING ACTION LE SURDIAGNOSTIC : PASSEZ À L’ACTION ABSTRACT BOOK CAHIER DES RÉSUMÉS Dear National Meeting Attendees, We are excited to be hosting the National Meeting in Montreal, Quebec and for the first time featuring both English and French sessions. I would like to thank our co-host, the Quebec Medical Association and our partner, the Canadian Medical Association for their contributions to this year’s event. The 2019 National Meeting includes a special celebration marking the fifth anniversary of the Choosing Wisely Canada campaign. I am thrilled to celebrate this important milestone with the Choosing Wisely Canada community and recognize our collective efforts in reducing unnecessary tests and treatments. In the past five years, Choosing Wisely Canada has evolved from a conversation between clinicians and patients to the national voice for reducing unnecessary tests and treatments in health care. There has been unparalleled engagement and dedication from clinicians, administrators, researchers and systems leaders. There are close to 350 quality improvement projects related to the campaign taking root across the country and 12 active provincial and territorial campaigns to help accelerate the pace of change locally. As Chair of Choosing Wisely Canada, I am proud of the sizable impact our community has had in Canada and the momentum the campaign has gained. This year’s theme Taking Action is reflective of our next chapter of the campaign. The abstracts featured in this book are a testament to the breadth of projects taking place from coast-to-coast and showcase the energy of our community in putting campaign recommendations into practice. -
Overdiagnosis and Overtreatment Over Time
University of Massachusetts Medical School eScholarship@UMMS Family Medicine and Community Health Publications and Presentations Family Medicine and Community Health 2015-6 Overdiagnosis and overtreatment over time Stephen A. Martin University of Massachusetts Medical School Et al. Let us know how access to this document benefits ou.y Follow this and additional works at: https://escholarship.umassmed.edu/fmch_articles Part of the Community Health and Preventive Medicine Commons, Diagnosis Commons, Family Medicine Commons, Preventive Medicine Commons, and the Primary Care Commons Repository Citation Martin SA, Podolsky SH, Greene JA. (2015). Overdiagnosis and overtreatment over time. Family Medicine and Community Health Publications and Presentations. https://doi.org/10.1515/dx-2014-0072. Retrieved from https://escholarship.umassmed.edu/fmch_articles/318 Creative Commons License This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License. This material is brought to you by eScholarship@UMMS. It has been accepted for inclusion in Family Medicine and Community Health Publications and Presentations by an authorized administrator of eScholarship@UMMS. For more information, please contact [email protected]. Diagnosis 2015; 2(2): 105–109 Opinion Paper Open Access Stephen A. Martin*, Scott H. Podolsky and Jeremy A. Greene Overdiagnosis and overtreatment over time Abstract: Overdiagnosis and overtreatment are often Introduction thought of as relatively recent phenomena, influenced by a contemporary combination of technology, speciali- In recent years, an increasing number of clinicians, jour- zation, payment models, marketing, and supply-related nalists, health service researchers, and policy-makers demand. Yet a quick glance at the historical record reveals have drawn attention to the problems of overdiagnosis that physicians and medical manufacturers have been and the overtreatment that it so often engenders [1, 2]. -
Opioid Weaning Guidance Document Primary Care GENERAL CONSIDERATIONS: 1
Opioid Weaning Guidance Document Primary Care GENERAL CONSIDERATIONS: 1. Determine if the goal is a dose reduction or complete discontinuation of agent(s). 2. Weans should occur gradually to minimize the risk of withdrawal symptoms. Weaning opioids may take 6 months or more depending on the total opioid dose and the individual patient’s response to the opioid wean. There is no need to rush this process as this may only cause more distress for the patient. 3. Optimize non-opioid pain management strategies. This link provides options for non-opioid strategies: https://www.cdc.gov/drugoverdose/pdf/alternative_treatments-a.pdf a. Recommend implementing one non-opioid agent at a time b. Evaluate and discontinue any agents that are ineffective c. Do not exceed maximum recommended doses or combine multiple agents from the same medication class d. Avoid use of benzodiazepines or any sedative hypnotic agents 4. Set expectations and functional goals with patient prior to initiation of the opioid wean. 5. Educate patient on the change in opioid tolerance over time during the opioid wean and risk for overdose if they resume their starting dose or a previously stable higher dose. Discuss/prescribe naloxone to minimize the risk of overdose. 6. Screen for and treat any untreated/under-treated depression. Depression may make the weaning process more challenging. MORPHINE EQUIVALENT DOSE CALCULATOR: 1. Link to calculator: http://www.agencymeddirectors.wa.gov/Calculator/DoseCalculator.htm 2. This calculator can be utilized to determine the current morphine equivalent dose your patient is receiving at baseline. If the goal is for opioid dose reduction, this calculator can also be used to determine your goal “ending” dose. -
BMJ Open Is Committed to Open Peer Review. As Part of This Commitment We Make the Peer Review History of Every Article We Publish Publicly Available
BMJ Open: first published as 10.1136/bmjopen-2017-018448 on 27 December 2017. Downloaded from BMJ Open is committed to open peer review. As part of this commitment we make the peer review history of every article we publish publicly available. When an article is published we post the peer reviewers’ comments and the authors’ responses online. We also post the versions of the paper that were used during peer review. These are the versions that the peer review comments apply to. The versions of the paper that follow are the versions that were submitted during the peer review process. They are not the versions of record or the final published versions. They should not be cited or distributed as the published version of this manuscript. BMJ Open is an open access journal and the full, final, typeset and author-corrected version of record of the manuscript is available on our site with no access controls, subscription charges or pay- per-view fees (http://bmjopen.bmj.com). If you have any questions on BMJ Open’s open peer review process please email [email protected] http://bmjopen.bmj.com/ on September 25, 2021 by guest. Protected copyright. BMJ Open: first published as 10.1136/bmjopen-2017-018448 on 27 December 2017. Downloaded from BMJ Open Overdiagnosis across medical disciplines: a systematic review ForJournal: peerBMJ Open review only Manuscript ID bmjopen-2017-018448 Article Type: Research Date Submitted by the Author: 29-Jun-2017 Complete List of Authors: Jenniskens, Kevin; University Medical Center, Utrecht , Julius Center -
20–22 September 2016 BARCELONA
20–22 September 2016 BARCELONA PREVENTING OVERDIAGNOSIS • 1 WORKSHOP ABSTRACTS Preventing Overdiagnosis 2016 Conference Hosts Notice of photography and filming Preventing Overdiagnosis 2016 is being visually documented. By attending you acknowledge that you have been informed that you may be caught on camera during this event. Images taken will be treated as the property of Preventing Overdiagnosis and may be used in the future for promotional purposes. These images may be used without limitation by any organisation approved by the PODC Committee and edited prior to publication as seen fit for purpose. Images will be available on the internet accessible to internet users throughout the world including countries that may have less extensive data protection than partnering countries. All films and images will be securely stored on University of Oxford servers. Please make yourself known at registration if you wish to remain off camera. 2 • PREVENTING OVERDIAGNOSIS HOLA I BENVINGUTS! HELLO AND WELCOME! to the 4th international conference on Preventing Overdiagnosis We are delighted to welcome everyone to the conference here in Barcelona, and a warm thank you for coming. This year we have delegates attending from 30 countries, across all continents on earth. Overdiagnosis and overtreatment are challenges to all health systems around the world and this conference is a truly international collaborative event to address the important challenges facing all of us. Most of the conference will take place in English, but each day there will also be parallel sessions in Spanish. Together we will work to better understand the causes and consequences of overdiagnosis, and discuss a range of interventions to move forward with preventing it. -
Qato Et Al, “Changes in Prescription and Over-The-Counter Medi
Polypharmacy: time to get beyond numbers Invited commentary on: Qato et al, “Changes in prescription and over-the-counter medication and dietary supplement use among older adults in the United States, 2005 vs 2011” and Jou et al, “Non-disclosure of complementary and alternative medicine (CAM) use to usual care providers: Findings from the 2012 National Health Interview Survey” Michael A. Steinman, MD Division of Geriatrics, University of California, San Francisco and the San Francisco VA Health Care System Word count: 1023 References: 7 Support: Supported by grants from the National Institute on Aging (K24-AG049057-01 and P30- AG044281) Acknowledgement / Disclosure: Dr. Steinman is a consultant for iodine.com, an internet start-up company. Corresponding author: Michael A. Steinman, MD 4150 Clement St, VA Box 181G San Francisco, CA 94121 [email protected] When I tell someone that I am a geriatrician, I often get the same response. I am told half- jokingly that the person needs my services. Then, I am regaled with a story of how the person’s older parent, grandparent, or spouse is prescribed an enormous number of medications, thinks they might be causing problems, and doesn’t know what to do about it. It is this view of polypharmacy that often dominates patients’, and increasingly clinicians’, experience of medication use. This skeptical perspective is largely justified. The number of medications a person uses is by far the strongest risk factor for medication-related problems. As the number of medications rises, adverse drug reactions become more common. Adherence worsens. Out-of-pocket costs rise. -
“Reducing Health Care Costs: Promoting Administrative Simplification and Efficiency”
“Reducing Health Care Costs: Promoting Administrative Simplification and Efficiency” by Matt Eyles President and CEO America’s Health Insurance Plans for the Senate Committee on Health, Education, Labor, and Pensions July 31, 2018 Chairman Alexander, Ranking Member Murray, and members of the committee, I am Matt Eyles, President and CEO of America’s Health Insurance Plans (AHIP). AHIP is the national association whose members provide coverage for health care and related services to millions of Americans every day. Through these offerings, we improve and protect the health and financial security of consumers, families, businesses, communities, and the nation. We are committed to market-based solutions and public-private partnerships that improve affordability, value, access, and well-being for consumers. We appreciate this opportunity to testify on our industry’s leadership in simplifying health care and in efforts to protect patients; support doctors and hospitals in delivering high quality, evidence-based care; and reduce administrative costs. Our members are strongly committed to working with clinicians and hospitals to reduce complexity, improve value and patient health, and increase patient satisfaction. Americans deserve affordable coverage choices that help to improve their health and financial security. To advance this goal, health insurance providers invest in a wide range of initiatives— some of which involve administrative spending—to improve patient care, enhance health outcomes, and protect patients from receiving inappropriate or unnecessary health care services and treatments that provide little to no value. Health insurance providers don’t just pay medical bills—we’re partners, dedicated to better health and well-being for consumers. We believe all patients should be treated with safe, effective care. -
Deprescribing
A GUIDE TO deprescribing OPIOIDS KEY POINTS CONTEXT This guide considers the use of opioid medications U Opioid therapy is not indicated for the long- in the treatment of chronic non-cancer pain. term management of chronic non-cancer pain. U Opioid treatment of chronic non-cancer RECOMMENDED pain does not seem to fulfil any of the key DEPRESCRIBING STRATEGY opioid treatment goals: pain relief, improved quality of life and improved functional Deprescribing or tapering of opioids is more likely to be successful when the person is aware of the issues with capacity. long term opioid use. U Opioids are playing a diminishing role in the A number of consumer resources are available to assist modern management of chronic pain. with management of chronic pain. A good quality Australian resource is available through the Hunter U Multidisciplinary pain management Integrated Pain Service at www.hnehealth.nsw.gov.au/ programs utilising psychology, exercise and pain/. functional-based outcomes result in better There are multiple sections written for consumers on quality of life and better pain management understanding chronic pain, and understanding five key than use of opioids. treatment areas: Biomedical, Mindbody, Connection, Activity and Nutrition. U Tolerance to the analgesic effects of opioids People with chronic non-cancer pain taking long term develops in almost all people with long term oral morphine milligram equivalent of: use. U 120mg or more daily should be considered for opioid deprescribing. This will usually include dose reduction U Long term opioid use is associated with with or without opioid rotation accompanied by serious adverse hormonal and psychological appropriate education and information. -
2020 Generated On: 09/25/2020, 9:54:14 AM
Pepper_Annual_Boston_2019-2020 Generated on: 09/25/2020, 9:54:14 AM BOSTON PEPPER CENTER Claude D. Pepper Older Americans Independence Center Principal Investigator Shalender Bhasin, M.D. Program Administrator Molly Lukas [email protected] I. CENTER DESCRIPTION The Boston OAIC is unique in its thematic focus on Function Promoting Therapies (FPTs) and its positioning across the entire spectrum of translational science from mechanism elucidation, preclinical proof-of-concept studies, biomarker validation, epidemiologic investigation to randomized trials of FPTs. The Boston OAIC integrates 19 NIH-funded studies of function promoting therapies, 3 Research Education Component projects, 3 pilot projects, and 3 developmental projects into an interdisciplinary program that is supported by a Leadership and Administrative Core, a Research Education Component (REC), a Pilot and Exploratory Studies Core (PESC), and 3 resource cores (Function Assessment Core, Preclinical Discovery Core, Biostatistical and Data Analysis Core). Our REC and PESC candidates include several rising stars in Geriatrics and Gerontology, including 3 Beeson and K grant awardees. The REC will recruit the most promising stars from a vast reservoir of talent at Harvard, Tufts and BU, and train them through a didactic education and mentored research program. Integration will be achieved by the PROMOTE Program that includes a research concierge service, research meetings, annual retreats, a website and a newsletter. The Boston OAIC is well integrated with the the Harvard Geriatrics and Gerontology research community and programs, including its T32 training grant, Harvard Clinical Translational Science Institute, the Roybal Center, The New England Geriatrics Research Clinical Education Center, and the Glenn Foundation Center for Biology of Aging. -
Screening for Social Needs: Guiding Care Teams to Engage Patients
Screening for Social Needs: Guiding Care Teams to Engage Patients ©2019 American Hospital Association | www.aha.org 1 Screening for Social Needs: Guiding Care Teams to Engage Patients Table of Contents Foreword .......................................................................................................................... 3 Background ....................................................................................................................... 4 Challenges in Screening for Social Needs ........................................................................ 4 Guiding Principles for Screening ....................................................................................... 6 Implementing Social Needs Screening ............................................................................. 7 Patient-centered Conversations about Social Needs ........................................................ 9 Referral Process for Positive Screens ............................................................................. 10 Tailoring Screenings ......................................................................................................... 11 Strategies to Scale Screenings ........................................................................................ 11 Conclusion ...................................................................................................................... 13 References ....................................................................................................................