scholarly journals Travel Medicine Encounters of Australian General Practice Trainees—A Cross-Sectional Study

2015 ◽  
Vol 22 (6) ◽  
pp. 375-382 ◽  
Author(s):  
Simon Morgan ◽  
Kim M. Henderson ◽  
Amanda Tapley ◽  
John Scott ◽  
Mieke L. van Driel ◽  
...  
BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039625
Author(s):  
Jason I Chiang ◽  
John Furler ◽  
Frances Mair ◽  
Bhautesh D Jani ◽  
Barbara I Nicholl ◽  
...  

ObjectivesTo explore the prevalence of multimorbidity as well as individual and combinations of long-term conditions (LTCs) in people with type 2 diabetes (T2D) attending Australian general practice, using electronic health record (EHR) data. We also examine the association between multimorbidity condition count (total/concordant(T2D related)/discordant(unrelated)) and glycaemia (glycated haemoglobin, HbA1c).DesignCross-sectional study.SettingAustralian general practice.Participants69 718 people with T2D with a general practice encounter between 2013 and 2015 captured in the MedicineInsight database (EHR Data from 557 general practices and >3.8 million Australian patients).Primary and secondary outcome measuresPrevalence of multimorbidity, individual and combinations of LTCs. Multivariable linear regression models used to examine associations between multimorbidity counts and HbA1c (%).ResultsMean (SD) age 66.42 (12.70) years, 46.1% female and mean (SD) HbA1c 7.1 (1.4)%. More than 90% of participants with T2D were living with multimorbidity. Discordant conditions were more prevalent (83.4%) than concordant conditions (69.9 %). The three most prevalent discordant conditions were: painful conditions (55.4%), dyspepsia (31.6%) and depression (22.8%). The three most prevalent concordant conditions were hypertension (61.4%), coronary heart disease (17.1%) and chronic kidney disease (8.5%). The three most common combinations of conditions were: painful conditions and hypertension (38.8%), painful conditions and dyspepsia (23.1%) and hypertension and dyspepsia (22.7%). We found no associations between any multimorbidity counts (total, concordant and discordant) or combinations and HbA1c.ConclusionsMultimorbidity was common in our cohort of people with T2D attending Australian general practice, but was not associated with glycaemia. Although we did not explore mortality in this study, our results suggest that the increased mortality in those with multimorbidity and T2D observed in other studies may not be linked to glycaemia. Interestingly, discordant conditions were more prevalent than concordant conditions with painful conditions being the second most common comorbidity. Better understanding of the implications of different patterns of multimorbidity in people with T2D will allow more effective tailored care.


2014 ◽  
Vol 23 (1) ◽  
pp. 92-97 ◽  
Author(s):  
Anthony J Stanley ◽  
Iqbal Hasan ◽  
Alan J Crockett ◽  
Onno CP van Schayck ◽  
Nicholas A Zwar

2019 ◽  
Vol 13 (2) ◽  
pp. 113-121 ◽  
Author(s):  
Jo-Anne E. Manski-Nankervis ◽  
Sharmala Thuraisingam ◽  
Janet K. Sluggett ◽  
Phyllis Lau ◽  
Irene Blackberry ◽  
...  

BMJ Open ◽  
2012 ◽  
Vol 2 (4) ◽  
pp. e001405 ◽  
Author(s):  
Sze Lin Yoong ◽  
Mariko Leanne Carey ◽  
Robert William Sanson-Fisher ◽  
Grant Russell ◽  
Danielle Mazza ◽  
...  

BJGP Open ◽  
2020 ◽  
pp. bjgpopen20X101120 ◽  
Author(s):  
Andrea L Schaffer ◽  
Doreen Busingye ◽  
Kendal Chidwick ◽  
Jonathan Brett ◽  
Suzanne Blogg

BackgroundIn 2013 pregabalin was subsidised by Australia’s Pharmaceutical Benefits Scheme (PBS) for neuropathic pain. Since the subsidy, pregabalin prescribing has been increasing in Australia and so has related harm. There are concerns it is being prescribed for indications other than neuropathic pain, which have little evidence of efficacy.AimTo describe pregabalin prescribing in Australian general practice.Design & settingA cross-sectional study of patients attending 445 general practice sites in the national MedicineInsight database from March 2012–February 2018.MethodThe following aspects were calculated: the proportion of prescriptions that were for pregabalin per year; the prevalence of pain conditions in patients prescribed pregabalin; and same-day prescribing of pregabalin with opioids or benzodiazepines.ResultsPrescribing increased from 13 per 10 000 to 104 per 10 000 prescriptions between 2012–2013 and 2017–2018. A total of 1 891 623 patients were identified of whom 114 123 (6.0%) were prescribed pregabalin; 49.7% (n = 56 772) had a recorded diagnosis of neuropathic pain. Among people prescribed pregabalin without a recorded diagnosis of neuropathic pain, 43.5% (n = 24 927) had a diagnosis of back problems, 8.8% (n = 5073) chronic pain, and 26.4% (n = 30 146) had no pain diagnosis. Pregabalin was prescribed the same day as an opioid to 38.1% of patients (95% confidence interval [CI] = 37.1% to 39.1%) and a benzodiazepine to 13.1% of patients (95% CI = 12.5% to 13.7%). Patients with a diagnosis of chronic pain had the highest rate of same-day prescribing of pregabalin with an opioid (70.4%, 95% CI = 68.9% to 71.9%) or a benzodiazepine (25.8%, 95% CI = 24.2% to 27.4%)ConclusionSubstantial increases in pregabalin prescribing were identified in Australian general practice, but only half of patients had a neuropathic pain diagnosis recorded, the only approved indication for subsidy. High rates of same-day prescribing with opioids and benzodiazepines may put patients at increased risk of harm.


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