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Merenda M, Earnest A, Ruseckaite R, Tse WC, Elder E, Hopper I, Ahern S. Patient-Reported Outcome Measures in High-Risk Medical Device Registries: A Scoping Review. Aesthet Surg J Open Forum 2024; 6:ojae015. [PMID: 38650972 PMCID: PMC11033681 DOI: 10.1093/asjof/ojae015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
Little is known about the methods and outcomes of patient-reported outcome measure (PROM) use among high-risk medical device registries. The objective of this scoping review was to assess the utility and predictive ability of PROMs in high-risk medical device registries. We searched Ovid Medline, Embase, APA PsychINFO, Cochrane Library, and Scopus databases for published literature. After searching, 4323 titles and abstracts were screened, and 262 full texts were assessed for their eligibility. Seventy-six papers from across orthopedic (n = 64), cardiac (n = 10), penile (n = 1), and hernia mesh (n = 1) device registries were identified. Studies predominantly used PROMs as an outcome measure when comparing cohorts or surgical approaches (n = 45) or to compare time points (n = 13) including pre- and postintervention. Fifteen papers considered the predictive ability of PROMs. Of these, 8 treated PROMs as an outcome, 5 treated PROMs as a risk factor through regression analysis, and 2 papers treated PROMs as both a risk factor and as an outcome. One paper described PROMs to study implant survival. To advance methods of PROM integration into clinical decision-making for medical devices, an understanding of their use in high-risk device registries is needed. This scoping review found that there is a paucity of studies using PROMs to predict long-term patient and clinical outcomes in high-risk medical device registries. Determination as to why PROMs are rarely used for predictive purposes in long-term data collection is needed if PROM data are to be considered suitable as real-world evidence for high-risk device regulatory purposes, as well as to support clinical decision-making. Level of Evidence 4
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Affiliation(s)
- Michelle Merenda
- Corresponding Author: Mrs Michelle Merenda, Level 3, 553 St Kilda Rd, Melbourne, Victoria 3004, Australia. E-mail:
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Hoque SS, Ahern S, O'Connell HE, Romero L, Ruseckaite R. Comparing Patient-Reported Outcome Measures for Pain in Women With Pelvic Floor Disorders: A Scoping Review. J Pain 2023:S1526-5900(23)00651-X. [PMID: 38142984 DOI: 10.1016/j.jpain.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 12/12/2023] [Accepted: 12/16/2023] [Indexed: 12/26/2023]
Abstract
Women with pelvic floor disorders (PFDs) typically undergo surgery involving transvaginal mesh implants; however, transvaginal mesh surgery is associated with many adverse events including post-surgical pain. Assessment of pain as a symptom is necessary using patient-reported outcome measures (PROMs). This scoping review aimed to describe and compare existing PROMs previously used to measure pain in women with PFDs. A scoping search of Ovid MEDLINE, EMBASE, CINAHL Plus, Ovid PsycInfo, and grey literature was conducted. Studies published in English describing the development, implementation, and application of PFD-associated pain PROMs among adult women before and after pelvic floor surgery were included. From each article, a descriptive summary organised by study first author, publication year, country, setting, aim, study characteristics, and results were extracted. From 2,604 articles identified, 54 studies were included, describing 44 PROMs. Most studies described at least 2 to 3 instruments. The Pelvic Floor Distress Inventory-20 was most commonly described by 12 studies followed by the Patient Global Impression of Improvement scale. Of the 44 PROMs, 27 were condition-specific, of which 9 included items on pain; 17 generic PROMs, 4 of which contained items on pain; and 6 pain-specific PROMs. PROMs identified in our review measured pain not related to PFDs or pelvic floor surgery and quantified the pain experienced. These PROMs did not measure all areas of pain including region, sensation, impact, and triggers. The findings of this review will assist with developing a new pain-specific PROM in this population. PERSPECTIVE: Women with pelvic floor disorders often undergo surgery involving transvaginal mesh, from which they experience debilitating pain. Pain is a major issue impacting women's lives. Patient-reported outcome measures can be used to assess the pain; however, it is unclear whether existing instruments are relevant.
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Affiliation(s)
- Sheymonti S Hoque
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Susannah Ahern
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Helen E O'Connell
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
| | - Lorena Romero
- The Ian Potter Library, Alfred Hospital, Melbourne, Victoria, Australia
| | - Rasa Ruseckaite
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Ruseckaite R, Caruso M, Mudunna C, Helwani F, Millis N, Ahern S. Informing a national rare disease registry strategy in Australia: a mixed methods study. BMC Health Serv Res 2023; 23:1187. [PMID: 37907945 PMCID: PMC10619239 DOI: 10.1186/s12913-023-10049-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/20/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Rare disease registries (RDRs) facilitate monitoring of rare diseases by pooling small datasets to increase clinical and epidemiological knowledge of rare diseases and promote patient centred best practice. The aim of this study was to understand the current state of RDRs in Australia, data captured, impact on patient outcomes, funding models, and barriers and enablers regarding their establishment and maintenance. METHODS An exploratory sequential mixed methods study design was adopted. First, a list of Australian RDRs, primary contacts and data custodians was generated through online and consumer group (Rare Voices Australia (RVA)) contacts. A cross-sectional, anonymous online survey was distributed to registry custodians, managers, or principal investigators of 74 identified Australian RDRs, 88 RVA Partners, 17 pharmaceutical organizations and 12 RVA Scientific and Medical Advisory Committee members. Next, managers and coordinators of RDRs and databases who participated in the survey were invited to participate in semi-structured interviews. Quantitative and qualitative data were analysed using basic descriptive statistics and content analysis, respectively. RESULTS Forty RDRs responded to the survey; nine were national, five were based in Australia and New Zealand, and the remaining were global. Of the 40 survey respondents, eight were interviewed. Most of the RDRs captured similar information regarding patient characteristics, comorbidities and clinical features, diagnosis, family history, genetic testing, procedures or treatment types, response to treatments and complications of treatments. Better treatment outcomes, changes in process of care and changes in quality of care were the most frequently reported benefits of the RDRs. The main challenges proved to be cost/funding of data collection, data completeness, and patient consent. When asked, the participants identified opportunities and challenges regarding potential options to streamline RDRs in Australia in the future. CONCLUSION Findings from this study highlighted significant dataset heterogeneity based on the individual disease, and current lack of interoperability and coordination between different existing RDRs in Australia. Nevertheless, a nationally coordinated approach to RDRs should be investigated given the particular benefits RDRs offer, such as access to research and the monitoring of new disease-modifying treatments.
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Affiliation(s)
- Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
- School of Public Health and Preventive Medicine, Monash University, Victoria, 3004, Australia.
| | - Marisa Caruso
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Chethana Mudunna
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | | | | | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Shanthikumar S, Ruseckaite R, Corda J, Mulrennan S, Ranganathan S, Douglas T. Telehealth use in Australian cystic fibrosis centers: Clinician experiences. Pediatr Pulmonol 2023; 58:2906-2915. [PMID: 37477510 DOI: 10.1002/ppul.26612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/30/2023] [Accepted: 07/10/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Telehealth has been rapidly adopted by cystic fibrosis (CF) centers and ongoing use in routine CF care is endorsed by CF consumers. However, data describing CF clinician perceptions regarding telehealth are scarce. We aimed to describe clinician experiences and attitudes towards telehealth in CF care among health professionals across Australia. METHODS CF multidisciplinary health professionals from all CF clinics in Australia were sent an anonymous electronic survey. RESULTS Eighty-five responses were received representing 15 of 23 (65%) centers. Most clinicians reported using telehealth for routine clinic visits, and a range of other clinical encounters (69.9%). Telehealth was widely perceived as acceptable (91.8%), and clinicians were comfortable/very comfortable (81.2%) integrating telehealth into future CF care. Despite this, 64.1% of respondents considered telehealth clinics to be much worse than face-to-face clinics and 57.5% reported quality of care was somewhat/much worse using telehealth. Home spirometry was available in 73.7% of centers, however, only 26.7% of clinics could provide spirometers for >75% eligible patients. Growth and microbiology assessments were often missed in telehealth clinics and 75.7% reported a technical issue had prevented a telehealth consultation from occurring. CONCLUSIONS Telehealth for CF in Australia is considered feasible and acceptable by CF clinicians, although use of telehealth varies widely between centers. Concerns exist around the impact of telehealth on health outcomes, especially given core assessments are frequently omitted. Guidelines may help ensure the benefits of telehealth are realized for people with CF without compromising the standard of care.
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Affiliation(s)
- Shivanthan Shanthikumar
- Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Parkville, Victoria, Australia
- Respiratory Diseases, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Rasa Ruseckaite
- Department of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jen Corda
- Department of Physiotherapy, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Siobhain Mulrennan
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- Institute for Respiratory Health, University of Western Australia, Nedlands, Western Australia, Australia
| | - Sarath Ranganathan
- Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Parkville, Victoria, Australia
- Respiratory Diseases, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Tonia Douglas
- Department of Respiratory and Sleep Medicine, Queensland Children's Hospital, South Brisbane, Queensland, Australia
- Clinical Unit, Faculty of Medicine, University of Queensland, St Lucia, Queensland, Australia
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Jayasinghe RT, Ruseckaite R, Dean J, Kartik A, Wickremasinghe AC, Daly O, O'Connell HE, Craig A, Duggan A, Vasiliadis D, Karantanis E, Gallagher E, Holme G, Keck J, Williams J, King J, Yin J, Short J, Sketcher-Baker K, Brennan P, Rayner S, Ahern S. Establishment and initial implementation of the Australasian Pelvic Floor Procedure Registry. Int Urogynecol J 2023; 34:1697-1704. [PMID: 36695860 PMCID: PMC10415488 DOI: 10.1007/s00192-022-05435-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 11/30/2022] [Indexed: 01/26/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Stress urinary incontinence (SUI) and pelvic organ prolapse (POP) are common pelvic floor disorders (PFDs). Owing to significant adverse events associated with mesh-related pelvic floor procedures (PFPs) in a proportion of the surgically treated population, and deficits in collection and reporting of these events, the Australian Government identified an urgent need for a tracking mechanism to improve safety and quality of care. The Australasian Pelvic Floor Procedure Registry (APFPR) was recently established following the 2018 Senate Committee Inquiry with the aim of tracking outcomes of PFP involving the use of devices and/or prostheses, with the objective of improving the health outcomes of women who undergo these procedures. This paper will describe the APFPR's aims, development, implementation and possible challenges on the way to its establishment. METHODS The APFPR has been developed and implemented in accordance with the national operating principles of clinical quality registries (CQRs). The minimum datasets (MDS) for the registry's database have been developed using a modified Delphi process, and data are primarily being collected from participating surgeons. Patient recruitment is based on an opt-out approach or a waiver of consent. Patient-reported outcome measures (PROMs) providing additional health and outcome information will be obtained from participating women to support safety monitoring of mesh-related adverse events. RESULTS Currently in the Australasian Pelvic Floor Procedure Registry (APFPR) there are 32 sites from various jurisdictions across Australia, that have obtained relevant ethics and governance approvals to start patient recruitment and data collection as of January 2023. Additionally, there are two sites that are awaiting governance review and five sites that are having documentation compiled for submission. Seventeen sites have commenced patient registration and have entered data into the database. Thus far, we have 308 patients registered in the APFPR database. The registry also published its first status report and a consumer-friendly public report in 2022. CONCLUSIONS The registry will act as a systematic tracking mechanism by collecting outcomes on PFP, especially those involving devices and/or prostheses to improve safety and quality of care.
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Affiliation(s)
- Randi T Jayasinghe
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia.
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
| | - Joanne Dean
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
| | - Aruna Kartik
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
| | - Anagi C Wickremasinghe
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
| | - Oliver Daly
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
- Department of Obstetrics and Gynaecology, Western Health, Melbourne, Victoria, Australia
| | - Helen E O'Connell
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
- Department of Surgery, University of Melbourne, Parkville, Australia
| | - Amanda Craig
- Department of Health and Aged Care, Therapeutic Goods Administration, Canberra, Australia
| | - Anne Duggan
- Australian Commission on Safety and Quality in Health Care, Sydney, Australia
| | - Dora Vasiliadis
- Consumer Representative, Australasian Pelvic Floor Procedure Registry, Melbourne, Australia
| | | | - Elizabeth Gallagher
- Calvary John James, Canberra Private and Canberra Hospital, Canberra, Australia
| | - Gwili Holme
- Commonwealth of Australia, Canberra, Australia
| | - James Keck
- St Vincent's Private Hospital Melbourne, Melbourne, Australia
| | | | | | - Jessica Yin
- Holywood Medical Centre (WA), Nedlands, Australia
| | - John Short
- Christchurch Women's Hospital & Southern Cross Hospital - Invercargill, Christchurch, New Zealand
| | | | - Pip Brennan
- Consumer Representative, Australasian Pelvic Floor Procedure Registry, Melbourne, Australia
| | | | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
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Ruseckaite R, Mudunna C, Caruso M, Helwani F, Millis N, Lacaze P, Ahern S. Current state of rare disease registries and databases in Australia: a scoping review. Orphanet J Rare Dis 2023; 18:216. [PMID: 37501152 PMCID: PMC10373259 DOI: 10.1186/s13023-023-02823-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 07/10/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Rare diseases (RDs) affect approximately 8% of all people or > 400 million people globally. The Australian Government's National Strategic Action Plan for Rare Diseases has identified the need for a national, coordinated, and systematic approach to the collection and use of RD data, including registries. Rare disease registries (RDRs) are established for epidemiological, quality improvement and research purposes, and they are critical infrastructure for clinical trials. The aim of this scoping review was to review literature on the current state of RDRs in Australia; to describe how they are funded; what data they collect; and their impact on patient outcomes. METHODS We conducted a literature search on MEDLINE, EMBASE, CINAHL and PsychINFO databases, in addition to Google Scholar and grey literature. Dissertations, government reports, randomised control trials, conference proceedings, conference posters and meeting abstracts were also included. Articles were excluded if they did not discuss RDs or if they were written in a language other than English. Studies were assessed on demographic and clinical patient characteristics, procedure or treatment type and health-related quality of life captured by RDRs or databases that have been established to date. RESULTS Seventy-four RDRs were identified; 19 were global registries in which Australians participated, 24 were Australian-only registries, 10 were Australia and New Zealand based, and five were Australian jurisdiction-based registries. Sixteen "umbrella" registries collected data on several different conditions, which included some RDs, and thirteen RDRs stored rare cancer-specific information. Most RDRs and databases captured similar types of information related to patient characteristics, comorbidities and other clinical features, procedure or treatment type and health-related quality of life measures. We found considerable heterogeneity among existing RDRs in Australia, especially with regards to data collection, scope and quality of registries, suggesting a national coordinated approach to RDRs is required. CONCLUSION This scoping review highlights the current state of Australian RDRs, identifying several important gaps and opportunities for improvement through national coordination and increased investment.
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Affiliation(s)
- Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
| | - Chethana Mudunna
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Marisa Caruso
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Falak Helwani
- Rare Voices Australia, VIC, 3194, Melbourne, Australia
| | - Nicole Millis
- Rare Voices Australia, VIC, 3194, Melbourne, Australia
| | - Paul Lacaze
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
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Ruseckaite R, Mudunna C, Caruso M, Ahern S. Response rates in clinical quality registries and databases that collect patient reported outcome measures: a scoping review. Health Qual Life Outcomes 2023; 21:71. [PMID: 37434146 DOI: 10.1186/s12955-023-02155-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 06/26/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Patient Reported Outcome Measures (PROMs) are being increasingly introduced in clinical registries, providing a personal perspective on the expectations and impact of treatment. The aim of this study was to describe response rates (RR) to PROMs in clinical registries and databases and to examine the trends over time, and how they change with the registry type, region and disease or condition captured. METHODS We conducted a scoping literature review of MEDLINE and EMBASE databases, in addition to Google Scholar and grey literature. All English studies on clinical registries capturing PROMs at one or more time points were included. Follow up time points were defined as follows: baseline (if available), < 1 year, 1 to < 2 years, 2 to < 5 years, 5 to < 10 years and 10 + years. Registries were grouped according to regions of the world and health conditions. Subgroup analyses were conducted to identify trends in RRs over time. These included calculating average RRs, standard deviation and change in RRs according to total follow up time. RESULTS The search strategy yielded 1,767 publications. Combined with 20 reports and four websites, a total of 141 sources were used in the data extraction and analysis process. Following the data extraction, 121 registries capturing PROMs were identified. The overall average RR at baseline started at 71% and decreased to 56% at 10 + year at follow up. The highest average baseline RR of 99% was observed in Asian registries and in registries capturing data on chronic conditions (85%). Overall, the average RR declined as follow up time increased. CONCLUSION A large variation and downward trend in PROMs RRs was observed in most of the registries identified in our review. Formal recommendations are required for consistent collection, follow up and reporting of PROMs data in a registry setting to improve patient care and clinical practice. Further research studies are needed to determine acceptable RRs for PROMs captured in clinical registries.
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Affiliation(s)
- Rasa Ruseckaite
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia.
| | - Chethana Mudunna
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
| | - Marisa Caruso
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
| | - Susannah Ahern
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
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Ruseckaite R, Jayasinghe R, Bavor C, Dean J, Daly O, Ahern S. Evaluation and acceptability of patient-reported outcome measures in women following pelvic organ prolapse procedures. BMC Health Serv Res 2023; 23:624. [PMID: 37312203 DOI: 10.1186/s12913-023-09540-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 05/12/2023] [Indexed: 06/15/2023] Open
Abstract
BACKGROUND The Australasian Pelvic Floor Procedure Registry (APFPR) captures clinical and surgical data in women undergoing pelvic floor procedures. The inclusion of patient reported outcome measures (PROMs) in the APFPR is a critical activity providing the additional patient perspective of their condition prior to surgery as well as monitoring beyond the usual post-surgical follow-up time. This study aimed to evaluate the acceptability of seven PROMs for women with pelvic organ prolapse (POP) and to determine the most suitable instrument for the APFPR. METHODS Semi-structured qualitative interviews were conducted with women with POP (n = 15) and their treating clinicians (n = 11) in Victoria, Australia. Interview topics covered appropriateness, content, and acceptability of seven POP-specific instruments identified through the literature to determine their suitability and acceptability for inclusion in the APFPR. We analysed the interview data using conventional content analysis. RESULTS All study participants agreed that PROMs were needed for the APFPR. Both women and clinicians suggested that some of the instruments were ambiguous, too long and confusing. The Australian Pelvic Floor Questionnaire was accepted widely amongst women and clinicians and recommended for inclusion in the APFPR. All participants agreed it would be appropriate to capture PROMs before surgery, and then followed up post-surgically. Email, phone call or postal mail-out were the preferred options for PROMs data collection. CONCLUSION Most women and clinicians supported incorporating PROMs in the APFPR. Study participants believed that capturing PROMs would have potential use in individual care and improve outcomes of women with POP.
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Affiliation(s)
- Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
| | - Randi Jayasinghe
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Claire Bavor
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Joanne Dean
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Oliver Daly
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
- Department of Obstetrics and Gynecology, Western Health, Melbourne, VIC, 3000, Australia
| | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
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Coriati A, Ma X, Sykes J, Stanojevic S, Ruseckaite R, Lemonnier L, Dehillotte C, Tate J, Byrnes CA, Bell SC, Burgel PR, Stephenson AL. Beyond borders: cystic fibrosis survival between Australia, Canada, France and New Zealand. Thorax 2023; 78:242-248. [PMID: 36109163 DOI: 10.1136/thorax-2022-219086] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/23/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Life expectancy for people with cystic fibrosis (CF) varies considerably both within and between countries. The objective of this study was to compare survival among countries with single-payer healthcare systems while accounting for markers of disease severity. METHODS This cohort study used data from established national CF registries in Australia, Canada, France and New Zealand from 2015 to 2019. Median age of survival for each of the four countries was estimated using the Kaplan-Meier method. A Cox proportional hazards model was used to compare risk of death between Canada, France and Australia after adjusting for prognostic factors. Due to low number of deaths, New Zealand was not included in final adjusted models. RESULTS Between 2015 and 2019, a total of 14 842 people (3537 Australia, 4434 Canada, 6411 France and 460 New Zealand) were included. The median age of survival was highest in France 65.9 years (95% CI: 59.8 to 76.0) versus 53.3 years (95% CI: 48.9 to 59.8) for Australia, 55.4 years (95% CI: 51.3 to 59.2) for Canada and 54.8 years (95% CI: 40.7 to not available) for New Zealand. After adjusting for individual-level factors, the risk of death was significantly higher in Canada (HR 1.85, 95% CI: 1.48 to 2.32; p<0.001) and Australia (HR 2.08, 95% CI: 1.64 to 2.64; p<0.001) versus France. INTERPRETATION We observed significantly higher survival in France compared with countries with single-payer healthcare systems. The median age of survival in France exceeded 60 years of age despite having the highest proportion of underweight patients which may be due to differences in availability of transplant.
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Affiliation(s)
- Adèle Coriati
- Department of Respirology, St Michael's Hospital, Toronto, Ontario, Canada
| | - Xiayi Ma
- Department of Respirology, St Michael's Hospital, Toronto, Ontario, Canada
| | - Jenna Sykes
- Department of Respirology, St Michael's Hospital, Toronto, Ontario, Canada
| | - Sanja Stanojevic
- Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Rasa Ruseckaite
- Public Health and Preventative Medicine, Monash University, Clayton, Victoria, Australia
| | - Lydie Lemonnier
- Association Vaincre la Mucoviscidose, Paris, Île-de-France, France
| | | | - Jan Tate
- Paediatric Department, Starship Children's Health, Auckland, New Zealand
| | - Catherine Ann Byrnes
- Paediatrics, Child and Youth Health, The University of Auckland School of Medicine, Auckland, New Zealand.,Paediatric Respiratory Department, Starship Children's Health, Auckland, New Zealand
| | - Scott C Bell
- Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Queensland, Australia.,Children's Health Research Centre, The University of Queensland Faculty of Medicine and Biomedical Sciences, Herston, Queensland, Australia
| | - Pierre Regis Burgel
- Assistance Publique Hôpitaux de Paris, Department of Respiratory Medicine and French Cystic Fibrosis Reference Center, Hopital Cochin Pneumologie, Paris, Île-de-France, France.,Institut Cochin, Université de Paris, Paris, Île-de-France, France.,European Reference Network Respiratory Diseases, Frankfurt, Germany
| | - Anne L Stephenson
- Department of Respirology, St Michael's Hospital, Toronto, Ontario, Canada .,St Michael's Hospital Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Shum BOV, Sng LMF, Ruseckaite R, Henner I, Twine N, Bauer DC, Wilgen U, Pretorius C, Barahona P, Ungerer JPJ, Bennett G. The inequity of targeted cystic fibrosis reproductive carrier screening tests in Australia. Prenat Diagn 2023; 43:109-116. [PMID: 36484552 DOI: 10.1002/pd.6285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/03/2022] [Accepted: 12/05/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE European and Australian guidelines for cystic fibrosis (CF) reproductive carrier screening recommend testing a small number of high frequency CF causing variants, rather than comprehensive CFTR sequencing. The study objective was to determine variant detection rates of commercially available targeted reproductive carrier screening tests in Australia. METHODS Next-generation DNA sequencing of the CFTR gene was performed on 2552 individuals from a whole population sample to identify CF causing variants. The variant detection rates of two commercially available Australian reproductive carrier screening tests, which target 50 or 175 CF causing variants, in this population were calculated. The ethnicity of individuals was determined using principal component analysis. RESULTS Variant detection rates of the tests for 50 and 175 CF causing variants were 88.2% and 90.8%, respectively. No CF causing variants in individuals of East Asian ethnicity (n = 3) were detected by either test, while >86.6% (n = 69) of CF causing variants in Europeans would be identified by either test. CONCLUSIONS Reproductive carrier screening tests for a targeted set of high frequency CF variants are unable to detect approximately 10% of CF variants in a multiethnic Australian population, and individuals of East Asian ethnicity are disproportionally affected by this test limitation.
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Affiliation(s)
- Bennett O V Shum
- Preventive Health Division, Genepath, Sydney, New South Wales, Australia.,EMBL Australia Node in Single Molecule Science, School of Biomedical Sciences, University of NSW, New South Wales, Sydney, Australia
| | - Letitia M F Sng
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Sydney, New South Wales, Australia.,Applied BioSciences, Faculty of Science and Engineering, Macquarie University, Sydney, New South Wales, Australia
| | - Rasa Ruseckaite
- Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ilya Henner
- Preventive Health Division, Genepath, Sydney, New South Wales, Australia
| | - Natalie Twine
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Sydney, New South Wales, Australia.,Applied BioSciences, Faculty of Science and Engineering, Macquarie University, Sydney, New South Wales, Australia
| | - Denis C Bauer
- Australian e-Health Research Centre, Commonwealth Scientific and Industrial Research Organisation, Sydney, New South Wales, Australia.,Applied BioSciences, Faculty of Science and Engineering, Macquarie University, Sydney, New South Wales, Australia.,Department of Biomedical Sciences, Faculty of Medicine and Health Science, Macquarie University, Sydney, New South Wales, Australia
| | - Urs Wilgen
- Pathology Queensland, Queensland Health, Herston, Queensland, Australia
| | - Carel Pretorius
- Pathology Queensland, Queensland Health, Herston, Queensland, Australia
| | - Paulette Barahona
- Preventive Health Division, Genepath, Sydney, New South Wales, Australia
| | - Jacobus P J Ungerer
- Pathology Queensland, Queensland Health, Herston, Queensland, Australia.,Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Glenn Bennett
- Preventive Health Division, Genepath, Sydney, New South Wales, Australia
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11
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Moore EC, Ioannou L, Ruseckaite R, Serpell J, Ahern S. Hereditary Endocrine Tumor Registries. J Endocr Soc 2022; 7:bvac194. [PMID: 36632485 PMCID: PMC9825730 DOI: 10.1210/jendso/bvac194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Indexed: 12/24/2022] Open
Abstract
Context Endocrine neoplasia syndromes are phenotypically complex, and there is a misconception that they are universally rare. Genetic alterations are increasingly recognized; however, true prevalence is unknown. The purpose of a clinical registry is to monitor the quality of health care delivered to a specified group of patients through the collection, analysis, and reporting of relevant health-related information. This leads to improved clinical practice, decision-making, patient satisfaction, and outcome. Objective This review aims to identify, compare, and contrast active registries worldwide that capture data relevant to hereditary endocrine tumors (HETs). Methods Clinical registries were identified using a systematic approach from publications (Ovid MEDLINE, EMBASE) peer consultation, clinical trials, and web searches. Inclusion criteria were hereditary endocrine tumors, clinical registries, and English language. Exclusion criteria were institutional audits, absence of clinical data, or inactivity. Details surrounding general characteristics, funding, data fields, collection periods, and entry methods were collated. Results Fifteen registries specific for HET were shortlisted with 136 affiliated peer-reviewed manuscripts. Conclusion There are few clinical registries specific to HET. Most of these are European, and the data collected are highly variable. Further research into their effectiveness is warranted. We note the absence of an Australian registry for all HET, which would provide potential health and economic gains. This review presents a unique opportunity to harmonize registry data for HET locally and further afield.
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Affiliation(s)
- Edwina C Moore
- Correspondence: Edwina C. Moore, MBBS (HONS), BMedSci, Peninsula Private Hospital, 525 McClelland Dr, Ste 16, Langwarrin, VIC, 3199, Australia.
| | - Liane Ioannou
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria 3800, Australia
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria 3800, Australia
| | - Jonathan Serpell
- Department of Breast, Endocrine and General Surgery, Alfred Health, Monash University, Melbourne, Victoria 3800, Australia
| | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria 3800, Australia
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12
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Doumit M, Chuang S, Middleton P, Selvadurai H, Sivam S, Ruseckaite R, Ahern S, Mallitt KA, Pacey V, Gray K, Jaffe A. Clinical outcomes of adults and children with cystic fibrosis during the COVID-19 pandemic. J Cyst Fibros 2022:S1569-1993(22)00685-3. [PMID: 36163166 PMCID: PMC9477965 DOI: 10.1016/j.jcf.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 09/06/2022] [Accepted: 09/14/2022] [Indexed: 11/30/2022]
Abstract
Background The onset of the COVID-19 pandemic was associated with restricted community movement and limited access to healthcare facilities, resulting in changed clinical service delivery to people with cystic fibrosis (CF). This study aimed to determine clinical outcomes of Australian adults and children with CF in the 12-months following the onset of the COVID-19 pandemic. Methods This longitudinal cohort study used national registry data. Primary outcomes were 12-month change in percent predicted forced expiratory volume in one second (FEV1 %pred), body mass index (BMI) in adults and BMI z-scores in children. A piecewise linear mixed-effects model was used to determine trends in outcomes before and after pandemic onset. Results Data were available for 3662 individuals (median age 19.6 years, range 0-82). When trends in outcomes before and after pandemic onset were compared; FEV1 %pred went from a mean annual decline of -0.13% (95%CI -0.36 to 0.11) to a mean improvement of 1.76% (95%CI 1.46-2.05). Annual trend in BMI improved from 0.03 kg/m2 (95%CI -0.02-0.08) to 0.30 kg/m2 (95%CI 0.25-0.45) and BMI z-scores improved from 0.05 (95%CI 0.03-0.07) to 0.12 (95%CI 0.09-0.14). Number of hospitalisations decreased from a total of 2656 to 1957 (p < 0.01). Virtual consultations increased from 8% to 47% and average number of consultations per patient increased from median (IQR) of 4(2-5) to 5(3-6) (p < 0.01). Conclusion In the 12-months following the onset of the COVID-19 pandemic, there was an improvement in the clinical outcomes of people with CF when compared to the pre-pandemic period.
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Affiliation(s)
- Michael Doumit
- Department of Health Sciences, Macquarie University, Department of Health Sciences, 75 Talavera Rd, Macquarie University, Macquarie Park, NSW 2109, Australia; School of Women's and Children's Health, University of New South Wales, Address Level 8, Bright Alliance Building, High St, Randwick, NSW, Australia.
| | - Sandra Chuang
- School of Women's and Children's Health, University of New South Wales, Address Level 8, Bright Alliance Building, High St, Randwick, NSW, Australia; Respiratory Medicine Department, Sydney Children's Hospital, Level 0, South West Wing, Sydney Children's Hospital, High St, Randwick, NSW, Australia
| | - Peter Middleton
- Respiratory Medicine Department, Westmead Hospital, Level 2, Clinical Sciences Building, PO Box 533, Westmead Hospital, Westmead, Australia
| | - Hiran Selvadurai
- Respiratory Medicine Department, The Children's Hospital at Westmead, Corner or Hawkesbury Rd and Hainsworth St, Locked Bag 4001, Westmead, Australia
| | - Sheila Sivam
- The Department of Respiratory Medicine, Royal Prince Alfred Hospital, Level 11, Building 75, RPA Hospital Missenden Rd, Camperdown, Australia
| | - Rasa Ruseckaite
- Department of Public Health and Preventive Medicine, Monash University, Level 3, 553 St Kilda Rd, Melbourne, Australia
| | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, Monash University, Level 3, 553 St Kilda Rd, Melbourne, Australia
| | - Kylie Ann Mallitt
- Sydney School of Public Health, University of Sydney, Edward Ford Building A27, The University of Sydney, NSW, Australia. Department of Health Sciences, Macquarie University, Macquarie Park, Australia
| | - Verity Pacey
- Department of Health Sciences, Macquarie University, Department of Health Sciences, 75 Talavera Rd, Macquarie University, Macquarie Park, NSW 2109, Australia
| | - Kelly Gray
- Department of Health Sciences, Macquarie University, Department of Health Sciences, 75 Talavera Rd, Macquarie University, Macquarie Park, NSW 2109, Australia
| | - Adam Jaffe
- School of Women's and Children's Health, University of New South Wales, Address Level 8, Bright Alliance Building, High St, Randwick, NSW, Australia; Respiratory Medicine Department, Sydney Children's Hospital, Level 0, South West Wing, Sydney Children's Hospital, High St, Randwick, NSW, Australia
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13
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Ralphsmith M, Ahern S, Dean J, Ruseckaite R. Patient-reported outcome measures for pain in women with pelvic floor disorders: a systematic review. Int Urogynecol J 2022; 33:2325-2334. [PMID: 35233681 PMCID: PMC9427903 DOI: 10.1007/s00192-022-05126-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 02/07/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Patient-reported outcome measures (PROMs) are helpful instruments when measuring and reporting changes in patient health status (Al Sayah et al. J Patient Rep Outcomes 5 (Suppl 2):99, 2021) such as the health-related quality of life (HrQoL) of women with pelvic organ prolapse (POP) and stress urinary incontinence (SUI). The Australasian Pelvic Floor Procedure Registry (APFPR) aims to increase capacity for women to report surgical outcomes through the collection of HrQoL data (Ruseckaite et al. Qual Life Res. 2021) but currently lacks a pain-specific PROM for women with pelvic floor disorders (PFDs), particularly POP and SUI. This review aims to systematically review the existing literature and identify instruments that measure pain in women with POP and SUI for inclusion within the APFPR, which reports on complications from these conditions. METHODS We conducted a literature search on OVID MEDLINE, Embase, CINAHL, PsycINFO and EMCARE databases in addition to Google Scholar and grey literature to identify studies from inception to April 2021. Full-text studies were included if they used PROMs to measure pain in women with POP and SUI. Two authors independently screened articles, extracted data and assessed methodological quality. RESULTS From 2001 studies, 23 publications describing 19 different PROMs were included for analysis. Eight of these instruments were specific to the pelvic floor; four were only specific to pain and used across multiple disorders; three were generic quality of life instruments and four were other non-validated instruments such as focus group interviews. These instruments were not specific to pain in women with POP or SUI, as they did not identify all relevant domains such as the sensation, region and duration of pain, or incidents where onset of pain occurs. CONCLUSIONS The findings of this review suggest there are no current PROMs that are suitable pain-specific instruments for women with POP or SUI. This knowledge may inform and assist in the development of a new PROM to be implemented into the APFPR.
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Affiliation(s)
- Maisie Ralphsmith
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
| | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
| | - Joanne Dean
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, 3004, Australia.
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14
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Carr SB, McClenaghan E, Elbert A, Faro A, Cosgriff R, Abdrakhmanov O, Brownlee K, Burgel PR, Byrnes CA, Cheng SY, Colombo C, Corvol H, Daneau G, Goss CH, Gulmans V, Gutierrez H, Harutyunyan S, Helmick M, Jung A, Kashirskaya N, McKone E, Melo J, Middleton PG, Mondejar-Lopez P, de Monestrol I, Nährlich L, Padoan R, Parker M, Pastor-Vivero MD, Rizvi S, Ruseckaite R, Salvatore M, da Silva-Filho LVRF, Versmessen N, Zampoli M, Marshall BC, Stephenson AL. Factors associated with clinical progression to severe COVID-19 in people with cystic fibrosis: A global observational study. J Cyst Fibros 2022; 21:e221-e231. [PMID: 35753987 PMCID: PMC9189103 DOI: 10.1016/j.jcf.2022.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/19/2022] [Accepted: 06/11/2022] [Indexed: 01/02/2023]
Abstract
BACKGROUND This international study aimed to characterise the impact of acute SARS-CoV-2 infection in people with cystic fibrosis and investigate factors associated with severe outcomes. Methods Data from 22 countries prior to 13th December 2020 and the introduction of vaccines were included. It was de-identified and included patient demographics, clinical characteristics, treatments, outcomes and sequalae following SARS-CoV-2 infection. Multivariable logistic regression was used to investigate factors associated with clinical progression to severe COVID-19, using the primary outcome of hospitalisation with supplemental oxygen. RESULTS SARS-CoV-2 was reported in 1555 people with CF, 1452 were included in the analysis. One third were aged <18 years, and 9.4% were solid-organ transplant recipients. 74.5% were symptomatic and 22% were admitted to hospital. In the non-transplanted cohort, 39.5% of patients with ppFEV1<40% were hospitalised with oxygen verses 3.2% with ppFEV >70%: a 17-fold increase in odds. Worse outcomes were independently associated with older age, non-white race, underweight body mass index, and CF-related diabetes. Prescription of highly effective CFTR modulator therapies was associated with a significantly reduced odds of being hospitalised with oxygen (AOR 0.43 95%CI 0.31-0.60 p<0.001). Transplanted patients were hospitalised with supplemental oxygen therapy (21.9%) more often than non-transplanted (8.8%) and was independently associated with the primary outcome (Adjusted OR 2.45 95%CI 1.27-4.71 p=0.007). CONCLUSIONS This is the first study to show that there is a protective effect from the use of CFTR modulator therapy and that people with CF from an ethnic minority are at more risk of severe infection with SARS-CoV-2.
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Affiliation(s)
- Siobhán B Carr
- Royal Brompton Hospital, part of GSST NHS Foundation Trust, London, UK; NHLI, Imperial College, London, UK.
| | - Elliot McClenaghan
- Cystic Fibrosis Trust, London, UK; London School of Hygiene and Tropical Medicine, London, UK
| | | | | | | | | | | | - Pierre-Régis Burgel
- Université de Paris, Inserm U1016, Institut Cochin and Cochin Hospital, Assistance Publique Hôpitaux de Paris (APHP), France
| | - Catherine A Byrnes
- Starship Children's Hospital and University of Auckland, Auckland, New Zealand
| | | | - Carla Colombo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Italy
| | - Harriet Corvol
- Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, Assistance Publique Hôpitaux de Paris (APHP), Hôpital Trousseau, Service de Pneumologie Pédiatrique, Paris, France
| | | | | | | | | | | | | | - Andreas Jung
- University Children's Hospital, Zurich, Switzerland
| | | | | | | | | | | | - Isabelle de Monestrol
- Department of Pediatrics, CLINTEC, Karolinska Institutet; Karolinska University Hospital Huddinge, Sweden
| | - Lutz Nährlich
- Department of Pediatrics, Justus-Liebig-University Giessen, Giessen, Germany
| | - Rita Padoan
- Cystic Fibrosis Support Center, Department of Paediatric, University of Brescia, Italy
| | | | | | | | | | - Marco Salvatore
- Istituto Superiore di Sanita, National Center Rare Diseases, Undiagnosed Rare Diseases Interdepartmental Unit, Rome, Italy
| | | | | | - Marco Zampoli
- University of Cape Town and Red Cross War Memorial Children's Hospital, South Africa
| | | | - Anne L Stephenson
- Cystic Fibrosis, Canada; Toronto Adult Cystic Fibrosis Centre, St. Michael's Hospital, Toronto, Canada
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15
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Ruseckaite R, Maharaj AD, Dean J, Krysinska K, Ackerman IN, Brennan AL, Busija L, Carter H, Earnest A, Forrest CB, Harris IA, Sansoni J, Ahern S. Preliminary development of recommendations for the inclusion of patient-reported outcome measures in clinical quality registries. BMC Health Serv Res 2022; 22:276. [PMID: 35232454 PMCID: PMC8886855 DOI: 10.1186/s12913-022-07657-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 02/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Clinical quality registries (CQRs) monitor compliance against optimal practice and provide feedback to the clinical community and wider stakeholder groups. Despite a number of CQRs having incorporated the patient perspective to support the evaluation of healthcare delivery, no recommendations for inclusion of patient-reported outcome measures (PROMs) in CQRs exist. The aim of this study was to develop a core set of recommendations for PROMs inclusion of in CQRs. METHOD An online two-round Delphi survey was performed among CQR data custodians, quality of life researchers, biostatisticians and clinicians largely recruited in Australia. A list of statements for the recommendations was identified from a literature and survey of the Australian registries conducted in 2019. The statements were grouped into the following domains: rationale, setting, ethics, instrument, administration, data management, statistical methods, and feedback and reporting. Eighteen experts were invited to participate, 11 agreed to undertake the first online survey (round 1). Of these, nine experts completed the online survey for round 2. RESULTS From 117 statements presented to the Delphi panel in round 1, a total of 72 recommendations (55 from round 1 and 17 from round 2) with median importance (MI) ≥ 7 and disagreement index (DI) < 1 were proposed for inclusion into the final draft set and were reviewed by the project team. Recommendations were refined for clarity and to read as stand-alone statements. Ten overlapped conceptually and, therefore, were merged to reduce repetition. The final 62 recommendations were sent for review to the panel members for their feedback, which was incorporated into the final set. CONCLUSION This is the first study to develop preliminary recommendations for PROMs inclusion in CQRs. Recommendations for PROMs implementation are critically important for registries to assure meaningful PROMs data capture, use, interpretation, and reporting to improve health outcomes and healthcare value.
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Affiliation(s)
- Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Ashika D Maharaj
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Joanne Dean
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Karolina Krysinska
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ilana N Ackerman
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Angela L Brennan
- Centre of Cardiovascular Research and Education in Therapeutics, Monash University, Melbourne, Victoria, 3004, Australia
| | - Ljoudmila Busija
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Helen Carter
- Australian Stroke Clinical Registry, The Florey Institute of Neuroscience & Mental Health, Melbourne, Victoria, Australia
| | - Arul Earnest
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | - Ian A Harris
- Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Sydney, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Janet Sansoni
- Centre for Health Service Development, Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia
| | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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16
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Ruseckaite R, Bavor C, Marsh L, Dean J, Daly O, Vasiliadis D, Ahern S. Evaluation of the acceptability of patient-reported outcome measures in women following pelvic floor procedures. Qual Life Res 2022; 31:2213-2221. [PMID: 35113307 PMCID: PMC9188490 DOI: 10.1007/s11136-022-03099-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE Patient-reported outcome measures (PROMs) are valuable tools in evaluating the outcomes of surgical treatment health-related quality of life (HRQoL) of women with stress urinary incontinence (SUI) and may be incorporated into related clinical quality registries. The aim of this study was to assess the feasibility and acceptability of incorporating PROMs into the Australian Pelvic Floor Procedure Registry (APFPR). METHODS Semi-structured qualitative interviews were conducted with women with SUI (N = 12) and their managing clinicians (N = 11) in Victoria, Australia. Interview topics covered content and face validity, appropriateness, and acceptability of three incontinence-specific, two pain, one anxiety and depression, one sexual function and one patient global impression of improvement instruments identified through the literature to determine their suitability and acceptability for the APFPR. We analysed interview data into topics using conventional content analysis. RESULTS Study participants agreed that PROMs were needed for the APFPR. Both participant groups suggested that some of the instruments were ambiguous, therefore only three instruments (one incontinence-specific, sexual function and patient global impression of improvement) will be included in the APFPR. Both clinicians and women agreed it would be appropriate to answer PROMs at baseline and then at 6- and 12-month postsurgically. Email, phone call and mail-out of the instruments were the preferred options for administration. CONCLUSION Most women and clinicians supported the feasibility of incorporating PROMs in the APFPR. Participants believed the PROMs would demonstrate useful aggregate HRQoL data and have potential for use in individual care.
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Affiliation(s)
- Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
| | - Claire Bavor
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Lucy Marsh
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Joanne Dean
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Oliver Daly
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.,Department of Obstetrics and Gynaecology, Western Health, Melbourne, VIC, Australia
| | - Dora Vasiliadis
- Consumer Representative, Australian Pelvic Floor Procedure Registry, Melbourne, Australia
| | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
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17
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Jayasinghe RT, Ruseckaite R, Gartoulla P, Elder E, Hopper I. Patient Reported Outcome Measures After Breast Augmentation - Using the BREAST-Q IS. Patient Relat Outcome Meas 2022; 13:1-8. [PMID: 35046741 PMCID: PMC8761034 DOI: 10.2147/prom.s330163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 11/16/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Cosmetic breast augmentation procedures are commonly performed breast device surgeries. The Australian Breast Device Registry (ABDR) administers a five-question patient reported outcome measure (PROM), the BREAST-Q Implant Surveillance module (BREAST-Q IS), to patients 1, 2 and 5 years after breast device surgery. The measure includes an open-ended question to add any comments. This study aimed to use the responses to this open-ended question to assess participants' experiences of breast devices 1 and 2 years after breast augmentation. The secondary objective was to identify emerging and important issues relating to breast augmentation and devices. PATIENTS AND METHODS This qualitative descriptive study was conducted using a randomly selected sample of 268 responses to the open-ended question in the BREAST-Q IS, from the ABDR database. These responses were from patients who underwent breast augmentation between 2015 and 2018. Comments were analyzed using conventional content analysis in NVivo 12. RESULTS Four major themes were identified: satisfaction following breast augmentation, dissatisfaction following breast augmentation, complications and breast symptoms following breast augmentation and other comments. Two dominant themes were regarding satisfaction (n = 112) with overall surgical outcome, medical team, and post-operative appearance and complications and breast symptoms (n = 177) following breast augmentation. Emerging issues identified were rippling of breast implants and breast implant illness (BII). CONCLUSION PROMs can be used to understand patients' perspectives on various aspects of their own surgical experiences. Participants provided responses regarding complications and breast symptoms experienced, and rippling of the breast implants and BII are emerging issues after breast augmentation.
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Affiliation(s)
- Randi T Jayasinghe
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Pragya Gartoulla
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Elisabeth Elder
- Westmead Breast Cancer Institute and Breast Surgeons of Australia and New Zealand, Westmead, NSW, Australia
| | - Ingrid Hopper
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Ruseckaite R, Herdiman J, Ahern S. 333: Perceptions of telehealth of patients with cystic fibrosis and their caregivers during the COVID-19 pandemic in Australia. J Cyst Fibros 2021. [PMCID: PMC8518445 DOI: 10.1016/s1569-1993(21)01757-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Coriati A, Ma X, Sykes J, Stanojevic S, Ruseckaite R, Lemonnier L, Tate J, Byrnes C, Bell S, Burgel P, Stephenson A. 36: International comparison of survival in cystic fibrosis between Canada, France, and Australia. J Cyst Fibros 2021. [DOI: 10.1016/s1569-1993(21)01461-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ayton DR, Gardam ML, Pritchard EK, Ruseckaite R, Ryan J, Robinson SJ, Brodaty H, Ward SA, Ahern S. Patient-Reported Outcome Measures to Inform Care of People With Dementia-A Systematic Scoping Review. Gerontologist 2021; 61:e185-e194. [PMID: 32369109 DOI: 10.1093/geront/gnz179] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Patient-reported outcome measures (PROMs) captures the patient's perspective regarding quality of life, daily functioning, symptom severity, and overall health, and how these may be impacted by health care or other interventions. PROMs are used in clinical quality registries (CQRs) for a number of diseases to assess the patient's perspective of the impact of clinical care on quality-of-life. This scoping review aimed to identify dementia-specific PROMs, determine how the PROMs are being used, and whether they are used within dementia registries. RESEARCH DESIGN AND METHODS Three electronic databases were searched using Medical Subject Heading terms for dementia, quality of life, and patient-reported outcomes. Data were extracted on the PROMs used and the methods and mode of administering the PROM. RESULTS Seven dementia-specific PROMs were identified, however none were used in a dementia registry. All the PROMs were used at the patient level to identify patient needs and health service impacts. Three PROMs were also used at a system level to examine difference in care models. The majority of the PROMs were administered via a researcher or clinician and were predominantly completed by a proxy. DISCUSSION AND IMPLICATIONS PROMs provide an opportunity for a patient with dementia to share experiences and perspectives of care. A number of dementia-specific PROMs exist, yet none are used in dementia registries and the majority of studies utilize PROMs via a proxy. The use of PROM for patients with dementia, particularly in the context of dementia registries, requires further exploration and consideration.
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Affiliation(s)
- Darshini R Ayton
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Madeleine L Gardam
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Elizabeth K Pritchard
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Joanne Ryan
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Sandra J Robinson
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Stephanie A Ward
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Ratnayake I, Ahern S, Ruseckaite R. Acceptability of patient reported outcome measures (PROMs) in a cystic fibrosis data registry. BMJ Open Respir Res 2021; 8:8/1/e000927. [PMID: 34281916 PMCID: PMC8291302 DOI: 10.1136/bmjresp-2021-000927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 06/27/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Improvements in the treatment of cystic fibrosis (CF) have resulted in longer survival and an increased focus on optimising daily functioning with the condition. Patient-reported outcome measures (PROMs) are valuable tools in evaluating the health-related quality of life of persons with chronic diseases. PROMs may be incorporated into clinical registries to assess and provide feedback regarding the health-related quality of life of the affected population. This study uses qualitative methodology to describe the views of patients with CF, caregivers and clinicians on the usefulness and practicality of incorporating a PROM in the Australian Cystic Fibrosis Data Registry (ACFDR). Methods We conducted semistructured interviews with a convenience sample of patients with CF (n=5), caregivers (n=7) and clinicians (n=13) on their opinions on incorporating the Cystic Fibrosis Questionnaire-Revised or the Cystic Fibrosis Quality of Life Questionnaire into the ACFDR. We analysed data into topics and subtopics using conventional content analysis. Results Participants believed that PROMs could generate useful aggregate health-related quality of life data to support better understanding of the experiences of the modern CF population. Participants emphasised that implementation must be supported by processes to feedback data to patients and clinicians. Most participants preferred electronic PROMs administration for easy integration into existing systems and the potential to support feedback. Conclusion Patients, caregivers and clinicians in this study generally supported the usefulness and practicality of PROM implementation in the ACFDR.
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Affiliation(s)
- Irushi Ratnayake
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Moore EC, Ioannou L, Ruseckaite R, Serpell J, Ahern S. Hereditary Endocrine Tumors and Associated Syndromes: A Narrative Review for Endocrinologists and Endocrine Surgeons. Endocr Pract 2021; 27:1165-1174. [PMID: 34265452 DOI: 10.1016/j.eprac.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Hereditary endocrine tumors (HET) were among the first group of tumors where predisposition syndromes were recognized. The utility of genetic awareness is having the capacity to treat at an earlier stage, screen for other manifestations and initiate family cascade testing. The aim of this narrative review is to describe the most common hereditary syndromes associated with frequently encountered endocrine tumors, with an emphasis on screening and surveillance. METHODS A MEDLINE search of articles for relevance to endocrine tumors and hereditary syndromes was performed. RESULTS The most common hereditary syndromes associated with frequently encountered endocrine tumors are described in terms of prevalence, genotype, phenotype, penetrance of malignancy, surgical management, screening and surveillance. CONCLUSION Medical practitioners involved in the care of patients with endocrine tumors, should have an index of suspicion for an underlying hereditary syndrome. Interdisciplinary care is integral to successful, long-term management of these patients and affected family members.
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Affiliation(s)
- Edwina C Moore
- Department of Endocrine Surgery, Peninsula Private Hospital and Department of Public Health and Preventive Medicine, Monash University.
| | - Liane Ioannou
- Department of Public Health and Preventive Medicine, Monash University
| | - Rasa Ruseckaite
- Department of Public Health and Preventive Medicine, Monash University
| | - Jonathan Serpell
- Department of Breast, Endocrine and General Surgery, Alfred Health, Monash University
| | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, Monash University
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Bryant J, Sellars M, Waller A, Detering K, Sinclair C, Ruseckaite R, White B, Nolte L. Advance care planning participation by people with dementia: a cross-sectional survey and medical record audit. BMJ Support Palliat Care 2021; 12:bmjspcare-2020-002550. [PMID: 33658249 PMCID: PMC9380490 DOI: 10.1136/bmjspcare-2020-002550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 11/26/2020] [Accepted: 12/01/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To describe among individuals with dementia: (1) self-reported awareness of, and engagement in, advance care planning; (2) presence of advance care planning documentation in the health record and (3) concordance between self-reported completion of advance care planning and presence of documentation in the health record. METHODS An Australian prospective multicentre audit and cross-sectional survey. Individuals diagnosed with dementia who were able to speak English and were judged by a healthcare provider as having decision-making capacity were recruited from self-selected hospitals, residential aged care facilities and general practices across Australia. RESULTS Fifty-two people with dementia completed surveys and were included. Overall, 59.6% of participants had heard about advance care planning and 55.8% had discussed advance care planning with someone, most often a family member (48.1%). While 38.5% of participants had appointed a medical substitute decision maker, only 26.9% reported that they had written down their values and preferences for future care. Concordance between self-reported completion of advance care planning and presence of documentation in the health record was low (56.8%, κ=0.139; 57.7%, κ=0.053). CONCLUSION Effective models that promote discussion, documentation and accessible storage of advance care planning documents for people with dementia are needed.
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Affiliation(s)
- Jamie Bryant
- Health Behaviour Research Collaborative,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- School of Medicine and Public Health, Health Behaviour Research Collaborative, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Marcus Sellars
- Advance Care Planning Australia, Austin Health, Melbourne, Victoria, Australia
| | - Amy Waller
- Health Behaviour Research Collaborative,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia
- School of Medicine and Public Health, Health Behaviour Research Collaborative, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Karen Detering
- Advance Care Planning Australia, Austin Health, Melbourne, Victoria, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Craig Sinclair
- Centre of Excellence in Population Ageing Research, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Ben White
- Australian Centre for Health Law Research, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Linda Nolte
- Advance Care Planning Australia, Austin Health, Melbourne, Victoria, Australia
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Ahern S, Dean J, Liman J, Ruseckaite R, Burke N, Gollan M, Keatley L, King S, Kotsimbos T, Middleton PG, Schultz A, Wainwright C, Wark P, Bell S. Redesign of the Australian Cystic Fibrosis Data Registry: A multidisciplinary collaboration. Paediatr Respir Rev 2021; 37:37-43. [PMID: 32331762 DOI: 10.1016/j.prrv.2020.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 03/19/2020] [Indexed: 10/24/2022]
Abstract
Clinical registries that monitor and review outcomes for patients with cystic fibrosis have existed internationally for many decades. However, their purpose continues to evolve and now includes the capability to support clinical effectiveness research, clinical trials and Phase IV studies, and international data comparisons and projects. To achieve this, registries must regularly update the information that they collect and ensure design that is adaptable and flexible to changing needs. The Australian Cystic Fibrosis Data Registry commenced in 1998, and in 2018-19 undertook a transformation to enable it to meet the needs of multiple stakeholders into the future. This included a comprehensive, multidisciplinary review of the registry's data elements, and a redesign and rebuild of the registry's database. The data element review comprised the processes of alignment, comparison, selection, consolidation, revision and definition of finalised data elements. The database redesign included attention to each of the registry functions of data collection, storage and management, and reporting. The revision of a national data collection system is a time-intensive process, and requires significant clinical and other expert engagement. The resulting database, while being continually refined, is now fit for purpose to support Australian clinicians and patients with CF to receive best practice care.
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Affiliation(s)
- Susannah Ahern
- Monash University, Department of Epidemiology and Preventive Medicine. 553 St Kilda Rd, Melbourne, Victoria 3004, Australia.
| | - Joanne Dean
- Monash University, Department of Epidemiology and Preventive Medicine. 553 St Kilda Rd, Melbourne, Victoria 3004, Australia.
| | - John Liman
- Monash University, Department of Epidemiology and Preventive Medicine. 553 St Kilda Rd, Melbourne, Victoria 3004, Australia.
| | - Rasa Ruseckaite
- Monash University, Department of Epidemiology and Preventive Medicine. 553 St Kilda Rd, Melbourne, Victoria 3004, Australia.
| | - Nettie Burke
- Cystic Fibrosis Australia, 2 Richardson Place North, Ryde, NSW 2113, Australia.
| | - Morgan Gollan
- Australian Cystic Fibrosis Data Registry, Victoria 3004, Australia
| | - Lucy Keatley
- Westmead Hospital, Cnr Hawkesbury Rd and Darcy Rd, NSW 2145, Australia.
| | - Susannah King
- The Alfred, 55 Commercial Rd, Melbourne, Victoria 3004, Australia; Department of Dietetics, Nutrition and Sport, LaTrobe University, Bundoora, Victoria 3086, Australia.
| | - Tom Kotsimbos
- The Alfred, 55 Commercial Rd, Melbourne, Victoria 3004, Australia.
| | - Peter G Middleton
- Westmead Hospital, Cnr Hawkesbury Rd and Darcy Rd, NSW 2145, Australia; Westmead Clinical School, University of Sydney, Australia.
| | - Andre Schultz
- Perth Children's Hospital, 15 Hospital Avenue, Nedlands, Western Australia 6009, Australia.
| | - Claire Wainwright
- Queensland Children's Hospital, 501 Stanley St South, Brisbane, Queensland 4101, Australia.
| | - Peter Wark
- John Hunter Hospital, Newcastle, Lookout Rd, New Lambton Heights, NSW 2305, Australia.
| | - Scott Bell
- Translational Research Institute 37 Kent Street Woolloongabba, Queensland 4102, Australia.
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McClenaghan E, Cosgriff R, Brownlee K, Ahern S, Burgel PR, Byrnes C, Colombo C, Corvol H, Cheng S, Daneau G, Elbert A, Faro A, Goss C, Gulmans V, Gutierrez H, de Monestrol I, Jung A, Nährlich L, Kashirskaya N, Marshall B, McKone E, Middleton P, Mondejar-Lopez P, Pastor-Vivero M, Padoan R, Rizvi S, Ruseckaite R, Salvatore M, Stephenson A, da Silva Filho L, Melo J, Zampoli M, Abdrakhmanov O, Harutyunyan S, Carr S. P083 Clinical progression of SARS-CoV-2 infection in people with cystic fibrosis: a global observational study. J Cyst Fibros 2021. [PMCID: PMC8192143 DOI: 10.1016/s1569-1993(21)01110-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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McClenaghan E, Cosgriff R, Brownlee K, Ahern S, Burgel PR, Byrnes CA, Colombo C, Corvol H, Cheng SY, Daneau G, Elbert A, Faro A, Goss CH, Gulmans V, Gutierrez H, de Monestrol I, Jung A, Justus LN, Kashirskaya N, Marshall BC, McKone E, Middleton PG, Mondejar-Lopez P, Pastor-Vivero MD, Padoan R, Rizvi S, Ruseckaite R, Salvatore M, Stephenson AL, Filho LVRDS, Melo J, Zampoli M, Carr SB. The global impact of SARS-CoV-2 in 181 people with cystic fibrosis. J Cyst Fibros 2020; 19:868-871. [PMID: 33183965 PMCID: PMC7641525 DOI: 10.1016/j.jcf.2020.10.003] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/21/2020] [Accepted: 10/23/2020] [Indexed: 01/06/2023]
Abstract
With the growing SARS-CoV-2 pandemic, we need to better understand its impact in specific patient groups like those with Cystic Fibrosis (CF). We report on 181 people with CF (32 post-transplant) from 19 countries diagnosed with SARS-CoV-2 prior to 13 June 2020. Infection with SARS-CoV-2 appears to exhibit a similar spectrum of outcomes to that seen in the general population, with 11 people admitted to intensive care (7 post-transplant), and 7 deaths (3 post-transplant). A more severe clinical course may be associated with older age, CF-related diabetes, lower lung function in the year prior to infection, and having received an organ transplant. Whilst outcomes in this large cohort are better than initially feared overall, possibly due to a protective effect of the relatively younger age of the CF population compared to other chronic conditions, SARS-CoV-2 is not a benign disease for all people in this patient group.
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Affiliation(s)
| | - Rebecca Cosgriff
- Cystic Fibrosis Trust, UK CF Registry, 1 Aldgate, London EC3N 1RE, UK
| | - Keith Brownlee
- Cystic Fibrosis Trust, UK CF Registry, 1 Aldgate, London EC3N 1RE, UK
| | | | - Pierre-Régis Burgel
- Université de Paris, Inserm U1016, Institut Cochin and Cochin Hospital, Assistance Publique Hôpitaux de Paris (APHP), France
| | - Catherine A Byrnes
- Starship Children's Hospital and University of Auckland, Auckland, New Zealand
| | - Carla Colombo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Harriet Corvol
- Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, Assistance Publique Hôpitaux de Paris (APHP), Hôpital Trousseau, Service de Pneumologie Pédiatrique, Paris, France
| | | | | | | | | | | | | | | | | | - Andreas Jung
- University Children's Hospital Zurich, Switzerland
| | | | | | | | | | | | | | | | - Rita Padoan
- Cystic Fibrosis Support Center, Department of Paediatric, University of Brescia, Italy
| | | | | | - Marco Salvatore
- National Center Rare Diseases Undiagnosed Rare Diseases Interdepartmental Unit Istituto Superiore di Sanità, Rome, Italy
| | - Anne L Stephenson
- Cystic Fibrosis Canada, Canada; Toronto Adult Cystic Fibrosis Centre, St. Michael's Hospital, Toronto, Canada
| | | | | | - Marco Zampoli
- University of Cape Town and Red Cross War Memorial Children's Hospital, South Africa
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Abstract
BACKGROUND To determine patient-reported outcome measures (PROMs) which may be suitable for incorporation into the Australian Cystic Fibrosis Data Registry (ACFDR) by identifying PROMs administered in adult and paediatric cystic fibrosis (CF) populations in the last decade. METHODS We searched MEDLINE, EMBASE, Scopus, CINAHL, PsycINFO and Cochrane Library databases for studies published between January 2009 and February 2019 describing the use of PROMs to measure health-related quality of life (HRQoL) in adult and paediatric patients with CF. Validation studies, observational studies and qualitative studies were included. The search was conducted on 13 February 2019. The COnsensus-based Standards for the selection of health Measurement INstruments Risk of Bias Checklist was used to assess the methodological quality of included studies. RESULTS Twenty-seven different PROMs were identified. The most commonly used PROMs were designed specifically for CF. Equal numbers of studies were conducted on adult (32%, n=31), paediatric (35%, n=34) and both (27%, n=26) populations. No PROMs were used within a clinical registry setting previously. The two most widely used PROMs, the Cystic Fibrosis Questionnaire-Revised (CFQ-R) and the Cystic Fibrosis Quality of Life Questionnaire (CFQoL), demonstrated good psychometric properties and acceptability in English-speaking populations. DISCUSSION We found that although PROMs are widely used in CF, there is a lack of reporting on the efficacy of methods and timepoints of administration. We identified the CFQ-R and CFQoL as the most suitable for incorporation in the ACFDR as they captured significant effects of CF on HRQoL and were reliable and valid in CF populations. These PROMs will be used in a further qualitative study assessing patients' with CF and clinicians' perspectives toward the acceptability and feasibility of incorporating a PROM in the ACFDR. PROSPERO REGISTRATION NUMBER CRD42019126931.
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Affiliation(s)
- Irushi Ratnayake
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Victoria, Australia
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Moore EM, King TA, Wood EM, Ruseckaite R, Klarica D, Spencer A, Ho PJ, Quach H, Prince HM, McQuilten ZK. Patient-reported outcome measures in multiple myeloma: Real-time reporting to improve care (My-PROMPT) - a pilot randomized controlled trial. Am J Hematol 2020; 95:E178-E181. [PMID: 32243613 DOI: 10.1002/ajh.25815] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 03/28/2020] [Indexed: 11/07/2022]
Affiliation(s)
- Elizabeth M Moore
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Tracy A King
- Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Cancer Nursing Research Unit, University of Sydney, Sydney, Australia
| | - Erica M Wood
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Rasa Ruseckaite
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Daniela Klarica
- Department of Malignant Haematology, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Andrew Spencer
- Department of Malignant Haematology, The Alfred Hospital, Melbourne, Victoria, Australia
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - P Joy Ho
- Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Hang Quach
- University of Melbourne, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - H Miles Prince
- Epworth Healthcare and University of Melbourne, Melbourne, Victoria, Australia
| | - Zoe K McQuilten
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Sellars M, Detering KM, Sinclair C, White BP, Buck K, Ruseckaite R, Clayton JM, Nolte L. Personal and Interpersonal Factors and Their Associations With Advance Care Planning Documentation: A Cross-sectional Survey of Older Adults in Australia. J Pain Symptom Manage 2020; 59:1212-1222.e3. [PMID: 31899284 DOI: 10.1016/j.jpainsymman.2019.12.371] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 11/23/2022]
Abstract
CONTEXT Personal and interpersonal factors may be influential in a person's decision to engage in advance care planning (ACP), including completion of ACP documentation. OBJECTIVES To conduct a cross-sectional survey of older adults accessing Australian general practices, hospitals, and residential aged care facilities, with the aim of describing associations between personal and interpersonal factors and self-reported ACP documentation completion. METHODS Eligible participants included in a national health record audit were approached to complete a survey measuring demographic and health characteristics, preferences for care, worries about the future, and experiences talking with others about ACP and completing ACP documentation. RESULTS Of 1082 people eligible to participate in the survey, 507 completed the survey (response rate = 47%; median age 82 years) and 54% (n = 272) reported having completed ACP documentation. Having ever discussed ACP with other people (anyone) or a doctor were both significant predictors of ACP documentation completion, whereas having previously spoken specifically to a partner about ACP, currently living with children compared to living alone, and being aged 55-69 versus 90-99 years were associated with reduced odds of ACP documentation completion. CONCLUSION Approximately half the participants reported having completed ACP documentation. The strongest predictor of ACP documentation completion was having spoken to anyone about ACP followed by having spoken to a doctor about ACP. These findings suggest that discussions about ACP are an important part of the process of completing ACP documentation.
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Affiliation(s)
- Marcus Sellars
- Advance Care Planning Australia, Austin Health, Melbourne, Australia; Kolling Institute, Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, Australia.
| | - Karen M Detering
- Advance Care Planning Australia, Austin Health, Melbourne, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | - Craig Sinclair
- Centre of Excellence in Population Ageing Research, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia
| | - Ben P White
- Australian Centre for Health Law Research, Faculty of Law, Queensland University of Technology, Brisbane, Australia
| | - Kimberly Buck
- Advance Care Planning Australia, Austin Health, Melbourne, Australia
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Josephine M Clayton
- Kolling Institute, Northern Clinical School, Faculty of Medicine, University of Sydney, Sydney, Australia; HammondCare Centre for Learning & Research in Palliative Care, Greenwich Hospital and University of Sydney, Sydney, Australia
| | - Linda Nolte
- Advance Care Planning Australia, Austin Health, Melbourne, Australia
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Ratnayake I, Ahern S, Ruseckaite R. Patient-Reported Outcome Measures in Cystic Fibrosis: Protocol for a Systematic Review. JMIR Res Protoc 2020; 9:e15467. [PMID: 32374269 PMCID: PMC7240448 DOI: 10.2196/15467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 11/24/2019] [Accepted: 02/26/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients with cystic fibrosis (CF) can struggle with burdensome symptoms and treatment regimens that negatively affect every aspect of their life. As physiological parameters can fail to capture these complications, the assessment of health-related quality of life (HRQOL) has gained prominence. HRQOL can be measured using standardized patient questionnaires called patient-reported outcome measures (PROMs). The Australian Cystic Fibrosis Data Registry (ACFDR) collects clinical data on adult and pediatric patients with CF. The incorporation of PROMs into the ACFDR would enable monitoring of HRQOL trends, benchmarking of HRQOL outcomes, and support of HRQOL research in CF. OBJECTIVE Prior to incorporation of a PROM in the ACFDR, this systematic review was planned to evaluate whether any suitable PROMs are currently being used for CF. METHODS This systematic review will be conducted in compliance with the PRISMA-P (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols) guidelines. MEDLINE, EMBASE, Scopus, CINAHL (Cumulative Index of Nursing and Allied Health Literature), PsycINFO, and Cochrane Library databases were searched for articles published between January 2009 and February 2019 on the use of PROMs to measure HRQOL in adult and pediatric patients with CF. Study designs such as observational studies, reviews and validation studies were included. Studies describing randomized controlled trials, dissertations, books, guideline statements, and abstracts were excluded. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) risk of bias checklist was used to assess the methodological quality of included studies. A descriptive synthesis of the results will be undertaken in line with the outcomes of this study. RESULTS As of July 2019, the search has been conducted and 4530 records were screened. After two phases of screening, 97 studies were included in the final review and subjected to data extraction. Reviewers are currently in the process of critical appraisal. CONCLUSIONS This review will identify any PROM(s) that may be used to measure HRQOL in the ACFDR. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42019126931; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=126931.
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Affiliation(s)
- Irushi Ratnayake
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
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Cosgriff R, Ahern S, Bell SC, Brownlee K, Burgel PR, Byrnes C, Corvol H, Cheng SY, Elbert A, Faro A, Goss CH, Gulmans V, Marshall BC, McKone E, Middleton PG, Ruseckaite R, Stephenson AL, Carr SB. A multinational report to characterise SARS-CoV-2 infection in people with cystic fibrosis. J Cyst Fibros 2020; 19:355-358. [PMID: 32376098 PMCID: PMC7183287 DOI: 10.1016/j.jcf.2020.04.012] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 04/22/2020] [Accepted: 04/22/2020] [Indexed: 01/08/2023]
Abstract
Information is lacking on the clinical impact of the novel coronavirus, SARS-CoV-2, on people with cystic fibrosis (CF). Our aim was to characterise SARS-CoV-2 infection in people with cystic fibrosis. METHODS Anonymised data submitted by each participating country to their National CF Registry was reported using a standardised template, then collated and summarised. RESULTS 40 cases have been reported across 8 countries. Of the 40 cases, 31 (78%) were symptomatic for SARS-CoV-2 at presentation, with 24 (60%) having a fever. 70% have recovered, 30% remain unresolved at time of reporting, and no deaths have been submitted. CONCLUSIONS This early report shows good recovery from SARS-CoV-2 in this heterogeneous CF cohort. The disease course does not seem to differ from the general population, but the current numbers are too small to draw firm conclusions and people with CF should continue to strictly follow public health advice to protect themselves from infection.
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Affiliation(s)
| | | | - Scott C Bell
- The Prince Charles Hospital, Brisbane, Australia
| | | | - Pierre-Régis Burgel
- Université de Paris, Inserm U1016, Institut Cochin and Cochin Hospital, Assistance Publique Hôpitaux de Paris (APHP)
| | - Cass Byrnes
- University of Auckland, Auckland, New Zealand
| | - Harriet Corvol
- Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, Assistance Publique Hôpitaux de Paris (APHP), Hôpital Trousseau, Service de Pneumologie Pédiatrique, Paris, France
| | | | | | | | | | | | | | | | | | | | - Anne L Stephenson
- Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, Assistance Publique Hôpitaux de Paris (APHP), Hôpital Trousseau, Service de Pneumologie Pédiatrique, Paris, France; Toronto Adult Cystic Fibrosis Centre, St. Michael's Hospital, Toronto, Canada
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Ayton D, Soh SE, Morello R, Ahern S, Earnest A, Brennan A, Lefkovits J, Evans S, Reid C, Ruseckaite R, McNeil J. Development of a percutaneous coronary intervention patient level composite measure for a clinical quality registry. BMC Health Serv Res 2020; 20:44. [PMID: 31952535 PMCID: PMC6969470 DOI: 10.1186/s12913-019-4814-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 06/12/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Composite measures combine data to provide a comprehensive view of patient outcomes. Despite composite measures being a valuable tool to assess post-intervention outcomes, the patient perspective is often missing. The purpose of this study was to develop a composite measure for an established cardiac outcome registry, by combining clinical outcomes following percutaneous coronary interventions (PCI) with a patient-reported outcome measure (PROM) developed specifically for this population (MC-PROM). METHODS Two studies were undertaken. Study 1: Patients who had undergone a PCI at one of the three participating registry hospital sites completed the 5-item MC-PROM. Clinical outcome data for the patients (e.g. death, myocardial infarction, repeat vascularisation, new bleeding event) were collected 30 days post-intervention as part of routine data collection for the cardiac registry. Exploratory factor analysis of clinical outcomes and MC-PROM data was conducted to determine the minimum number of constructs to be included in a composite measure. Study 2: Clinical experts participated in a Delphi technique, consisting of three rounds of online surveys, to determine the clinical outcomes to be included and the weighting of the clinical outcomes and MC-PROM score for the composite measure. RESULTS Study 1: Routine clinical outcomes and the MC-PROM data were collected from 266 patients 30 days post PCI. The MC-PROM score was not significantly correlated with any clinical outcomes. Study 2: There was a relatively consistent approach to the weighting of the clinical outcomes and MC-PROM items by the expert panel (n = 18) across the three surveys with the exception of the clinical outcome of 'deceased at 30 days'. The final composite measure included five clinical outcomes within 30 days weighted at 90% (new heart failure, new myocardial infarction, new stent thrombosis, major bleeding event, new stroke, unplanned cardiac rehospitalisation) and the MC-PROM score (comprising 10% of the total weighting). CONCLUSIONS A single patient level composite score, which incorporates weighted clinical outcomes and a PROM was developed. This composite score provides a more comprehensive reported measure of individual patient wellbeing at 30 days post their PCI-procedure, and may assist clinicians to further assess and address patient level factors that potentially impact on clinical recovery.
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Affiliation(s)
- Darshini Ayton
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Sze-Ee Soh
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
- Department of Physiotherapy, Monash University, Melbourne, Australia
| | - Renata Morello
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Arul Earnest
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Angela Brennan
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Jeffrey Lefkovits
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Susan Evans
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Christopher Reid
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
- NHMRC Centre for Research Excellence in Cardiovascular Outcomes Improvement, Curtin University, Bentley, Western Australia Australia
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - John McNeil
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
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Ruseckaite R, Richards C, Rutherford C, Team V, Turnour L, Franks P, Weller C. A conceptual framework of patient-reported outcomes in people with venous leg ulcers. Wound Repair Regen 2019; 28:355-363. [PMID: 31794080 DOI: 10.1111/wrr.12787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/11/2019] [Accepted: 11/22/2019] [Indexed: 02/07/2023]
Abstract
Venous leg ulcers (VLUs) are a common chronic often undertreated condition, which affects individual's health-related quality of life (HRQoL). Numerous patient-reported outcome measures (PROMs) have been validated to capture HRQoL in patients with VLUs. However, available instruments contain many items, are hard to use in clinical practice, and present with weak responsiveness. This study aims to determine clinical utility of an existing VLU-QoL instrument and to develop a comprehensive PROs assessment framework to guide clinical practice treatment in people with VLUs in Australia. Semi-structured qualitative interviews were conducted with VLU patients (N = 13) and their managing clinicians (N = 6) in Victoria, Australia. Interview topics covered content and face validity, appropriateness, and acceptability of the VLU-QoL instrument to determine suitable and appropriate for use in clinical practice. Clinicians and patients agreed that a VLU-QoL instrument was needed in clinical practice. Both clinicians and patients agreed it would be appropriate to answer PROMs questions prior to consultation with clinicians every 3-6 months. However, patients considered that some of the questions are ambiguous and too technical. Patients reported that it would be useful to include additional items relating to daily wound care, compression bandaging, and dressings. Clinicians reported that the VLU-QoL instrument was too long and required restructuring to facilitate utility in practice. A conceptual framework for HRQoL in VLUs included traditional HRQoL components and VLU-specific issues. Overall, the VLU-QoL was well accepted, although changes to make it more concise, comprehensive, and to clearly reflect consumers' perspectives were lacking. The proposed conceptual framework will inform the development of a new PROM for use by clinicians and patients in clinical settings.
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Affiliation(s)
- Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Catelyn Richards
- Wound Research Unit, Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
| | - Claudia Rutherford
- Faculty of Science, School of Psychology, University of Sydney, Sydney, New South Wales, Australia.,Sydney Nursing School, Cancer Nursing Research Unit (CNRU), University of Sydney, Sydney, New South Wales, Australia
| | - Victoria Team
- Wound Research Unit, Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
| | - Louise Turnour
- Wound Research Unit, Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
| | - Peter Franks
- Centre for Research and Implementation of Clinical Practice, London, United Kingdom
| | - Carolina Weller
- Wound Research Unit, Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
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Ruseckaite R, Maharaj AD, Krysinska K, Dean J, Ahern S. Developing a Preliminary Conceptual Framework for Guidelines on Inclusion of Patient Reported-Outcome Measures (PROMs) in Clinical Quality Registries. Patient Relat Outcome Meas 2019; 10:355-372. [PMID: 31849553 PMCID: PMC6911317 DOI: 10.2147/prom.s229569] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 11/27/2019] [Indexed: 11/25/2022]
Abstract
Purpose Patient-centred and value-based health-care organisations are increasingly recognising the importance of the patient perspective in the measurement and evaluation of health outcomes. This has been primarily implemented using patient-reported outcome measures (PROMs). Clinical quality registries (CQRs) are specifically designed to improve direct clinical care, benchmark health-care provision and inform health service planning and policy. Despite CQRs having incorporated the patient perspective to support the evaluation of health-care provision, no evidence-based guidelines for inclusion of PROMs in CQRs exist. This has led to substantial heterogeneity in capturing and reporting PROMs within this setting. This publication is the first in a series describing the development of evidence-informed guidelines for PROMs inclusion within CQRs in Australia. Methods This study consisted of three components: 1) a literature review of existing evidence of guidelines, enablers, barriers, and lessons learnt of PROMs use within the CQRs setting; 2) a survey of Australian CQRs to determine current practices for PROMs use and reporting; and 3) development of a preliminary conceptual framework for PROMs inclusion in CQRs. Results Content analysis of the literature review and survey of 66 Australian registries elicited eight categories for the conceptual framework. The framework covers eight components: rationale, setting, ethics, selection of PROMs, administration, data management, statistical methods, feedback, and reporting. Conclusion We developed a preliminary conceptual framework, which classified findings, from both the literature and the survey, into broad categories ranging from initial development to outcome dissemination providing the structure for development of guidelines in the next phase of this project, engaging national and international leaders in health-related quality of life research, clinicians, researchers, patient advocates and consumers.
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Affiliation(s)
- Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ashika D Maharaj
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Karolina Krysinska
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Joanne Dean
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Buck K, Detering KM, Pollard A, Sellars M, Ruseckaite R, Kelly H, White BP, Sinclair C, Nolte L. Concordance Between Self-Reported Completion of Advance Care Planning Documentation and Availability of Documentation in Australian Health and Residential Aged Care Services. J Pain Symptom Manage 2019; 58:264-274. [PMID: 31029805 DOI: 10.1016/j.jpainsymman.2019.04.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/18/2019] [Accepted: 04/18/2019] [Indexed: 11/21/2022]
Abstract
CONTEXT Advance care planning (ACP) documentation needs to be available at the point of care to guide and inform medical treatment decision-making. OBJECTIVE To examine concordance between self-reported completion of ACP documentation and self-reported storage of the documentation at the person's current point of care with the availability of the documentation in that person's health record. METHODS A national multicenter audit of health records and a self-report survey of eligible audit participants in 51 Australian health and residential aged care services. The audit assessed availability of ACP documentation in the health record, whereas the survey assessed self-reported completion and storage of the ACP documentation at the person's current place of care. To ascertain concordance, survey and audit data were cross-tabulated and concordance rates and kappa statistics were calculated overall and by health care sector and ACP documentation type. RESULTS The audit included 2285 people, of whom 1082 were eligible for the survey. Of 507 who completed the survey (response rate = 47%), 272 (54%) reported completing ACP documentation, of whom 130 (48%) had documentation identified in the audit. Conversely, 39 of 235 people (17%) who reported not completing ACP documentation had documentation identified (concordance rate = 64%; κ = 0.303, P < .001). The concordance rate increased to 79% when self-reported storage of ACP documentation at the person's current point of care was compared with the existence of the document in their health record (κ = 0.510, P < .001). Concordance varied by health care setting and type of ACP documentation. CONCLUSION Discrepancies exist between self-reported completion of ACP documentation and the presence of these documents in the health records of older adults, representing a significant patient safety issue. Public education campaigns and improvements to systems for document storage and accessibility are required to support person-centered medical and end-of-life care.
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Affiliation(s)
- Kimberly Buck
- Advance Care Planning Australia, Austin Health, Melbourne, Australia.
| | - Karen M Detering
- Advance Care Planning Australia, Austin Health, Melbourne, Australia; Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
| | - Annabel Pollard
- Advance Care Planning Australia, Austin Health, Melbourne, Australia
| | - Marcus Sellars
- Advance Care Planning Australia, Austin Health, Melbourne, Australia
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - Helana Kelly
- Advance Care Planning Australia, Austin Health, Melbourne, Australia
| | - Benjamin P White
- Australian Centre for Health Law Research, Faculty of Law, Queensland University of Technology, Brisbane, Australia
| | - Craig Sinclair
- Centre of Excellence in Population Ageing Research, University of New South Wales, Sydney, Australia
| | - Linda Nolte
- Advance Care Planning Australia, Austin Health, Melbourne, Australia
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Samoborec S, Ayton D, Ruseckaite R, Evans SM. Biopsychosocial barriers affecting recovery after a minor transport-related injury: A qualitative study from Victoria. Health Expect 2019; 22:1003-1012. [PMID: 31155834 PMCID: PMC6803416 DOI: 10.1111/hex.12907] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 04/17/2019] [Accepted: 04/18/2019] [Indexed: 11/30/2022] Open
Abstract
Objective The aim of the study was to understand the recovery phenomena and to explore participants' perspectives on the biopsychosocial facilitators and barriers affecting their recovery after a minor transport injury. Methods A qualitative method was used involving semi‐structured interviews with 23 participants who sustained a minor transport injury. Interviews and analysis were guided by the biopsychosocial model (BPS) of health. The outcomes were themes capturing biopsychosocial barriers to, and personal experiences of, recovery using a previously defined framework. Results The themes indicate that recovery is a multifaceted phenomenon affected by comorbidities such as chronic pain, depression and anxiety. A range of subsequent complexities such as the inability to self‐care and undertaking daily domestic duties, and incapacity to participate in recreational activities were major barriers to recovery. These barriers were found to be an on‐going source of frustration, dissatisfaction and a perceived cause of depressive symptomatology in many participants. Most participants reported mixed feelings of the care received. Other common issues raised included a lack of understanding of the assessment time, regular follow‐up, guidance and on‐going support. Conclusion This study revealed that recovery after a minor transport‐related injury was a challenging, complex, demanding and a long‐term process for the individuals in this study. Findings from this limited cohort suggested that, for participants to return to their pre‐accident health status, a more coordinated approach to information and care delivery may be required.
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Affiliation(s)
- Stella Samoborec
- Department of Epidemiology and Preventive Medicine (DEPM), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Darshini Ayton
- Department of Epidemiology and Preventive Medicine (DEPM), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine (DEPM), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Susan M Evans
- Department of Epidemiology and Preventive Medicine (DEPM), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Ahern S, Ruseckaite R, Dean J. P081 Emerging Registry uses requires adaptable systems: reinventing the Australian Cystic Fibrosis Data Registry. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30375-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Samoborec S, Simpson P, Hassani-Mahmooei B, Ruseckaite R, Giummarra M, Ayton D, Evans S. Impact of comorbidity on health outcome after a transport-related injury. Inj Prev 2019; 26:254-261. [PMID: 31004008 DOI: 10.1136/injuryprev-2019-043195] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 03/26/2019] [Accepted: 03/30/2019] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Understanding the impact of comorbidity on health outcomes is important given that comorbidities can affect survival, morbidity, service delivery costs and healthcare utilisation. However, little is known about the types of comorbidities affecting specific health outcomes after minor to moderate road trauma. METHODS This study involved 1574 participants who claimed injury compensation following transport-related injury. Cross sectional data were collected. Health outcomes were assessed using the EQ-5D-3L specific domains and summary score. Twelve self-reported pre-existing chronic conditions were assessed using a multivariate logistic regression, adjusting for demographic and injury characteristics. RESULTS Out of 1574 participants, only 17 (1%) participants reported no pre-existing comorbidities, 72% reported one, 13% reported two and 14% reported three or more comorbidities. Hypertension (15%), depression (14%) and anxiety (14%) were the most commonly reported comorbidities, followed by arthritis (13%), chronic pain (11%) and asthma (11%). Participants with a history of arthritis (adjusted odds ratio [AOR] 1.90, 95% CI 1.24 to 2.91); chronic back pain (AOR 1.59, 95% CI, 1.04 to 2.43); other chronic pain (AOR 2.73, 95% CI 1.42 to 4.24); depression (AOR 2.55, 95% CI 1.60 to 4.05) and anxiety (AOR 2.08, 95% CI 1.32 to 3.26) were at increased risk of poorer health outcomes, after controlling for age, gender, type of injury and time since injury. CONCLUSION This study found that comorbidities such as arthritis, chronic back pain, other chronic pain, depression and anxiety significantly increase the odds of poorer health postinjury, regardless of the time since injury. Regular screening of comorbid conditions may help identify people likely to have poorer outcomes, thereby enabling the implementation of interventions to optimise health despite the presence of comorbidities.
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Affiliation(s)
- Stella Samoborec
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Pamela Simpson
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Melita Giummarra
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Darshini Ayton
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sue Evans
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Mazza D, Brijnath B, O'Hare MA, Ruseckaite R, Kosny A, Collie A. Do Health Service Use and Return-to-Work Outcomes Differ with GPs' Injured-Worker Caseload? J Occup Rehabil 2019; 29:64-71. [PMID: 29476311 DOI: 10.1007/s10926-018-9765-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Purpose To determine whether healthcare use and return-to-work (RTW) outcomes differ with GPs' injured-worker caseload. Methods Retrospective analyses of the Compensation Research Database, which captures approximately 85% of all injured worker claims in Victoria, Australia was conducted. Four injured-worker caseload groups were examined that represented the 25th, 50th, 75th, and 100th percentiles of claimants seen per GP over the 8-year study period (2003-2010): (i) 1-13 claimants; (ii) 14-26 claimants; (iii) 27-48 claimants; and (iv) 49+ claimants (total claims, n = 124,342; total GPs, n = 9748).The characteristics of claimants in each caseload group, as well as the influence of caseload on three outcomes relevant to RTW (weekly compensation paid, work incapacity days, medical-and-like costs), were examined. Results Distinct profiles for high versus low caseload groups emerged. High caseload GPs treated significantly more men in blue collar occupations and issued significantly more 'alternate duties' certificates. Conversely, low caseload GPs treated significantly more women in white collar occupations, predominantly for mental health injuries, and issued significantly more 'unfit-for-work' certificates. Few significant differences were found between the two intermediate GP caseload groups. High caseload was associated with significantly greater medical-and-like costs, however, no caseload group differences were detected for weekly compensation paid or duration of time-off-work. Conclusions Training GPs who have a low injured-worker caseload in workers' compensation processes, utilising high caseload GPs in initiatives involving peer-to-peer support, or system changes where employers are encouraged to provide preventive or rehabilitative support in the workplace may improve RTW outcomes for injured workers.
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Affiliation(s)
- Danielle Mazza
- Department of General Practice, School of Primary Health Care, Monash University, Notting Hill, VIC, Australia.
| | - Bianca Brijnath
- Department of General Practice, School of Primary Health Care, Monash University, Notting Hill, VIC, Australia
- National Ageing Research Institute, Parkville, VIC, Australia
| | - Mary Alice O'Hare
- Department of General Practice, School of Primary Health Care, Monash University, Notting Hill, VIC, Australia
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | | | - Alex Collie
- Insurance Work and Health Group, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
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Samoborec S, Ayton D, Ruseckaite R, Winbolt G, Evans SM. System complexities affecting recovery after a minor transport-related injury: The need for a person-centred approach. J Rehabil Med 2019; 51:120-126. [PMID: 30426136 DOI: 10.2340/16501977-2500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To understand clients' experiences of the recovery journey through the compensation system and to identify areas and strategies for quality improvement. METHODS A qualitative study of 23 participants with physical or mental disabilities caused by traffic accidents, which occurred, on average, 4 years ago. Purposive sampling of long-term recovery clients who made a compensation claim after their injuries was applied until data saturation was reached. Data were collected using semi-structured interviews and analysed through conventional thematic analysis. RESULTS This study demonstrated that recovery is a complex phenomenon that can be impacted by numerous challenges of navigating the compensation system and using its services. Clients perceived the compensation provider as limited in rules around which services they could access. A common perception amongst clients was that the compensation provider did not have the capacity and knowledge to understand health and recovery processes nor did it provide adequate guidelines or instructions that would assist clients with their recovery. Many clients dealt with numerous case managers and felt insufficiently informed on what to expect and do, which led to a lack of trust in rehabilitation management and case managers' decisions. According to clients, financial impacts were neglected and not addressed effectively. Many clients felt abandoned by the system which led to perceived feelings of desertion and negligence. CONCLUSION Understanding modifiable barriers to recovery in compensation systems presents opportunities to amend current practices and consider a holistic, person-centred care approach. It is apparent that improved recovery management, communication and adequate provision of guidelines are needed to meet clients' needs and facilitate better outcomes. A person-centred care approach is likely to improve quality of life and help clients navigate the compensation system more effectively with assistance from health and compensation professionals, who should be actively involved in their recovery processes.
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Affiliation(s)
- Stella Samoborec
- Department of Epidemiology and Preventive Medicine, Monash University, , 3004 Melbourne, Australia.
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Abstract
OBJECTIVES To summarise and evaluate evidence from men who had not been diagnosed with prostate cancer about their perspectives on prostate care and prostate cancer. DESIGN A systematic review of qualitative research, on the perspectives of non-cancerous men regarding prostate cancer prevention and care. SETTING A wide range of settings including primary and secondary care. PARTICIPANTS Men from varied demographic backgrounds ranging between 40 to 80 years of age. DATA SOURCES Three databases (Ovid MEDLINE, Informit, PsychInfo) and Google Scholar were searched for peer-reviewed papers in English reporting research using qualitative methods (in-depth or semistructured interviews and focus groups). REVIEW METHODS Thematic analysis using inductive and deductive codes. Thematic synthesis was achieved through iterative open, axial and thematic coding. RESULTS Eight papers (reporting seven studies conducted in Australia, UK and Germany) met inclusion criteria. Four major themes were identified: understanding prostate cancer, masculinity and prostate cancer, barriers to prostate healthcare and managing prostate health. It was reported that men often did not understand screening, prostate anatomy or their prostate cancer risk, and that concerns about masculinity could deter men from seeking health checks. There was evidence of a need to improve doctor-patient communication about case finding. CONCLUSION Further investigation is required to identify and understand any differences in the perspectives and experiences of men who have not been diagnosed with prostate cancer in metropolitan and regional areas, especially where there may be variations in access to healthcare.
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Affiliation(s)
- Ashwini Kannan
- Clinical Registry Unit, Department of Epidemiology and Preventive Medicine, Monash University Australia, Melbourne, Victoria, Australia
| | - Maggie Kirkman
- School of Public Health and Preventive Medicine, Monash University Australia, Melbourne, Victoria, Australia
| | - Rasa Ruseckaite
- Clinical Registry Unit, Department of Epidemiology and Preventive Medicine, Monash University Australia, Melbourne, Victoria, Australia
| | - Sue M Evans
- Clinical Registry Unit, Department of Epidemiology and Preventive Medicine, Monash University Australia, Melbourne, Victoria, Australia
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Detering KM, Buck K, Ruseckaite R, Kelly H, Sellars M, Sinclair C, Clayton JM, Nolte L. Prevalence and correlates of advance care directives among older Australians accessing health and residential aged care services: multicentre audit study. BMJ Open 2019; 9:e025255. [PMID: 30647047 PMCID: PMC6340468 DOI: 10.1136/bmjopen-2018-025255] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES It is important that the outcomes of advance care planning (ACP) conversations are documented and available at the point of care. Advance care directives (ACDs) are a subset of ACP documentation and refer to structured documents that are completed and signed by competent adults. Other ACP documentation includes informal documentation by the person or on behalf of the person by someone else (eg, clinician, family). The primary objectives were to describe the prevalence and correlates of ACDs among Australians aged 65 and over accessing health and residential aged care services. The secondary aim was to describe the prevalence of other ACP documentation. DESIGN AND SETTING A prospective multicentre health record audit in general practices (n=13), hospitals (n=12) and residential aged care facilities (RACFs; n=26). PARTICIPANTS 503 people attending general practice, 574 people admitted to hospitals and 1208 people in RACFs. PRIMARY AND SECONDARY OUTCOME MEASURES Prevalence of one or more ACDs; prevalence of other ACP documentation. RESULTS 29.8% of people had at least one ACD on file. The majority were non-statutory documents (20.9%). ACD prevalence was significantly higher in RACFs (47.7%) than hospitals (15.7%) and general practices (3.2%) (p<0.001), and varied across jurisdictions. Multivariate logistic regression showed that the odds of having an ACD were positively associated with greater functional impairment and being in an RACF or hospital compared with general practice. 21.6% of people had other ACP documentation. CONCLUSIONS In this study, 30% of people had ACDs accessible and a further 20% had other ACP documentation, suggesting that approximately half of participants had some form of ACP. Correlates of ACD completion were greater impairment and being in an RACF or hospital. Greater efforts to promote and standardise ACDs across jurisdictions may help to assist older people to navigate and complete ACDs and to receive care consistent with their preferences. TRIAL REGISTRATION NUMBER ACTRN12617000743369.
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Affiliation(s)
- Karen M Detering
- Advance Care Planning Australia, Austin Health, Heidelberg, Victoria, Australia
- Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Melbourne, Victoria, Australia
| | - Kimberly Buck
- Advance Care Planning Australia, Austin Health, Heidelberg, Victoria, Australia
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - Helana Kelly
- Advance Care Planning Australia, Austin Health, Heidelberg, Victoria, Australia
| | - Marcus Sellars
- Advance Care Planning Australia, Austin Health, Heidelberg, Victoria, Australia
| | - Craig Sinclair
- Rural Clinical School of Western Australia, University of Western Australia, Albany, Western Australia, Australia
| | - Josephine M Clayton
- Centre for Learning and Research in Palliative Care, Hammond Care, Greenwich Hospital and Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Linda Nolte
- Advance Care Planning Australia, Austin Health, Heidelberg, Victoria, Australia
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Samoborec S, Simpson P, Ruseckaite R, Ayton D, Evans S. Biopsychosocial factors associated with poor health-related quality of life after minor to moderate transport-related injuries: Insights into the Victorian compensable population. J Rehabil Med 2019; 52:jrm00018. [DOI: 10.2340/16501977-2616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Md Emdadul Hoque D, Ruseckaite R, Lorgelly P, McNeil JJ, Evans SM. Cross-sectional study of characteristics of clinical registries in Australia: a resource for clinicians and policy makers. Int J Qual Health Care 2018; 30:192-199. [PMID: 29385457 DOI: 10.1093/intqhc/mzx196] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 12/22/2017] [Indexed: 01/21/2023] Open
Abstract
Objectives To investigate the attributes of Australian clinical quality registries (CQR). Design and setting Survey of 40 CQRs between September 2015 and April 2016. Participants CQR lead investigators/project managers. Intervention None. Main outcome measures Registry organization, geographical coverage, data quality, management, characteristics, output and outcomes. Results Of those who responded (34/40; 85.0%), 12 (34.3%) were binational (Australia and New Zealand); 22 (64.7%) were Australian-only registries; and 13 (38.2%) had national coverage. CQRs covered critical care, infection control, cardiovascular diseases, cancer, chronic diseases, procedures and devices, and transplants. Overall, 24/34 CQRs (70.6%) were public sector funded. In total, 14 (41.2%) scored >75% on a composite score developed to assess data quality. Overall, 29/34 (85.3%) produced an annual multi-centred report; only 15/34 (44.1%) produced provider-specific reports. Mortality/survival and quality of life were collected by 82.4 and 32.4% of CQRs, respectively. Most CQRs displayed data in bar/column charts (28/34, 82.4%) and funnel plots (17/34, 50%). Most CQRs adopted an opt-out consent process (n = 17/31; 54.8%). Linear regression indicated that longer duration of CQR was associated with higher data quality (>20 vs 0-5 years coefficient = 4.76, 95% CI: 0.26, 9.26). Opt-in consent was associated with lower data quality (no active consent vs opt-in approval method, coefficient = -5.22, 95% CI: -8.71, -1.72). Six CQRs self-reported having undertaken an economic evaluation of their registry. Conclusion CQRs varied in geographical coverage; stage of development, approach to recruitment; method and frequency of reporting their output; and data quality assurance. An accreditation system for CQRs would likely assist in recognizing high-quality registries.
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Affiliation(s)
- Dewan Md Emdadul Hoque
- Department of Epidemiology and Preventive Medicine (DEPM), Monash University, Melbourne, Australia.,International Centre for Diarrhoeal Diseases Research in Bangladesh (ICDDR,B), Dhaka, Bangladesh
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine (DEPM), Monash University, Melbourne, Australia
| | | | - John J McNeil
- Department of Epidemiology and Preventive Medicine (DEPM), Monash University, Melbourne, Australia
| | - Sue M Evans
- Department of Epidemiology and Preventive Medicine (DEPM), Monash University, Melbourne, Australia
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Samoborec S, Ruseckaite R, Ayton D, Evans S. Biopsychosocial factors associated with non-recovery after a minor transport-related injury: A systematic review. PLoS One 2018; 13:e0198352. [PMID: 29894490 PMCID: PMC5997362 DOI: 10.1371/journal.pone.0198352] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 05/17/2018] [Indexed: 11/29/2022] Open
Abstract
Background Globally, road transport accidents contribute significantly to mortality and burden of disability. Up to 50 million people suffer a transport-related non-fatal injury each year, which often leads to long-term disability. A substantial number of people with minor injuries struggle to recover and little is known about the factors leading to poor or non-recovery. The aim of this paper is to present a systematic review of biopsychosocial factors related to poor or non-recovery after a minor transport-related injury. Methods and findings Studies were selected through searches of PubMed, Medline, Embase, and Cochrane library. Methodological quality was assessed using a Scottish Intercollegiate Guidelines Network (SIGN) critical appraisal checklist for quantitative cohort studies and Standards for Reporting Qualitative Research (SRQR) checklist for qualitative articles. Data were extracted using the Cochrane data extraction tool based on the biopsychosocial model of health (BPS). In total, there were 37 articles included. However, heterogeneity of the techniques and tools used to assess factors and outcomes across studies meant that pooling of results to determine biopsychosocial factors most predictive of poor or non-recovery was not possible. Hence, a narrative synthesis was conducted and shown multiple factors to be associated with poorer outcomes or non-recovery, most being identified in the biological and psychological domain of the BPS model. Factors that were the most representative across studies and have shown to have the strongest associations with poor or non-recovery were high initial pain intensity, pain duration and severity, pre-accident physical and mental health status and pain catastrophising. Conclusions This review demonstrates the complexity of recovery and a challenge in reporting on predictors of recovery. It is evident that a range of multi-factorial biopsychosocial factors impact recovery. These factors are often inter-connected and multi-faceted and therefore, it was not feasible to select or focus on one single factor. In defining the most predictive factors, further research is required, yet the consensus around which tools to use to measure recovery outcomes is needed and is highly recommended. Regardless of the descriptive nature, the review demonstrated that high levels of post-injury pain are associated with poorer outcomes such as chronic pain and physical and mental disability. Therefore, early targeting of modifiable factors such as pain, pain catastrophizing and arising comorbidities such as PTSD, depression and anxiety may assist in reducing chronic pain and ongoing related disabilities. Systematic review trial registration number Systematic review protocol was registered in International Prospective Register for Systematic Reviews (PROSPERO) on 14 December 2016. Registration number CRD42016052276.
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Affiliation(s)
- Stella Samoborec
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
- * E-mail:
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Darshini Ayton
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Sue Evans
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
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Ruseckaite R, Pekin N, King S, Carr E, Ahern S, Oldroyd J, Earnest A, Sims G, Wainwright C, Armstrong D. EPS5.07 Evaluating the impact of 2006 clinical practice guidelines for nutrition in children with cystic fibrosis in Australia. J Cyst Fibros 2018. [DOI: 10.1016/s1569-1993(18)30267-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cullen KL, Irvin E, Collie A, Clay F, Gensby U, Jennings PA, Hogg-Johnson S, Kristman V, Laberge M, McKenzie D, Newnam S, Palagyi A, Ruseckaite R, Sheppard DM, Shourie S, Steenstra I, Van Eerd D, Amick BC. Effectiveness of Workplace Interventions in Return-to-Work for Musculoskeletal, Pain-Related and Mental Health Conditions: An Update of the Evidence and Messages for Practitioners. J Occup Rehabil 2018; 28:1-15. [PMID: 28224415 PMCID: PMC5820404 DOI: 10.1007/s10926-016-9690-x] [Citation(s) in RCA: 216] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Purpose The objective of this systematic review was to synthesize evidence on the effectiveness of workplace-based return-to-work (RTW) interventions and work disability management (DM) interventions that assist workers with musculoskeletal (MSK) and pain-related conditions and mental health (MH) conditions with RTW. Methods We followed a systematic review process developed by the Institute for Work & Health and an adapted best evidence synthesis that ranked evidence as strong, moderate, limited, or insufficient. Results Seven electronic databases were searched from January 1990 until April 2015, yielding 8898 non-duplicate references. Evidence from 36 medium and high quality studies were synthesized on 12 different intervention categories across three broad domains: health-focused, service coordination, and work modification interventions. There was strong evidence that duration away from work from both MSK or pain-related conditions and MH conditions were significantly reduced by multi-domain interventions encompassing at least two of the three domains. There was moderate evidence that these multi-domain interventions had a positive impact on cost outcomes. There was strong evidence that cognitive behavioural therapy interventions that do not also include workplace modifications or service coordination components are not effective in helping workers with MH conditions in RTW. Evidence for the effectiveness of other single-domain interventions was mixed, with some studies reporting positive effects and others reporting no effects on lost time and work functioning. Conclusions While there is substantial research literature focused on RTW, there are only a small number of quality workplace-based RTW intervention studies that involve workers with MSK or pain-related conditions and MH conditions. We recommend implementing multi-domain interventions (i.e. with healthcare provision, service coordination, and work accommodation components) to help reduce lost time for MSK or pain-related conditions and MH conditions. Practitioners should also consider implementing these programs to help improve work functioning and reduce costs associated with work disability.
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Affiliation(s)
- K L Cullen
- Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada.
| | - E Irvin
- Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada
| | - A Collie
- Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - F Clay
- Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia
| | - U Gensby
- National Centre for Occupational Rehabilitation, Rauland, Norway
- Team WorkingLife ApS, Copenhagen, Denmark
| | - P A Jennings
- Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, VIC, Australia
| | - S Hogg-Johnson
- Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada
| | - V Kristman
- Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada
- Lakehead University, Thunder Bay, ON, Canada
| | - M Laberge
- University of Montreal and CHU Ste-Justine Research Centre, Montreal, QC, Canada
| | - D McKenzie
- Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia
| | - S Newnam
- Accident Research Centre, Monash University, Melbourne, VIC, Australia
| | - A Palagyi
- Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia
| | - R Ruseckaite
- Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, VIC, Australia
| | - D M Sheppard
- Accident Research Centre, Monash University, Melbourne, VIC, Australia
| | - S Shourie
- Accident Research Centre, Monash University, Melbourne, VIC, Australia
| | - I Steenstra
- Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada
- Ted Rogers School of Management, Ryerson University, Toronto, ON, Canada
| | - D Van Eerd
- Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
| | - B C Amick
- Institute for Work & Health, 481 University Ave, Toronto, ON, M5G 2E9, Canada
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
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Ahern S, Ruseckaite R, Ackerman IN. Collecting patient-reported outcome measures. Intern Med J 2017; 47:1454-1457. [DOI: 10.1111/imj.13633] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 06/05/2017] [Accepted: 06/23/2017] [Indexed: 12/24/2022]
Affiliation(s)
- Susannah Ahern
- Department of Epidemiology and Preventive Medicine; Monash University; Melbourne Victoria Australia
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine; Monash University; Melbourne Victoria Australia
| | - Ilana N. Ackerman
- Department of Epidemiology and Preventive Medicine; Monash University; Melbourne Victoria Australia
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Ruseckaite R, Detering KM, Evans SM, Perera V, Walker L, Sinclair C, Clayton JM, Nolte L. Protocol for a national prevalence study of advance care planning documentation and self-reported uptake in Australia. BMJ Open 2017; 7:e018024. [PMID: 29101142 PMCID: PMC5695482 DOI: 10.1136/bmjopen-2017-018024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Advance care planning (ACP) is a process between a person, their family/carer(s) and healthcare providers that supports adults at any age or stage of health in understanding and sharing their personal values, life goals and preferences regarding future medical care. The Australian government funds a number of national initiatives aimed at increasing ACP uptake; however, there is currently no standardised Australian data on formal ACP documentation or self-reported uptake. This makes it difficult to evaluate the impact of ACP initiatives. This study aims to determine the Australian national prevalence of ACP and completion of Advance Care Directives (ACDs) in hospitals, aged care facilities and general practices. It will also explore people's self-reported use of ACP and views about the process. METHODS AND ANALYSIS Researchers will conduct a national multicentre cross-sectional prevalence study, consisting of a record audit and surveys of people aged 65 years or more in three sectors. From 49 participating Australian organisations, 50 records will be audited (total of 2450 records). People whose records were audited, who speak English and have a decision-making capacity will also be invited to complete a survey. The primary outcome measure will be the number of people who have formal or informal ACP documentation that can be located in records within 15 min. Other outcomes will include demographics, measure of illness and functional capacity, details of ACP documentation (including type of document), location of documentation in the person's records and whether current clinical care plans are consistent with ACP documentation. People will be surveyed, to measure self-reported interest, uptake and use of ACP/ACDs, and self-reported quality of life. ETHICS AND DISSEMINATION This protocol has been approved by the Austin Health Human Research Ethics Committee (reference HREC/17/Austin/83). Results will be submitted to international peer-reviewed journals and presented at international conferences. TRIAL REGISTRATION NUMBER ACTRN12617000743369.
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Affiliation(s)
- Rasa Ruseckaite
- Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Karen M Detering
- Advance Care Planning Australia, Austin Health, Heidelberg, Victoria, Australia
- Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Melbourne, Victoria, Australia
| | - Sue M Evans
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Veronica Perera
- Advance Care Planning Australia, Austin Health, Heidelberg, Victoria, Australia
| | - Lynne Walker
- Advance Care Planning Australia, Austin Health, Heidelberg, Victoria, Australia
| | - Craig Sinclair
- Rural Clinical School of Western Australia, University of Western Australia, Albany, Western Australia, Australia
| | - Josephine M Clayton
- Hammond Care Palliative and Supportive Care Service, Greenwich Hospital, Sydney, New South Wales, Australia
| | - Linda Nolte
- Advance Care Planning Australia, Austin Health, Heidelberg, Victoria, Australia
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Kirkman M, Young K, Evans S, Millar J, Fisher J, Mazza D, Ruseckaite R. Men's perceptions of prostate cancer diagnosis and care: insights from qualitative interviews in Victoria, Australia. BMC Cancer 2017; 17:704. [PMID: 29078768 PMCID: PMC5659031 DOI: 10.1186/s12885-017-3699-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 10/22/2017] [Indexed: 11/21/2022] Open
Abstract
Background The Victorian Prostate Cancer Registry (Australia) revealed poorer rates of survival for men diagnosed with prostate cancer in one Victorian regional area than for men in metropolitan Melbourne. We sought to explore the perceptions and experiences of prostate cancer diagnosis, treatment, and care of men diagnosed with prostate cancer who lived in regional or metropolitan areas and of men who had not been so diagnosed. Our goal was to contribute to the evidence from which can be built continuing improvements in prostate health care. Methods Using the qualitative method of in-depth interviews to gain access to explanation and meaning, we interviewed 21 men: 10 recruited through the Prostate Cancer Outcome Registry-Victoria and 11 from the community. Transcripts were analysed thematically. Results We identified four main themes within which men discussed prostate cancer: Case-finding, Diagnosis, Treatment and Care, and Spreading the Word. Contrasts revealed between regional and metropolitan areas related mostly to the more limited supportive care in regional areas. Conclusions It is evident from the perspectives of these men that every aspect of prostate cancer care would benefit from attention: publicising the need to check prostate health, treatment, and supporting men in the years after treatment. Continuing to work on systemic improvements is an important goal for all those committed to men’s health. Electronic supplementary material The online version of this article (10.1186/s12885-017-3699-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maggie Kirkman
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
| | - Kate Young
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Susan Evans
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Jeremy Millar
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia.,Radiation Oncology, Alfred Health, Melbourne, VIC, Australia
| | - Jane Fisher
- Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Danielle Mazza
- Department of General Practice, School of Primary Health Care, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Rasa Ruseckaite
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
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