Australian osteopaths as non-medical prescribers: comparison of healthcare practitioner characteristics from a nationally representative survey

2020 ◽  
Vol 26 (5) ◽  
pp. 417
Author(s):  
Brett Vaughan ◽  
Michael Fleischmann ◽  
Kylie Fitzgerald ◽  
Sandra Grace ◽  
Paul Orrock ◽  
...  

The study aimed to compare the characteristics of Australian osteopaths who definitely agree that prescribing scheduled medicines is part of their future scope of practice with those who do not. A secondary analysis of a cross-sectional survey of osteopaths from an Australian practice-based research network was undertaken. Demographic, practice and treatment characteristics were identified using inferential statistics and backward linear regression modelling. Over one-quarter (n=257, 25.9%) of the total participants (n=992) indicated that they ‘definitely’ agree that osteopaths should seek prescription rights. Adjusted odds ratios (OR) suggested these osteopaths were more likely to engage in medication discussions with patients (OR 1.88), frequently manage migraines (OR 1.68) and seek increased practice rights for referrals to medical specialists (OR 2.61) and diagnostic imaging (OR 2.79). Prescribing as part of the future scope of practice for Australian osteopaths is associated with patient management (medication discussions) and practice characteristics (increased referral rights for specialists and diagnostic imaging) that warrant additional investigation. Understanding of the practice, clinical and patient management characteristics of Australian osteopaths who see prescribing as part of the future scope of practice informs the case for regulatory and health policy changes for prescribing scheduled medicines.

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e023731 ◽  
Author(s):  
Dee Mangin ◽  
Jenna Parascandalo ◽  
Olga Khudoyarova ◽  
Gina Agarwal ◽  
Verdah Bismah ◽  
...  

ObjectiveThere is increasing awareness of the burden of medical care experienced by those with multimorbidity. There is also increasing interest and activity in engaging patients with chronic disease in technology-based health-related activities (‘eHealth’) in family practice. Little is known about patients’ access to, and interest in eHealth, in particular those with a higher burden of care associated with multimorbidity. We examined access and attitudes towards eHealth among patients attending family medicine clinics with a focus on older adults and those with polypharmacy as a marker for multimorbidity.DesignCross-sectional survey of consecutive adult patients attending consultations with family physicians in the McMaster University Sentinel and Information Collaboration practice-based research network. We used univariate and multivariate analyses for quantitative data, and thematic analysis for free text responses.SettingPrimary care clinics.Participants693 patients participated (response rate 70%). Inclusion criteria: Attending primary care clinic. Exclusions: Too ill to complete survey, cannot speak English.ResultsThe majority of participants reported access to the internet at home, although this decreased with age. Participants 70 years and older were less comfortable using the internet compared with participants under 70. Univariate analyses showed age, multimorbidity, home internet access, comfort using the internet, privacy concerns and self-rated health all predicted significantly less interest in eHealth. In the multivariate analysis, home internet access and multimorbidity were significant predictors of disinterest in eHealth. Privacy and loss of relational connection were themes in the qualitative analysis.ConclusionThere is a significant negative association between multimorbidity and interest in eHealth. This is independent of age, computer use and comfort with using the internet. These findings have important implications, particularly the potential to further increase health inequity.


BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e015830 ◽  
Author(s):  
Jon Adams ◽  
Wenbo Peng ◽  
Amie Steel ◽  
Romy Lauche ◽  
Craig Moore ◽  
...  

ObjectivesThe Australian Chiropractic Research Network (ACORN) practice-based research network (PBRN) cohort was established to provide sustainable infrastructure necessary to address lack of rigorous investigation and to bridge the research–practice gap focused on chiropractic care for future years. This paper presents the profile of chiropractors recruited to the ACORN PBRN, a nationally representative sample of chiropractors working in Australia.DesignCross-sectional analysis of baseline data from a cohort study of chiropractors in Australia.SettingAll registered chiropractors in Australia were invited to participate in the ACORN study and those who completed a practitioner questionnaire and consent form were included in the PBRN cohort.ParticipantsA total of 1680 chiropractors (36%) were recruited to the cohort database. The average age of the PBRN participants is 41.9 years and 63% are male. The vast majority of the PBRN participants hold a university degree.ResultsGeneral practitioners were identified as the most popular referral source for chiropractic care and low back pain and neck pain were the most common conditions ‘often’ treated by the PBRN chiropractors. The chiropractors in this PBRN cohort rated high velocity, low amplitude adjustment/manipulation/mobilisation as the most commonly used technique/method and soft tissue therapy as the most frequently employed musculoskeletal intervention in their patient management.ConclusionsThe ACORN PBRN cohort constitutes the largest coverage of any single healthcare profession via a national voluntary PBRN providing a sustainable resource for future follow-up. The ACORN cohort provides opportunities for further nested substudies related to chiropractic care, chiropractors, their patients and a vast range of broader healthcare issues with a view to helping build a diverse but coordinated research programme and further research capacity building around Australian chiropractic.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Bin Jiang ◽  
Hongmei Liu ◽  
Dongling Sun ◽  
Haixin Sun ◽  
Xiaojuan Ru ◽  
...  

Abstract Background and purpose Epidemiological data on primary brain tumours (PBTs) are lacking due to the difficulty in case ascertainment among the population. Thus, we aimed to estimate mortality due to PBTs in China nationwide and the detection rate in people with suspected symptoms. Methods A multistage, complex sampling survey regarding mortality due to PBTs in Chinese individuals was carried out by reviewing all causes of death within a year. The detection rates in people with suspected symptoms were estimated based on PBT symptom screening and neurologist reviews and compared between groups by logistic regression analysis. Results Weighted mortality due to PBT was 1.6 (0.8–3.3) per 100,000 population in Chinese individuals, 1.8 (0.7–4.6) per 100,000 population in men, and 1.5 (0.5–4.5) per 100,000 population in women. Among 14,990 people with suspected symptoms, the PBT detection rate was 306.9 (95% CI 224.7–409.3) per 100,000 population in the total population, 233.0 (95% CI 135.7–373.1) per 100,000 population in men, and 376.9 (95% CI 252.4–546.3) per 100,000 population in women. People with an unsteady gait (OR 2.46; 95% CI 1.09–5.51; P=0.029), visual anomalies (3.84; 1.88–7.85; P<0.001), and headache (2.06; 1.10–3.86; P=0.023) were more likely to have a brain tumour than those without corresponding symptoms, while people with dizziness/vertigo were less likely to have a brain tumour than those without corresponding symptoms (0.45; 0.23–0.87; P=0.017). Conclusions Mortality due to PBT in China was low, with a nationwide estimate of 21,215 (10,427–43,165) deaths attributable to PBTs annually. However, the detection rate of PBTs can be greatly improved based on symptom screening in the population.


2021 ◽  
pp. 089011712110340
Author(s):  
Bhagyashree Katare ◽  
Shuoli Zhao ◽  
Joel Cuffey ◽  
Maria I. Marshall ◽  
Corinne Valdivia

Purpose: Describe preferences toward COVID-19 testing features (method, location, hypothetical monetary incentive) and simulate the effect of monetary incentives on willingness to test. Design: Online cross-sectional survey administered in July 2020. Subjects: 1,505 nationally representative U.S. respondents. Measures: Choice of preferred COVID-19 testing options in discrete choice experiment. Options differed by method (nasal-swab, saliva), location (hospital/clinic, drive-through, at-home), and monetary incentive ($0, $10, $20). Analysis: Latent class conditional logit model to classify preferences, mixed logit model to simulate incentive effectiveness. Results: Preferences were categorized into 4 groups: 34% (n = 517) considered testing comfort (saliva versus nasal swab) most important, 27% (n = 408) were willing to trade comfort for monetary incentives, 19% (n = 287) would only test at convenient locations, 20% (n = 293) avoided testing altogether. Relative to no monetary incentives, incentives of $100 increased the percent of testing avoiders (16%) and convenience seekers (70%) that were willing to test. Conclusion: Preferences toward different COVID-19 testing features vary, highlighting the need to match testing features with individuals to monitor the spread of COVID-19.


Author(s):  
Katherine D. Ellingson ◽  
Brie N. Noble ◽  
Genevieve L. Buser ◽  
Graham M. Snyder ◽  
Jessina C. McGregor ◽  
...  

Abstract Objective: To describe interfacility transfer communication (IFTC) methods for notification of multidrug-resistant organism (MDRO) status in a diverse sample of acute-care hospitals. Design: Cross-sectional survey. Participants: Hospitals within the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN). Methods: SRN members completed an electronic survey on protocols and methods for IFTC. We assessed differences in IFTC frequency, barriers, and perceived benefit by presence of an IFTC protocol. Results: Among 136 hospital representatives who were sent the survey, 54 (40%) responded, of whom 72% reported having an IFTC protocol in place. The presence of a protocol did not differ significantly by hospital size, academic affiliation, or international status. Of those with IFTC protocols, 44% reported consistent notification of MDRO status (>75% of the time) to receiving facilities, as opposed to 13% from those with no IFTC protocol (P = .04). Respondents from hospitals with IFTC protocols reported significantly fewer barriers to communication compared to those without (2.8 vs 4.3; P = .03). Overall, however, most respondents (56%) reported a lack of standardization in communication. Presence of an IFTC protocol did not affect whether respondents perceived IFTC protocols as having a significant impact on infection prevention or antimicrobial stewardship. Conclusions: Most respondents reported having an IFTC protocol, which was associated with reduced communication barriers at transfer. Standardization of protocols and clarity about expectations for sending and receipt of information related to MDRO status may facilitate IFTC and promote appropriate and timely infection prevention practices.


2021 ◽  
pp. 026010602098234
Author(s):  
Pradeep Kumar ◽  
Himani Sharma ◽  
Kamalesh Kumar Patel

Background: Despite various programmes initiated by the Government of India, the nutritional indicators are not encouraging, as several problems like undernutrition, malnutrition and anaemia – still persist in the country, especially in the Empowered Action Group (EAG) states. Aim: Because of the dearth of studies regarding anaemia among men in India, the present study aimed to determine its prevalence in this population in the EAG states and to analyse its geographical and socio-demographic determinants. Methods: The study utilized nationally representative, cross-sectional survey data from round 4 of the National Family Health Survey conducted in 2015–16. Bivariate analysis along with binary logistic regression were performed to assess the predictors of anaemia among men in the EAG states. Results: Around a quarter of the men in the EAG states suffered from anaemia. A similar high-prevalence pattern was observed across the EAG states. Wherein, Bihar and Jharkhand had the highest prevalence of anaemia while Uttarakhand showed the lowest. Age, place of residence, marital status and caste were positively associated with the likelihood of anaemia among men in the EAG states. Conclusions: Focusing on the EAG states, this study considered the severity of anaemia as a public health problem among men. Strategies to reduce the burden of anaemia among this population are needed. The government should formulate programmes targeting anaemia specifically, and improving the nutritional status among men in general in the EAG states.


Author(s):  
Ta-Chuan Yeh ◽  
Ya-Mei Bai ◽  
Shih-Jen Tsai ◽  
Tzeng-Ji Chen ◽  
Chih-Sung Liang ◽  
...  

Irritable bowel syndrome (IBS) is a functional bowel disorder that is highly comorbid with mental disorders. However, few studies have examined the risk of attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), bipolar disorder, major depressive disorder (MDD), and schizophrenia in the offspring of parents with IBS. We used nationally representative cross-sectional survey data to analyze cross-generational transmission patterns of both IBS and major mental disorders. Odds ratio (OR) was calculated by using logistic regression models with adjustment for potential confounding factors. Offspring of parents with IBS were more likely to develop IBS themselves (OR = 2.41, 95% confidence interval (CI), 2.09–2.78), ADHD (OR = 1.33, 95% CI, 1.08–1.62), and MDD (OR = 1.32, 95% CI, 1.04–1.68) than the controls. Data stratification by parental sex revealed that paternal IBS increased risk of ADHD (OR = 1.34, 95% CI, 1.01–1.77) in the offspring, while maternal IBS increased the risk of MDD (OR = 1.51, 95% CI, 1.11–2.06). This is the first study to reveal parental IBS is associated with IBS, ADHD, and MDD among offspring, suggesting the necessity for early implementation of prevention strategies for at-risk children.


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