Performance and opportunity: retrospective cohort study of general medicine heart failure management.

Background: Heart failure (HF) is increasingly prevalent, with growing patient complexity. Understanding the quality of care delivered is key to optimising management.

Aims: To characterise HF care by a general medicine service compared to established quality indicators.

Clinical presentations and outcomes of respiratory tract infections in an Australian cohort of centenarians.

Centenarians are a rapidly growing patient population. Little is known about their clinical responses to respiratory tract infections. This study examines a cohort of centenarians admitted to a tertiary centre with multiplex polymerase chain reaction-confirmed respiratory tract infections to characterise clinical characteristics and management outcomes better.

Measuring variations in healthcare data using run charts and statistical process control charts: a survey of general physicians attending the quality improvement workshop.

General physicians as system leaders play a significant role in quality improvement (QI) initiatives within respective health services. However, there are very few formal QI training programmes available for general physicians in Australia. This survey described the experiences of attendees at the 2024 Internal Medicine Society of Australia and New Zealand QI workshop, which delivered topics on understanding variations in healthcare data using QI tools such as run charts and statistical process control (Shewhart) charts.

Understanding influences on psychiatry specialty selection in Victoria's Medical workforce.

Objective: Australia faces a psychiatrist shortage, making it crucial to understand factors influencing specialty choice and workforce retention.

Method: An online cross-sectional survey was conducted among medical doctors in their prevocational and vocational stages working in Victoria, Australia. Participants were asked about various factors that influenced their choice of specialty.

Putting skin in the game: a descriptive study of lower extremity ulcers in general medical inpatients.

Lower extremity ulcers contribute a significant burden to patient care. Targeted investigation and management are pertinent to improving patient outcomes. We evaluated the aetiology, risk factors, investigations and management of lower extremity ulcers in general medicine patients.

The Australasian Registry for Severe Cutaneous Adverse Reactions (AUS-SCAR) - Providing a roadmap for closing the diagnostic, patient, and healthcare gaps for a group of rare drug eruptions.

Background: Severe cutaneous adverse reactions (SCAR) are a group of delayed presumed T-cell mediated hypersensitivities associated with significant morbidity and mortality. Despite their shared global healthcare burden and impact, the clinical phenotypes, genomic predisposition, drug causality, and treatment outcomes may vary. We describe the establishment and results from the first Australasian registry for SCAR (AUS-SCAR), that via a collaborative network advances strategies for the prevention, diagnosis and treatment of SCAR.

General physicians' perspectives on SGLT2 inhibitors for heart failure.

Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2is) are novel agents for heart failure (HF) and are now recommended in guidelines. Understanding general physicians' perspectives can help to optimise utilisation of this new medication.

Aim: To understand the clinical concerns and barriers from general physicians about prescribing SGLT2is in a general medicine cohort.

Physician Perceptions of Medication Prescribing in Heart Failure: A Scoping Review.

Introduction: The swift uptake of new medications into clinical practice has many benefits; however, slow uptake has been seen previously with other guideline-directed medical therapies (GDMT) in heart failure (HF). Sodium glucose co-transporter 2 inhibitors are a novel therapy in HF proven to be efficacious and will have beneficial clinical outcomes if prescribed. Understanding physician perspectives on prescribing GDMT in HF can help target strategies to bridge the gap between guidelines and practice.

Epidemiological trends of respiratory tract pathogens detected via mPCR in Australian adult patients before COVID-19.

Background: Respiratory tract infections (RTIs) are a major global health burden due to their high morbidity and mortality. This retrospective study described the epidemiology of respiratory pathogens in adults over a 5-year period at an Australian tertiary healthcare network.

Methods: All multiplex reverse transcription polymerase chain reaction respiratory samples taken between the 1st of November 2014 and the 31st of October 2019 were included in this study.

Contribution of general medicine to perioperative and consultative care: an Australian metropolitan teaching hospital experience.

Little is known about the contribution of general medicine to perioperative and consultative care in Australia. A descriptive observational study was undertaken at a quaternary institution to evaluate the characteristics of perioperative and nonoperative consultations undertaken by general medicine. Results demonstrated patterns of engagement within a 'traditional' model of perioperative care and highlighted several opportunities for a redesign to a more proactive and collaborative cross-disciplinary model.

Development and application of Adverse drug reactions reports QUality Algorithm (AQUA-12) score: a single-centre quality improvement initiative.

Purpose: To develop a reliable assessment tool to monitor the quality of adverse drug reaction (ADR) reports and evaluate its performance within a quaternary hospital setting.

Methods: Adverse drug reactions report QUality Algorithm (AQUA-12) was developed by a multidisciplinary team with the expertise in the management of ADRs. The design was based on data elements required to establish medication causality.

Understanding the contribution of general medical services to acute inpatient care in Victorian public hospitals.

Background: General medicine is an integral part of health services, yet there is little data highlighting their contribution to acute hospital care in Australia.

Aims: To utilise the Victorian Department of Health's administrative dataset for hospital admissions to evaluate the relative contribution and trends over time of general medical services to acute multiday inpatient hospital separations in the Victorian public healthcare system.

Methods: A retrospective time-series study of general medical activity compared to other major specialties using hospital-level data provided by the Department of Health: (i) extrapolation from diagnosis-related group (DRG) activity data (2011-2021) and, (ii) directly reported discharge unit-based activity (available from 2018).

Risk factors and management outcomes in epistaxis: a tertiary centre experience.

Background: Risk factors and outcomes associated with severe epistaxis are not well understood. This study explores the associations between epistaxis severity, comorbidities, use of antiplatelets or anticoagulants and management outcomes.

Methods: This is a retrospective cross-sectional study of all epistaxis cases presenting to the emergency department at a tertiary academic hospital from January 2016 to December 2019.

Research activities in general medicine: a scoping survey by the Internal Medicine Society of Australia and New Zealand.

Background: In developing an effective framework for a collaborative research network (RN) that supports members involved in research, the Internal Medicine Society of Australia and New Zealand (IMSANZ) required a better understanding of the current level of research activity and engagement by general physicians, and factors influencing such engagement.

Aims: To explore the current research landscape amongst general physicians in Australia and Aotearoa New Zealand.

Methods: A questionnaire exploring research participation, scope, research enablers and barriers was disseminated to IMSANZ members over a 3-month period.

Adverse drug reaction management in hospital settings: review on practice variations, quality indicators and education focus.

Purpose: Adverse drug reactions (ADRs) contribute significantly to healthcare burden. However, they are largely preventable through appropriate management processes. This narrative review aims to identify the quality indicators that should be considered for routine monitoring of processes within hospital ADR management systems.

Blister fluid as a cellular input for diagnostics in drug-induced severe cutaneous adverse reactions improves sensitivity and explores immunopathogenesis.

Background: Drug-induced severe cutaneous adverse reactions (SCARs) are presumed T-cell-mediated hypersensitivities associated with significant morbidity and mortality. Traditional testing methods, such as patch or intradermal testing, are limited by a lack of standardization and poor sensitivity. Modern approaches to testing include measurement of IFN-γ release from patient PBMCs stimulated with the suspected causative drug.

Collective pause: improving staff performance in acute medicine through a brief mindfulness-based group programme.

Background: Hospital wards are a complex and dynamic environment that rely on optimal staff performance. However, there is little research evaluating group interventions to improve staff attention and teamwork.

Aims: To evaluate whether a regular, short and guided group mindfulness practice for staff in an acute general medicine team improves attention and teamwork.

Cost-analysis of opportunistic influenza vaccination in general medical inpatients.

Influenza vaccination is an important preventative health measure in the elderly and those with medical comorbidities. It has been shown to reduce hospitalisations, cardiovascular and respiratory complications. A significant proportion of patients admitted to general medicine are eligible for opportunistic inpatient influenza vaccination.

Aetiologies and factors associated with poor clinical outcomes in rhabdomyolysis: a retrospective cohort study in an Australian trauma centre.

Rhabdomyolysis is a clinical syndrome with significant morbidity and mortality that occurs as a result of traumatic and non-traumatic aetiologies. Acute kidney injury, the need for dialysis, and death, can occur due to rhabdomyolysis. This study explores the aetiologies, clinical outcomes and associated factors for poor outcomes in a cohort of patients with rhabdomyolysis in a tertiary trauma centre in Australia.