Setting priorities for high-cost medications in public hospitals in Australia: should the public be involved?

Aim: To explore healthcare decision makers' perceptions about public involvement in setting priorities for high-cost medications (HCMs) in public hospitals in Australia.

Methods: In-depth, semi-structured interviews were conducted with 24 decision-makers (executive directors of hospitals, area health service managers, directors of hospital pharmacy departments and senior medical doctors) in a Sydney Area Health Service. Interviews were digitally recorded, transcribed verbatim, thematically content analysed and coded.

Pharmacy students' intention to practise in a rural setting: measuring the impact of a rural curriculum, rural campus and rural placement on a predominantly metropolitan student cohort.

Objective: To compare pharmacy students' intention to practise in a rural setting expressed in their first year of university with that expressed during their final year.

Design: Longitudinal survey of students in their first and final years.

Setting: Tertiary educational institution.

Successful salvage of a recurrently dislocating Oxford medial unicompartmental bearing.

Dislocation of the bearing of the Oxford medial unicompartmental arthroplasty is a rare but serious complication. We report the case of a 48-year-old woman with a classic anteromedial arthritis who had 2 bearing dislocations within the first 3 months after index surgery. These were attributable to posterior bony impingement of the bearing against a small retained osteophyte.

Funding and access to high cost medicines in public hospitals in Australia: decision-makers' perspectives.

Aim: To investigate the perceptions, concerns and attitudes of decision-makers regarding access to high cost medicines (HCMs) in public hospitals.

Methods: In-depth semi-structured interviews were conducted with 24 decisions-makers (executive directors of hospitals, area health service managers, directors of hospital pharmacy departments and senior medical doctors) in a Sydney Area Health Service. The interviews were digitally recorded and transcribed and analysed using a modified grounded theory approach.

Human organ/tissue growth algorithms that include obese individuals and black/white population organ weight similarities from autopsy data.

Physiologically based pharmacokinetic (PBPK) models need the correct organ/tissue weights to match various total body weights in order to be applied to children and the obese individual. Baseline data from Reference Man for the growth of human organs (adrenals, brain, heart, kidneys, liver, lungs, pancreas, spleen, thymus, and thyroid) were augmented with autopsy data to extend the describing polynomials to include the morbidly obese individual (up to 250 kg). Additional literature data similarly extends the growth curves for blood volume, muscle, skin, and adipose tissue.

Public views on priority setting for high cost medications in public hospitals in Australia.

Objective: To gather information about views of members of the general public about access to High Cost Medications (HCMs) in public hospitals.

Methods: A structured questionnaire was administered to members of the general public. Individuals were approached in train stations, shopping centres and different venues in the Sydney metropolitan area.

Priority setting for high cost medications (HCMs) in public hospitals in Australia: a case study.

Health care providers (HCPs) are increasingly aware of pressures on funding for health care services, including high cost medicines (HCMs). Allocating resources to innovative and expensive medications is particularly challenging and the decision-making processes and criteria used to allocate resources to HCMs have not been widely described in the literature. This case study aimed to describe the operations of the first reported High Cost Drug Sub-Committee (HCD-SC) in a public hospital in Australia.

Provision of pharmaceuticals in Australian hospitals: equity of access?

In Australia, medicines are funded under a complex set of financial arrangements. Currently there are dual funding arrangements in public and private hospitals that can lead to differences in patient access to medications. There are considerable concerns about the consequences of the fragmentation and "lack of cohesion of the system".

Issues with prescribed medications in Aboriginal communities: Aboriginal health workers' perspectives.

Introduction: The health of Indigenous Australians remains appalling. The causes of this situation are multi-factorial, however one contributing factor is poor medication compliance within Aboriginal populations. Anecdotal evidence provided by Aboriginal health workers in western New South Wales (NSW), Australia, has suggested that there are problems associated with the use of prescribed medications within the Aboriginal community.

Effect of different sitting postures on lung capacity, expiratory flow, and lumbar lordosis.

Objective: To investigate the effect of sitting posture on lung capacity and expiratory flow (LC-EF) and lumbar lordosis.

Design: Repeated measures on 1 group of subjects in 4 postures.

Setting: Laboratory.

Impact on medication use and adherence of Australian pharmacists' diabetes care services.

Objective: To assess the effect of a specialized service implemented in community pharmacies for patients with type 2 diabetes on medication use and medication-related problems.

Design: Parallel group, multisite, control versus intervention, repeated measures design, with three different regions in New South Wales, Australia, used as intervention regions, then matched with control regions as much as possible.

Intervention: After initial training, pharmacists followed a clinical protocol for more than 9 months, with patient contact approximately monthly.

Implementation and evaluation of Australian pharmacists' diabetes care services.

Objective: To implement and evaluate a specialized service for type 2 diabetes mellitus in the community pharmacy.

Design: Parallel group, multisite, control versus intervention, repeated measures design, with three different regions in New South Wales, Australia, used as intervention regions, then matched with control regions as much as possible.

Intervention: Following training, pharmacists followed a clinical protocol over 9 months, with approximately monthly intervention site visits during which blood glucose readings were downloaded and discussed with the patient, interventions were documented, and goals set with each patient.

An overview of evaluation for wheelchair seating for people who have had strokes.

For many clients who have had strokes, the seating and mobility system provides access to and the ability to perform in all of their environments. It allows performance of all or most of their functional and activities of daily living (ADL) skills. Without appropriate and stable positioning, the client is at risk of developing postural deformities or bad postural habits, which can interfere with accomplishment of ADL and functional skills.

Acceptability of willingness to pay techniques to consumers.

Objective: The purpose of this study was to assess and compare the proportion of usable responses and protest votes obtained with two willingness to pay (WTP) techniques, contingent valuation (CV) and discrete choice experiment (DCE) and to assess the acceptability of the techniques to respondents.

Setting And Participants: Pregnant women attending the public antenatal clinics of a Sydney teaching hospital were surveyed.

Main Variables Studied: Preference for either Treatment A (artificial rupture of the membranes followed by intravenous oxytocin) or Treatment B (prostaglandin E2 gel followed by oxytocin if necessary) was assessed.

Measurement of consumer preference for treatments used to induce labour: a willingness-to-pay approach.

AIM: The purpose of the study was to assess the acceptability to consumers of two methods of induction of labour using a willingness-to-pay (WTP) approach. The methods compared were amniotomy plus oxytocin and prostaglandin E2 vaginal gel, followed by oxytocin if necessary. METHODS: A description of each method was presented, in questionnaire format, to pregnant women attending a public hospital ante-natal clinic.