Volume 217 Issue 9

Australia’s transition to renewables and zero carbon remains unacceptably slow

Paul J Beggs · Ying Zhang · Alice McGushin · Stefan Trueck · Martina K Linnenluecke · Hilary Bambrick · Anthony G Capon · Sotiris Vardoulakis · Donna Green · Arunima Malik · Ollie Jay · Maddie Heenan · Ivan C Hanigan · Sharon Friel · Mark Stevenson · Fay H Johnston · Celia McMichael · Fiona Charlson · Alistair J Woodward · Marina B Romanello

Future threats require an integrated approach to the health of humans, animals and the environment

Sandra G Steele · Jenny‐Ann LML Toribio · Siobhan M Mor

Our efforts to prepare and respond to the challenges posed by climate change must focus on community support and recovery, providing sustainable financial security and social connectedness

George Braitberg

Addressing the social determinants and the structural consumptogenic system is critically important if we are to avert a planetary health inequity crisis

Sharon Friel

Health professionals must be prepared to address the health risks and impacts of climate change

Hayden Burch · Laura J Beaton · Grace Simpson · Ben Watson · Janie Maxwell · Kenneth D Winkel

If colleges aspire to be leaders in health, they must show leadership on climate

Henry Oakley · Caroline Shaw · Jesse Gale

A 70-year-old man presented to the emergency department with abdominal pain, vomiting, diarrhoea and shortness of breath on the background of a one-week history of fevers, dysuria and headaches

Ajinkya Bhonsle · Mithun Nambiar · Michael Swan · Ralph Junckerstorff

The health impacts of climate change demand Australia rapidly end its reliance on fossil fuels

Elizabeth Zuccala · Nicholas J Talley

Wealthy nations must step up support for Africa and vulnerable countries in addressing past, present and future impacts of climate change

Lukoye Atwoli · Gregory E Erhabor · Aiah A Gbakima · Abraham Haileamlak · Jean‐Marie Kayembe Ntumba · James Kigera · Laurie Laybourn‐Langton · Bob Mash · Joy Muhia · Fhumulani Mavis Mulaudzi · David Ofori‐Adjei · Friday Okonofua · Arash Rashidian · Maha El‐Adawy · Siaka Sidibé · Abdelmadjid Snouber · James Tumwine · Mohammad Sahar Yassien · Paul Yonga · Lilia Zakhama · Chris Zielinski

It is time to reimagine wellbeing and place the future of our children and young people at the centre of public action

Sandro Demaio · Sharon R Goldfeld · Anne Hollonds · George C Patton · Fiona J Stanley · Rosemary Calder · Kate Lycett · Zuleika Arashiro

Pathways and a culture that view blood as disposable must yield to approaches that value patients’ own blood

Philip Crispin

The management of peri-operative anaemia after major abdominal surgery should be standardised to improve patient outcomes

The POSTVenTT Study Collaborative*

To the Editor: We read with interest the article by Drewett and colleagues,1 on anaphylaxis presentations to emergency departments in Victoria, and the linked editorial by Lucas and Vale,2 which proposes a comprehensive adverse drug reaction registry to improve patient safety and care. Re‐exposure of a patient to a medicine to which they have had a previously documented allergy or adverse drug reaction (ADR) is a preventable clinical incident. The Australian sentinel events list includes “medication error resulting in serious harm or death” to ensure public accountability and transparency and drive national improvements in patient safety.3 The availability of accurate and up to date allergy/ADR information for prescribers is vital to support the decision on appropriate treatment and to prescribe a medicine. It is also critical that health professionals who administer medicines and pharmacists who dispense medicines have access to accurate allergy/ADR information, as they provide redundancy within the medication management system to prevent unintentional re‐exposure. We recently undertook an audit to assess the accuracy of medication history documentation performed by pharmacists. Our methodology has been published elsewhere.4 As part of this work, we assessed the quality of pharmacist‐documented allergy/ADR information. Allergy/ADR documentation best practice suggests documentation of the medication name, reaction details and reaction date.5 New findings from our audit identified a total of 108 allergies/ADRs across 99 patients. Of the 52 patients with a previous history of allergy/ADR, only 31% (n = 16) had complete and correct allergy/ADR information documented. These results highlight that the current systems do not adequately support clinicians to provide safe and high quality care. Moreover, these systems risk patient harm through inadvertent re‐exposure to a medicine where there is a previously documented allergy/ADR, given that, at the point of prescribing, administration or dispensing, data are not available, disparate, incorrect or incomplete. We believe the national allergy/ADR registry proposed by Lucas and Vale2 should go one step further, and legislation should mandate interoperability between all electronic prescribing, administration and dispensing systems in Australia. A further challenge will be populating accurate historical allergy/ADR information into the registry. It would require high quality documentation to assist informed clinical decision making. An additional challenge is the complex, hybrid paper and electronic prescribing and documentation systems used across health care settings. Even though these may be challenges to overcome, there are potential opportunities through patient engagement, incentive schemes and machine learning. There needs to be a national consumer‐focused education campaign so the public can be active participants in their own care to support optimal medicine choice based on their allergy/ADR history. We believe a national allergy/ADR registry is of key importance to further enhance patient safety and will be a true system change to overcome the barriers we face in day‐to‐day clinical practice.

Martin L Canning · Andrew Munns · Bonnie Tai

Med J Aust 2022; 217 (9 Suppl).