Topics
General medicine
Care of older people and people requiring palliative care with COVID‐19: guidance from the Australian National COVID‐19 Clinical Evidence Taskforce
The Care of Older People and Palliative Care Panel developed two clinical flow charts with practice points providing guidance on the delivery of quality geriatric and palliative care during the COVID-19 pandemic
for the National COVID‐19 Clinical Evidence Taskforce
What doctors should consider before prescribing e‐liquids for e‐cigarettes
An Australian standard for prescribing e-cigarette nicotine has arrived — are you prepared with the facts?
Miranda P Ween · David G Chapman · Alexander N Larcombe
Revision of the Australian guidelines to reduce health risks from drinking alcohol
These revised guidelines have three key recommendations which provide evidence-based advice on how to reduce the health risks from alcohol consumption
Katherine M Conigrave · Robert L Ali · Rebecca Armstrong · Tanya N Chikritzhs · Peter d’Abbs · Mark F Harris · Nicole Hewlett · Michael Livingston · Dan I Lubman · Anne McKenzie · Colleen O’Leary · Alison Ritter · Scott Wilson · Melanie Grimmond · Emily Banks
Lifestyle risks for chronic disease among Australian adolescents: a cross‐sectional survey
Screening by GPs for six major risk factors and brief interventions in primary care or schools may help
the Heath4Life team †
Universal genetic testing of patients with newly diagnosed breast cancer — ready for prime time?
Current genetic testing guidelines may overlook patients with actionable mutations in high risk breast and ovarian cancer predisposition genes
Dilanka L De Silva · Paul A James · G Bruce Mann · Geoffrey J Lindeman
Absolute risk assessment for guiding cardiovascular risk management in a chest pain clinic
To the Editor: We read with interest the study by Black and colleagues1 on the effectiveness of a pro‐active risk factor management strategy based on absolute cardiovascular disease risk score compared with usual care, in a rapid access chest pain clinic setting. The study suggested that such a strategy significantly improved 5‐year cardiovascular risk scores; however, we would consider some caution before reaching such a conclusion. Although the authors point out several potential sources for bias in their study, there is an additional one that has not been highlighted. In the results, the authors state that “the increase in use of guideline‐based therapies was similar in the two groups,” yet do not go on to explain the differential effect as to why the blood pressure and lipid profiles decreased in the interventional group only. We suggest that the reason for this lies in a fundamental difference between the groups selected. The interventional group at baseline was receiving proportionately greater amounts of lipid‐lowering and anti‐hypertensive therapy: 56% and 30% higher, respectively, than in the control arm. These higher treatment rates may explain the lower blood pressure, the lipid profiles observed and, consequently, the improved final risk scores in the interventional arm. Also, as the authors pointed out, almost a third of eligible patients approached declined to participate and is therefore an important source of potential selection bias. We also note that the offer of referral to a public smoking cessation service was limited to those in the intervention group. National guidelines recommend this strategy as part of standard care,2 and hence we question whether this intervention should truly be considered to deviate from best practice or usual care.
Penni L Blazak · Kim Greaves
Absolute risk assessment for guiding cardiovascular risk management in a chest pain clinic
In reply
James A Black · James E Sharman · Thomas H Marwick
Clinical care of children and adolescents with COVID‐19: recommendations from the National COVID‐19 Clinical Evidence Taskforce
Clinical guidelines must be continually updated and tailored to specific populations, including children and adolescents.
Clinical care of children and adolescents with COVID-19: recommendations from the National COVID-19 Clinical Evidence Taskforce
Cancer Australia consensus statement on COVID‐19 and cancer care: embedding high value changes in practice
Widespread adoption of high value cancer care practices during the pandemic will benefit cancer care delivery into the future
Vivienne Milch · Rhona Wang · Carolyn Der Vartanian · Melissa Austen · Debra Hector · Cleola Anderiesz · Dorothy Keefe
The silence around miscarriage hurts health care and bereaved parents
We need to talk about miscarriage, to provide sensitive, patient-centred, evidence-based continuity of care
Melanie Keep
Abortion care in the 21st century
Identifying inequity of access and assessing the effectiveness of interventions is difficult without systematic abortion data collection
Caroline M Costa · Kirsten I Black
Screening for post‐stroke depression: who, when and how?
What Australia can learn from overseas guidelines
Katherine Sewell · Tamara Tse · Geoffrey A Donnan · Leeanne M Carey
Treatment of alcohol problems: current status and future directions
Scaling up the treatment of alcohol problems will lead to considerable health benefit across the nation
Paul S Haber · Benjamin C Riordan · Kirsten C Morley
Eliminating hepatitis C in Australia needs informed patients and enabled GPs
A national education program would facilitate achieving the full potential of highly effective curative therapies
Paul J Clark
OPTIMISE: a pragmatic stepped wedge cluster randomised trial of an intervention to improve primary care for refugees in Australia
Low intensity practice facilitation improves aspects of primary care for people from refugee backgrounds
Grant M Russell · Katrina Long · Virginia Lewis · Joanne C Enticott · Nilakshi Gunatillaka · I‐Hao Cheng · Geraldine Marsh · Shiva Vasi · Jenny Advocat · Shoko Saito · Hyun Song · Sue Casey · Mitchell Smith · Mark F Harris
Why we should and how we can increase medical school admissions for persons with disabilities
Medical students with disabilities bring lived experience as patients, with a positive impact on school culture and learning
Liz Fitzmaurice · Kenneth Donald · Carl Wet · Dinesh Palipana
Adding saliva testing to oropharyngeal and deep nasal swab testing increases PCR detection of SARS‐CoV‐2 in primary care and children
Saliva may be suitable as a stand-alone test specimen for people aged 10 years or more
Jane Oliver · Shidan Tosif · Lai‐yang Lee · Anna‐Maria Costa · Chelsea Bartel · Katherine Last · Vanessa Clifford · Andrew Daley · Nicole Allard · Catherine Orr · Ashley Nind · Karyn Alexander · Niamh Meagher · Michelle Sait · Susan A Ballard · Eloise Williams · Katherine Bond · Deborah A Williamson · Nigel W Crawford · Katherine B Gibney
Regulating complementary, unconventional and emerging treatments in Australia: a missed opportunity
What now for the regulation of complementary, unconventional and emerging treatments following the Medical Board of Australia’s decision not to revise its guidelines?
Miriam Wiersma · Ian H Kerridge · Cameron L Stewart · Wendy L Lipworth
Updated Australian guidance for health care providers about “undetectable = untransmittable” for HIV
Whether the U=U message is received with scepticism or not, it is clear it is radically challenging the stigma associated with HIV
James H McMahon · Brent Allan · Daniel Grace · Nic Holas
Chalky urate in a patient with bullous tophi
An 86-year-old man presented with multiple, asymptomatic tense, white bullae over bilateral toes one week after a resolved episode of acute gouty arthritis
Hsi Yen · Hsing‐Jou Su · Wei‐Ti Chen
What is the role of general practice in the Chain of Survival for treating people with cardiac arrest?
Patient survival is more likely when general practitioners and their staff are trained in resuscitation and equipped with defibrillators
Siobhán Masterson · Tomás Barry
Excessive PSA testing in general practice
The time for actively recommending the screening of asymptomatic men has passed
Justin J Coleman
Medico‐legal risks associated with fragmented care in general practice
Fragmented patient care can lead to missed diagnoses, inappropriate prescribing and failure of preventive medicine
Jack Marjot · Georgie Haysom · Penny Browne
Prescribing of direct‐acting antiviral therapy by general practitioners for people with hepatitis C in an unrestricted treatment program
GPs are gaining confidence in prescribing DAA therapy, an important foundation for further enhancing access to treatment
Fergus Stafford · Gregory J Dore · Shawn Clackett · Marianne Martinello · Gail V Matthews · Jason Grebely · Anne C Balcomb · Behzad Hajarizadeh
Co‐occurring depression and insomnia in Australian primary care: recent scientific evidence
It is critical primary care clinicians dedicate specific attention to the management of both depression and insomnia when they co-occur
Alexander Sweetman · Leon Lack · Emer Van Ryswyk · Andrew Vakulin · Richard L Reed · Malcolm W Battersby · Nicole Lovato · Robert J Adams
