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General medicine

Environmental health Letters 16 January 2023 Open Access

Smoking cessation on discharge summaries

To the Editor: With the increasing interoperability of electronic medical records across health services, smoking and e‐cigarette use need to be systematically collected on hospital admission, and advice to quit smoking should be automatically included on hospital discharge summaries. Including information on smoking status in the discharge summary, and ultimately on My Health Record, presents an opportunity to address the use of tobacco and e‐cigarette products — the first being Australia's leading cause of preventable death and disease and the second an emerging exposure of increasing concern.1 Evidence from the United States Surgeon General reports that smoking cessation after cancer diagnosis lowers the risk of dying by 30–40%.2 For some patients with cancer, cessation benefits are equal to or exceed the value of state‐of‐the‐art cancer therapies. In addition, the Surgeon General report shows most patients admitted to hospital wish to quit smoking,2 and there are proven, workable but underused interventions to cease smoking. Peak medical bodies such as the Australian National Health and Medical Research Council and the Australian Commission on Safety and Quality in Health Care3 advise that adherence to post‐hospital referral practice guidelines leads to better outcomes, fewer readmissions, and improved patient survival. Australia's National Preventive Health Strategy has a goal of reducing the adult smoking prevalence from 14% to 5% over the next 8years.4 The newly released draft National Tobacco Strategy includes key policy actions to increase the use of cessation services and to support people who use tobacco and e‐cigarettes to quit.5 Around 1.2 million Australian adults are admitted to hospital at least once each year, and it is estimated that about one in five of them would benefit from smoking cessation services.6 Given most hospitalised patients want to quit smoking, providing this recommendation in a discharge summary for appropriate referral to a Quitline (www.quit.org.au) or a general practitioner is a practical solution to provide best practice care to patients, reduce the risk of readmission to hospital, and increase their survival.

Freddy Sitas · Ben Harris‐Roxas · Sarah L White · Fiona A Haigh · Margo L Barr · Mark F Harris

Mja2 51792
Respiratory disease Research letter 16 January 2023 Free

Diagnosis of cystic fibrosis in adults: Australian Cystic Fibrosis Data Registry data, 2000–2019

CF diagnosed in adults can manifest with milder symptoms across a range of organ systems than classical CF

Amelia Lin · Keith Wong · Simone K Visser · Helen Jo · Yasmeen Al‐Hindawi · Katrin Kosbab‐Jackson · Molly Cocks · Anastasia Volovets · Paul Haber · Kirsten Hammond · Nicole Taylor · Veronica Yozghatlian · Edmund MT Lau · Nathaniel S Marshall · Tara Aquino‐Salomon · Sheila Sivam

Mja2 51797
General medicine Perspectives 19 September 2022 Open Access

Roadmap to incorporating group A Streptococcus molecular point‐of‐care testing for remote Australia: a key activity to eliminate rheumatic heart disease

Strep A POCT is a critical element in preventing acute rheumatic fever and will contribute to the elimination of rheumatic heart disease in Australia

Dylan D Barth · Gelsa Cinanni · Jonathan R Carapetis · Rosemary Wyber · Louise Causer · Caroline Watts · Belinda Hengel · Susan Matthews · Anna P Ralph · Janessa Pickering · Jeffrey W Cannon · Lorraine Anderson · Vicki Wade · Rebecca J Guy · Asha C Bowen

Mja2 51692
Infectious diseases Research 8 August 2022 Open Access

COVID‐19 in New South Wales children during 2021: severity and clinical spectrum

Community support for children with special care needs could reduce the number of COVID-19-related hospitalisations

Phoebe Williams · Archana Koirala · Gemma L Saravanos · Laura K Lopez · Catherine Glover · Ketaki Sharma · Tracey Williams · Emma Carey · Nadine Shaw · Emma Dickens · Neela Sitaram · Joanne Ging · Paula Bray · Nigel W Crawford · Brendan McMullan · Kristine Macartney · Nicholas Wood · Elizabeth L Fulton · Christine Lau · Philip N Britton

Mja2 51661
Health services administration Letters 18 July 2022 Free

Patient‐reported outcome measures (PROMs) to guide clinical care: recommendations and challenges

To the Editor: We read with interest the article by Agarwal and colleagues1 outlining the recommendations from the Health Services Research Association of Australia and New Zealand for implementing patient‐reported outcome measures (PROMs) to guide clinical care. The article regrettably fails to acknowledge that most of the commonly used PROMs — largely developed without direct patient participation — may merely provide a patient‐rated version of a measure that nevertheless reflects the clinician’s or researcher’s, not the patient’s, perspective.2,3 Importantly, “patient‐reported” conveys only that the measurement instrument — usually a scale or questionnaire — is completed by the patient. The emphasis is placed on the source of the information (ie, the patient) rather than on its content. It does not automatically imply that the information thus obtained is necessarily of value or relevance to the patient. As an attempt to shed light on this issue, our group elaborated a classification system for PROMs according to the degree of patient involvement in their development:2 patient‐generated PROMs — a type of PROM developed entirely from the patient perspective, as at all stages of PROM development the researchers are themselves patients; patient‐centred PROMs — a kind of PROM that explicitly incorporates, to a greater or lesser extent, patient priorities, given that patients themselves codeveloped the PROM jointly with other stakeholders (eg, clinicians); patient‐valued PROMs — a variety of PROM developed without patient input but valued by most patients because it reflects, at least in part, their priorities; and patient‐irrelevant PROMs — a type of PROM developed entirely without patient participation, whose contents are evaluated as not relevant by patients themselves. Fortunately, the epistemic injustice of disregarding the patient’s perspective in PROMs development is being progressively abandoned, and there seems to be a growing consensus that patients should be significantly involved — through truly participatory methods — in developing any new PROM.2,4,5 Without genuinely incorporating the patient’s perspective in PROMs development, PROMs collection will not contribute to a true and meaningful involvement of patients in their health care.

Joan Trujols · Santiago Duran‐Sindreu · Maria J Portella

Mja2 51614

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