3 results on '"Barratt, John D."'
Search Results
2. Bridging evidence-practice gaps: improving use of medicines in elderly Australian veterans.
- Author
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Roughead, Elizabeth E., Kalisch Ellett, Lisa M., Ramsay, Emmae N., Pratt, Nicole L., Barratt, John D., LeBlanc, Vanessa T., Ryan, Philip, Peck, Robert, Killer, Graeme, and Gilbert, Andrew L.
- Subjects
HEALTH promotion ,MEDICAL care of veterans ,HEALTH services administration ,REGRESSION analysis ,NONSTEROIDAL anti-inflammatory agents ,ANTIPSYCHOTIC agents ,AUSTRALIA. Dept. of Veterans' Affairs - Abstract
Background The Australian Government Department of Veterans' Affairs (DVA) funds an ongoing health promotion based program to improve use of medicines and related health services, which implements interventions that include audit and feedback in the form of patient-specific feedback generated from administrative claims records. We aimed to determine changes in medicine use as a result of the program. Methods The program provides targeted patient-specific feedback to medical practitioners. The feedback is supported with educational material developed by a clinical panel, subject to peer review and overseen by a national editorial committee. Veterans who meet target criteria also receive educational brochures. The program is supported by a national call centre and ongoing national consultation. Segmented regression analyses (interrupted time series) were undertaken to assess changes in medication use in targeted veterans pre and post each intervention. Results 12 interventions were included; three to increase medicine use, seven which aimed to reduce use, and two which had combination of messages to change use. All programs that aimed to increase medicine use were effective, with relative effect sizes at the time of the intervention ranging from 1% to 8%. Mixed results were seen with programs aiming to reduce inappropriate medicine use. Highly specific programs were effective, with relative effect sizes at the time of the intervention of 10% decline in use of NSAIDs in high risk groups and 14% decline in use of antipsychotics in dementia. Interventions targeting combinations of medicines, including medicine interactions and potentially inappropriate medicines in the elderly did not change practice significantly. Interventions with combinations of messages targeting multiple components of practice had an impact on one component, but not all components targeted. Conclusions The Veterans' MATES program showed positive practice change over time, with interventions increasing use of appropriate medicines where under-use was evident and reduced use of inappropriate medicines when single medicines were targeted. Combinations of messages were less effective, suggesting specific messages focusing on single medicines are required to maximise effect. The program provides a model that could be replicated in other settings. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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3. Reducing hypnotic use in insomnia management among Australian veterans: results from repeated national interventions
- Author
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Renly Lim, Elizabeth E. Roughead, John D. Barratt, Lisa M. Kalisch Ellett, Mhairi Kerr, Tammy LeBlanc, Emmae N. Ramsay, Nicole L. Pratt, Kalisch Ellett, Lisa M, Lim, Renly, Pratt, Nicole L, Kerr, Mhairi, Ramsay, Emmae N, Leblanc, Tammy V, Barratt, John D, and Roughead, Elizabeth E
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trends ,medicine.medical_specialty ,Insomnia ,Health service areas ,insomnia ,Health Personnel ,Population ,Psychological intervention ,Poison control ,hypnotics ,Pharmacists ,Suicide prevention ,Occupational safety and health ,Health administration ,03 medical and health sciences ,0302 clinical medicine ,Health Facility Administrators ,Patient Education as Topic ,General Practitioners ,Sleep Initiation and Maintenance Disorders ,medicine ,Homes for the Aged ,Humans ,Hypnotics and Sedatives ,030212 general & internal medicine ,education ,health care economics and organizations ,health service areas ,Veterans ,education.field_of_study ,business.industry ,lcsh:Public aspects of medicine ,Health Policy ,Australia ,lcsh:RA1-1270 ,Interrupted Time Series Analysis ,3. Good health ,Hospitalization ,Family medicine ,Accidental Falls ,medicine.symptom ,Trends ,business ,030217 neurology & neurosurgery ,Hypnotics ,Cohort study ,Research Article - Abstract
Background:The Australian Government Department of Veterans' Affairs (DVA) Veterans' Medicines Advice and Therapeutics Education Services (Veterans' MATES) programme conducted two intervention (March 2009, follow-up intervention June 2012) both of which aimed to reduce hypnotic use among Australian veterans. We evaluated the effectiveness of the interventions, and estimated the associated health consequences Methods:Both interventions targeted veterans who had been dispensed hypnotics prior to the intervention.Patient-specific prescriber feedback containing patient details and the volume of hypnotics dispensed, along with tailored educational information, was mailed to general practitioners. Veterans, pharmacists and directors of care in residential aged care facilities were mailed tailored educational information. Interrupted time-series and segmented regression modelling were used to determine the effect of the two interventions on the rate of hypnotics dispensing. The cumulative patient-months of hypnotic treatment avoided as a result of the interventions was calculated. We estimated improvements in health consequences of as a result of hypnotic treatment avoided based on the results of cohort studies in the same population identifying the association between hypnotic and sedativeuse on the outcomes of falls, and confusion Results:After the first Veterans' MATES intervention in March 2009, hypnotic use declined by 0.2% each month,when compared to the baseline level (p= 0.006). The intervention effect was attenuated after one year, and use of hypnotics was found to increase by 0.2% per month after March 2010. Following the second intervention in June2012, there was a further significant decline in use of 0.18% each month over the 12 months of follow up (p=0.049). The cumulative effect of both interventions resulted in 20,850 fewer patient-months of treatment with hypnotics. This cumulative reduction in hypnotic use was estimated to lead to a minimum of 1 fewer hospital admissions for acute confusion and 7 fewer hospital admissions due to falls. Conclusions:The Veterans' MATES insomnia interventions which involved multiple stakeholders were effective in reducing hypnotic use among older Australians. Repetition of key messages led to sustained practice change Refereed/Peer-reviewed
- Published
- 2018
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