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3. PB2087: EFFICACY OF A 3RD COVID VACCINE, INCLUDING DURING A BTKI PAUSE, IN INDIVIDUALS WITH WALDENSTRÖM MACROGLOBULINEMIA AND FOLLICULAR LYMPHOMA

Author

Rankin, K., primary, Beaton, B., additional, Sasson, S., additional, Raedemaecker, J., additional, Wong, A., additional, Hastak, P., additional, Phetsouphanh, C., additional, Warden, A., additional, Patel, M., additional, Klemm, V., additional, Munier, C. M. L., additional, Carey Hoppe, A., additional, Tea, F., additional, Pillay, A., additional, Ospina, A., additional, Aggarwal, A., additional, Lavee, O., additional, Caterson, I. D., additional, Turville, S., additional, Kelleher, A. D., additional, Brilot, F., additional, and Trotman, J., additional

Published
2022
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4. Surgeon Engagement with Patient-Reported Measures in Australian and Aotearoa New Zealand Bariatric Practices

Author

Budin, AJ, Sumithran, P, MacCormick, AD, Caterson, I, Brown, WA, Budin, AJ, Sumithran, P, MacCormick, AD, Caterson, I, and Brown, WA

Abstract

PURPOSE: Patient-reported measures are an important emerging metric in outcome monitoring; however, they remain ill-defined and underutilized in bariatric clinical practice. This study aimed to determine the characteristics of patient-reported measures employed in bariatric practices across Australia and Aotearoa New Zealand, including barriers to their implementation and to what extent clinicians are receptive to their use. METHODS: An online survey was distributed to all bariatric surgeons actively contributing to the Australian and Aotearoa New Zealand Bariatric Surgery Registry (n = 176). Participants reported their use of patient-reported measures and identified the most important and useful outcomes of patient-reported data for clinical practice. RESULTS: Responses from 64 participants reported on 120 public and private bariatric practices across Australia and Aotearoa New Zealand. Most participants reported no collection of any patient-reported measure (39 of 64; 60.9%), citing insufficient staff time or resources as the primary barrier to the collection of both patient-reported experience measures (34 of 102 practices; 33.3%) and patient-reported outcome measures (30 of 84 practices; 35.7%). Participants indicated data collection by the Registry would be useful (47 of 57; 82.5%), highlighting the most valuable application to be a monitoring tool, facilitating increased understanding of patient health needs, increased reporting of symptoms, and enhanced patient-physician communication. CONCLUSION: Despite the current lack of patient-reported measures, there is consensus that such data would be valuable in bariatric practices. Widespread collection of patient-reported measures by registries could improve the collective quality of the data, while avoiding implementation barriers faced by individual surgeons and hospitals.

Published
2022

10. Modelling vaccination capacity at mass vaccination hubs and general practice clinics

Author

Mark Hanly, Caterson I, Chandini Raina MacIntyre, Oisin Fitzgerald, Tim Churches, and Louisa Jorm

Subjects
Vaccination, Service (business), Government, Community pharmacies, education.field_of_study, General practice, Population, Operations management, Mass vaccination, Business, education, Queue
Abstract

COVID-19 population vaccination programs are underway globally. In Australia, the federal government has entered into three agreements for the supply of vaccines, with roll-out beginning for the highest priority groups in February 2021. Expansion of the vaccination program throughout February and March failed to meet government targets and this has been attributed to international supply issues. However, Australia has local capacity to manufacture one million doses of the AstraZeneca vaccine weekly and once fully operational this will greatly increase the national vaccination capacity. Under current plans, these vaccine doses will be distributed primarily through a network of general practices, to be joined in later phases by community pharmacies. It remains unclear whether these small distribution venues have the logistical capacity to administer vaccines at the rate they will become available. To inform this discussion, we applied stochastic queue network models to estimate the capacity of vaccination sites based on assumptions about appointment schedules, service times and available staff numbers. We specified distinct queueing models for two delivery modes: (i) mass vaccination hubs located in hospitals or sports arenas and (ii) smaller clinics situated in general practices or community pharmacies. Based on our assumed service times, the potential daily throughput for an eight hour clinic at a mass vaccination hub ranged from around 500 vaccinations for a relatively small hub to 1,400 vaccinations a day for a relatively large hub. For GP vaccination clinics, the estimated daily throughput ranged from about 100 vaccinations a day for a relatively small practice to almost 300 a day for a relatively large practice. Stress tests showed that for both delivery modes, sites with higher staff numbers were more robust to system pressures, such as increased arrivals or staff absences, and mass vaccination sites were more robust that GP clinics. Our analysis is accompanied by an interactive web-based queue simulation applet, which allows users to explore queue performance under their own assumptions regarding appointments, service times and staff availability. Different vaccine delivery modes offer distinct benefits and may be particularly appealing to specific population segments. A combination of expanded mass vaccination hubs and expanded GP vaccination is likely to achieve mass vaccination faster than either mode alone.

Published
2021

11. Effect of a smartphone application (Perx) on medication adherence and clinical outcomes: a 12-month randomised controlled trial

Author

Li, A, Del Olmo, MG, Fong, M, Sim, K, Lymer, SJ, Cunich, M, Caterson, I, Li, A, Del Olmo, MG, Fong, M, Sim, K, Lymer, SJ, Cunich, M, and Caterson, I

Abstract

OBJECTIVE: To determine whether the Perx app improves medication adherence and clinical outcomes over 12 months compared with standard care in patients requiring polypharmacy. DESIGN: Randomised controlled trial with 12-month follow-up. SETTING: Outpatient clinics in three tertiary hospitals in Sydney, Australia. PARTICIPANTS: Eligible participants were aged 18-75 years, with at least one chronic condition, taking ≥3 different medications (oral medications or injections), with smartphone accessibility. Participants were randomised in a 1:1 ratio. INTERVENTIONS: The intervention group used the Perx app that contained customised reminders and gamified interactions to reward verified medication adherence. MAIN OUTCOME MEASURES: The primary outcome was medication adherence over 12 months measured using pill counts. Secondary outcomes included clinical outcomes (haemoglobin A1c (HbA1c), cholesterol, blood glucose, triglycerides, creatinine, thyroid function, blood pressure and weight). RESULTS: Of 1412 participants screened for eligibility, 124 participants were randomised; 45 in the Perx arm and 40 in the control arm completed the study. The average age was 59.5, 58.9% were women, chronic conditions were cardiovascular disease (78%), type 2 diabetes (75%), obesity (65%) or other endocrine disorders (18%). On average, participants were taking six medications daily. The Perx group had greater improvements in adherence at month 2 (Coef. 8%; 95% CI 0.01 to 0.15), month 3 (Coef. 7%; 95% CI 0.00 to 0.14) and month 12 (Coef. 7%; 95% CI 0.00 to 0.13). The probability of HbA1c ≤6.5% was greater in the Perx group at months 9 and 12 and cholesterol (total and low-density lipoprotein cholesterol) was lower in the Perx group at month 3. The intervention was particularly effective for those with obesity, taking medications for diabetes and taking ≤4 medications. CONCLUSIONS: This study provides evidence that app-based behavioural change interventions can increase medication adherence

Published
2021

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