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The Safety And Effectiveness Of Hospital E-prescribing Systems: A Controlled Time Series Study
Funder
National Health and Medical Research Council
Funding Amount
$740,460.00
Summary
Prescribing errors represent a significant public health issue internationally. In the US over 770,000 people are harmed or die each year in hospitals as a result of adverse drug events. In Australia 2% of hospital patients experience harm or death due to medication errors. The risk of these errors is rising each year with the increased intensity of medical care, use of complex and potent drug regimens and the increasing age and severity of hospital patients. Electronic prescribing systems are b ....Prescribing errors represent a significant public health issue internationally. In the US over 770,000 people are harmed or die each year in hospitals as a result of adverse drug events. In Australia 2% of hospital patients experience harm or death due to medication errors. The risk of these errors is rising each year with the increased intensity of medical care, use of complex and potent drug regimens and the increasing age and severity of hospital patients. Electronic prescribing systems are believed to significantly reduce the number of errors which occur and reduce harm to patients as a result. No studies have demonstrated that these systems result in reducing prescribing errors that cause harm to patients. Alarmingly, anecdotal evidence from overseas suggests that use of electronic prescribing systems introduces new types of errors. This is consistent with a growing body of scientific research which suggests that individuals' decision-making may be significantly influenced by information generated by a computer, resulting in new types of errors. The aim of this project is to undertake a controlled time series study to assess the safety and effectiveness of two electronic prescribing systems to reduce prescribing errors in Australian hospitals. The study will compare error rates before and after the introduction of the systems. In addition, the study will be the first to focus on measuring new types of errors that may result from system use and to investigate how computer use influences clinicians' decision-making. This study will provide critical information about the effectiveness and safety of these systems which are being introduced into Australian hospitals. Unlike other medical interventions, which require stringent safety testing before use with patients, there are no minimum safety requirements for electronic prescribing systems. The data from this study is urgent in developing recommendations to ensure the safety of electronic prescribing systems for Australia.Read moreRead less
Evaluating The Safety Of Computer Decision Support Systems In General Practice
Funder
National Health and Medical Research Council
Funding Amount
$300,389.00
Summary
Use of clinical software has many benefits. However it is also likely that clinical software will introduce new computer-generated errors that may harm patients. This project will evaluate the safety of software for prescribing in general practice. We will firstly examine mechanisms for errors generated by clinical software on its own, and then in the hands of typical users. The outcomes will have broad potential to guide the regulation, use and design of clinical software in general practice.
A Randomised Controlled Trial Of Internet-based Therapy For Panic Disorder.
Funder
National Health and Medical Research Council
Funding Amount
$202,575.00
Summary
Approximately 9.7% of the adult population have an anxiety disorder with one of the more common, panic disorder, often with agoraphobia, afflicting 2.4% of the community. Around 8% of patients consulting a GP also have panic disorder (PD). A further 10% of the community experience spontaneous panic, but do not have full PD (termed non-clinical panic). People with PD frequently experience clinical depression, about 15% abuse alcohol and non-prescription drugs and PD is associated with an increase ....Approximately 9.7% of the adult population have an anxiety disorder with one of the more common, panic disorder, often with agoraphobia, afflicting 2.4% of the community. Around 8% of patients consulting a GP also have panic disorder (PD). A further 10% of the community experience spontaneous panic, but do not have full PD (termed non-clinical panic). People with PD frequently experience clinical depression, about 15% abuse alcohol and non-prescription drugs and PD is associated with an increased risk of suicide. Over time people with PD appear to have an increased risk of heart problems. They also have substantial financial burdens through multiple attendances at doctors' rooms and through restricted employment opportunities. Only just over one in four people with an anxiety disorder consults a health professional for their problems, with most going to their GP. It has been estimated that less than 10% of these people seek the services of a mental health specialist such as a clinical psychologist or psychiatrist. Therefore because of blocks to do with access, cost or embarrassment, many people with mental health problems do not seek face-to-face specialised mental health treatment. People in rural and regional Australia are particularly disadvantaged by limited access to these specialists. We have developed an internet-based treatment program on panic and anxiety for people in the community, and particularly in regional Australia. Early evaluation of this program has found it is more effective than other types of therapist-assisted self-help treatment. The aim of this research project is to compare it to best-practice face-to-face psychological and pharmacological treatment for PD. If the effectiveness of our internet-based treatment is comparable to best-practice face-to-face treatment, its availability will assist the many Australians who suffer from debilitating panic but who are unable to access specialised mental health assistance.Read moreRead less
A Comprehensive Self-Management Programme For Chronic Obstructive Pulmonary Disease In The Community
Funder
National Health and Medical Research Council
Funding Amount
$391,610.00
Summary
Chronic obstructive pulmonary disease (COPD) is the third leading cause of burden of disease in Australia. It has a major impact on sufferers, their carers and society. This study introduces a new model of community care, based on case management, mentoring to improve self-efficacy and information systems to deliver information and closely monitor disease status. This will improve the quality of life of sufferers, develop healthcare networks and decrease healthcare utilisation.
Optimisation Of Salmonella Genotyping And Epidemiological Data Analysis For Detection And Investigation Of Outbreaks
Funder
National Health and Medical Research Council
Funding Amount
$508,051.00
Summary
Bacteria known as salmonella are the most important causes of food-borne diarrhoeal disease. They occasionally cause potentially fatal septicaemia, especially in young children and people with underlying disease. We estimate that more than 80,000 cases of salmonella infection occur in Australia, each year, at a cost to the community of $37 million. Salmonella are divided into more than 2000 different types, but one - called Typhimurium - causes about 40% of infections and a few others cause most ....Bacteria known as salmonella are the most important causes of food-borne diarrhoeal disease. They occasionally cause potentially fatal septicaemia, especially in young children and people with underlying disease. We estimate that more than 80,000 cases of salmonella infection occur in Australia, each year, at a cost to the community of $37 million. Salmonella are divided into more than 2000 different types, but one - called Typhimurium - causes about 40% of infections and a few others cause most of the rest. This means that is difficult to distinguish cases of salmonella infection that have originated from one source (an outbreak) from cases that have originated from another. Without this information, is it hard to track the source, which is usually inadequately cooked meat or chicken another food that has been contaminated with salmonella after preparation. There are several existing methods for fingerprinting salmonella, but they are quite slow or do not distinguish different strains well enough to identify outbreaks quickly. This means that sources of contaminated food are often not identified in time to prevent more cases occurring. We aim to develop a faster and more discriminatory system for fingerprinting salmonella, based on novel technology that can identify many small genetic sequences that occur in different combinations in different strains. As well, we will develop electronic scanning tools that will link the fingerprints of the salmonella strains with information about the people infected with them, such as the types of food and places where they have eaten, to identify patterns or clusters that indicate a common source. The more rapidly this can be done the sooner the source of contaminated food can be found and eliminated and additional cases can be prevented. This has important implications for public health - it will increase food safety and reduce illness and economic loss.Read moreRead less