ORCID Profile
0000-0001-8846-216X
Current Organisation
Saint Vincent's Hospital Sydney
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Publisher: Informa UK Limited
Date: 14-12-2022
DOI: 10.1080/09638288.2020.1852616
Abstract: The aim of this study was to describe differences in long-term outcomes for patients discharged to inpatient rehabilitation facilities (IRFs) following stroke compared to patients discharged directly home or to residential aged care facilities (RACFs). Cohort study. Data from the Australian Stroke Clinical Registry were linked to hospital admissions records and the national death index. Main outcomes: death and hospital readmissions up to 12 months post-admission, Health-related Quality of Life (HRQoL) 90-180 days post-admission. Of 8,555 included patients (median age 75, 55% male, 83% ischemic stroke), 4,405 (51.5%) were discharged home, 3,442 (40.2%) to IRFs, and 708 (8.3%) to RACFs.No between-group differences were observed in hazard of death between patients discharged to IRFs versus home. Fewer patients discharged to IRFs were readmitted to hospital within 90, 180 or 365-days compared to patients discharged home (adjusted subhazard ratio [aSHR]:90-days 0.54, 95%CI 0.49, 0.61 aSHR:180-days 0.74, 95%CI 0.67, 0.82 aSHR:365-days 0.85, 95%CI 0.78, 0.93). Fewer patients discharged to IRFs reported problems with mobility compared to those discharged home (adjusted OR 0.54, 95%CI 0.47, 0.63), or to RACFs (aOR 0.35, 95%CI 0.25, 0.48). Overall HRQoL between 90-180 days was worse for people discharged to IRFs versus those discharged home and better than those discharged to RACFs. Several long-term outcomes differed significantly for patients discharged to different settings after stroke. Patients discharged to IRFs reported some better outcomes than people discharge directly home despite having markers of more severe stroke.Implications for rehabilitationPeople with mild strokes are usually discharged directly home, people with moderate severity strokes to inpatient rehabilitation, and people with very severe strokes are usually discharged to residential aged care facilities.People discharged to inpatient rehabilitation reported fewer problems with mobility and had a reduced risk of hospital readmission in the first year post-stroke compared to people discharged directly home after stroke.The median self-reported health-related quality of life for people discharged to residential aged care equated to 'worst health state imaginable'.
Publisher: Elsevier BV
Date: 05-2021
Publisher: Wiley
Date: 10-11-2021
DOI: 10.1111/AJR.12803
Abstract: To describe the rehabilitation services available for people with stroke and hip fracture across New South Wales/Australian Capital Territory metropolitan and rural/regional public hospitals in Australia. A cross‐sectional study design was used. New South Wales/Australian Capital Territory public hospital providing rehabilitation services for stroke and hip fracture. Delegates from 59 eligible hospitals. Information about the type, number and availability of inpatient and outpatient rehabilitation services at each hospital was collected via survey. Counts, percentages, mean (SD), median (IQR) were used to quantify the number and type of inpatient and outpatient services available. Across inpatient rehabilitation units, reduced availability was noted in the number of clinical disciplines available, availability of neuropsychology and social work in rural units. Across outpatient rehabilitation services, reduced availability was noted in the number of disciplines available, availability of occupational therapy, psychology, rehabilitation physicians, specialist nursing, geriatricians, and podiatry in rural services. Five rural hospitals had no access to outpatient rehabilitation. There was reduced availability of rehabilitation services and health disciplines in rural/regional settings. A follow‐up study is underway investigating relationships between reduced outpatient service availability and inpatient length of stay in rural/regional versus metropolitan hospitals.
Publisher: JMIR Publications Inc.
Date: 02-05-2021
Abstract: lder adults are at an increased risk of falls with the consequent impacts on the health of the in idual and health expenditure for the population. Smartwatch apps have been developed to detect a fall, but their sensitivity and specificity have not been subjected to blinded assessment nor have the factors that influence the effectiveness of fall detection been fully identified. his study aims to assess accuracy metrics for a novel fall detection smartwatch algorithm. e performed a cross-sectional study of 22 healthy adults comparing the detection of induced forward, side (left and right), and backward falls and near falls provided by a smartwatch threshold-based algorithm, with a video record of induced falls serving as the gold standard a blinded assessor compared the two. Three different smartwatches with two different operating systems were used. There were 226 falls: 64 were backward, 51 forward, 55 left sided, and 56 right sided. he overall smartwatch app sensitivity for falls was 77%, the specificity was 99%, the false-positive rate was 1.7%, and the false-negative rate was 16.4%. The positive and negative predictive values were 98% and 84%, respectively, while the accuracy was 89%. There were 249 near falls: the sensitivity was 89%, the specificity was 100%, there were no false positives, 11% were false negatives, the positive predictive value was 100%, the false-negative predictive value was 83%, and the accuracy was 93%. alls were more likely to be detected if the fall was on the same side as the wrist with the smartwatch. There was a trend toward some smartwatches and operating systems having superior sensitivity, but these did not reach statistical significance. The effectiveness data and modifying factors pertaining to this smartwatch app can serve as a reference point for other similar smartwatch apps.
Publisher: JMIR Publications Inc.
Date: 07-06-2021
Abstract: nternet-based treatment programs present a solution for providing access to pain management for those unable to access clinic-based multidisciplinary pain programs. Attrition from internet interventions is a common issue. Clinician-supported guidance can be an important feature in web-based interventions however, the optimal level of therapist guidance and expertise required to improve adherence remains unclear. he aim of this study is to evaluate whether augmenting the existing Reboot Online program with telephone support by a clinician improves program adherence and effectiveness compared with the web-based program alone. 2-armed, CONSORT (Consolidated Standards of Reporting Trials)–compliant, registered randomized controlled trial with one-to-one group allocation was conducted. It compared a web-based multidisciplinary pain management program, Reboot Online, combined with telephone support (n=44) with Reboot Online alone (n=45) as the control group. Participants were recruited through web-based social media and the This Way Up service provider network. The primary outcome for this study was adherence to the Reboot Online program. Adherence was quantified through three metrics: completion of the program, the number of participants who enrolled into the program, and the number of participants who commenced the program. Data on adherence were collected automatically through the This Way Up platform. Secondary measures of clinical effectiveness were also collected. eboot Online combined with telephone support had a positive effect on enrollment and commencement of the program compared with Reboot Online without telephone support. Significantly more participants from the Reboot Online plus telephone support group enrolled (41/44, 93%) into the course than those from the control group (35/45, 78% i χ /i sup /sup sub /sub =4.2 i P /i =.04). Furthermore, more participants from the intervention group commenced the course than those from the control group (40/44, 91% vs 27/45, 60%, respectively i χ sup /sup /i sub /sub =11.4 i P /i =.001). Of the participants enrolled in the intervention group, 43% (19/44) completed the course, and of those in the control group, 31% (14/45) completed the course. When considering the subgroup of those who commenced the program, there was no significant difference between the proportions of people who completed all 8 lessons in the intervention (19/40, 48%) and control groups (14/27, 52% i χ sup /sup /i sub /sub =1.3 i P /i =.24). The treatment efficacy on clinical outcome measures did not differ between the intervention and control groups. elephone support improves participants’ registration, program commencement, and engagement in the early phase of the internet intervention however, it did not seem to have an impact on overall course completion or efficacy. ustralian New Zealand Clinical Trials Registry ACTRN12619001076167 anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12619001076167
Publisher: Informa UK Limited
Date: 15-06-2023
Publisher: Wiley
Date: 15-05-2022
DOI: 10.5694/MJA2.51520
Publisher: Elsevier BV
Date: 10-2021
Publisher: JMIR Publications Inc.
Date: 03-02-2022
DOI: 10.2196/30880
Abstract: Internet-based treatment programs present a solution for providing access to pain management for those unable to access clinic-based multidisciplinary pain programs. Attrition from internet interventions is a common issue. Clinician-supported guidance can be an important feature in web-based interventions however, the optimal level of therapist guidance and expertise required to improve adherence remains unclear. The aim of this study is to evaluate whether augmenting the existing Reboot Online program with telephone support by a clinician improves program adherence and effectiveness compared with the web-based program alone. A 2-armed, CONSORT (Consolidated Standards of Reporting Trials)–compliant, registered randomized controlled trial with one-to-one group allocation was conducted. It compared a web-based multidisciplinary pain management program, Reboot Online, combined with telephone support (n=44) with Reboot Online alone (n=45) as the control group. Participants were recruited through web-based social media and the This Way Up service provider network. The primary outcome for this study was adherence to the Reboot Online program. Adherence was quantified through three metrics: completion of the program, the number of participants who enrolled into the program, and the number of participants who commenced the program. Data on adherence were collected automatically through the This Way Up platform. Secondary measures of clinical effectiveness were also collected. Reboot Online combined with telephone support had a positive effect on enrollment and commencement of the program compared with Reboot Online without telephone support. Significantly more participants from the Reboot Online plus telephone support group enrolled (41/44, 93%) into the course than those from the control group (35/45, 78% χ21=4.2 P=.04). Furthermore, more participants from the intervention group commenced the course than those from the control group (40/44, 91% vs 27/45, 60%, respectively χ21=11.4 P=.001). Of the participants enrolled in the intervention group, 43% (19/44) completed the course, and of those in the control group, 31% (14/45) completed the course. When considering the subgroup of those who commenced the program, there was no significant difference between the proportions of people who completed all 8 lessons in the intervention (19/40, 48%) and control groups (14/27, 52% χ21=1.3 P=.24). The treatment efficacy on clinical outcome measures did not differ between the intervention and control groups. Telephone support improves participants’ registration, program commencement, and engagement in the early phase of the internet intervention however, it did not seem to have an impact on overall course completion or efficacy. Australian New Zealand Clinical Trials Registry ACTRN12619001076167 anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12619001076167
Publisher: JMIR Publications Inc.
Date: 21-03-2022
DOI: 10.2196/30121
Abstract: Older adults are at an increased risk of falls with the consequent impacts on the health of the in idual and health expenditure for the population. Smartwatch apps have been developed to detect a fall, but their sensitivity and specificity have not been subjected to blinded assessment nor have the factors that influence the effectiveness of fall detection been fully identified. This study aims to assess accuracy metrics for a novel fall detection smartwatch algorithm. We performed a cross-sectional study of 22 healthy adults comparing the detection of induced forward, side (left and right), and backward falls and near falls provided by a smartwatch threshold-based algorithm, with a video record of induced falls serving as the gold standard a blinded assessor compared the two. Three different smartwatches with two different operating systems were used. There were 226 falls: 64 were backward, 51 forward, 55 left sided, and 56 right sided. The overall smartwatch app sensitivity for falls was 77%, the specificity was 99%, the false-positive rate was 1.7%, and the false-negative rate was 16.4%. The positive and negative predictive values were 98% and 84%, respectively, while the accuracy was 89%. There were 249 near falls: the sensitivity was 89%, the specificity was 100%, there were no false positives, 11% were false negatives, the positive predictive value was 100%, the false-negative predictive value was 83%, and the accuracy was 93%. Falls were more likely to be detected if the fall was on the same side as the wrist with the smartwatch. There was a trend toward some smartwatches and operating systems having superior sensitivity, but these did not reach statistical significance. The effectiveness data and modifying factors pertaining to this smartwatch app can serve as a reference point for other similar smartwatch apps.
Publisher: Oxford University Press (OUP)
Date: 21-03-2022
DOI: 10.1093/PM/PNAC049
Abstract: Societal and health system pressures associated with the coronavirus disease 2019 (COVID-19) pandemic exacerbated the burden of chronic pain and limited access to pain management services for many. Online multidisciplinary pain programs offer an effective and scalable treatment option, but have not been evaluated within the context of COVID-19. This study aimed to investigate the uptake and effectiveness of the Reboot Online chronic pain program before and during the first year of the COVID-19 pandemic. Retrospective cohort analyses were conducted on routine service users of the Reboot Online program, comparing those who commenced the program during the COVID-19 pandemic (March 2020–March 2021), to those prior to the pandemic (April 2017–March 2020). Outcomes included the number of course registrations commencements completion rates and measures of pain severity, interference, self-efficacy, pain-related disability, and distress. Data from 2,585 course users were included (n = 1138 pre-COVID-19 and n = 1,447 during-COVID-19). There was a 287% increase in monthly course registrations during COVID-19, relative to previously. Users were younger, and more likely to reside in a metropolitan area during COVID-19, but initial symptom severity was comparable. Course adherence and effectiveness were similar before and during COVID-19, with moderate effect size improvements in clinical outcomes post-treatment (g = 0.23–0.55). Uptake of an online chronic pain management program substantially increased during the COVID-19 pandemic. Program adherence and effectiveness were similar pre- and during-COVID. These findings support the effectiveness and scalability of online chronic pain management programs to meet increasing demand.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2020
DOI: 10.1161/STROKEAHA.120.030656
Abstract: A comprehensive understanding of the long-term impact of stroke assists in health care planning. We aimed to determine changes in rates, causes, and associated factors for hospital presentations among long-term survivors of stroke. Person-level data from the AuSCR (Australian Stroke Clinical Registry) during 2009 to 2013 were linked with state-based health department emergency department and hospital admission data. The study cohort included adults with first-ever stroke who survived the first 6 months after discharge from hospital. Annualized rates of hospital presentations (nonadmitted emergency department or admission) erson/year were calculated for 1 to 12 months prior, and 7 to 12 months (inclusive) after hospitalization. Multilevel, negative binomial regression was used to identify associated factors after adjustment for prestroke hospital presentations and stratification for perceived impairment status. Perceived impairments to health were defined according to the subscales and visual analog health status scores on the 5-Dimension European Quality of Life Scale. There were 7183 adults with acute stroke, 7-month survivors (median age 72 years 56% male 81% ischemic, and 42% with impairment at 90–180 days) from 39 hospitals included in this landmark analysis. Annualized presentations erson increased from 0.88 (95% CI, 0.86–0.91) to 1.25 (95% CI, 1.22–1.29) between the prestroke and poststroke periods, with greater rate increases in those with than without perceived impairment (55% versus 26%). Higher presentation rates were most strongly associated with older age (≥85 versus 65 years, incidence rate ratio, 1.52 [95% CI, 1.27–1.82]) and greater comorbidity score (incidence rate ratio, 1.06 [95% CI, 1.02–1.10]), whereas reduced rates were associated with greater social advantage (incidence rate ratio, 0.71 [95% CI, 0.60–0.84]). Poststroke hospital presentations (7–12 months) were most frequently related to recurrent cardiovascular and cerebrovascular events and sequelae of stroke. A large increase in annualized hospital presentation rates after stroke indicates the potential for improved community management and support for this vulnerable patient group.
Publisher: Informa UK Limited
Date: 19-02-2022
DOI: 10.1080/09638288.2021.1887377
Abstract: Persistent activity limitations are common among road trauma survivors, yet access to rehabilitation in hospital and in the community remains variable. This study aimed to identify unmet rehabilitation needs following road trauma and assess the feasibility of a novel rehabilitation consultation service delivered A pilot cohort study was conducted with survivors of road trauma who were hospitalized but did not receive formal inpatient rehabilitation. All participants received a multidisciplinary rehabilitation consultation 38 participants were enrolled. All (100%) reported functional limitations at baseline 86.5% were found to have unmet rehabilitation needs, and 75.7% were recommended rehabilitation interventions. Functional ability improved over time, but more than half the cohort continued to report activity limitations (67.6%), pain (64.7%) and/or altered mood (41.2%) for up to three months. Participants found the telehealth service to be acceptable, convenient, and helpful for recovery. A high proportion of mild-moderate trauma survivors report unmet rehabilitation needs following hospital discharge. Telehealth appears to be a feasible, convenient and acceptable mode of assessing these needs.Implications for rehabilitationSurvivors of road-related injuries often experience ongoing impairments and activity limitations.Among those who don't receive rehabilitation in hospital, we found a high proportion (86.5%) had unmet rehabilitation needs after discharge.A telehealth rehabilitation service was feasible to deliver and could successfully identify unmet rehabilitation needs.The piloted telehealth intervention was viewed as acceptable, convenient and beneficial by patients.
Location: Australia
Location: Australia
Location: No location found
No related grants have been discovered for Steven Faux.