Remote interpreting services are essential for people with limited English — during COVID-19 and beyond

According to 2016 Census data, 3.5% of Australians have limited English proficiency. When they’re receiving health care, it’s essential these Australians have access to interpreters. Research has shown professional interpreters facilitate effective communication between the patient and clinician, boost the quality of care, and improve the patient’s health outcomes. With COVID-19, we’ve seen a shift towards interpreting services being delivered remotely. These remote services are important for vulnerable groups during the pandemic. They should also pave the way for improved care for people with limited English in the future

Have mobile devices changed working patterns in the 21st Century? A time-diary analysis of work extension in the UK

It is commonly claimed that ubiquitous connectivity erodes the boundaries that once separated work from other aspects of life. Mobile devices in particular enable people to perform work-related activities anytime anywhere. Surprisingly, however, we know little about how people nationwide organise their daily working time over a period that has witnessed rapid technological change. Using the United Kingdom Time Use Surveys 2000 and 2015, covering this period of technological change, we studied work extension practices, and the links between work extension, total work hours and subjective time pressure. We found a significant, though small, increase in work extension, and evidence that it was significantly associated with time pressure in 2015, but not in 2000. Additionally, work extension increased total work hours, which was concentrated entirely in time working with a mobile device. We discuss our results in light of some taken-for-granted narratives about mobile devices allowing work to colonise life

Enriching a medical curriculum with community-based public health projects: are there opportunities for inter-professional learning?

The University of Wollongong graduate-entry medical course embeds research and critical analysis within the curriculum, concluding with the students designing and undertaking a 12-month regional/ rural community-based research project

Challenges of Older Patients’ Knowledge About Warfarin Therapy

Objective: To review the challenges of warfarin education for older patients (aged 65 years or older) in terms of knowledge, access to warfarin education, and education resources. Methods: A quasi-systematic review of the literature was performed via electronic database searches (eg, Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, International Pharmaceutical Abstracts, Meditext, and Google Scholar) from 1990 to May 2011. Results: The 62 articles reviewed found that improved patient knowledge results in better anticoagulation control. The review also found that between 50% and 80% of older patients have inadequate knowledge about the basic aspects of warfarin therapy (eg, action, benefits and risks, interactions with other drugs or foods, international normalized ratio management). Demographic factors, such as advancing age, lower family income, and limited health literacy, were found to inversely affect patients’ warfarin knowledge, and access to warfarin education and information resources were often suboptimal in different practice settings. Finally, a number of educational strategies and resources that could be readily incorporated to improve the effectiveness of current warfarin education programs were extracted from the review. Conclusion: This comprehensive review highlights that education about warfarin in older patients is currently suboptimal and may in part contribute to poor therapeutic outcomes. This review article also acknowledges the need to identify, target, and develop educational strategies and resources to further improve older patients’ knowledge about their warfarin therapy

Attitudes towards deprescribing and the influence of health literacy among older Australians

Aim This study aimed to explore attitudes, beliefs and experiences regarding polypharmacy and discontinuing medications, or deprescribing, among community living older adults aged ≥65 years, using ≥5 medications. It also aimed to investigate if health literacy capabilities influenced attitudes and beliefs towards deprescribing. Background Polypharmacy use is common among Australian older adults. However, little is known about their attitudes towards polypharmacy use or towards stopping medications. Previous studies indicate that health literacy levels tend to be lower in older adults, resulting in poor knowledge about medications. Methods A self-administered survey was conducted using two previously validated tools; the Patients’ Attitude Towards Deprescribing (PATD) tool to measure attitudes towards polypharmacy use and deprescribing and the All Aspects of Health Literacy Scale (AAHLS) to measure functional, communicative and critical health literacy. Descriptive statistical analysis was conducted. Findings The 137 responses showed that 80% thought all their medications were necessary and were comfortable with the number taken. Wanting to reduce the number of medications taken was associated with concerns about the amount taken (P\u3c0.001), experiencing side effects (P\u3c0.001), or believing that one or more medications were no longer needed (P\u3c0.000). Those who were using ten or more medications were more likely to want to reduce the number taken (P=0.019). Most (88%) respondents would be willing to stop medication/s in the context of receiving this advice from their doctor. Willingness to consider stopping correlated with higher scores on the critical health literacy subscale (P\u3c0.021) and overall AAHLS score (P\u3c0.009). Those with higher scores on the overall AAHLS measure were more likely to report that they understood why their medications were prescribed (P\u3c0.000) and were more likely to participate in decision-making (P=0.027). Opportunities to proactively consider deprescribing may be missed, as one third of the respondents could not recall a recent review of their medications

The role of health literacy and social networks in arthritis patients\u27 health information-seeking behavior : a qualitative study

Background. Patients engage in health information-seeking behaviour to maintain their wellbeing and to manage chronic diseases such as arthritis. Health literacy allows patients to understand available treatments and to critically appraise information they obtain from a wide range of sources. Aims. To explore how arthritis patients\u27 health literacy affects engagement in arthritis-focused health information-seeking behaviour and the selection of sources of health information available through their informal social network. Methods. An exploratory, qualitative study consisting of one-on-one semi-structured interviews. Twenty participants with arthritis were recruited from community organizations. The interviews were designed to elicit participants\u27 understanding about their arthritis and arthritis medication and to determine how the participants\u27 health literacy informed selection of where they found information about their arthritis and pain medication. Results. Participants with low health literacy were less likely to be engaged with health information-seeking behaviour. Participants with intermediate health literacy were more likely to source arthritis-focused health information from newspapers, television, and within their informal social network. Those with high health literacy sourced information from the internet and specialist health sources and were providers of information within their informal social network. Conclusion. Health professionals need to be aware that levels of engagement in health information-seeking behaviour and sources of arthritis-focused health information may be related to their patients\u27 health literacy.<br /

An Australian discharge summary quality assessment tool: A pilot study

Background and objective Patients\u27 transition from hospital care to their general practitioner (GP) can put them at risk of unforeseen adverse events, which can be minimised by the GP receiving timely access to hospital discharge summaries. The objective of this article was to develop and pilot a discharge summary assessment tool, inclusive of components that Australian GPs identified as being most important for the safe transfer of care. Method Development of the instrument was informed by a literature review pertaining to key components of effective discharge summaries. These components were included in a survey instrument, which was piloted by Australian GP participants. Results From 118 responses, the five highest ranked components of a discharge summary included lists of medications on discharge, diagnoses on discharge, reasons for any changes in medications, and details of follow-up arrangements and treatment in hospital. Discussion This paper describes the initial development and results of piloting an Australian discharge summary quality assessment tool

Patients\u27 experiences of a clinical pharmacist integrated into a General Practice setting

Presentation at 2015 Primary Health Care Research Conference, Adelaide, Australia, 29-31 July

Introduction to Health Behavior Change Support Systems Minitrack

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Web-based Information About Warfarin For Patients

Background Warfarin is a high-risk medication where patient information may be critical to help ensure safe and effective treatment. Considering the time constraints of healthcare providers, the internet can be an important supplementary information resource for patients prescribed warfarin. The usefulness of internet-based patient information is often limited by challenges associated with finding valid and reliable health information. Given patients’ increasing access of the internet for information, this study investigated the quality, suitability and readability of patient information about warfarin presented on the internet. Method Previously validated tools were used to evaluate the quality, suitability and readability of patient information about warfarin on selected websites. Results The initial search yielded 200 websites, of which 11 fit selection criteria, comprising seven non-commercial and four commercial websites. Regarding quality, most of the non-commercial sites (six out of seven) scored at least an ‘adequate’ score. With regard to suitability, 6 of the 11 websites (including two of the four commercial sites) attained an ‘adequate’ score. It was determined that information on 7 of the 11 sites (including two commercial sites) was written at reading grade levels beyond that considered representative of the adult patient population with poor literacy skills (e.g. school grade 8 or less). Conclusion Despite the overall ‘adequate’ quality and suitability of the internet derived patient information about warfarin, the actual usability of such websites may be limited due to their poor readability grades, particularly in patients with low literacy skills