An innovative Australian point-of-care model for urine albumin: creatinine ratio testing that supports diabetes management in indigenous medical services and has international application

Shephard, Mark Douglas; Gill, Janice

doi:10.1258/0004563053857806

Cited by 25 publications

(17 citation statements)

References 18 publications

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“…Large-scale national models such as the QAAMS PoCT program for diabetes management in Aboriginal and Torres Strait Islander medical services has provided a sound evidence base for the analytical, clinical and cultural effectiveness of PoCT in this most challenging of primary health care environments. 48,68,71 While local PoCT models have been developed for use in the Australian rural general practice environment 47 , the evidence base for the usefulness of PoCT in general practice both within Australia and globally has thus far been limited. 3,13 The objectives of this component of the PoCT Trial in General Practice were to develop, deliver and manage both:…”

Section: Discussionmentioning

confidence: 99%

“…44 Four of the RCTs investigated PoCT with another intervention. 8,18,21,34,58,59 The geographical setting included the United Kingdom (n=13) 8,16,18,21,33,[60][61][62][63][64][65][66][67] , Australia (n=7) 17,23,47,[68][69][70][71] , USA (n=5) 44,58,[72][73][74] , Belgium (n=2) 34,59 , Sweden (n=1) 75 and Ireland (n=1). 76 A description of the 29 studies included in the review is reported in Table 13 and Table 14.…”

Section: Excluded Studiesmentioning

confidence: 99%

“…Four of the six studies investigated the correlation between PoCT and laboratory values with all concluding that the results were adequate 16,17,62,63 . In four studies Bland Altman plots were performed [16][17][18]62 but only two studies 16,62 reported the 95% limits of agreement between PoCT and laboratory and only Seamark et al 16 Three studies 69,71,72 reported the safety of PoCT diabetes testing. Schwartz et al 72 showed the mean HbA1c result of the PoCT device to be significantly higher compared to the laboratory.…”

Section: Inrmentioning

confidence: 99%

“…Schwartz et al 72 showed the mean HbA1c result of the PoCT device to be significantly higher compared to the laboratory. The remaining two studies 69,71 conducted in the Australian indigenous setting showed that the HbA1c and urine albumin creatinine ratio (ACR) met the desired goals for imprecision.…”

Section: Inrmentioning

confidence: 99%

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The impact of non‐vitamin K antagonist oral anticoagulants (NOACs) on anticoagulation therapy in rural Australia

Bellinge

Paul

Walsh³

et al. 2018

Medical Journal of Australia

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Objective: To determine the use of different anticoagulation therapies in rural Western Australia; to establish whether remoteness from health care services affects the choice of anticoagulation therapy; to gather preliminary data on anticoagulation therapy safety and efficacy. Design: Retrospective cohort study of patients hospitalised with a principal diagnosis of atrial fibrillation/flutter (AF) or venous thromboembolism (VTE) during 2014–2015. Setting: Four hospitals serving two‐thirds of the rural population of Western Australia. Participants: 609 patients with an indication for anticoagulation therapy recorded in their hospital discharge summary for index admission. Main outcome measures: Prescribing rates of anticoagulation therapies by indication for anticoagulation and distance of patient residence from their hospital. The primary safety outcome was re‐hospitalisation with a major or clinically relevant non‐major bleeding event; the primary lack‐of‐efficacy outcome was re‐hospitalisation for a thromboembolic event. Results: The overall rates of prescription of NOACs and warfarin were similar (34% v 33%). A NOAC was prescribed more often than warfarin for patients with AF (56.0% v 42.2% of those who received an anticoagulant; P < 0.001), but less often for patients with VTE (29% v 48%; P < 0.001). Warfarin was prescribed for 38% of patients who lived locally, a NOAC for 31% (P = 0.013); for non‐local patients, the respective proportions were 29% and 36% (P = 0.08). 69% of patients with AF and a CHA2DS2–VASc score ≥ 1 were prescribed anticoagulation therapy. Patients treated with NOACs had fewer bleeding events than patients treated with warfarin (nine events [4%] v 20 events [10%]; P = 0.027). Conclusions: In rural WA, about one‐third of patients with an indication for anticoagulation therapy receive NOACs, but one‐third of patients with AF and at risk of stroke received no anticoagulant therapy, and may benefit from NOAC therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Excluded Studiesmentioning

confidence: 99%

Section: Inrmentioning

confidence: 99%

Section: Inrmentioning

confidence: 99%

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The impact of non‐vitamin K antagonist oral anticoagulants (NOACs) on anticoagulation therapy in rural Australia

Bellinge

Paul

Walsh³

et al. 2018

Medical Journal of Australia

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“…For example, there is evidence to suggest that Aboriginal and Torres Strait Islander Health Workers (ATSIHW), otherwise known as Indigenous Health Workers (IHW), may help to improve attendance at appointments and acceptance of treatment and assessment recommendations [9], reduce discharge against medical advice, increase patient contact time, enhance patient referral linkages, and improve patient follow up practices [13]. Preliminary evidence also shows potential for IHWs to improve diabetes screening [15,16] and care management processes [17,18], as well as palliative care [19] and maternal and infant care [20].…”

Section: Introductionmentioning

confidence: 99%

Working Well: Strategies to Strengthen the Workforce of the Indigenous Primary Healthcare Sector

Jongen

McCalman

Campbell

et al. 2019

Preprint

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Background The capacity of the Indigenous primary healthcare (PHC) sector to continue playing a crucial role in meeting the health needs of Aboriginal and Torres Strait Islander Australians is in large part reliant on the skills, motivation and experience of its workforce. While exhibiting many workforce strengths, the sector faces significant challenges in building and maintaining a strong and stable workforce. Drawing on data from one Aboriginal Community Controlled Health Service (ACCHS), this study reports what is working well and what could be improved to strengthen the Indigenous PHC sector workforce.Methods Using grounded theory methods, interviews with 17 ACCHS staff from a range of organisational positions were transcribed, coded and analysed. This paper focuses on the strategies identified that contribute towards strengthening the Indigenous PHC workforce.Results Four overarching strategies for Indigenous PHC workforce strengthening were identified. These were Strengthening Workforce Stability, Having Strong Leadership, Growing Capacity, and Working Well Together . A range of enabling factors at the macro, community, organisational and individual levels were also identified.Conclusion Indigenous PHC services are already implementing many important workforce-development strategies that are having a positive impact on the sector. There are also several persistent challenges which need to be addressed through action at organisational and structural levels. Approaches to workforce strengthening in Indigenous PHC should be tailored to local needs to ensure they address the unique workforce challenges experienced in different contexts.

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Agreement between laboratory results and on-site pathology testing using Bayer DCA2000+ and Cholestech LDX point-of-care methods in remote Australian Aboriginal communities

Shemesh

Rowley

Shephard

et al. 2006

Clinica Chimica Acta

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An innovative Australian point-of-care model for urine albumin: creatinine ratio testing that supports diabetes management in indigenous medical services and has international application

Abstract: This unique POC model for supporting diabetes management is the first of its type to be developed for indigenous communities and has considerable potential to be adopted worldwide.

Cited by 25 publications

References 18 publications

The impact of non‐vitamin K antagonist oral anticoagulants (NOACs) on anticoagulation therapy in rural Australia

The impact of non‐vitamin K antagonist oral anticoagulants (NOACs) on anticoagulation therapy in rural Australia

Working Well: Strategies to Strengthen the Workforce of the Indigenous Primary Healthcare Sector

Agreement between laboratory results and on-site pathology testing using Bayer DCA2000+ and Cholestech LDX point-of-care methods in remote Australian Aboriginal communities

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