Digital Commons Network^™

How Are Junior Doctors Managing Patients With Self-Limiting Illnesses At Their First Presentation? A Video Vignette Study, Eugene D'Souza, Catherine Krejany, Rosie Meng, Moyez Jiwa

Medical Papers and Journal Articles

Purpose: To conduct a video vignette survey of medical students and doctors investigating test ordering for patients presenting with self-limiting or minor illness.

Methods: Participants were shown six video vignettes of common self-limiting illnesses and invited to devise investigation and management plans for the patients’ current presentation. The number of tests ordered was compared with those recommended by an expert panel. A Theory of Planned Behaviour Questionnaire explored participants’ beliefs and attitudes about ordering tests in the context of self-limiting illness.

Results: Participants (n=61) were recruited from across Australia. All participants ordered at least one test that was not recommended …

Relaxation Techniques For Pain Management In Labour, C. Smith, K. Levett, C. Collins, H. Dahlen, M. Suganuma

Medical Papers and Journal Articles

Background: Many women would like to avoid pharmacological or invasive methods of pain management in labour and this may contribute to the popularity of complementary methods of pain management. This review examined currently available evidence on the use of relaxation therapies for pain management in labour. This is an update of a review first published in 2011.

Objectives: To examine the effects of mind-body relaxation techniques for pain management in labour on maternal and neonatal well-being during and after labour.

Search methods: We searched Cochrane Pregnancy and Childbirth’s Trials Register (9 May 2017), the Cochrane Central Register of Controlled Trials …

Massage, Reflexology And Other Manual Methods For Pain Management In Labour, C. Smith, K. Levett, C. Collins, H. Dahlen, C. Ee, M. Suganuma

Medical Papers and Journal Articles

Background

Many women would like to avoid pharmacological or invasive methods of pain management in labour, and thismay contribute towards the popularity of complementary methods of pain management. This review examined the evidence currently available on manual methods, including massage and reflexology, for pain management in labour. This review is an update of the review first published in 2012.

Objectives

To assess the effect, safety and acceptability of massage, reflexology and other manual methods to manage pain in labour.

Search methods

For this update, we searched Cochrane Pregnancy and Childbirth’s Trials Register (30 June 2017), the Cochrane Central Register of …

Impact Of Aging On The Auditory System And Related Cognitive Functions: A Narrative Review, Dona M.P Jayakody, Peter L. Friedland, Ralph N. Martins, Hamid R. Sohrabi

Medical Papers and Journal Articles

Age-related hearing loss (ARHL), presbycusis, is a chronic health condition that affects approximately one-third of the world’s population. The peripheral and central hearing alterations associated with age-related hearing loss have a profound impact on perception of verbal and non-verbal auditory stimuli. The high prevalence of hearing loss in the older adults corresponds to the increased frequency of dementia in this population. Therefore, researchers have focused their attention on age-related central effects that occur independent of the peripheral hearing loss as well as central effects of peripheral hearing loss and its association with cognitive decline and dementia. Here we review the …

Actinomyces Cavernous Sinus Infection: A Case And Systematic Literature Review, Michal Lubomski, James Dalgliesh, Kenneth Lee, Omprakash Damodaran, Genevieve Mckew, Stephen Reddel

Medical Papers and Journal Articles

A 63-year-old man presented with a 2-month history of progressive right-sided exophthalmos, painful ophthalmoplegia and fevers. As more features developed, he was diagnosed with giant cell arteritis then Tolosa-Hunt syndrome and transiently responded to corticosteroids. A bland cerebrospinal fluid and highly metabolically active brain (18F)-fluoro-D-glucose-positron emission tomography suggested lymphoma. Biopsy of the mass showed sulphur granules with Gram-positive filamentous bacteria with Actinomyces-like colonies. Actinomyces cavernous sinus infections are rare and indolent. They often mimic non-infective causes including other inflammatory and infiltrative conditions, vascular and neoplastic causes, particularly lymphoma. Clinicians should consider infective cavernous sinus syndromes in people with a …

Informing Implementation Of Quality Improvement In Australian Primary Care, Charlotte Hespe, Lucie Rychetnik, David Peiris, Mark Harris

Medical Papers and Journal Articles

Background: Quality Improvement (QI) initiatives in primary care are effective at improving uptake of evidence based guidelines, but are difficult to implement and sustain. In Australia meso-level health organisations such as Primary health care Organisations (PHCO) offer new opportunities to implement area-wide QI programs. This study sought to identify enablers and barriers to implementation of an existing Australian QI program and to identify strategic directions that PHCOs can use in the ongoing development of QI in this environment.

Methods: Semi-structured telephone interviews were conducted with 15 purposively selected program staff and participants from the Australian Primary Care Collaborative (APCC) QI …

Risk Of Pelvic Inflammatory Disease In Relation To Chlamydia And Gonorrhea Testing, Repeat Testing, And Positivity: A Population-Based Cohort Study, Joanne Reekie, Basil Donovan, Rebecca Guy, Jane S. Hocking, John M. Kaldor, Donna B. Mak, Sallie Pearson, David Preen, Louise Stewart, James W.B Liu

Medical Papers and Journal Articles

Background: There is uncertainty around whether the risks of pelvic inflammatory disease (PID) differ following Chlamydia trachomatis (chlamydia) and Neisseria gonorrhoeae (gonorrhea) infection. We quantified the risk of PID associated with chlamydia and gonorrhea infection and subsequent repeat infections in a whole-population cohort.

Methods: A cohort of 315123 Western Australian women, born during 1974–1995, was probabilistically linked to chlamydia and gonorrhea testing records and to hospitalizations and emergency department presentations for PID from 2002 to 2013. Time-updated survival analysis was used to investigate the association between chlamydia and gonorrhea testing, and positivity, and risk of PID.

Results: Over 3199135 person-years, …

Using A Chronic Hepatitis B Registry To Support Population-Level Liver Cancer Prevention In Sydney, Australia, Monica C. Robotin, Ximena Masgoret, Mamta Porwal, David Goldsbury, Chee Khoo, Jacob George

Medical Papers and Journal Articles

Background: Approximately 1% of Australians have chronic hepatitis B (CHB), which disproportionately affects people born in hepatitis B-endemic countries. Currently, approximately half of the people affected remain undiagnosed and antiviral treatment uptake is suboptimal (~5%). This increases the likelihood of developing end-stage disease complications, particularly hepatocellular cancer (HCC), and largely accounts for the significant increases in HCC incidence and mortality in Australia over the last decades. As our previous economic modeling suggested that CHB screening and treatment is cost-effective, we tested the feasibility of a primary carebased model of CHB diagnosis and management to prevent HCC.

Materials and methods: From …

Single-Inhaler Fluticasone Furoate/Umeclidinium/Vilanterol Versus Fluticasone Furoate/Vilanterol Plus Umeclidinium Using Two Inhalers For Chronic Obstructive Pulmonary Disease: A Randomized Non-Inferiority Study, Peter R. Bremner, Ruby Birk, Noushin Brealey, Afisi S. Ismaila, Chang-Qing Zhu, David A. Lipson

Medical Papers and Journal Articles

Background: Single-inhaler fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) 100/62.5/25 μg has been shown to improve lung function and health status, and reduce exacerbations, versus budesonide/formoterol in patients with chronic obstructive pulmonary disease (COPD). We evaluated the non-inferiority of single-inhaler FF/UMEC/VI versus FF/VI + UMEC using two inhalers.

Methods: Eligible patients with COPD (aged ≥40 years; ≥1 moderate/severe exacerbation in the 12 months before screening) were randomized (1:1; stratified by the number of long-acting bronchodilators [0, 1 or 2] per day during run-in) to receive 24-week FF/UMEC/VI 100/62.5/25 μg and placebo or FF/VI 100/25 μg + UMEC 62.5 μg; all treatments/placebo were delivered using …

How Is Chaplaincy Marginalised-By Our Faith Communities And By Our Institutions And Can We Change It?, Jeffrey Cohen

Medical Papers and Journal Articles

This paper reviews the issues confronting chaplaincy/spiritual care in the 21st century. It looks at how faith communities are changing their view of chaplaincy as well how institutions respond. The paper looks at two qualitative studies and what can be learned from them in confronting the questions raised at the beginning. It concludes with the question of how the evidence base can be expanded to make chaplaincy/spiritual care more relevant over the next few years.

Effect Of Adjunctive Ranitidine For Antipsychotic-Induced Weight Gain: A Systematic Review Of Randomized Placebo-Controlled Trials, Xiaojing Gu, Rui Chen, Chen-Hui Sun, Wei Zheng, Xin-Hu Yang, Shi-Bin Wang, Gabor S. Ungvari, Chee Ng, Andrei Golenkov, Grace Lok, Lu Li, Ines Chow, Fei Wang, Yu-Tao Xiang

Medical Papers and Journal Articles

This study was a meta-analysis of randomized controlled trials (RCTs) of ranitidine as an adjunct for antipsychotic-induced weight gain in patients with schizophrenia. RCTs reporting weight gain or metabolic side effects in patients with schizophrenia were included. Case reports/series, nonrandomized or observational studies, reviews, and meta-analyses were excluded. The primary outcome measures were body mass index (BMI) (kg/m2) and body weight (kg). Four RCTs with five study arms were identified and analyzed. Compared with the control group, adjunctive ranitidine was associated with marginally significant reductions in BMI and body weight. After removing an outlier study for BMI, the effect of …

Pain Medicine Content, Teaching And Assessment In Medical School Curricula In Australia And New Zealand, Elspeth E. Shipton, Frank Bate, Raymond Garrick, Carole Steketee, Eric J. Visser

Medical Papers and Journal Articles

Background: The objective of pain medicine education is to provide medical students with opportunities to develop their knowledge, skills and professional attitudes that will lead to their becoming safe, capable, and compassionate medical practitioners who are able to meet the healthcare needs of persons in pain. This study was undertaken to identify and describe the delivery of pain medicine education at medical schools in Australia and New Zealand.

Method: All 23 medical schools in Australia and New Zealand in 2016 were included in this study. A structured curriculum audit tool was used to obtain information on pain medicine curricula including …

Cerebral Small Vessel Disease Burden Is Associated With Poststroke Depressive Symptoms: A 15-Month Prospective Study, Yan Liang, Yang-Kun Chen, Vincent C. Mok, De-Feng Wang, Gabor S. Ungvari, Winnie C. Chu, Hee-Ju Kang, Wai-Kwong Tang

Medical Papers and Journal Articles

Objective: All types of cerebral small vessel disease (SVD) markers including lacune, white matter hyperintensities (WMH), cerebral microbleeds, and perivascular spaces were found to be associated with poststroke depressive symptoms (PDS). This study explored whether the combination of the four markers constituting an overall SVD burden was associated with PDS.

Methods: A cohort of 563 patients with acute ischemic stroke were followed over a 15-month period after the index stroke. A score of _7 on the 15-item Geriatric Depression Scale was defined as clinically significant PDS. Scores of the four SVD markers ascertained on magnetic resonance imaging were summed …

Mobile Phone Dependence, Social Support And Impulsivity In Chinese University Students, Songli Mei, Jingxin Chai, Shi-Bin Wang, Chee H. Ng, Gabor S. Ungvari, Yu-Tao Xiang

Medical Papers and Journal Articles

This study examined the frequency of mobile phone dependence in Chinese university students and explored its association with social support and impulsivity. Altogether, 909 university students were consecutively recruited from a large university in China. Mobile phone use, mobile phone dependence, impulsivity, and social support were measured with standardized instruments. The frequency of possible mobile phone use and mobile phone dependence was 78.3% and 7.4%, respectively. Multinomial logistic regression analyses revealed that compared with no mobile phone dependence, possible mobile phone dependence was significantly associated with being male (p = 0.04, OR = 0.7, 95% CI: 0.4–0.98), excessive mobile phone …

Nonstandard Lumbar Region In Predicting Fracture Risk, Dima Alajlouni, Dana Bliuc, Thach Tran, Nicholas Pocock, Tuan Nguyen, John A. Eisman, Jacqueline Center

Medical Papers and Journal Articles

Background: Femoral neck BMD is the most commonly used skeletal site to estimate fracture risk. The role of lumbar spine BMD in fracture risk prediction is less clear due to osteophytes that spuriously increase LS BMD, particularly at lower levels. The aim of this study was to compare fracture predictive ability of upper L1-L2 BMD compared to standard L2-L4 BMD and assess whether the addition of either lumbar spine site could improve fracture prediction over FN BMD.

Methodology: A prospective cohort of 3016 women and men 60+ years from the Dubbo Osteoporosis Epidemiology Study followed for occurrence of minimal trauma …

Midwives' Knowledge, Attitudes And Learning Needs Regarding Antenatal Vaccination, Annette Regan, Yvonne Hauck, Lisa Nicolaou, Danielle Engelbrecht, Janice Butt, Donna B. Mak, Rikki Priest, Ronit Cukierman, Paul Effler

Medical Papers and Journal Articles

Objective: To determine the knowledge, attitudes and learning needs of midwives regarding antenatal vaccination.

Design & Setting: A cross-sectional, paper-based survey of midwives employed at the only public tertiary maternity hospital in the Australian state of XX between November 2015 and July 2016.

Participants: 252 midwives providing care in antepartum, intrapartum, and/or postpartum settings.

Measurements: Self-reported responses to a 41-item survey.

Findings: The vast majority of midwives supported influenza and pertussis vaccination for pregnant women, with 90.0% and 71.7% reporting they would recommend pertussis and influenza vaccine, respectively, to a pregnant friend or family member, and almost all stating that …

Long-Term Impact Of Childhood Hepatitis B Vaccination Programs On Prevalence Among Aboriginal And Non-Aboriginal Women Giving Birth In Western Australia, Joanne Reekie, John M. Kaldor, Donna B. Mak, James Ward, Basil Donovan, Jane S. Hocking, David Preen, Bette Liu

Medical Papers and Journal Articles

Background/Aims: To evaluate the long-term effect of infant and childhood hepatitis B (HBV) vaccination programs among birthing women in Western Australia.

Methods: A cohort of Western Australian women born from 1974 to 1995 was created using Birth Registrations and Electoral Roll records. They were linked to a perinatal register and notifiable diseases register to identify women having respectively their first births between 2000 and 2012 and diagnoses of HBV infections. HBV prevalence was estimated in Aboriginal and non-Aboriginal women, and according to maternal birth year cohorts.

Results: Of 66,073 women, 155 (0.23%) had a linked non-acute HBV notification. HBV prevalence …

Chlamydia Trachomatis And The Risk Of Spontaneous Preterm Birth, Babies Who Are Born Small For Gestational Age, And Stillbirth: A Population-Based Cohort Study, Joanne Reekie, Christine Roberts, David Preen, Jane S. Hocking, Basil Donovan, James Ward, Donna B. Mak, Bette Liu

Medical Papers and Journal Articles

Background: Chlamydia trachomatis is one of the most commonly diagnosed sexually transmitted infections worldwide, but reports in the medical literature of an association between genital chlamydia infection and adverse obstetric outcomes are inconsistent.

Methods: The Western Australia Data Linkage Branch created a cohort of women of reproductive age by linking records of birth registrations with the electoral roll for women in Western Australia who were born from 1974 to 1995. The cohort was then linked to both chlamydia testing records and the state perinatal registry for data on preterm births and other adverse obstetric outcomes. We determined associations between chlamydia …

Differences In Swedish And Australian Medical Student Attitudes And Beliefs About Chronic Pain, Its Management, And The Way It Is Taught, Linda Rankin, Britt-Marie Stalnacke, Christopher J. Fowler, Gisselle Gallego

Medical Papers and Journal Articles

Background and aims: Medical students receive training in the management of chronic pain, but the training is often suboptimal. Considering that the basis for physician’s knowledge is their medical education, it is important to explore the attitudes and beliefs of medical students with respect both to chronic pain management and to their views on current pain education. Therefore, the aim of this study was to compare Swedish and Australian medical student’s attitudes and beliefs about patients with chronic pain, and their perceptions regarding their chronic pain management education.

Methods: An online survey was conducted with final year Australian and Swedish …

Indigenous Youth Peer-Led Health Promotion In Canada, New Zealand, Australia, And The United States: A Systematic Review Of The Approaches, Study Designs, And Effectiveness, Daniel Vujcich, Jessica Thomas, Katy Crawford, James Ward

Medical Papers and Journal Articles

Background: Youth peer-led interventions have become a popular way of sharing health information with young people and appear well suited to Indigenous community contexts. However, no systematic reviews focusing on Indigenous youth have been published. We conducted a systematic review to understand the range and characteristics of Indigenous youth-led health promotion projects implemented and their effectiveness.

Methods: A systematic search of Medline, Embase, and ProQuest Social Sciences databases was conducted, supplemented by gray literature searches. Included studies focused on interventions where young Indigenous people delivered health information to age-matched peers.

Results: Twenty-four studies were identified for inclusion, based on 20 …

Standard Setting In Australian Medical Schools, Helena Ward, Neville Chiavaroli, James Fraser, Kylie Mansfield, Darren Starmer, Laura Surmon, Martin Veysey, Deborah O'Mara

Medical Papers and Journal Articles

Background: Standard setting of assessment is critical in quality assurance of medical programs. The aims of this study were to identify and compare the impact of methods used to establish the passing standard by the 13 medical schools who participated in the 2014 Australian Medical Schools Assessment Collaboration (AMSAC).

Methods: A survey was conducted to identify the standard setting procedures used by participating schools. Schools standard setting data was collated for the 49 multiple choice items used for benchmarking by AMSAC in 2014. Analyses were conducted for nine schools by their method of standard setting and key characteristics of 28 …

The Voice Study: Valuing Opinions, Individual Communication And Experience: Building The Evidence Base For Undertaking Patient-Centred Family Meetings In Palliative Care - A Mixed Methods Study, Philippa J. Cahill, Christine R. Sanderson, Elizabeth A. Lobb, Jane L. Phillips

Medical Papers and Journal Articles

Background: Despite family meetings being widely used to facilitate discussion among patients, families, and clinicians in palliative care, there is limited evidence to support their use. This study aims to assess the acceptability and feasibility of Patient-Centred Family Meetings in specialist inpatient palliative care units for patients, families, and clinicians and determine the suitability and feasibility of validated outcome measures from the patient and family perspectives.

Methods: The study is a mixed-methods quasi-experimental design with pre-planned Patient-Centred Family Meetings at the intervention site. The patient will set the meeting agenda a priori allowing an opportunity for their issues to be …

A Process For Developing Standards To Promote Quality In General Practice, Julie Khoury, Catherine Krejany, Ronald Versteeg, Michaela Lodewyckx, Simone Pike, Michael Civil, Moyez Jiwa

Medical Papers and Journal Articles

Background: Since 1991, the Royal Australian College of General Practitioners (RACGP) Standards for general practices (the Standards) have provided a framework for quality care, risk management and best practice in the operation of Australian general practices. The Standards are also linked to incentives for general practice remuneration. These Standards were revised in 2017.

Objective: The objective of this study is to describe the process undertaken to develop the fifth edition Standards published in 2017 to inform future standards development both nationally and internationally.

Method: A modified Delphi process was deployed to develop the fifth edition Standards. Development was directed by …

Does Implementation Matter If Comprehension Is Lacking? A Qualitative Investigation Into Perceptions Of Advance Care Planning In People With Cancer, Anna Ugalde, Clare O'Callaghan, Clem Byard, Samantha Brean, Jenelle Mackay, Anna Boltong, Sondra Davoren, Deborah Lawson, Phillip Parente, N Michael, Patricia Livingstone

Medical Papers and Journal Articles

Purpose: While advance care planning holds promise, uptake is variable and it is unclear how well people engage with or comprehend advance care planning. The objective of this study was to explore how people with cancer comprehended Advance Care Plans and examine how accurately advance care planning documentation represented patient wishes.

Methods: This study used a qualitative descriptive design. Data collection comprised interviews and an examination of participants’ existing advance care planning documentation. Participants included those who had any diagnosis of cancer with an advance care plan recorded: Refusal of Treatment Certificate; Statement of Choices; and/or Enduring Power of Attorney …

Comorbidities Only Account For A Small Proportion Of Excess Mortality After Fracture: A Record Linkage Study Of Individual Fracture Types, Chen Weiwen, Judy Simpson, Lynette March, Fiona Blyth, Dana Bliuc, Thach Tran, Tuan Nguyen, John A. Eisman, Jacqueline Center

Medical Papers and Journal Articles

Background: Non-hip non-vertebral fractures (NHNV) constitute the majority of osteoporotic fractures but few studies have examined the association between these fractures, co-morbidity and mortality.

Objective: To examine the relationship between individual non-hip non-vertebral fractures, co-morbidities and mortality.

Methods: Prospective population-based cohort of 267,043 subjects (45 and Up Study, Australia) had baseline questionnaires linked to hospital administrative and all-cause mortality data from 2006 - 2013. Associations between fracture and mortality examined using multivariate, time dependent Cox models, adjusted for age, prior fracture, body mass index, smoking and co-morbidities (cardiovascular disease, diabetes, stroke, thrombosis and cancer) and survival function curves. Population attributable …

Meta-Analysis Of The Efficacy And Safety Of Adjunctive Rosuvastatin For Dyslipidemia In Patients With Schizophrenia, Wei Zheng, Wei Yang, Qing-E Zhang, Xin-Hu Yang, Dong-Bin Cai, Jin-Qing Hu, Gabor S. Ungvari, Chee H. Ng, Marc De Hert, Yu-Ping Ning, Yu-Tao Xiang

Medical Papers and Journal Articles

Background: Metabolic syndrome in patients with schizophrenia is a major health concern. The efficacy and safety of adjunctive rosuvastatin in treating dyslipidemia were controversial.

Aims: To assess the efficacy and safety of adjunctive rosuvastatin for dyslipidemia in patients with schizophrenia.

Methods: We systematically searched for relevant controlled clinical trials from the following databases: PubMed, PsycINFO, Cochrane Library, China Knowledge Network, WanFang Database and Chinese Biomedical Database up to September 28, 2017. Standardized mean difference (SMD) and risk ratio (RR) along with their 95% confidence intervals (CIs) were calculated. The quality of the included studies was assessed using the Cochrane risk …

Inferior Vena Cava Filters (Ivcfs): A Review Of Uses And Application To International Guidelines At A Single Australian Center; Implications Of Venous Thromboembolism Associated With Malignancy, Philip Craven, Ciara Daly, Randall Oates, Nisha Sikotra, Tim Clay, Eli Gabbay

Medical Papers and Journal Articles

Venous thromboembolism (VTE) is a potentially lethal event. Anticoagulation is the cornerstone of treatment. Inferior vena cava filters (IVCFs) may be used in circumstances when anticoagulation is contraindicated or as an adjunct to anticoagulation. IVCF use is not without controversy due to concerns over their safety profile, differences in guidelines from international societies, and a limited randomized control trial evidence. We retrospectively undertook a review of IVCF use over a three-year period (2014–2016) at our center, which has a large oncology service but no trauma unit. There were 44 patients with successful IVCF insertion and one patient with an unsuccessful …

International Medical Electives In Selected African Countries: A Phenomenological Study On Host Experience, Elspeth Fotheringham, Pippa Craig, Elina Tor

Medical Papers and Journal Articles

Objectives: To explore the host experience on international medical electives at a selection of hospitals in low- and middle-income countries in Africa. Outcomes of the study may inform and improve the preparation of global health curriculum, pre-elective training and debriefing for international medical electives.

Methods: A descriptive phenomenological study was undertaken, involving semi-structured interviews with ten elective hosts at seven study sites in three African countries. Purposive convenience sampling augmented by snowballing was utilised to recruit study participants. The data were thematically analysed and interpreted with reflexivity to generate an accurate aggregate of the experience of participants in hosting international …

Developing A Mental Health Eclinic To Improve Access To And Quality Of Mental Health Care For Young People: Using Participatory Design As Research Methodologies, Laura Ospina-Pinillos, Tracey A. Davenport, Cristina S. Ricci, Alyssa C. Milton, Elizabeth M. Scott, Ian B. Hickie

Medical Papers and Journal Articles

Background: Each year, many young Australians aged between 16 and 25 years experience a mental health disorder, yet only a small proportion access services and even fewer receive timely and evidence-based treatments. Today, with ever-increasing access to the Internet and use of technology, the potential to provide all young people with access (24 hours a day, 7 days a week) to the support they require to improve their mental health and well-being is promising.

Objective: The aim of this study was to use participatory design (PD) as research methodologies with end users (young people aged between 16 and 25 years …

Reduced Mortality And Subsequent Fracture Risk Associated With Oral Bisphosphonate Recommendation In A Fracture Liaison Service Setting: A Prospective Cohort Study, Tineke A. Van Geel, Dana Bliuc, Piet P. Geusens, Jacqueline R. Center, Geert-Jan Dinant, Thach Tran, Joop P. Van Den Bergh, Alastair R. Mclellan, John A. Eisman

Medical Papers and Journal Articles

Objective: Osteoporotic fragility fractures, that are common in men and women, signal increased risk of future fractures and of premature mortality. Less than one-third of postmenopausal women and fewer men are prescribed active treatments to reduce fracture risk. Therefore, in this study the association of oral bisphosphonate recommendation with subsequent fracture and mortality over eight years in a fracture liaison service setting was analysed.

Materials and methods: In this prospective cohort study, 5011 men and women aged >50 years, who sustained a clinical fracture, accepted the invitation to attend the fracture liaison service of the West Glasgow health service between …