Australian Family Physician July - Clots
Vol 39, (6) 449 - 528
The theme for the July issue of AFP is clots. This month's
articles include Atrial fibrillation - changes
2000 to 2009, Pulmonary embolism, Deep vein thrombosis - risks and
diagnosis, Warfarin - indications, risks and
drug interactions & Clot prevention - common questions
about medications, Health care reform - can we maintain
personal continuity & Patient 'buy-in' and prevention.
Atrial fibrillation – changes 2000 to 2009
Janice Charles, Ying Pan, Graeme Miller
From April 2000 to March 2001 in BEACH (Bettering the
Evaluation and Care of Health), atrial fibrillation (AF) was
managed at a rate of 0.6 per 100 encounters, suggesting it
was managed by general practitioners about 578 000 times
per year nationally.
Pulmonary embolism
Simon McRae
Pulmonary embolism remains a common and potentially
preventable cause of death.
Deep vein thrombosis – risks and diagnosis
Wai Khoon Ho
Venous thromboembolism, comprising deep vein
thrombosis (DVT) and pulmonary embolism, is common in
Australia and is associated with high morbidity.
Warfarin – indications, risks and drug interactions
Rami Tadros, Sepehr Shakib
Warfarin is a commonly used medication for the prevention
and treatment of venous thromboembolism. It can be
challenging for both the patient and the prescriber to
manage at times.
Clot prevention – common questions about medications
Rami Tadros, Sepehr Shakib
Warfarin is commonly used in a number of clinical settings.
Given the difficulties in managing patients taking warfarin,
several questions are usually raised by clinicians in relation
to its use.
Patient ‘buy-in’ and prevention
Danielle Mazza
Implementing preventive care and
achieving adherence to preventive
care plans is a difficult task for general
practitioners.
Health care reform – can we maintain personal continuity?
Andrew Bonney, Elizabeth A Farmer
Healthcare reform is high on the political
agenda, and among the critical issues that
have generated significant discussion
are proposals for new models of general
practice organisation.
Letters to the editor
The opinions expressed by correspondents in this column are in no way endorsed by either the Editors or The Royal Australian College of General Practitioners.
DVT in acute stroke – the use of graduated compression stockings
Bo Xu
Graduated compression stockings (GCS) are routinely prescribed for deep vein
thrombosis (DVT) prophylaxis in acute stroke patients. In the light of recent data from
the CLOTS trial 1, this practice needs to be reviewed.
Belinda’s back pain
Patrick J Phillips, Simon Burnet
Belinda is 37 years of age and presents 2 weeks after the
acute onset of severe midthoracic pain which ocurred as
she was lifting her son’s pram out of the car boot.
Leptospirosis
Andrew Slack
This article forms part of our travel medicine series for 2010, providing a summary of
prevention strategies and vaccination for infections that may be acquired by travellers.
The series aims to provide practical strategies to assist general practitioners in giving
travel advice, as a synthesis of multiple information sources which must otherwise be
consulted.
Visual field defects after stroke – a practical guide for GPs
Susie Luu, Andrew W Lee, Andrew Daly, Celia S Chen
Visual field defect after stroke can result in significant disability and reduction in quality
of life. Visual rehabilitation aims to maximise the residual vision and decrease functional
disability. Understanding the rehabilitation options available, and where to refer
patients with visual defects after a stroke, can help patients, and their families, in the
rehabilitation process.
Enabling research in general practice – increasing functionality of electronic medical records
Jacqueline Young, Diann Eley, Paul Fahey,
Elizabeth Patterson, Desley Hegney
With an estimated 80% of Australians
visiting a general practitioner at least
once a year, the data generated by
GPs is a rich source of the overall health
profile of patients. However, this data is
rarely used to report on health outcomes.
Barriers to diagnosing and managing hypertension - a qualitative study in Australian general practice
Faline Howes, Emily Hansen, Danielle Williams, Mark Nelson
Elevated blood pressure (BP) is
a major modifiable risk factor.
However hypertension still remains
underdiagnosed, untreated or
suboptimally treated. This study
aimed to identify and explore barriers
to initiating medication and treating
elevated BP to target levels in the
general practice setting.
Proof of age required – estimating age in adults without birth records
Christine Phillips, Shanti Narayanasamy
Many adults from refugee source countries do not have documents of
birth, either because they have been lost in flight, or because the civil
infrastructure is too fragile to support routine recording of birth. In Western
countries, date of birth is used as a basic identifier, and access to services
and support tends to be age regulated.
Business plans – tips from the toolkit 6
Neville Steer
General practice is a business. Most practices can stay afloat by having
appointments, billing patients, managing the administration processes
and working long hours. What distinguishes the high performance
organisation from the average organisation is a business plan. This
article examines how to create a simple business plan that can be
applied to the general practice setting and is drawn from material
contained in The Royal Australian College of General Practitioners’
‘General practice management toolkit’.
Book reviews
Books reviewed this month are Advanced prostate cancer by the Cancer Council of Australia, and Primary Care Mental Health by Linda Gask, Helen Lester, Tony Kendrick and Robert Peveler.
AFP in Practice
Carolyn O'Shea
AFP in Practice questions are designed to get you started in a small group learning (SGL) activity in your practice or with colleagues.
Clinical challenge
Questions for this month’s clinical challenge are based on articles in this issue.