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Biomedical subjects

I D Steven

Publications and source records attributed to I D Steven.

At least 19 recordsLinked to original sources
PubMed1995

Opioid dependence in 15 patients after a work injury.

OBJECTIVE: To document aspects of the management of 15 patients with workers' compensation injuries which led to opioid dependence and suggest preventive strategies. METHOD: Details of general practitioner and deputising service visits for a 38-week period, 1 May 1991 - 22 January 1992, were obtained from WorkCover case files and general practitioners' patient records, and claims for reimbursement for afterhours home visits (Item 97) were obtained from the Health Insurance Commission (HIC) for the years 1991, 1992 and 1993. RESULTS: Fourteen of the patients had a lumbosacral injury. A total of 2489 deputising service visits were provided on 3227 days (0.77/day). A statistically significant 20% higher visit rate occurred on Sundays and public holidays compared with the rate for the rest of the week. Deputising service practitioners provided 4.7 times as many services as general practitioners. In 1299 visits to 12 of these patients, parenteral drugs administered included 108 385 mg pethidine, 2680 mg morphine, and 20 400 mg promethazine. All 15 patients were independently assessed as having features indicating opioid dependence. In only one patient was there evidence of opioid dependence before injury. An alternative management plan not requiring deputising service visits was instituted early in 1992. The number of claims from the HIC for afterhours visits to these 15 patients rose from 125 in 1991 to 630 in 1992, while 409 were provided in 1993. CONCLUSION: Appropriate strategies, such as restricting the ability of deputising services to bill directly for the services they provide, and a sharing of information between the HIC and other statutory authorities, should prevent a similar occurrence in the future.

Adult↗
PubMed1995

Changes to recommended immunisation procedures.

The fifth edition of the Australian Immunisation Procedures Handbook updates what has become an important reference and practical guide to immunisation practice in Australia. A number of significant changes have been incorporated into this edition. The purpose of this paper is to alert and remind general practitioners of these changes.

Adolescent↗
PubMed1994

Hepatitis C.

Hepatitis C is particularly prevalent among injecting drug users. The infection is asymptomatic over 50% of the time. A significant proportion of those infected ultimately develop cirrhosis or carcinoma of the liver or both. While prevention is the best form of treatment, alpha interferon may benefit up to 30% of those with active infection.

Hepatitis C↗
PubMed1994

Reported diabetes mellitus management among South Australian general practitioners.

Diabetes mellitus is a chronic disease commonly managed in general practice. This article reviews the findings of a questionnaire survey of 173 randomly chosen South Australian general practitioners and their reported management in the areas of detection, diagnosis, assessment, monitoring and GP knowledge. Substantial differences between respondents were found in all areas, suggesting the need for improved educational methods aimed at all general practitioners.

Adult↗
PubMed1994

Knowledge of and reported asthma management among South Australian general practitioners.

AIM: This study, carried out in 1989, set out to assess general practitioners' knowledge of asthma management and their reported management practices. METHOD: Of 153 randomly selected South Australian general practitioners 127 (83%) completed a questionnaire designed to explore issues relating to the management of asthma. RESULTS: The survey revealed substantial differences between general practitioners in their knowledge and management practices including the assessment of the severity of asthma, the need for objective monitoring, that is by the use of spirometry and peak flow meters, and the use of medication. Overall, the sampled general practitioners believed that patient-related factors were the main barriers to effective treatment of asthma. CONCLUSION: The findings of this study suggest that ideal asthma management was not being attained. More research is required to ascertain why such variability among practitioners exists and how best to remedy these differences.

Adult↗
PubMed1993

The effect of prazosin on patients with symptoms of benign prostatic hypertrophy.

OBJECTIVE: To evaluate the effect of prazosin on the symptoms of benign prostatic hypertrophy for patients of general practitioners. SETTING AND PATIENTS: Eighty-two general practitioner patients from 317 who were identified as being eligible for inclusion in the trial. They were randomly allocated to receive either prazosin or placebo for the first 3 month arm then crossed-over for the second 3 months. RESULTS: Seventy-six patients completed the trial. An analogue scale of patient rating of symptoms showed a statistically significant decrease in symptoms for patients taking prazosin when compared with patients taking placebo, regardless of the order in which they had been administered. A total symptom score and an obstructive symptom score for benign prostatic hypertrophy showed a statistically significant difference between the two treatments at 4 weeks. A difference was still apparent at 8 and 12 weeks but it was not statistically significant. No difference was detected for irritative symptoms. CONCLUSION: Prazosin may have a limited place in the management of benign prostatic hypertrophy.

Aged↗
PubMed1993

A pattern of decline in general practice obstetric care in Adelaide.

Some educational, training and politico-economic reasons for the decline in GP obstetrics in Adelaide, South Australia, are described. It is recommended that similar studies be done in other centres in Australia to evaluate the general nature of the findings.

Clinical Competence↗
PubMed1993

Facilitation for demonstration practice grant holders.

Our results indicate that most demonstration practice grant holders in South Australia and the Northern Territory accept and regularly access facilitator services. Grant holders had little experience with granting body procedures and most frequently discussed administrative matters regarding their individual projects with the facilitator. Concerns about project progress and evaluation issues were other popular topics discussed during grant holder facilitator interactions. The present study did not seek to measure the impact of facilitation on the success of projects. A further study should be undertaken to examine the efficacy and effectiveness of facilitation on project outcome.

Family Practice↗
PubMed1993

Haemophilus influenzae type b. Conjugate vaccines for use in infants and children.

Haemophilus influenzae type b (Hib) is a bacterial pathogen that causes serious, sometimes fatal, infections primarily in young children, especially in the second 6 months of life. Immunisation of children against Hib is now an important issue and four conjugate Hib vaccines have become available. The various vaccines, and their characteristics are documented in this paper.

Age Factors↗
PubMed1993

Immunisation.

Explore the source record for details and available documents.

Diphtheria-Tetanus-Pertussis Vaccine↗
PubMed1993

Improving childhood immunisation in your practice.

There are many ways of improving immunisation rates in a practice. For most practices, however, the best methods will be a combination of opportunism, and accurate knowledge of contraindications. This means ensuring that every child that walks through the door will, if appropriate, be offered immunisation, and that children are not inappropriately excluded from immunisation.

Child↗
PubMed1992

South Australian hypertension survey. General practitioner experiences with drug treatment.

OBJECTIVE: To investigate prescribing habits, educational approaches and perceived needs of general practitioners in the drug treatment of hypertension. DESIGN, SETTING AND PARTICIPANTS: Of 156 randomly selected South Australian general practitioners 132 responded to a questionnaire survey. MAIN FINDINGS: Diuretics are the most commonly chosen drug for the initial management of uncomplicated moderate hypertension. Equivalent patients aged 45, 60 and 75 years would be prescribed a diuretic as drug of first choice in 41%, 55% and 68% of cases respectively. Despite this, there are wide differences in the choice of initial therapy between individual practitioners. These differences can have a substantial cost impact, given that in Australia the cost of diuretic therapy for one month can be as low as $1.97 compared with $34.08 for standard angiotensin converting enzyme inhibitor therapy for one month. There was also a perceived need, and demand, for patient education materials to assist practitioners in the drug treatment of hypertension.

Adult↗