A5030467523- Medication Adherence and Compliance
- Patient Safety and Medication Errors
- Pharmaceutical Economics and Policy
- Medical Malpractice and Liability Issues
- Healthcare Quality and Management
- Health Systems, Economic Evaluations, Quality of Life
- Pharmaceutical Practices and Patient Outcomes
- Occupational Health and Safety Research
- Blood Pressure and Hypertension Studies
- Healthcare Policy and Management
- Diabetes Treatment and Management
- Emergency and Acute Care Studies
- Healthcare cost, quality, practices
- Health Promotion and Cardiovascular Prevention
- Pharmaceutical studies and practices
- Primary Care and Health Outcomes
- Lipoproteins and Cardiovascular Health
- Global Public Health Policies and Epidemiology
- Pharmaceutical industry and healthcare
- Disaster Response and Management
- Quality and Safety in Healthcare
- Machine Learning in Healthcare
- Chronic Disease Management Strategies
- Treatment of Major Depression
- Nosocomial Infections in ICU
Royal College of Surgeons in Ireland
2014-2024
University of Medicine and Health Sciences
2022
Cappagh National Orthopaedic Hospital
2021
University of Auckland
2005-2017
Royal College of Physicians of Ireland
2014
Ollscoil na Gaillimhe – University of Galway
2014
<b>Objective</b> To evaluate whether provision of fixed dose combination treatment improves adherence and risk factor control compared with usual care patients at high cardiovascular disease in primary care. <b>Design</b> Open label randomised trial: IMPACT (IMProving Adherence using Combination Therapy). <b>Setting</b> 54 general practices the Auckland Waikato regions New Zealand, July 2010 to August 2013. <b>Participants</b> 513 adults (including 257 indigenous Māori) (established or five...
Most individuals at high cardiovascular disease (CVD) risk worldwide do not receive any or optimal preventive drugs. We aimed to determine whether fixed dose combinations of generic drugs (‘polypills’) would promote use such medications. conducted a randomized, open-label trial involving 623 participants from Australian general practices. Participants had established CVD an estimated five-year ≥15%, with indications for antiplatelet, statin and ≥2 blood pressure lowering (‘combination...
Introduction Irish healthcare has undergone extensive change recently with spending cuts and a focus on quality initiatives; however, little is known about adverse event occurrence. Objective To assess the frequency nature of events in hospitals. Methods 1574 (53% women, mean age 54 years) randomly selected adult inpatient admissions from sample eight hospitals, stratified by region size, across Republic Ireland 2009 were reviewed using two-stage (nurse review patient charts, followed...
A decade of cardiovascular disease (CVD) risk-based guidelines, education programmes and widespread availability paper-based risk prediction charts have not significantly influenced targeting CVD management in New Zealand primary care practice. web-based decision support system (PREDICT-CVD), integrated with electronic medical record software was developed as one strategy to address this problem.A before-after audit 3564 patient records assessed the impact on documentation factors....
Objectives To quantify the prevalence and nature of adverse events in acute Irish hospitals 2015 to assess impact National Clinical Programmes Guidelines on by comparing these results with previously published data from 2009. Design methods A retrospective chart review 1605 admissions eight 2015, using identical those used Results The percentage associated one or more was unchanged (p=0.48) at 14% (95% CI=10.4% 18.4%) compared 12.2% CI=9.5% 15.5%) Similarly, preventable (p=0.3) 7.4% CI=5.3%...
Recent trials of cardiovascular polypills in high-risk populations show improvements the use preventive treatments, compared to usual care. We describe patterns pill burden Australian practice, define impact polypill therapy on burden, and explore how physicians add medication therapy.The Kanyini Guidelines Adherence with Polypill Study was an open-label trial involving 623 participants Australia which randomized a strategy (containing statin, antiplatelet agent, two blood-pressure-lowering...
After Action Review (AAR) is a debriefing methodology for learning from events. The method facilitated discussion among team exploring what they expected to happen, did and learned. Ireland's Health Service Executive includes the AAR as part of its national Incident Management Framework. This paper explores enablers barriers implementation in an Irish tertiary specialist hospital. Fifty staff were trained facilitators 1.5 day simulation training programme. Six months after training, focus...
Objective: To measure the costs of a polypill strategy and compare them with those usual care in people established cardiovascular disease (CVD) or at similarly high risk. Design: A within-trial cost analysis polypill-based versus separate medications, using data from Kanyini Guidelines Adherence Polypill (GAP) trial linked health service medication administrative claims data. Participants: GAP participants who consented to Australian Medicare record access. Main outcome measures: Mean...
Objectives To assess the effect of a point care (POC) device for testing lipids and HbA1c in addition to by community laboratory facilities (usual practice) on completion cardiovascular disease (CVD) risk assessments general practice. Methods We conducted pragmatic, cluster randomised controlled trial 20 New Zealand practices stratified size rurality POC plus usual practice or alone (controls). Patients aged 35–79 years were eligible if they met national guideline criteria CVD assessment....
Abstract Introduction Māori are disproportionately affected by cardiovascular disease (CVD), which is the main reason for eight year difference in life expectancy between and non-Māori. The primary care-based IMPACT (IMProving Adherence using Combination Therapy) trial evaluates whether fixed dose combination therapy (a “polypill”) improves adherence to guideline-based compared with current care among people at high risk of CVD. Interventions shown trials be effective do not necessarily...
The purpose of this study was to investigate the consistency proportional effect fixed-dose combination therapy (the 'polypill') on use recommended cardiovascular preventative medications among indigenous Māori and non-indigenous adults in New Zealand. We randomised non-Māori primary care patients at high risk disease (either because a prior event or with an estimated 5-year first least 15%) polypill (containing aspirin, statin two antihypertensives) usual for minimum 12 months. All had...
In spite of bearing a heavier burden death, disease and disability, there is mixed evidence as to whether Indigenous Australians utilise more or less healthcare services than other given their elevated risk level. This study analyses the Medicare expenditure its predictors in cohort non-Indigenous at high cardiovascular disease. The participants Kanyini Guidelines Adherence with Polypill (GAP) pragmatic randomised controlled trial was modelled using linear regression methods. 535 adult (48%...