Hope Alexander MPH

Archive for the ‘Hope’s Commentary’ Category

Hope was invited to contribute to DVD content and attend a focus group, the outcome of which will be used to to develop a DVD for WA consumers with a long term condition.

The researchers are particularly interested in learning about the experiences/difficulties we or someone we care for have encountered in managing a long term condition and ways we have overcome them.

This study has been approved by the Curtin University Human Research Ethics Committee. The Principal Investigator is Professor Duncan Boldy of the Centre for Research into Disability and Society, School of Occupational Therapy and Social Work, Curtin University. The Project Officer is Doctor Setareh Ghahari.

This week Hope has been pursuing her “free” hearing aids. After the hearing test and consultation on 14 June, Hope was given to understand that her aids would be free under the Federal Government scheme. Then the rules change after the 1 July, according to the audiologist, and Hope is asked to pay $800 for the aids, plus a $1000 “care plan” to cover loss, damage and maintenance over three years. This necessitated three phone calls to the Office of Hearing Services. The jury is still out.

Today Hope submitted her abstract for the Australian National Conference on Evidence-Based Clinical Leadership. The title of her paper is “Chasing the rainbow – the difficulties experienced in accessing age and condition-specific programs”. These programs include oral health, hearing services and Enhanced Care Plans. The conference is to be held in Adelaide, one of Hope’s favourite places, in November.

Hope has been appointed to the North Metro Public Health and Ambulatory Care Executive management group as a community representative. She attended her first meeting of the group this week.

Hope has skills and expertise in public health, being awarded her Masters in 2008, and is committed to the social model of health. She is also keen to see oral health become part of mainstream health instead of being an orphan.

Hope will be attending the following Clinical Senate meeting on 26 March 2010 in Perth, Western Australia.

Event: 26 March 2010 - Pre-Hospital Assessment - Avoiding the Revolving Door

The Consumers Health Forum-nominated consumer representative on the Medical Services Advisory Committee panel reviewing Vertebroplasty, has asked for comments on consumer issues around treatments such as Vertebroplasty (or injection of bone cement into diseased vertebrae such as osteoporotic fractures).

She is keen to ensure that all consumer issues relating to potential Medicare funding for this procedure are considered in the evaluation.

The Question:
Are we aware of any consumer issues relating to the current treatment and management of painful vertebral compression fracture as a consequence of osteoporosis or vertebral malignant tumours?

In a letter to the editor of the Medical Journal of Australia (MJA 2010; 192 (3): 174-17) Paul J Graziotti states that “Vertebroplasty appears no better than placebo for painful osteoporotic spinal fractures, and has potential to cause harm”.

Some years earlier Vertebroplasty was described as “a promising but as yet unproven intervention for painful osteoporotic spinal fractures” by Rachelle Buchbinder and Richard H Osborne (MJA 2006; 185 (7): 351-352). It was further claimed that “Medicare funding could jeopardise the research needed to establish the benefits and risks of this procedure”.

I read elsewhere that the “slurry” they inject into the bones, can leak out and cause even more problems. Therefore I would suggest caution to anyone who may be contemplating this procedure … as yet the evidence is not available.

The Response:
I would be very wary of suggesting that this procedure be funded by Medicare until there is some strong evidence that it works, and does not cause further harm. The way I read it, the evidence is just not there, and the possibility of damage and the “potential to cause harm” has already been established.

Further information about treatment for osteoporotic vertebral fractures can be found on The Health Report ABC National Radio web site here:
http://www.abc.net.au/rn/healthreport/stories/2009/2647587.htm

I am continually attending “Patient Safety and Quality” meetings yet the matter of hand hygiene is not raised, or even on the agenda till I bring it up.

1. “Can we wipe out … “  is about research in the UK and comes from the virtualmedicalcentre.com web site
2. MRSA consumers’ document is a WA Health Department document which can be accessed here http://www.public.health.wa.gov.au/cproot/1760/2/MRSA%20Consumers.pdf
3. “Doctors should be “horrified” by their hand hygiene-studies … is an article on research in NSW from HealthAlerts website and can be accessed via this link http://www.healthalerts.com.au/news/news.php?action=fullnews&id=541
4. Ignaz Semmelweis… discovered the importance of hand-washing hygiene by medical care-givers in 1847 …

Only after Dr. Semmelweiss’ death, was the germ theory of disease developed, and he is now recognized as a pioneer of antiseptic policy and prevention of nosocomial disease.