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Book ; Online: Urban Blue Spaces : Planning and Design for Water, Health and Well-Being

Bell, Simon / Fleming, Lora E. / Grellier, James / Kuhlmann, Friedrich / Nieuwenhuijsen, Mark J. / White, Mathew P. / Nieuwenhuijsen, Mark J.

2022

Keywords	City & town planning - architectural aspects ; Architecture: professional practice ; Environmentally-friendly architecture & design ; Applied ecology ; Blue space ; Coastal management ; Coastal planning ; EU Horizon 2020 ; Landscape planning ; Planning ; Public ; Public health ; Resilient cities ; Seascapes ; Sustainability ; Sustainable design ; Urban design ; Well-being
Size	1 electronic resource (506 pages)
Publisher	Taylor and Francis
Document type	Book ; Online
Note	English ; Open Access
HBZ-ID	HT021231929
ISBN	9780367173173 ; 0367173174
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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Article: Shoulder Replacement in the Elderly with Anatomic versus Reverse Total Prosthesis? A Prospective 2-Year Follow-Up Study.

Simon, Maciej J K / Coghlan, Jennifer A / Bell, Simon N

Journal of clinical medicine

2022 Volume 11, Issue 3

Abstract: Background: In older patients requiring a total shoulder replacement (TSR) and with an intact rotator cuff, there is currently uncertainty on whether an anatomic TSR (aTSR) or a reverse TSR (rTSR) is best for the patient. This comparison study of same- ... ...

Abstract	Background: In older patients requiring a total shoulder replacement (TSR) and with an intact rotator cuff, there is currently uncertainty on whether an anatomic TSR (aTSR) or a reverse TSR (rTSR) is best for the patient. This comparison study of same-aged patients aims to assess clinical and radiological outcomes of older patients (≥75 years) who received either an aTSR or an rTSR. Methods: Consecutive patients with a minimum age of 75 years who received an aTSR ( Results: We found postoperative improvement for ROM and all clinical assessment scores for both groups. There were significantly better patient reported outcome scores (PROMs) in the aTSR group compared with the rTSR patients ( Conclusions: This study of older patients (≥75 years) demonstrated that an aTSR for a patient with good rotator cuff muscles can lead to a better clinical outcome and less early complications than an rTSR. Level of evidence: Level II-prospective cohort study.
Language	English
Publishing date	2022-01-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11030540
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Article: Frailty Status and Cognitive Function Should Guide Prescribing in Long-term Care Facilities.

Liau, Shin J / Bell, J Simon

The Senior care pharmacist

2021 Volume 36, Issue 10, Page(s) 469–473

Abstract: Frailty, dementia and complex multimorbidity are highly prevalent among residents of long-term care facilities (LTCFs). Prescribing for residents of LTCFs is often informed by disease-specific clinical practice guidelines based on research conducted ... ...

Abstract	Frailty, dementia and complex multimorbidity are highly prevalent among residents of long-term care facilities (LTCFs). Prescribing for residents of LTCFs is often informed by disease-specific clinical practice guidelines based on research conducted among younger and more robust adults. However, frailty and cognitive impairment may modify medication benefits and risks. Residents with frailty and advanced dementia may be at increased susceptibility to adverse drug events (ADEs) and often have a lower likelihood of achieving long-term therapeutic benefit from chronic preventative medications. For this reason, there is a strong rationale for deprescribing, particularlyamong residents with high medication burdens, swallowing difficulties or limited dexterity. Conversely, frailty and dementia have also been associated with under-prescribing of clinically indicated medications. Unnecessarily withholding treatment based on assumed risk may deprive vulnerable population groups from receiving evidence-based care. There is a need for specific evidence regarding medication benefits and risks in LTCF residents with frailty and dementia. Observational studies conducted using routinely collected health data may complement evidence from randomized controlled trials that often exclude people living with dementia, frailty and in LTCFs. Balancing over- and under-prescribing requires consideration of each resident's frailty and cognitive status, therapeutic goals, time-to-benefit, potential ADEs, and individual values or preferences. Incorporating frailty screening into medication review may also provide better alignment of medication regimens to changing goals of care. Timely identification of frail residents as part of treatment decision-making may assist with targeting interventions to minimize and monitor for ADEs. Shifting away from rigid application of conventional disease-specific clinical practice guidelines may provide an individualized and more holistic assessment of medication benefits and risks in the LTCF setting.
MeSH term(s)	Cognition ; Frailty/epidemiology ; Humans ; Long-Term Care ; Nursing Homes ; Skilled Nursing Facilities
Language	English
Publishing date	2021-10-01
Publishing country	United States
Document type	Journal Article
ISSN	2639-9636
ISSN	2639-9636
DOI	10.4140/TCP.n.2021.469
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Off-label medicine use: Ethics, practice and future directions.

Bell, J Simon / Richards, Georgia C

Australian journal of general practice

2021 Volume 50, Issue 5, Page(s) 329–331

Abstract: Background: Medicine use is considered off-label when used for an indication, at a dose, via a route of administration or in a patient group not included in the approved product information. Off-label use varies according to therapeutic class and ... ...

Abstract	Background: Medicine use is considered off-label when used for an indication, at a dose, via a route of administration or in a patient group not included in the approved product information. Off-label use varies according to therapeutic class and patient group, and often occurs in those who are vulnerable. Objective: The aim of this article is to discuss ethical, practice and policy considerations associated with off-label medicine use. Discussion: A number of professional organisations have issued guidance in relation to off-label medicine use. Prescribers should inform patients and document consent when prescribing off-label, including an open discussion about known and unknown benefits and risks. It is important that the prescriber documents the reason for off-label use in the patient's record and ensures that patients are aware of the intended duration and relevant monitoring. Australia's new national health priority of Quality Use of Medicine and Medicine Safety should stimulate all stakeholders including consumers to work together to address off-label medicine use.
MeSH term(s)	Humans ; Medicine ; Off-Label Use ; Product Labeling
Language	English
Publishing date	2021-04-17
Publishing country	Australia
Document type	Journal Article
ZDB-ID	2924889-9
ISSN	2208-7958 ; 2208-794X
ISSN (online)	2208-7958
ISSN	2208-794X
DOI	10.31128/AJGP-08-20-5591
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Zs.B 2235: Show issues

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Article ; Online: Current and Future Cost Burden of Ischemic Stroke in Australia: Dynamic Model.

Abebe, Tamrat Befekadu / Ilomaki, Jenni / Livori, Adam / Bell, J Simon / Morton, Jedidiah I / Ademi, Zanfina

Neuroepidemiology

2024

Abstract: Background: Stroke remains one of the leading causes of morbidity and mortality in Australia. The objective of this study was to estimate the current and future cost burden of ischemic stroke (IS) in Australia.: Method: First, chronic management ... ...

Abstract	Background: Stroke remains one of the leading causes of morbidity and mortality in Australia. The objective of this study was to estimate the current and future cost burden of ischemic stroke (IS) in Australia. Method: First, chronic management costs following IS were derived for all people aged ≥ 30 years discharged from a public or private hospital in Victoria, Australia between July 2012 and June 2017 (n = 34 471). These costs were then used to project total costs following IS (combination of acute event and chronic management cost) over a 20-year period (2019-2038) for people aged between 30 and 99 years in Australia using a dynamic multistate lifetable model. Data for the dynamic model were sourced from the Victorian Admitted Episodes Dataset (VAED) and supplemented with other published data. Result: The estimated annual total chronic management cost following IS was 13 525 Australian dollars (AUD) per person (95%CI: AUD 13 380, AUD 13 670) for cohorts in the VAED between July 2012 and June 2017. The annual chronic management cost was estimated to decline following IS. The highest cost was incurred in the first year of follow-up post-IS (AUD 14 309 per person) and declined to AUD 9 776 in the sixth year of follow-up post-IS. The total healthcare cost for people aged 30-99 years was projected to be AUD 47.7 billion (95% UI: AUD 44.6 billion, AUD 51.0 billion) over the 20-year period (2019-2038) Australia-wide, of which 91.3% (AUD 43.6 billion) was attributed to chronic management costs and the remaining 8.7% (AUD 4.2 billion) were due to acute IS events. Conclusion: IS has and will continue to have a considerable financial impact in the next two decades on the Australian healthcare system. Our estimated and projected cost burden following IS provides important information for decision making in relation to IS.
Language	English
Publishing date	2024-04-01
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	603189-4
ISSN	1423-0208 ; 0251-5350
ISSN (online)	1423-0208
ISSN	0251-5350
DOI	10.1159/000538564
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Zs.A 1722: Show issues

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Article ; Online: Trajectories of oral bisphosphonate use after hip fractures: a population-based cohort study.

Leung, Miriam T Y / Turner, Justin P / Marquina, Clara / Ilomaki, Jenni / Tran, Tim / Bell, J Simon

Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA

2024 Volume 35, Issue 4, Page(s) 669–678

Abstract: Bisphosphonates prevent future hip fractures. However, we found that one in six patients with hip fractures had a delay in bisphosphonate initiation and another one-sixth discontinued treatment within 12 months after discharge. Our results highlight the ... ...

Abstract	Bisphosphonates prevent future hip fractures. However, we found that one in six patients with hip fractures had a delay in bisphosphonate initiation and another one-sixth discontinued treatment within 12 months after discharge. Our results highlight the need to address hesitancy in treatment initiation and continuous monitoring. Purpose: Suboptimal antiresorptive use is not well understood. This study investigated trajectories of oral bisphosphonate use following first hip fractures and factors associated with different adherence and persistence trajectories. Methods: We conducted a retrospective study of all patients aged ≥ 50 years dispensed two or more bisphosphonate prescriptions following first hip fracture in Victoria, Australia, from 2012 to 2017. Twelve-month trajectories of bisphosphonate use were categorized using group-based trajectory modeling. Factors associated with different trajectories compared to the persistent adherence trajectory were assessed using multivariate multinomial logistic regression. Results: We identified four patterns of oral bisphosphonate use in 1811 patients: persistent adherence (66%); delayed dispensing (17%); early discontinuation (9%); and late discontinuation (9%). Pre-admission bisphosphonate use was associated with a lower risk of delayed dispensing in both sexes (relative risk [RR] 0.28, 95% confidence interval [CI] 0.21-0.39). Older patients ( Conclusion: Two-thirds of patients demonstrated good adherence to oral bisphosphonates over 12 months following hip fracture. Efforts to further increase post-discharge antiresorptive use should be sex-specific and address possible persistent uncertainty around delaying treatment initiation.
MeSH term(s)	Male ; Female ; Humans ; Aged, 80 and over ; Middle Aged ; Diphosphonates/adverse effects ; Bone Density Conservation Agents ; Retrospective Studies ; Aftercare ; Cohort Studies ; Patient Discharge ; Hip Fractures/epidemiology ; Hip Fractures/etiology ; Hip Fractures/prevention & control ; Logistic Models ; Victoria/epidemiology
Chemical Substances	Diphosphonates ; Bone Density Conservation Agents
Language	English
Publishing date	2024-01-10
Publishing country	England
Document type	Journal Article
ZDB-ID	1064892-6
ISSN	1433-2965 ; 0937-941X
ISSN (online)	1433-2965
ISSN	0937-941X
DOI	10.1007/s00198-023-06974-6
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 3163: Show issues

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Article ; Online: Impact of oral bisphosphonate drug holiday on mortality following hip fracture: a population-based cohort study.

Leung, Miriam T Y / Turner, Justin P / Marquina, Clara / Ilomaki, Jenni / Tran, Tim / Bell, J Simon

The Journal of clinical endocrinology and metabolism

2024

Abstract: Context: Current clinical guidelines recommend a drug holiday after extended use of oral bisphosphonates. However, no studies have investigated the impact of drug holidays before hip fractures on post-fracture mortality.: Objective: To investigate ... ...

Abstract	Context: Current clinical guidelines recommend a drug holiday after extended use of oral bisphosphonates. However, no studies have investigated the impact of drug holidays before hip fractures on post-fracture mortality. Objective: To investigate the effect of drug holiday on post-fracture mortality in patients with extended use of oral bisphosphonates. Design: Retrospective population-based cohort study. Setting: All patients with hip fractures in Victoria, Australia from 2014-18. Patients: Patients adherent to oral alendronate or risedronate for ≥5 years prior to hip fracture. Intervention(s): Group-based trajectory modelling categorized patients into different bisphosphonate usage after 5-year good adherence. Main outcome measure(s): Post-fracture mortality. Results: We identified 365 patients with good adherence (medication possession ratio ≥80%) to oral alendronate/risedronate for ≥5 years. Most patients (69%) continued to use oral bisphosphonates till admission for hip fracture; 17% had discontinued for one year and 14% had discontinued for two years. Post-fracture mortality was higher in patients who had discontinued risedronate for one year (Hazard ratio [HR] 2.37, 95% confidence interval [CI] 1.24-4.53) and two years (HR 3.08, 95% CI 1.48-6.41) prior to hip fracture. No increase or decrease in post-fracture mortality was observed in patients who had discontinued alendronate for one year (HR 0.59, 95% CI 0.29-1.18) or two years (HR 1.05, 95% CI 0.57-1.93) prior to hip fracture. Conclusions: Post-fracture mortality is higher in people who discontinue risedronate, but not alendronate, for 1 or 2 years after being adherent to treatment for at least 5 years. The type of bisphosphonate may be a factor to consider when planning drug holidays.
Language	English
Publishing date	2024-04-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	3029-6
ISSN	1945-7197 ; 0021-972X
ISSN (online)	1945-7197
ISSN	0021-972X
DOI	10.1210/clinem/dgae272
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Correction to: Hip fracture incidence and post-fracture mortality in Victoria, Australia: a state-wide cohort study.

Leung, Miriam T Y / Marquina, Clara / Turner, Justin P / Ilomaki, Jenni / Tran, Tim / Bell, J Simon

Archives of osteoporosis

2023 Volume 18, Issue 1, Page(s) 74

Language	English
Publishing date	2023-05-22
Publishing country	England
Document type	Published Erratum
ZDB-ID	2253231-6
ISSN	1862-3514 ; 1862-3522
ISSN (online)	1862-3514
ISSN	1862-3522
DOI	10.1007/s11657-023-01286-y
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Article ; Online: Diabetes treatment deintensification in Australians with dementia compared to the general population: A national cohort study.

Picton, Leonie J / George, Johnson / Bell, J Simon / Ilomaki, Jenni S

Journal of the American Geriatrics Society

2023 Volume 71, Issue 8, Page(s) 2506–2519

Abstract: Background: Diagnosis of dementia may change peoples' goals of care. In people with diabetes, this may lead to relaxing treatment targets and reducing the use of diabetes medications. The aim of this study was to examine changes in diabetes medication ... ...

Abstract	Background: Diagnosis of dementia may change peoples' goals of care. In people with diabetes, this may lead to relaxing treatment targets and reducing the use of diabetes medications. The aim of this study was to examine changes in diabetes medication use before and after initiating medication for dementia. Methods: A national cohort of people aged 65-97 years, living with dementia and diabetes, and a general population cohort with diabetes matched for age, sex, and index date were extracted from the Australian national medication claims database. Trajectories of diabetes medication use, expressed as mean defined daily dose (DDD) each month for each individual from 24 months before to 24 months after the index date, were estimated using group-based trajectory modeling (GBTM). Cohorts were analyzed separately. Results: People with dementia (N = 1884) and the matched general population (N = 7067) had a median age of 80 years (interquartile range 76-84) and 55% were female. In both models, people exhibited one of five diabetes medication trajectories, with 16.5% of people with dementia and 24.0% of the general population assigned to trajectories that represented deintensification. In the general population model, those on deintensifying trajectories were older than those on stable trajectories (median 83 vs. 79 years). In the dementia cohort model, those on high or low deintensifying trajectories were slightly older (median age 81 or 82, respectively, vs. 80 years) and had at least 1 more comorbidity (median 8 or 7, respectively, vs. 6) than those on stable trajectories. Conclusions: Initiating medication for dementia does not appear to be a trigger for deintensification of diabetes treatment regimens. Deintensification was more common in the general population; people living with dementia are potentially overtreated for diabetes.
MeSH term(s)	Aged, 80 and over ; Female ; Humans ; Male ; Australia/epidemiology ; Cohort Studies ; Dementia/epidemiology ; Diabetes Mellitus/drug therapy ; Diabetes Mellitus/epidemiology ; Hypoglycemic Agents/therapeutic use ; Aged
Chemical Substances	Hypoglycemic Agents
Language	English
Publishing date	2023-06-09
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80363-7
ISSN	1532-5415 ; 0002-8614
ISSN (online)	1532-5415
ISSN	0002-8614
DOI	10.1111/jgs.18452
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Embedded on-site aged care pharmacists in Australia: Insights from early adopters of a new workforce model.

Cross, Amanda J / Bell, J Simon / Steeper, Michelle / La Caze, Adam

Australasian journal on ageing

2023 Volume 43, Issue 1, Page(s) 79–90

Abstract: Objective: To explore the roles of early adopters of Australia's embedded on-site pharmacist model in supporting quality use of medications in residential aged care facilities (RACFs).: Methods: Qualitative semistructured interviews were conducted ... ...

Abstract	Objective: To explore the roles of early adopters of Australia's embedded on-site pharmacist model in supporting quality use of medications in residential aged care facilities (RACFs). Methods: Qualitative semistructured interviews were conducted with 15 pharmacists working as embedded on-site pharmacists, or beyond the scope of traditional consultant pharmacist roles in Australian RACFs. Interviews were audio-recorded, transcribed and thematically analysed independently by two investigators using an inductive approach. Deductive analysis was also undertaken using a knowledge broker framework: knowledge manager, linkage agent and capacity builder. Results: Dominant themes were roles and benefits of embedded pharmacists, factors associated with success and challenges. Roles and benefits included (1) resident-level interventions and an enhanced ability to provide collaborative outcome-focussed resident-centred care, including timely input and follow-up, and improved relationships with residents, family and interdisciplinary team; and (2) system-level interventions such as contributing to clinical governance and quality improvement. Factors associated with success included personal capabilities and approach of the pharmacist, and organisational culture and sector-wide support. Challenges included pharmacist workforce shortages, perceived lack of pharmacist readiness and difficulty determining an appropriate service model. Deductive coding demonstrated roles of embedded pharmacists were consistent with all three activities of a knowledge broker. Conclusions: This study highlights the resident- and system-level roles and benefits of embedded on-site pharmacists, and provides a framework for defining this emerging workforce model in Australian RACFs.
MeSH term(s)	Aged ; Humans ; Australia ; Pharmacists ; Qualitative Research ; Homes for the Aged ; Workforce
Language	English
Publishing date	2023-10-25
Publishing country	Australia
Document type	Journal Article
ZDB-ID	1457406-8
ISSN	1741-6612 ; 0726-4240 ; 1440-6381
ISSN (online)	1741-6612
ISSN	0726-4240 ; 1440-6381
DOI	10.1111/ajag.13254
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