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The article looks at a randomized controlled trial in Australia that examined the effectiveness of a pharmacist-led multi-component smoking cessation programme compared with usual care in hospitalised smokers. Study highlights include the use of an interview technique to conduct all patient assessments using standardised instruments, assessment of smoking cessation self-efficacy through the Smoking Abstinence Self-efficacy Questionnaire, and improvements in nicotine dependence.

Purpose: The purpose of this study is to evaluate the impact of the structured bowel management program (SBMP) in an inpatient rehabilitation service.Method: Prospective recruitment of consecutive patients admitted to the rehabilitation unit (n = 100). Each patient was assessed for bowel dysfunction on admission and an individualised SBMP was instituted based on the clinical needs. The assessments were at baseline (T1), and discharge from ward (T2) using validated questionnaires. Program evaluation was at 3-month (T3) post-discharge.Results: Participants were predominantly female (52%), mean age 68 ± 13 years. Almost one-half (43%) had neurological conditions and 41% musculoskeletal problems. At admission, 62% self-reported bowel dysfunction, mainly constipation (82%) and faecal incontinence (FI) (11%). At T2, participants showed significant improvement in bowel habit and stool consistency (Bristol stool chart,p < 0.001); severity of bowel symptoms such as FI (Wexner FI score,p < 0.05); and impact on quality of life (FI Quality of Life (QoL) subscales: “life style” and “coping/behaviour”,p < 0.05 for both). All functional independent measure “motor” and “cognition” subscales improved significantly (p < 0.01 for all), with moderate to large effect sizes (r = 0.5–0.7). No adverse effects were reported.Conclusions: Bowel management should be a priority within rehabilitative services. Evidence-based SBMP can improve bowel symptoms and enhance overall QoL in patients admitted to rehabilitation settings.Implications for RehabilitationBowel dysfunction is common in inpatient rehabilitation settings.A structured bowel management program can improve bowel symptoms and enhance overall QoL in patient.Bowel management should be a priority for patients admitted to rehabilitation settings. [ABSTRACT FROM PUBLISHER]

Objective. To assess and identify patient-reported supportive care needs following definitive treatment in persons with breast cancer (BC) and primary brain tumours (gliomas) (BT) in an Australian community cohort and to assess the commonalities and/or discrepancies of the reported needs in these oncological populations. Methods. A prospective cross-sectional survey of persons with BC (P = 85) and BT (P = 106) using questionnaires for supportive care needs, psychological morbidity, and quality of life. Results. BT participants were younger than BC patients (mean ages 51 and 57 years). The median time since diagnosis for both groups was over 2 years. The level of psychological morbidity, mainly depression, was high in both groups: BC (22%) and BT (20%). Participants in both groups reported at least one need ("met" or "unmet"). The BC patients reported higher numbers of "needs" and "unmet" needs compared with BT patients (mean 13.7 versus 11.6 needs; "unmet" needs mean 6.0 versus 4.1). The common "met" and "unmet" needs highlighted by both groups were comparable; the domain for most "met" needs included comprehensive cancer care, while "unmet" needs related to existential survivorship issues. Conclusion. Despite successful treatment many cancer survivors experience unmet supportive care needs in longer term. Understanding the impact of these beyond the acute phase is important as care shifts to community settings. More research in existential survivorship issues is needed. [ABSTRACT FROM AUTHOR]

Objectives. The study aimed to develop a set of clinical indicators to minimise the risk and adverse outcomes of functional decline in older hospitalised people. Methods. Existing Australian and international clinical indicators relevant to cognition and emotional health, mobility, vigour and self care, continence, nutrition, skin integrity, person-centred care, assessment and medication management were identified by literature and electronic website review. A multidisciplinary expert advisory group used modified Delphi methods, including two anonymous voting rounds and a group discussion, to gain consensus for a prioritised set of clinical indicators. For each indicator, experts voted on a scale of 1 (low level of prioritisation) to 9 (high level of prioritisation) based on measurement attributes and utility for use at the level of clinical teams, hospital managers and jurisdictional policy makers. Results. There were 55 existing clinical indicator sets identified, from which 63 relevant indicators were extracted. The final prioritised set covered all domains and included 19 indicators of which 17 were process indicators and 2 were outcome indicators. Scores for scientific measurement attributes and practicality for implementation were only moderate. Conclusion. These clinical indicators offer a consistent basis for monitoring hospital performance and improving care of older people in Victoria and other jurisdictions. INSET: What is known about the topic?. [ABSTRACT FROM AUTHOR]

Osteoarthritis of the hip and knee is a highly prevalent chronic condition in Australia that commonly affects older people who have other comorbidities. We report the pilot implementation of a new chronic disease management osteoarthritis service, which was multidisciplinary, evidence-based, supported patient self-management and care coordination. A musculoskeletal coordinator role was pivotal to service redesign and osteoarthritis pathway implementation. Impact evaluation included: service utilization, patient and general practitioner service experience, a 'before and after' audit of clinician adherence to recommendations, and 3- and 6-month patient health outcomes (pain, physical function, patient and physician global health (Visual Analogue Scale), disability (Multi-Attribute Prioritisation Tool), Partners in Health Scale and body mass index). A total of 123 patients, median age of 66 years, were assessed. Documentation of osteoarthritis assessment and management improved for all parameters. At 3 months there were improvements in self-reported pain ( P < 0.001), global function ( P < 0.001), physician and patient reported global health ( P < 0.001), Partners in Health Score ( P < 0.001) and Hip and Knee Multi-Attribute Prioritisation Tool score ( P < 0.014). Body mass index did not improve. Patients and general practitioners reported positive experiences, but there was variable uptake of recommendations by patients. The main factors influencing uptake of recommendations were access block to community services in the first 3 months and patient preferences for therapy. The cost implications for implementation were low. The osteoarthritis service model is feasible to implement, is well received by patients and staff, and provides a template for translation into other settings. [ABSTRACT FROM AUTHOR]