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1,011 results on '"Hardy, Janet"'

21. Drug dependence epidemiology in palliative care medicinal cannabis trials

Author

Lee, Chee Yen, Good, Phillip, Huggett, Georgie, Greer, Ristan, and Hardy, Janet

Abstract

ObjectivesDrug dependence is becoming increasingly common and meeting palliative care patients with substance use disorders is inevitable. However, data on substance use in these patients are lacking. This study aims to evaluate the prevalence of drug dependence in palliative care patients with advanced cancer and correlate with symptom distress and opioid use.MethodsPalliative care patients with advanced cancer interested in participation in a medicinal cannabis trial were required to complete Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), Edmonton Symptom Assessment Scale (ESAS) and record of concomitant medications including baseline opioid use as part of the eligibility screen.ResultsOf the 182 participants, 167 (92%) reported lifetime alcohol and 132/182 (73%) lifetime tobacco use. No participant reached the threshold criteria for high risk of drug dependence with majority being low risk. There was no correlation between ASSIST score, ESAS and oral morphine equivalent.ConclusionThis study identified alcohol and tobacco as the main substances used in this group of patients and that most were of very low risk for drug dependence. This suggests routine drug screening for palliative care patient may not be justified, but the high possibility of questionnaire bias is acknowledged.

Published
2024
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42. Bugs, drugs, and the placenta

Author

Hardy, Janet R. and Tassinari, Melissa S.

Subjects
Placenta -- Physiological aspects -- Health aspects, Perinatal infection -- Complications and side effects -- Development and progression, Prenatal drug exposure -- Health aspects, Pregnancy, Complications of -- Risk factors -- Development and progression, Health
Abstract

How exquisitely designed is the human body? Despite our efforts to occasionally derail our health and well-being, our bodies come with helpful built-in protective functional barriers. The blood-brain barrier and [...]

Published
2022

44. Results from a type two hybrid‐effectiveness study to implement a preoperative anemia and iron deficiency screening, evaluation, and management pathway.

Author

Delaforce, Alana, Farmer, Shannon, Duff, Jed, Munday, Judy, Miller, Kristin, Glover, Lynne, Corney, Chris, Ansell, Gareth, Gutta, Naadir, Tuffaha, Haitham, Hardy, Janet, and Hurst, Cameron

Subjects
RED blood cell transfusion, IRON deficiency anemia, MEDICAL screening, COST effectiveness, LENGTH of stay in hospitals, ECONOMIC impact analysis
Abstract

Background: Implementation of pathways to screen surgical patients for preoperative anemia and iron deficiency remains limited. This study sought to measure the impact of a theoretically informed, bespoke change package on improving the uptake of a Preoperative Anemia and Iron Deficiency Screening, Evaluation, and Management Pathway. Study Design and Methods: Pre‐post interventional study using a type two hybrid‐effectiveness design evaluated implementation. Four hundred (400) patient medical record reviews provided the dataset (200 pre‐ and 200‐post implementation). The primary outcome measure was compliance with the pathway. Secondary outcome measures (clinical outcomes) were anemia on day of surgery, exposure to a red blood cell (RBC) transfusion, and hospital length of stay. Validated surveys facilitated data collection of implementation measures. Propensity score‐adjusted analyses determined the effect of the intervention on clinical outcomes, and a cost analysis determined the economic impact. Results: For the primary outcome, compliance improved significantly post‐implementation (Odds Ratio 10.6 [95% CI 4.4–25.5] p <.000). In secondary outcomes, adjusted analyses point estimates showed clinical outcomes were slightly improved for anemia on day of surgery (Odds Ratio 0.792 [95% CI 0.5–1.3] p =.32), RBC transfusion (Odds Ratio 0.86 [95% CI 0.41–1.78] p =.69) and hospital length of stay (Hazard Ratio 0.96 [95% CI 0.77–1.18] p =.67), although these were not statistically significant. Cost savings of $13,340 per patient were realized. Implementation outcomes were favorable for acceptability, appropriateness, and feasibility. Conclusion: The change package significantly improved compliance. The absence of a statistically significant change in clinical outcomes may be because the study was powered to detect an improvement in compliance only. Further prospective studies with larger samples are needed. Cost savings of $13,340 per patient were achieved and the change package was viewed favorably. [ABSTRACT FROM AUTHOR]

Published
2023
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