Australian Doctor Australian Doctor 24th November 2017

AUSTRALIA’S LEADING INDEPENDENT MEDICAL PUBLICATION I www.australiandoctor.com.au
TOO YOUNG TO
CHOOSE?
The ethics of treating
transgender youth
News Review, page 11
24 NOVEMBER 2017
THE WRONG DRUG? GOOGLED
A cautionary tale
of evidence over
clinical dogma
Grand Rounds, page 14 How I ended up naked
and confused searching
online for health advice
Editorial, page 28
Exercise in futility?
Hospitals viewing one GP health summary for every 350 uploaded
ANTONY SCHOLEFIELD AND
PAUL SMITH
GPs are largely wasting their
time uploading thousands
of shared health summaries
to the My Health Record,
alarming new figures sug-
gest.
Doctors have been pres-
sured to take on the task of
creating the summaries —
which list medications, diag-
noses and allergies — under
threat of their practices
losing thousands of dollars
in practice incentive pay-
ments.
The figures, released by
the Australian Digital Health
Agency, show that in August
Who was looking at shared health summaries
on My Health Record in August 2017
Number of health
summaries either
uploaded or updated
by GPs
Total number
of health summaries
viewed by public and
private hospitals
70,000
200
3000
Number of health
summaries viewed
by GP practices
this year, GPs uploaded
70,000 summaries.
However only 200 were
viewed by staff working in
public and private hospitals
over the same period.
This means GPs are
uploading 350 health sum-
maries for every one looked
at by a hospital.
The figures raise more
questions about the clinical
utility of the multibillion-
dollar My Health Record
system, despite some 5.2 mil-
lion patients who are being
told it will improve their
healthcare signing up.
Dr Trina Gregory, a health
IT expert and GP in Port
Macquarie, NSW, said: “All
the GPs and practices I have
spoken to just upload the
summaries for the eHealth
Practice Incentives Program.
I haven’t heard of any GPs
finding it useful. And no one
I know in hospitals knows
much about them or knows
how to access them.
“I don’t think you can spin
it any way to make it sound
better than the stats show. I
don’t know whether to laugh
or cry when I think about the
cost.”
The Australian Digital
Health Agency said that
when the system becomes
opt-out next year, more
doctors would view the
documents on the system,
including pathology and
imaging results, as well as
information on medications
dispensed to patients.
“The agency will continue
to publish these statistics reg-
ularly as part of being open
and transparent.
“However, these numbers
will have greater relevance
by the end of 2018 when the
My Health Record expan-
sion has been completed,” a
spokesperson said.
Dr Chris Pearce, a Mel-
bourne GP and president of
the Australasian College of
cont’d page 4
Warning over looming opioid crisis among patients with osteoarthritis
CLARE PAIN
AUSTRALIA faces a
prescription opioid crisis if
inappropriate use among
patients with osteoarthritis
(OA) continues to escalate,
epidemiologists warn.
More than one million opioid
prescriptions are already being
dispensed every year for OA
patients and this is projected
to triple to three million scripts
a year by 2030, according
to researchers from Monash
University in Melbourne.
Their estimates are based
on PBS data, which revealed
that 1.1 million opioid
prescriptions were dispensed
for 404,000 people with OA in
2015/16.
Assuming current trends in
opioid use and OA prevalence
continue, there will be
3,032,000 scripts dispensed
for an estimated 562,610
people with OA by 2030, they
estimate.
The researchers say it is
concerning that opioids are
already prescribed for one in
five people with osteoarthritis,
despite the lack of evidence to
support their use for chronic
pain, and concerns about
dependence and adverse
effects.
“There are clinical
Efficacy
Established
Safety Profile
circumstances in which
short-term opioid use [with
appropriate monitoring] is
appropriate for people with
severe OA pain, such as when
simple analgesics and/or
anti-inflammatory medications
are no longer effective or while
waiting for joint replacement
surgery,” they write.
“However, from a public
health perspective, valid
concerns have been raised
about escalating opioid
addiction and overdose issues
and these harms undoubtedly
contribute to the societal
burden of opioid use.”
cont’d page 6
Professor Ric Day
says GPs have got the
message about opioids
and the pendulum
is swinging against
prescribing them.
Choose JANUVIA with confidence
1-7
Before prescribing please review the PBS and Product Information in the primary advertisement in this publication.
References: 1. JANUVIA Approved Product Information, April 2017. 2. Nauck MA et al. Diabetes Obes Metab 2007;9(2):194–205. 3. Barzilai N et al. Curr Med Res Opin 2011; 7(5):1049–58. 4. Arjona Ferreira JC et al. Am
J Kidney Dis 2013;61(4): 579-587. 5. Chan JCN et al. Diabetes Obes Metab 2008;10:545–555. 6. Arjona Ferreira JC et al. Diabetes Care 2013;36(5): 1067-1073. 7. Green JB et al. N Engl J Med 2015; 373(3): 232–242.
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