What is learned from an Australian older person health assessment?

Objective To examine what new health information is identified at a patient's most recent 75+HA compared with their standard GP consultations in the prior 24 months. Methods Parameters measured included newly identified chronic conditions, new management for previously diagnosed chronic conditions, medication management, referrals, vaccinations, and positive test results for the monitoring of previously diagnosed chronic conditions. A retrospective patient record study collecting data from two GP clinics in metropolitan and regional Victoria was undertaken. A total of 195 75+HA recipients were included. Results No significant difference was found in the number of new chronic conditions recorded at patients' most recent 75+HA compared with standard GP consultations in the prior 24 months. However, significant differences in the types of conditions were noted, with 75+HAs significantly more likely to record elevated lipids (P<0.001), vitamin D deficiencies (P=0.004), eye/vision-related (P=0.011), diabetes (P=0.019), and hearing conditions (P=0.045) compared with standard GP consultations. Significantly more referrals (P<0.001) and new management for previously diagnosed conditions (P=0.009) occurred at 75+HA than at standard GP consultations. Patients who were receiving their first 75+HA were significantly more likely to receive vaccinations than those receiving a subsequent 75+HA (P=0.022). Conclusion 75+HAs fulfil a role in addressing chronic health problems otherwise overlooked during standard GP consultations. What is known about the topic? Since their introduction in 1999, uptake of 75+HAs has been low. Two studies from 2001 to 2002 have suggested benefits of conducting 75+HAs to identify new health problems. What does this paper add? When compared with standard GP consultations, 75+HAs identify different types of new health problems, including elevated lipids, vitamin D deficiencies, eye/vision-related conditions, diabetes, and hearing conditions. Furthermore, more referrals and new management of previously identified problems occur at 75+HA. What are the implications for practitioners? 75+HAs fulfil a role in identifying and addressing chronic health problems in older patients that may otherwise have been overlooked at standard GP consultations. Suggestions of additions to the 75+HA template are made based on common chronic conditions detected in standard consultations but not included currently within the 75+HA.

Maternal iodine dietary supplements and neonatal thyroid stimulating hormone in Gippsland, Australia.

BACKGROUND AND OBJECTIVES: Pregnant women are at particular risk of iodine deficiency due to their higher iodine requirements. Iodine is known to be essential for normal growth and brain development, therefore neonatal outcomes in mildly iodine deficient areas, such as Gippsland, are a critical consideration. This study aimed to investigate whether iodine supplementation prevented iodine insufficiency as determined by neonatal thyroid stimulating hormone (TSH) screening criteria. METHODS AND STUDY DESIGN: Gippsland-based women aged >=18 years, in their third trimester of pregnancy, provided self-reported information regarding their iodine supplement use and consent to access their offspring's neonatal TSH screening data. 126 women consented to participate, with 111 women completing all components of this study. RESULTS: Only 18.9% of participants followed the National Health and Medical Research Council (NHMRC) recommendation of 150 µg/day iodine supplement, with 42.3% of participants not taking any supplements, or taking supplements with no iodine or insufficient iodine. The remaining women (38.7%) were taking supplements with doses of iodine much higher (200-300 µg) than the NHMRC recommended dose or were taking multiple supplements containing iodine. When correlating iodine intake to their neonates' TSH, no correlation was found. When iodine supplementation usage was categorised as below, equal to, or above NHMRC recommendations there was no significant difference in neonatal TSH. CONCLUSION: This study found that iodine supplementation appeared to prevent maternal iodine insufficiency when measured against neonatal TSH screening criteria.