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Margaret Williamson

Margaret Williamson
Health Research and Evaluation Services

BPharm, MPH, GradDipApplEpi

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89
Publications
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Publications

Publications (89)
Article
Search AJGP > 2020 > November > Near end of life status in older patients from routine general practice data RESEARCH Volume 49, Issue 11, November 2020 It is feasible to flag ‘near end-of-life’ status in older patients from routine general practice data Magnolia Cardona Margaret Williamson Mark Jones Danielle Ní Chróinín John Gullotta Ken Hillman...
Article
Background: General practitioners' (GPs) play a central role in facilitating end-of-life discussions with older patients nearing the end-of-life. However, prognostic uncertainty of time to death is one important barrier to initiation of these discussions. Objective: To explore GPs' perceptions of the feasibility and acceptability of a risk predi...
Conference Paper
Full-text available
https://osf.io/pz2ch/ Background Initiation of discussions on patient’s end of life (EOL) care preferences are often delayed by clinicians due to prognostic uncertainty. We aimed to 1) enhance clinician confidence by identifying objective risk flags for ‘near EOL’; and 2) understand the barriers and facilitators to the use of a risk prediction che...
Article
Objective To investigate views, determinants and barriers to end‐of‐life discussions for doctors, nurses and members of the public (MoP) and their acceptability of risk prediction tools. Methods Concurrent surveys of 360 doctors and nurses and 497 MoP. Results Sixty per cent of clinicians reported high confidence in initiating end‐of‐life discuss...
Article
Objectives: To determine the prevalence of frailty in Emergency Departments (EDs); examine the ability of frailty to predict poor outcomes post-discharge; and identify the most appropriate instrument for routine ED use. Methods: In this prospective study we simultaneously assessed adults 65+yrs admitted and/or spent one night in the ED using Fried,...
Article
Background: Many patients near the end of life are subject to rapid response system (RRS) calls. A study was conducted in a large Sydney teaching hospital to identify a cutoff point that defines nonbeneficial treatment for older hospital patients receiving an RRS call, describe interventions administered, and measure the cost of hospitalization....
Article
Objectives: The aim of this study was to assess the validity of a set of European quality indicators for assessing antimicrobial prescribing in Australian General Practice. Methods: A modified UCLA/RAND appropriateness method was used to assess the validity of 30 antimicrobial prescribing indicators. An expert panel of 12 general practitioners s...
Poster
Introduction/Aim: Resistance to antibacterials is growing, and is common in Australian health facilities and the community. We assessed the prescribing rates of antibiotics for upper respiratory tract infection (URTI), acute tonsillitis and acute otitis media and whether recommended antibiotics were used for their treatment using MedicineInsight da...
Poster
Objective: Based on MedicineInsight data, this study was sought to provide a comprehensive view into the prevalence, drug utilisation and management of chronic obstructive pulmonary disease (COPD) patients in general practice and the prescribing of medicines related to their care. Data and Method: Data is drawn for 365 clinically relevant practices...
Poster
Introduction: In any one year, around 1 million adults in Australia experience depression. We investigated the demographics, comorbidities, and pharmacological management of general practice patients who have a diagnosis of depression. Methods: We analysed data from MedicineInsight, a large scale general practice platform funded by the Australian D...
Poster
The use of antidepressants has doubled over the last decade; this is not entirely explained by an increase in GP management of depression. We investigated why antidepressants were prescribed to primary care patients. This was an analysis from MedicineInsight data, an Australian national primary health care panel collecting anonymised electronic hea...
Poster
Background/Introduction MedicineInsight is a new NPS MedicineWise program aimed at improving decisions about medicine use and other clinical care in general practice. MedicineInsight extracts data from two general practice systems and produces reports focusing on type 2 diabetes care to aid facilitator-led practice meetings at participating practic...
Conference Paper
Full-text available
Aims and rationale Much large project evaluation focuses only on collection, analysis and interpretation of quantitative information. In the current time and budget poor context we seek to demonstrate the value of case studies in understanding the impact of large primary care programs. We show how we used case studies to investigate impacts of Med...
Article
Objectives The need to maintain medicine adherence when travelling is irrefutable, yet how people achieve this goal and the challenges they encounter in doing so have seldom been explored in previous research. This study examined how consumers residing in Australia experience and manage their multiple medicines while travelling.Methods Face-to-face...
Conference Paper
Background MedicineInsight is an innovative large-scale Australian general practice program that aims to advance understanding of medicines use to inform and improve medicines policy, research and clinical practice. It uses innovative technology to collect routine clinical data from GP clinical software; provides data reports back to participating...
Presentation
Aims & rationale/Objectives MedicineInsight is a novel large-scale Australian general practice program that aims to advance understanding of medicines use to inform and improve medicines policy, research and clinical practice. It collects routine clinical data from GP clinical software; provides data reports back to participating general practices...
Conference Paper
Aims & rationale/Objectives We aimed to develop a systematic process to identify relevant and useable information that can be provided to inform care in general practice. MedicineInsight collects data from Australian general practices. Non-identifiable patient data includes prescriptions, clinical history and test results. Methods A process was fo...
Article
Full-text available
Inter-professional learning has been promoted as the solution to many clinical management issues. One such issue is the correct use of asthma inhaler devices. Up to 80% of people with asthma use their inhaler device incorrectly. The implications of this are poor asthma control and quality of life. Correct inhaler technique can be taught, however th...
Conference Paper
Full-text available
We present the developmental evaluation of MedicineInsight, a large scale innovative program in the Australian health sector which contains significant technological and organisational components, has multiple stakeholders and uses big data to influence behaviour. MedicineInsight aims to advance our understanding of prescribing in general practice...
Presentation
Full-text available
Feedback on GPs' experiences in using data to improve GP prescribing and patient outcomes in patients with hypertension and chronic heart failure using a data extraction and reporting tool as part of the Prescribing Data in General Practice Demonstration Project which is a multi-faceted QI activity developed by NPS and AGPN.
Article
Full-text available
Background Research literature consistently documents that scientifically based therapeutic recommendations are not always followed in the hospital or in the primary care setting. Currently, there is evidence that some general practitioners in Australia are not prescribing appropriately for patients diagnosed with 1) hypertension (HT) and 2) chroni...
Data
Appendix 3. Medicines relevant to the intervention.
Data
Appendix 2. Scope of CHF and HT definitions.
Data
Appendix 1. PDGPD Study Governance membership and functions.
Data
Appendix 4. Key Data Management and Data Cleaning Activities Undertaken by Facilitators or Practice Staff.
Poster
Full-text available
To evaluate the training and support for facilitators implementing a multi-faceted quality improvement intervention to improve prescribing practice and outcomes for patients with hypertension and chronic heart failure within 166 GP practices in Australia. Training for complex QI interventions should foster skills as well as provide information and...
Article
Full-text available
To explore the current use of conventional and complementary medicines in Australians aged ≥ 50 years. Cross-sectional postal survey sent to a random sample of 4500 Australians aged ≥ 50 years between June 2009 and February 2010. Prevalence of medicines use, reasons for medicines use and sources of medicines. Response rate was 37.3%. Medicines use...
Article
Full-text available
To explore Australian general practitioners' and pharmacists' preferences in relation to content, format and usability of drug interaction alerts in prescribing and dispensing software. Surveys that sought opinions on drug interaction decision support were mailed to a random sample of GPs and community pharmacists (1000 of each) in June 2010. Usefu...
Article
Full-text available
ABSTRACT: Electronic prescribing is now the norm in many countries. We wished to find out if clinical software systems used by general practitioners in Australia include features (functional capabilities and other characteristics) that facilitate improved patient safety and care, with a focus on quality use of medicines. Seven clinical software sys...
Article
Full-text available
Investments in eHealth worldwide have been mirrored in Australia, with >90% of general practices computerized. Recent eHealth incentives promote the use of up to date electronic information sources relevant to general practice with flexibility in mode of access. To determine GPs' access to and use of electronic information sources and computerized...
Article
Integrative medicine is a holistic approach to patient care that utilises both conventional and complementary therapy. This article compares the demographics of Australian general practitioners who do, and those who do not, practise integrative medicine, and their perceptions and knowledge about complementary medicines. A postal survey sent to a ra...
Poster
Full-text available
This was a pilot evaluation of The Prescribing Data in General Practice Demonstration Project to identify what worked, what needed to be improved, any barriers, and the acceptability of the activity. THE PDGPD project is a quality improvement initiative for general practice developed by NPS and AGPN. The project uses a data extraction tool, prescri...
Data
Features list including expected impact in 4 domains. Shows the 114 features and the expert panel ratings for each feature. Expected impact: H = high positive impact, M = medium positive impact, L = low or negative impact * Features marked with an asterisk were rated by the expert group as high positive impact across 3 or 4 domains including safety...
Article
Full-text available
Electronic prescribing is increasingly being used in primary care and in hospitals. Studies on the effects of e-prescribing systems have found evidence for both benefit and harm. The aim of this study was to identify features of e-prescribing software systems that support patient safety and quality of care and that are useful to the clinician and t...
Article
Full-text available
Computerised clinical decision support systems (CDSSs) are being used increasingly to support evidence-based decision-making by health care professionals. This systematic review evaluated the impact of CDSSs targeting pharmacists on physician prescribing, clinical and patient outcomes. We compared the impact of CDSSs addressing safety concerns (dru...
Article
There is wide variability in the use and adoption of recommendations generated by computerized clinical decision support systems (CDSSs) despite the benefits they may bring to clinical practice. We conducted a systematic review to explore the barriers to, and facilitators of, CDSS uptake by physicians to guide prescribing decisions. We identified 5...
Article
Background The use of complementary medicines (CM) is increasing in the community. Hospital pharmacists need to expand their knowledge of CM and have access to and become familiar with reliable information sources.AimTo ascertain hospital pharmacists' knowledge on adverse effects of CM; and to investigate their information seeking practices and pre...
Article
Full-text available
Computerised clinical decision support systems (CDSSs) are used widely to improve quality of care and patient outcomes. This systematic review evaluated the impact of CDSSs in targeting specific aspects of prescribing, namely initiating, monitoring and stopping therapy. We also examined the influence of clinical setting (institutional vs ambulatory...
Data
Table S1 - Full summary of results - Initiating treatment. a Other clinical areas include: salicylates or paracetamol in patients with history of GI bleed; erythropoietin low Hb; HIV medications; various medications. b Other clinical areas include: various medications interacting with warfarin; various conditions in children (e.g. croup, otitis med...
Data
Table S3: Key study features and results (Initiating treatment - Before drug selection). * Unless otherwise stated, number of patients is close to or equal to that specified in the "participants" column, or was not reported. + (NS) indicates intervention favoured the CDSS but was not statistically significant; - (NS) indicates intervention favoured...
Data
Table S4: Key study features and results (Initiating treatment - After drug selection). * Unless otherwise stated, number of patients is close to or equal to that specified in the "participants" column, or was not reported. + (NS) indicates intervention favoured the CDSS but was not statistically significant; - (NS) indicates intervention favoured...
Data
Table S5: Key study features and results (Monitoring existing therapy). * Unless otherwise stated, number of patients is close to or equal to that specified in the "participants" column, or was not reported. + (NS) indicates intervention favoured the CDSS but was not statistically significant; - (NS) indicates intervention favoured comparison group...
Data
Table S6: Key study features and results (Stopping treatment). * Unless otherwise stated, number of patients is close to or equal to that specified in the "participants" column, or was not reported. + (NS) indicates intervention favoured the CDSS but was not statistically significant; - (NS) indicates intervention favoured comparison group but was...
Data
Table S2 - Full summary of results - Monitoring treatment. c Other clinical areas include: hormone treatment for infertility; etretinate for psoriasis; HIV medications; various conditions (e.g. epilepsy, gout, diabetes).
Data
Table S7: Key differences between the studies included in the current review and previous reviews. * Studies were not prescribing focused (screening, preventive care/disease management). † Studies addressed automated drug dosing studies without decision support. # Review excluded studies below a defined quality rating. ‡ Review did not include moni...
Article
Full-text available
To update 2 comprehensive reviews of systematic reviews on prescribing interventions and identify the latest evidence about the effectiveness of the interventions. Systematic searches for English-language reports of experimental and quasi-experimental research were conducted in PubMed (1951-May 2007), EMBASE (1974-March 2008), International Pharmac...
Article
To explore clopidogrel use within Australia, investigating geography, age, sex and cardiac stenting rates. Data for clopidogrel supply (Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS)) and cardiac stenting procedures (State Health Departments) were obtained for four different geographic regions (very remo...
Chapter
IntroductionHouse-Dust Mite ExposureOther Indoor Allergen ExposuresOutdoor AllergensIngested AllergensEnvironmental Tobacco Smoke and Maternal Smoking During PregnancyBreast-FeedingOther Dietary FactorsAir PollutionOccupational ExposuresConclusions Appendix: Classifying the Quality of Evidence for InterventionsAcknowledgementsReferences
Article
Full-text available
There is an increasing interest in complementary and alternative medicines and therapies in Australia and overseas. Many consumers purchase a wide range of complementary medicines (CMs) and consult a wide range of complementary and alternative practitioners including naturopaths, acupuncturists and Chinese herbal medicine practitioners who may also...
Article
Full-text available
The aim of this study was to identify the factors that influence prescribing of new drugs among general practitioners, endocrinologists and psychiatrists. Four focus groups were conducted with GPs, endocrinologists and psychiatrists on sources of awareness and influences on prescribing of new drugs. Pharmaceutical companies were the most important...
Article
Computerised physician order entry (CPOE) systems hold the promise of significant improvements to health care delivery and patient care. The implementation of such systems is costly and complex. The purpose of this paper is to review current evidence of the impact of CPOE on hospital pathology services. This paper presents a review of the literatur...
Article
Reattendance rates at hospitals and emergency departments (ED) can provide a valuable marker of the quality and effectiveness of clinical care. Linked hospital and ED data from New South Wales and Victoria, Australia, were used to examine reattendances for asthma. Hospital and ED data were linked to identify individuals who reattended hospital or E...
Article
Evidence regarding how health information technologies influence clinical work patterns and support efficient practices is limited. Traditional paper-based data collection methods are unable to capture clinical work complexity and communication patterns. Our objective was to design and test an electronic data collection tool for work measurement st...
Article
To investigate whether the variables in the National Hospital Morbidity Database (NHMD) provide sufficient information to validly link hospital admission records for the same person so that persons admitted and re-admissions for a specified disease can be enumerated. Records of hospital admissions where asthma was the principal diagnosis were extra...
Article
A recent report outlines the good and the bad news about asthma.
Article
Full-text available
The impact of asthma has traditionally been measured in terms of the prevalence of the disease, mortality rates, and levels of healthcare utilisation, particularly hospital admissions. However, the impact of asthma extends beyond these outcomes to include effects on lifestyle, well being, and perceived health status. Information on self-reported cu...
Article
Objective To determine whether the injection of local anaesthetic through the hysteroscope at outpatient hysteroscopy, with or without endometrial biopsy, will reduce abdominal pain and increase patient acceptability of the two procedures.DesignProspective randomized double-blind placebo-controlled study.SettingOutpatient hysteroscopy clinic, Royal...
Article
The difficulty of getting research data to influence practice is well recognised in many fields including public health, education, social science, and clinical healthcare. A number of factors appear to limit the use of research. First, researchers and practitioners often work in isolation of each other. Second, researchers have few incentives to e...
Article
Diabetes is among the most costly of health conditions both for the person with diabetes and its complications and for the health service providing care. There is now good evidence that optimal standards of care for people with diabetes will ultimately reduce the burden of the disease on individuals and the community.
Article
This study reports chronic pain prevalence in a randomly selected sample of the adult Australian population. Data were collected by Computer-Assisted Telephone Interview (CATI) using randomly generated telephone numbers and a two-stage stratified sample design. Chronic pain was defined as pain experienced every day for three months in the six month...
Article
(1) To measure the extent of use of preventer medications (ie, inhaled corticosteroids or cromones) and possession of written asthma management plans (AMPs) among people with asthma in New South Wales in 1997. (2) To assess factors associated with underuse of preventer medications and AMPs. A cross-sectional survey by computer-assisted telephone in...
Article
Objectives: (1) To measure the extent of use of preventer medications (ie, inhaled corticosteroids or cromones) and possession of written asthma management plans (AMPs) among people with asthma in New South Wales in 1997. (2) To assess factors associated with underuse of preventer medications and AMPs. Design and setting: A cross-sectional survey b...
Article
Full-text available