Efficiently managing a long and growing six-month waiting list is one of the most significant challenges facing Orthopedic Spinal Surgeon Dr Laurence McEntee at his Gold Coast clinic.
Premium Technology.
Leading Experience.
Personalised Patient Care.
Panorama Radiology Specialists' state-of-the-art comprehensive Benowa clinic is located at 117 Ashmore Rd (in the AMart Complex).
As the Benowa medical precinct’s only comprehensive, doctor-owned medical imaging clinic, our highly experienced technologist team, alongside principal radiologist Dr Angus Watts and Dr Sam Kruger, are committed to providing the Gold Coast community with personalised patient-focussed care, premium and innovative technologies, and outcomes-driven imaging-guided pain management.
The Panorama team are passionate about our craft and proudly committed to providing the highest standard of medical imaging technology and services in a personalised, non-corporate environment.
BULK BILLING OF MOST MEDICARE-ELIGIBLE REFERRALS
ALL REFERRALS ACCEPTED
90 FREE ONSITE CARPARKS
Dr Watts and Dr Kruger are Fellowship-trained musculoskeletal and interventional radiologists, and are always happy to discuss cases and imaging-guided pain management with our referring clinicians.
Call (07) 5654 5133
3T MRI - with Deep Resolve AI, in-scan TV & 80% noise suppression
• Subspecialist Musculoskeletal Imaging and Interventional Pain Management.
• 2 minutes from Pindara Hospital.
• Industry-leading Technology.
• Radiologist owned & operated.
• Prompt, clinically-focussed reporting.
Monday to Friday 8am - 5pm 117 Ashmore Rd, Benowa (In the AMart Complex)
General
GenesisCare OncologyGold Coast
Our team of dedicated radiation oncologists have treatment experience across many adult tumour streams. The team at GenesisCare offer evidence-based, personalised multidisciplinary care, and aim to provide the best clinical outcomes possible.
A/Prof Siddhartha Baxi MBBS, GAICD, FRANZCR
Prof David Christie MBChB, FRANZCR
Dr Sagar Ramani MBBS, MRCP (UK), FRCR (UK), FRANZCR
Initial consultation appointment within five days of referral (on average)*
Initial consultation with radiation oncologist will be bulk-billed
Medicare covers approximately 80% of treatment costs (depending on your position within your Medicare Safety Net)
*In 2022-2023, the median referral to initial consultation for patients receiving radiation therapy was 4.4 days as reported by 37 centres providing radiation therapy Australia wide.
genesiscare.com
Regional Medical Director Gold Coast
Gold Coast’s NEW Premier Women’s Imaging Centre
Discover a new standard in medical imaging at the only dedicated women’s imaging facility on the Gold Coast. Offering a range of advanced imaging services including 3D Mammography, Breast Procedures, Pregnancy Ultrasounds and more. We aim to provide not just exceptional medical imaging, but a sanctuary of care, support, and understanding, tailored to meet women’s unique needs.
BRAND NEW LOCATION:
Experience unparalleled, advanced women’s imaging services at our brand new facility, opening soon at Level 1, 147 Smith Street, Southport.
STATE-OF-THE-ART FACILITY:
Our new purpose-built destination is set to redefine comfort and care. The meticulously designed centre includes a women’s lounge with plush robes, a tea and coffee area, private consultation rooms, and cutting-edge technology, all contributing to a calm, comfortable, and non-clinical atmosphere.
EXPERT TEAM:
From specialist breast Radiologists to our friendly support staff, our team is dedicated to providing a professional and comfortable experience, ensuring exceptional results. Proudly serving the Gold Coast community since 2009. 07 5564 0851 | thewomensimagingcentre.com.au
Level 1, 147 Smith Street, Southport
Empowering Women, One Scan at a Time!
OPENING EARLY SEPTEMBER!
Gold Coast’s New Nuclear Medicine Imaging Centre
Join us on a groundbreaking journey with our dedicated Nuclear Medicine Imaging Centre and Australia’s first GE Healthcare Omni 21cm PET/CT scanner; offering unmatched precision and clarity in imaging technology.
STATE-OF-THE-ART FACILITY:
Our brand new clinic is also set to open in early September at Southport, provide cutting-edge imaging services and a patient-first experience.
EXPERT CARE:
Our skilled team of Nuclear Medicine Technologists & Radiologists ensure unparalleled services in a compassionate environment for utmost comfort and well-being.
CONVENIENT LOCATION:
Located adjacent to The Women’s Imaging Centre and South Coast Radiology clinic at the Spine Centre at Smith Street Southport, we offer easy access to comprehensive imaging services.
Be among the first to experience advanced healthcare at the Nuclear Medicine Imaging Centre.
08 Partnering To Help Manage Surgical Waiting Lists
Dr Laurence McEntee
12 Literature Review on Smoking Behaviours Among Younger Population and Predicted Healthcare Burden in Samoa
Dr. Anne Lazari, Oceania University of Medicine
14 Antihypertensive, Antibiotics, Proton Pump Inhibitors, Anti-Lipid and Antidepressants Usage Analysis Among Different Age Groups of Patients in a Particular Suburb of Melbourne
Monir, Final Year Medical Student, Oceania University of Medicine
18 Healthcare Workforce Burnout and Turnover
AMA Queensland
20 A New Era of Retirement Funding: The Benefits of Reverse Mortgages
Australian Seniors Advisory Group
22 The Intersection of Medical Devices and Artificial Intelligence: Revolutionising Healthcare Brendan Griffiths, B.Bus, The Medical Link
A Message from the GCMA President
Prof Philip Morris AM, President GCMA MB BS BSc PhD FAChAM (RACP) FRANZCP FPOA FFP ABPN
The Gold Coast Medical Association had a very successful Thursday evening dinner meeting on 18 July at Bumbles Café/restaurant, Budd’s Beach, Surfers Paradise. The topic on ‘Strength and fitness for patients and doctors’ was adeptly presented by the Bundall site staff from the Kieser Group of physiotherapy and exercise physiology clinics. Around 30 members attended and participated in the post presentation discussion.
Upcoming Thursday evening meetings at Bumbles Café/restaurant in September and October will cover ‘Cancer Ra-
diology and Therapy’ (19 September –sponsor CRT) and ‘Hope and Healing: Innovations in Breast Cancer Care’ (17 October – sponsor Genesis Care).
Additionally, our GCMA Annual General Meeting is set for 21 November, also at Bumbles Café/Restaurant. We are very privileged to have as our guest dinner speaker that evening Dr Barbara Woodhouse. Dr Woodhouse is an oral and maxillofacial specialist surgeon. She qualified first in dentistry and then completed a medical degree and then surgical qualifications in Australian and in the United Kingdom. In addition to her specialist practice in Wickham Terrace she teaches
and consults at the main teaching hospitals in Brisbane and for the Australian Army Reserve. She has made major contributions to the development of oral and maxillofacial training programs in the Pacific and Asian regions. Dr Woodhouse will reflect on her career path and provide an update on significant clinical developments in her professional field. We look forward to meeting Dr Woodhouse in November! The GCMA plans a social event also in November – keep a lookout for that announcement.
In other news, The Medical Link magazine has a new publisher, Mr. Brendan Griffiths, who succeeds Aaron Chapman.
I extend my gratitude to Aaron for his dedicated work over the past two years. Brendan is enthusiastic about enhancing the magazine's content and impact. I encourage all members to contribute articles or advertorials—short pieces of 500700 words are especially welcome. Please contact Brendan at Brendan.Griffiths@themedicallink.com. au to submit your contributions.
Membership expansion remains a priority. Please invite your doctor colleagues to join the GCMA. Membership is straightforward via our website (www.gcma.org. au) with a $150 annual fee. This membership provides excellent value, covering
regular evening meetings, a two-course meal, and opportunities for professional networking.
I look forward to seeing you at our next meeting.
Yours sincerely,
Prof Philip Morris AM President GCMA
“ People who do commit to pre-habilitation are naturally more motivated and because they have goals and a plan seem to be happier with the end results”
Partnering To Help Manage Surgical Waiting Lists
Efficiently managing a long and growing six-month waiting list is one of the most significant challenges facing Orthopedic Spinal Surgeon Dr Laurence McEntee at his Gold Coast clinic.
“We see a vast range of patients in our clinic, from adolescents and seniors to private patients and Work Cover and DVA referrals,” explains Laurence. “Getting patients into the clinic in a timely fashion, and then being efficient in terms of allocating our time appropriately for their needs, is a major challenge.”
An initiative the clinic has implemented is a partnership with Kieser Bundall, where suitable waiting list patients are ‘triaged’ by the Practice Manager and offered a physiotherapy assessment and targeted strengthening services provided by Kieser. “It is very comforting to know that a number of patients on the waiting list, who I’m yet to meet, are doing something proactive for their condition,” explains Laurence. “And to receive an assessment and ongoing communication about that patient’s progress at Kieser, means I can focus my time on those who are more likely to require surgery.”
Laurence explains that many patients who visit his clinic often don’t require surgery at all. “If patients have been undertaking physiotherapy and targeted strengthening prior to seeing me, and I’ve got the feedback from Kieser on their journey to date, I can make a better decision regarding the need for surgery at that point,” says Laurence. “Someone referred to me five months ago, and in significant pain at that time thinking
they need surgery, may actually find out that’s not the case at all.”
Apart from the physical side of a patient’s presentation, Laurence and his team look at further issues such as comorbidities, modifiable factors such as smoking and obesity, as well as a person’s commitment and motivation overall, to determine if someone is a candidate for surgery. Often a patient will say they have been undertaking physiotherapy, but when Laurence digs a little deeper, he finds they may be simply referring to massage, and nothing particularly active such as targeted strengthening.
“People who do commit to pre-habilitation are naturally more motivated and because they have goals and a plan seem to be happier with the end results,” says Laurence. “If patients come to me first, without having undertaken such activities, they can find themselves behind on their treatment journey.”
" It is very comforting to know that a number of patients on the waiting list, who I’m yet to meet, are doing something proactive for their condition
Another consideration for Laurence and his team is the collection of data on a patient’s progress and measurable outcomes both before and after any intervention. “All surgeries today face significant scrutiny in terms of outcomes and cost effectiveness, and therefore it is critical for us to be able to understand that anything we do is going to help people and improve their condition,” says Laurence. “With Kieser, getting an initial report on a patient, and then ongoing communication on their progress, provides an invaluable snapshot to help us determine the most appropriate treatment.”
Laurence considers such multi-disciplinary partnerships, with providers such as Kieser, will become increasingly important in the future healthcare landscape to ensure patients are not exposed to either ‘over treatment’, or ‘under treatment’, for their conditions.
“From a medicolegal point of view, we will more and more be required to prove before any surgery is undertaken, that a patient has participated in appropriate preoperative rehabilitation,” says Laurence. “I can see a day when a patient is allocated a single pool of funds to be used accordingly across a range of treatment providers so it is vital that we are selecting the right treatment for each patient.”
The views expressed by individuals identified in this article are the personal opinions of such individuals and not that of Kieser.
Orthopedic Spinal Surgeon
Dr Laurence McEntee
Advertising in The Medical Link
If you would like to advertise your products or services, positions vacant, rooms for rent etc. in The Medical Link, please feel free to contact us at admin@themedicallink.com.au.
Advertising of medical services in The Medical Link should comply with the same advertising guidelines released in the Medical Board of Australia Code of Conduct:
Be factual and verifiable | Not include testimonials | Only make justifiable claims regarding quality and outcomes | Not raise unrealistic expectation | Not offer inducements | Not make unfair or inaccurate comparisons between your services and those of colleagues
The Medical Link is designed and published by Swan Management Services. It is the advertiser’s responsibility to ensure that advertisements comply with the Trade Practices Act 1947 as amended. All advertisements are published on the condition that the advertiser indemnifies the publisher and its servants against all claims, suits, actions, loss and/ or damages as a result of anything published on the advertiser’s behalf.
DISCLAIMER: The contents of articles and opinions published are not necessarily held by the publisher, editor or the Gold Coast Medical Association. No responsibility is accepted by the publisher, editor or Gold Coast Medical Association for the accuracy of information contained in any opinion, information, editorial or advertisement contained in this publication and readers should rely upon their own enquiries in making decisions touching own interest. Unless specifically stated, products and services advertised or otherwise appearing in The Medical Link are not endorsed by the publisher, editor or the Gold Coast Medical Association.
Philip Morris, Geoff Adsett, Stephen Withers, John Kearney, Maria Coliat
GCMA MEMBERS gcma.org.au
GCMA EXECUTIVE COMMITTEE
President Prof Philip Morris 5531 4838
Vice-President Dr Maria Coliat 5571 7233
Secretary Prof Philip Morris 5531 4838
Immediate Past President Dr Sonu Haikerwal 5564 6255
Treasurer Dr Geoff Adsett 5578 6866
Specialist Representative Prof John Kearney 5519 8319
GP Representative Dr Katrina McLean 5564 6501
Academic Representative Prof Gordon Wright 5595 4414
Keeping the Medical Community Informed
The Medical Link enriches the Gold Coast medical community by uniting the voice of its doctors.
Here you will find insightful stories and the latest trends in field research conducted abroad, and of course, right here on the Gold Coast. Keep informed of new health services, developments in the medical profession, and general interest items.
We invite you to submit your company updates, new recruits and promotions to the following email: admin@themedicallink.com.au
And if you would like to advertise your products or services, positions vacant, rooms for rent etc. in The Medical Link, please feel free to contact us admin@themedicallink.com.au.
Physiotherapists can play a crucial role in managing complex musculoskeletal issues through specialized approaches and comprehensive care strategies
Detailed Assessment and Advanced Diagnostics
Perform thorough and specialised assessments to understand the complexity of the issue
Interdisciplinary Collaboration
Work closely within our own allied health teams as well as specialists, GPs and surgeons
Advanced Manual Therapy Techniques
Incorporate techniques such as dry needling or acupuncture when appropriate
Design specific, graded plans and programs that cater to the patient's unique needs and limitations
Pain Management Strategies
Use cognitive-behavioural approaches to help patients manage chronic pain
Patient Education and Self-Management
Empower patients with self-management strategies to handle flare-ups and maintain function
Literature Review on Smoking Behaviours Among Younger Population and Predicted Healthcare Burden in Samoa
Dr. Anne Lazari, Oceania University of Medicine | anne.lazari@oum.edu.ws
Abstract
Aim: this preliminary pilot study aimed to explore a correlation between COVID-19 presentation with e-cigarettes vapers in the Western Sydney region of Australia.
Method: extracted data from questionaries completed by 100 Australians residing in Western Sydney region who were infected with COVID-19 during the pandemic from March 2020 to March 2022 was analyzed. Data collected included patient age, biological gender, years of vaping, if vaping began prior to COVID-19, weekly vaping frequency, the year COVID-19 was contracted, and the category of COVID-19 symptoms. The symptoms are scaled in four categories for this study from lowest severity to high severity based on World Health Organization’s classifications.
Results: Vapers in Western Sydney Australia experienced higher severity COVID-19 presentations compared to non-vapers. Biological males were found to be more susceptible than biological females for experiencing the highest severity. Vapers with higher years of vaping had severe COVID-19 presentations compared to lesser years of vaping.
Conclusion: Among adults in Western Sydney Australia aged 18 years and above, the collected data showed a correlation between e-cigarette vapers reporting higher severity of COVID-19 presentations compared to non-vapers of the same demographic when they contracted
Introduction
The purpose of this literature review is to explore the smoking behaviour in Samoa which continues to cause a weight burden on the healthcare system because of tobacco smoking on cardiovascular diseases and lung diseases. Samoa is in the South Pacific region with a population of 222,382 at the 2022 census.
Samoa experienced a demographic and an epidemiological transition in the mid-twentieth century with an increase in non-communicable diseases (Ministry of Health Samoa. Preventing chronic condition) which was attributed to increasing secular trends with one of the highest risk factors being tobacco smoking. This increase in risk factor contributes significantly to cardiovascular disease, lung cancer and chronic obstructive disease (Doll R, Hill B. 1956). Notably, tobacco smoking is the single greatest cause of preventable mortality.
Tobacco smoking was introduced in the Pacific Islands during the European maritime global exploration and since then sixteenth and seventeenth centuries, it became a sought after good to the Pacific Islanders. In 1979, Fiji Tobacco Company opened a cigarette manufacturing company in Samoa. During that time education on tobacco cigarettes was disseminated across medical and health departments as well as non-government organizations. With those subsequent declines in smoking was documented
by high-income countries but not in lower- and middle-income countries, particularly in the Pacific Island region (Taylor R et al 2006). A country-wide study was conducted with surveys analysed between 1991-2013 which found education about tobacco was higher in non-smokers compared to current smokers. Similarly, the data showed a decline in overall use compared to the 1960s-1970s.
The hesitation of the Pacific Island Governments to discourage tobacco smoking in the peak period of 1960s-1970s was likely influenced by the economic growth from Fiji manufacturing industry (Linhart C et al 2017). The delay in roll out of education early on especially to the younger population likely contributed to the current comorbidities experienced by the elderly population. Notably, it can be assumed with education in the period after, a decline in smoking habit was achieved, which indicates more efforts towards education against tobacco smoking could further improve prevalence in Samoa.
How Smoking Contributes to Mortality Increase in Samoa
Cigarette smoking is associated with significantly higher fibrinogen values which further increased with the amount smoked in each sex. Smoking significantly increases mortality rates in Samoa for both males and females as it causes physiological changes to multiple body systems. The Framingham Study with over 10 years of follow, showed 165 men and 147 women developing cardiovascular
COVID-19.
diseases in relation to fibrinogen values over the 180 to 450 mg/dl range (William. Kannel MD 2004). This association of increased fibrinogen is related prospectively to the occurrence of atherosclerotic disease including coronary disease, peripheral arterial disease and stroke. The leading respiratory disease associated with smoking is Chronic Obstructive Pulmonary Disease (COPD), emphysema and chronic bronchitis. Smoking damages lung tissues and leads to increased susceptibility to infections and respiratory illnesses (Vestbo and Hurd 2013). In relation to cancer, smoking is the leading cause of lung, throat, oesophageal, bladder and pancreatic cancers due to tobacco-containing carcinogens damaging DNA structure and promoting tumour cell proliferation (Doll & Peto 2004). Additionally, growing evidence has linked smoking to mental health diseases such as anxiety and depression due to the nicotine addiction that alters neurotransmitter activities in the brain which disrupts mood (Tjora et al, 2014).
These significant diseases impact the mortality rates for the Samoan people.
The Samoan population’s behaviour with Smoking
The history of smoking in Samoa is derived from influences by historical, social and familial factors. Smoking is embedded within the cultural norms of the Samoan communities as smoking is seen as a social activity to connect and maintain connections. (Swinburn et al 2011). The Asian Pacific Journal of Public Health
References
1. Linhart C, Naseri T, Lin S, Taylor R, Morrell S, McGarvey ST, Magliano DJ, Zimmet P. Tobacco smoking trends in Samoa over four decades: can continued globalization rectify that which it has wrought? Global Health. 2017 Jun 12;13(1):31. doi: 10.1186/s12992-017-0256-2. PMID: 28606163; PMCID: PMC5469026.
2. Doll R, Hill B. Lung cancer and other causes of death in relation to smoking. A second report on the mortality of British doctors. Br Med J. 1956;2(5001):1071–1081. doi: 10.1136/bmj.2.5001.1071).
3. Ministry of Health Samoa . Preventing chronic conditions. Apia: Ministry of Health; 2010. National non communicable disease policy 2010–2015)
4. Taylor R, Dobson A, Mirzaei M. Contribution of changes in risk factors to the decline of coronary heart disease mortality in Australia over three decades. Eur J Cardiovasc Prev Rehabil. 2006;13(5):760–768. doi: 10.1097/01.hjr.0000220581.42387.d4.).
5. Fibrinogen, cigarette smoking, and risk of cardiovascu-
published on how smoking serves as fostering camaraderie within Samoan communities to strengthen social bonds. (Saito et al 2009). A research in Drug and Alcohol Review further explored the cultural perceptions of masculinity associated with Samoan men compared to Samoan women (Barnett et al, 2018).
Future Samoa health burden of smoking
Given the prevalence of smoking and a significant increase in non-communicable diseases, these diseases are expected to rise in Samoa and with the population ageing the future burden on the Samoan healthcare system is critical. Consequently, the economic burden of treating smoking-related illnesses will increase in Samoa. The studies published in Tobacco Control indicates straining limits on healthcare resources in the region (Levy et al 2018).
Intervention Strategies for Tobacco Smoking in Samoa
Tobacco control measures such as taxation, community educational programs and public health campaigns are effective intervention strategies for smoking cessations. (McGee et al 2008). The tobacco control policies such as advertising bans and smoke-free legislations in public areas are added measures to the smoking initiation and cessation strategies. In particular, public health campaigns play a pivotal role in raising awareness about the dangers of smoking specifically regarding cancer links. The educational
lar disease: Insights from the Framingham Study Author links open overlay panelWilliam B. Kannel M.D. a b c, Ralph B. D'Agostino Ph.D. a b c, Albert J. Belanger a b c 2004.
6. Benowitz N.L 2003. Cigarette smoking and cardiovascular disease, patholophysiology and implication for treatment. Circulation 108(17), 2073-2082.
7. Tjora. T. Hetland J. Aaro L.E. and Wold B (2014). Initation of tobacco smoking: a systemic review of factors that influence the degree to which children and adolescents start to smoke. addiction 99(4), 407-418.
8. Vestbo J & hurd S.S (2013). Agusti AG Jones PW voglemier C Anzueto A et al. Global strategy for the diagnosis management and prevention of chronic obstructive pulmonary disease: GOLD executive summary. American Journal of Respiratory and Critical Care Medicine 187(4), 347-365.
9. Barnett R, Samu K, S, Degerud E & Faumina 2018 (Samoan Mens perspective on smoking and mascuaulinity: indigenous methodologies informing health promotion strategies in the Samoan archipelago. Drug and Alcohol
campaign goes as far as explicitly demonstrating terminal cases caused by smoking. The educational campaigns are further strengthen when local leaders of the Samoan community are involved with advocating for smoke free environments and cessation support. (Lana et al 2016).
Targeting the youth through school education is another pivotal measure to combat smoking behaviours in Samoa. Implementing these strategies in Samoa requires collaboration between government agencies, non-government organisations, healthcare providers, and community leaders to ensure a sustainable reduction in smoking prevalence and improve Samoan public health outcome holistically.
Conclusion
This literature review encapsulates the dire implications of smoking on the Samoan population and the critical interventional strategies required to address smoking cessation, especially among the younger population to prevent further economic burden for disease treatments caused by smoking as this younger population ages. It is evident educational campaigns are effective in reducing smoking initiation and promoting smoking cessation, therefore implementing multifaceted intervention strategies with the cooperation of local leaders and government and non-government bodies will likely improve public health outcomes and reduce the impact of smoking-related diseases in Samoa.
Review 37(1), 110-117.
10. Saito E Nichter M Tong E K & Samoa. T 2009. Culutral context of smoking among women in Samoa (Asia-Pacific Journal of Public Health) 21(3), 246-258.
11. Swinburn B.A Ley S.J & Carmichael H E (2011). Cultural perspective on smoking and smoking cessation among Pacific Islanders. A Literature review Social sciences & Medicine 33(6) 667-677.
12. McGee R Nosa V Williams S & Reeder A 2008. Prevalence, trends and attitudes towards smoking among Samoan adolescents in New Zealand, New Zealand Medical Journal 121(1275) 11
13. Levy D T Tam J Kuo C Fong G T Chaloupka F.J & Cummings K M 2018. The impact of implementing tobacco control policies. The 2017 tobacco control policies. The 2017 tobacco control policy scorecard Tobacco Control 27(6), 683-688.
14. Lana A Borlase T NAseri T & Robertson L (2016). Tobacco control in Samoa. A case study of a multi sectoral approach to policy implementation. Asia-Pacific Journal of Public Health 28(2) 165-174.
Abstract
Introduction
The intensity of medication usage depends on the prevalence of a specific disease. This also varies among population groups of different ages. Here we have investigated the usage of medications in a population of various age groups. The medicines were divided into five therapeutic categories. We found that anti-lipid drug usage was high in patients aged 56-65 years.
Methodology
The prescriptions were collected and dispensed. Then they were classified based on the type of disease. Prescriptions from each disease were then further divided based on types of medication. The most frequently used therapeutic group and mostly prescribed medication were identified. The medication usage was also ranked based on age. The study was conducted by collecting the prescription for four weeks.
Results
A total of 5934 prescriptions were studied from the five most common therapeutic classes. Out of these, 1577 prescriptions were anti-lipid category. Rosuvastatin was the greatest prescribed medication. The population group between 56 and 65 consumed the highest number of tablets.
Discussion
This study provided us with information about the most used therapeutic groups in the population. This indicates the dominance of a particular disease in the community. It also revealed that age is a critical factor for the increase in lipid profile and thus usage of medicines. With ageing, chronic health conditions such as hyperlipidaemia were a major concern that was reflected by the number of anti-lipid drugs prescribed.
Introduction
The healthcare system in Australia is regulated and organized. Every pharmacy is operated by a registered pharmacist,1,2,3 who instructs the patients about medication usage, side effects, and precautions about the dosage. The medications are dispensed by using the software
where patients' information is recorded. The data can be retrieved and monitored for reviewing and further dispensing.4,5,6 Patients usually come back monthly to the pharmacy to collect the medication. From the dispensing record in the software, we can investigate the prescribing trend of a medication.
Medication usage is varied in different places in Australia.7,8,9 This is because of the age, ethnicity, lifestyle, and food habit differences among the population. With ageing, atherosclerosis continues to develop in blood vessels. Also, as we age, mental health becomes common because of stressful lifestyles and biochemical changes in our bodies. Whereas young children have developing immune systems, which are more susceptible to infection. Based on these physiological variations in different age groups, we observed that blood pressure medication and cholesterol-lowering agents were mostly used by elderly people, whereas antibiotics were more used by children.10,11,12
This study included prescription medication usage analysis which has not been done anywhere in Australia. The Pharmaceutical Benefits Scheme (PBS) studied medicine dispensing from national electronic data.13 While that study was comprehensive, they did not explore the age-wise analysis of the consumption of medications. We were focused on the most prevalent disease and the most prescribed age group. From that point of view, this study was different and remarkable. Clinically, general medical practitioners will benefit from understanding the prevalence of the illness among the population.
Methodology
In this study, medications were selected from five different groups those were prescribed for chronic diseases. From those groups, the top five medications were chosen for investigation. Together we had twenty-five medications for analysis. The number of prescriptions for each medication was calculated and presented in order. To identify the most popular drug of a group, percentages were estimated. After studying this, the ranking was done for the five most popular drugs among all the twenty-five medications studied.
The data was collected from the dispensing system of the largest pharmacy in this suburb of Melbourne. Patients who attended the pharmacy over four weeks [from 15th April 2023 to 13th May 2023] duration to collect
medication were included in the study. Only anti-lipid, antidepressant, proton pump inhibitor, anti-infective, and antihypertensive were included in the study. Prescriptions presented by patients themselves were included in the study because of privacy and consent concerns. The patients who presented prescriptions for medications for other medical conditions were excluded from the study. Patients with limited English-speaking capability and limited written communication were excluded.
After analyzing the prescription number, the emphasis was given to the patient’s age which was determined from the date of birth. The studied population was classified into 9 different age groups. Then the number of prescriptions for each age group was presented by a bar graph.
The privacy and confidentiality of the patients were ensured during the study as there was no need to use the names and details of patients. The study was approved by the internal approval team of Oceania University of Medicine.
Results
Together 5934 prescriptions were considered of which 1577 were anti-lipid medications, 1182 were antidepressants, 1181 were proton pump inhibitors, 1063 were anti-infective and 931 were antihypertensives. (Table: 1)
The study found that rosuvastatin was the highest prescribed medication. It was 58% of the sum of anti-lipid medications. Atorvastatin, the 2nd greatest lipid-lowering drug 25% less popular than Rosuvastatin. Thus, the absolute dominance of rosuvastatin was observed over its competitor anti-lipid drugs.
On the other hand, in the antidepressant and proton pump inhibitor groups, two drugs from each were nearly equally popular. Out of the five antidepressants, sertraline and escitalopram were almost equally recommended by doctors. Similarly, among the five proton pump inhibitors, esomeprazole and pantoprazole were prescribed almost at the same frequency.
Amoxicillin was found to be the most fa-
miliar antibiotic. It was 12% more popular than its nearest competitor anti-infective. Also, amoxicillin occupied 7% of the total of the medications that were explored. Contrary to popular belief, antihypertensives were found to be the least frequently prescribed treatment in this study. None of the antihypertensive medications was in the top five most prescribed medications.
Age-wise analysis of medication usage:
It was observed that the age of patients had a significant impact on choosing medications. Anti-lipid, antihypertensive, antidepressant, and proton pump inhibitors were more common in aged people. On the other hand, antibiotics were mostly used by children.
As the age of the patients increased, the total number of prescriptions increased gradually. It reached the highest number for the age group 56-65 years. After that, the number of prescriptions decreased gradually. The oldest group of patients was the lowest on the graph.
Almost all the drugs sold to patients of 0-15 years were antibiotics. With the advancement of age, anti-infective medications were less used. Whereas anti-lipid prescriptions increased with ageing. It occupied almost half of all prescriptions dispensed for the age group of 56-65.
Overall, the prescribing trends among different age groups were very intriguing. There were no patients found under the age of 25 who had hyperlipidaemia or hypertension. There was a sudden rise in anti-lipid prescriptions for patients older than 55. In the same way, blood pressure prescriptions increased by many folds after the age of 45. In contrast to this, the number of depressed patients was almost consistent for the population aged between 26 and 75.
Discussion
Statins are still the most used medication all over the world.14 This group of drugs prevents the narrowing of blood vessels that is caused by cholesterol deposition.15 This narrowing can result in many complications such as ischemic heart disease and stroke.16
Among the anti-lipid medications, rosuvastatin was the most recommended. The reason may be fewer side effects of rosuvastatin. The most common side effect of statins is muscular pain.17 Rosuvastatin may have the least effect on muscle.18 Besides this, rosuvastatin has reduced low-density lipoprotein (LDL) more effectively than Atorvastatin.19 Also, rosuvastatin has been proven to decrease mortality in patients with coronary artery disease.20,21
Gastrointestinal disorders like dyspepsia, gastrointestinal reflux disease, gastric ulcer, and duodenal ulcer were prevalent among Australians. Esomeprazole was the preferred medication for the treatment of gastrointestinal disorders because of its better remission of symptoms compared to lansoprazole22 and pantoprazole.23 Esomeprazole had a history of lower rates of relapse of symptoms compared to lansoprazole and pantoprazole.24
About 8.6 million Australians aged 16-85 are estimated to have experienced a mental health problem at some time in their life.25 Of all the antidepressants, escitalopram had better efficacy and tolerability.26 Lifestyle, diet, family structure, and financial stress may be some of the causes of the prevalence of depression in the Australian population.27
Infection was more prevalent in lower age groups because most children (87% of children aged 4 years) attended daycare.28 Amoxicillin was calculated to be the most prescribed antibiotic. This antibiotic had a wide range of indications such as ear, nose, and throat infections29, lower respiratory tract infection, Helicobacter Pylori infection30, acute bacterial sinusitis, and urinary tract infections. This made amoxicillin more popular than other antibiotics.
Hypertension is a vey common condition among elderly people. When people get older, their blood vessels lose elasticity. Stiff vessels increase blood pressure.31 Perindopril was the most prescribed antihypertensive found in this study. This medication reduces progressive left ventricular remodeling.32
The limitation of this study maybe that
the data was collected from one particular suburb. However, this suburb has a population of all ages and a variety of origins based on birthplace. The data was collected over one month which may seem short, but a month’s data was enough to represent a real scenario. The reason is that patients refill their prescriptions monthly and medications are repeated every month.
Conclusion
This study focused on finding out the most frequent medication used by patients in a suburb of Melbourne, Australia. Lipid-lowering agents were at the top of the list whereas antihypertensive were at the bottom. Cardiovascular drugs were more used by the elderly whereas antibiotics were more common in children. Overall, the age group 56-65, consumed the highest number of drugs. The results will be useful to medical practitioners. They will be able to recognize the most popular drug and the most disease-prone age group.
References
1. Pharmacy Board of Australia, Australian Health Practitioner Regulation Agency. Statistic: Registration Data September 2018 (Webpage). Updated August 2020. Available online: https:// www.pharmacyboard.gov.au/ About/Statistics. aspx (accessed on 23 September 2020).
2. Pharmacy registrant data: June 2014. Canberra (Australia): Pharmacy Board of Australia; 2014 Jul. Also available from: www.pharmacyboard. gov.au/About/Statistics.aspx
3. Australia’s health workforce series: pharmacists in focus. Adelaide (Australia): Health Workforce Australia; 2014 Mar. Also available from: https:// www.hwa.gov.au/sites/default/files/ HWA_Australia-Health-WorkforceSeries_Pharmacists
4. Evolution of the immune system in humans from infancy to old age A. Katharina Simon,1 Georg A. Hollander,2 and Andrew McMichael Proc Biol Sci. 2015 Dec 22; 282(1821): 20143085. doi: 10.1098/rspb.2014.3085
5. Pearce, C.; Bainbridge, M. A personally controlled electronic health record for Australia. J. Am. Med. Inform. Assoc. 2014, 21, 707–713. [CrossRef]
6. Jackson, S.; Peterson, G. My Health Record: A community pharmacy perspective. Aust. Prescr. 2019, 42, 46–47. [CrossRef]
7. de Oliveira Costa, J.; Bruno, C.; Schaffer, A.L.; Raichand, S.; Karanges, E.A.; Pearson, S.A. The changing face of Australian data reforms: Impact on pharmacoepidemiology research. Int. J. Popul. Data Sci. 2021, 6, 1418. [Google Scholar] [CrossRef]
8. Pearson, S.A.; Pesa, N.; Langton, J.M.; Drew, A.; Faedo, M.; Robertson, J. Studies using Australia’s Pharmaceutical Benefits Scheme data for pharmacoepidemiological research: A systematic review of the published literature (1987–2013). Pharmacoepidemiol. Drug. Saf.
9. Australia - most prescribed prescription drugs 2020 | Statista
10. Australian Institute of Health and Welfare, ‘What is health?’ https:///www.aihw.gov.au/reports/australias-health/what-is-health
11. Australian Institute of Health and Welfare, ‘Australia’s health 2022: data insights’?’https:/// www.aihw.gov.au/reports/australias-health/australias-health-2002-data-insights/about
12. Australian Institute of Health and Welfare, ‘Chronic conditions and multimorbidity?’ https:///www.aihw.gov.au/reports/australias-health/chronic-conditions-and-multimorbidity
14. Reference: Nuti SV, Wayda B, Ranasinghe I, et al. The use of google trends in health care research: a systematic review. PLoS One. 2014; 9(10):e109583.
15. Mayerl C, Lukasser M, Sedivy R, Niederegger H, Seiler R, Wick G. Atherosclerosis research from past to present--on the track of two pathologists with opposing views, Carl von Rokitansky and Rudolf Virchow. Virchows Archiv : an international journal of pathology 2006; 449:96103. [PubMed].
16. [Mozaffarian D, Benjamin EJ, Go AS, Arnett DK et.al. Heart disease and stroke statistics--2015 update: a report from the American Heart Association. Circulation. 2015;131:e29–322. [PubMed].
17. [Kunakorntham P, Pattanaprateep O, Dejthevaporn C, Thammasudjarit R, Thakkinstian A.. Detection of statin-induced rhabdomyolysis and muscular related adverse events through data mining technique. BMC Med Inform Decis Mak 2022; 22: 233. [PMC free article] [PubMed] [Google Scholar]
18. Williams D, Feely J. Pharmacokinetic–pharmacodynamic drug interactions with HMGCoA reductase inhibitors. Clin Pharmacokinet
2002;41:343–70. [PubMed] [Google Scholar].
19. LA Leiter, RS Rosenson, E Stein, et al. Efficacy and safety of rosuvastatin 40 mg versus atorvastatin 80 mg in high-risk patients with hypercholesterolemia: Results of the POLARIS study Atherosclerosis, 194 (2) (2007), 10.1016/j.atherosclerosis.2006.12.001
20. NJ Stone, JG Robinson, AH Lichtenstein, et al. ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: A report of the American college of cardiology/American heart association task force on practice guidelines Circulation (2013) 2014;129(25 SUPPL. 1):1-45. doi:10.1161/01.cir.0000437738.63853.7a
21. SM Grundy, NJ Stone, AL Bailey, etAHA/ ACC/AACVPR/AAPA/ABC/ACPM/ADA/ AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines Circulación, 139 (25) (2019), pp.E1082-E1143,10.1161/ CIR.0000000000000625
22. KR, Johanson JF, Johnson DA et al. Maintenance of healed erosive esophagitis: a randomized six-month comparison of esomeprazole twenty milligrams with lansoprazole fifteen milligrams. Clin Gastroenterol Hepatol 2006; 4: 852–9.
23. Labenz J, Armstrong D, Lauritsen K et al. Esomeprazole 20 mg vs. pantoprazole 20 mg for maintenance therapy of healed erosive oesophagitis: results from the EXPO study. Aliment Pharmacol Ther 2005; 22: 803–11.
24. Lauritsen K, Devière J, Bigard MA et al. Esomeprazole 20 mg and lansoprazole 15 mg in maintaining healed reflux oesophagitis: Metropole study results. Aliment Pharmacol Ther 2003; 17(Suppl. 1): 24; discussion 25–7.
25. Australian Bureau of Statistics, National Study of Mental Health and Wellbeing: Summary Results, 2020–21; Tables 1.1, 1.3, 2.1, 2.3, 5.1, 5.3,
14.1, 14.3
26. A comparative review of escitalopram, paroxetine, and sertraline are they all alike? Sanchez, Conniea; Reines, Elin H.b; Montgomery, Stuart A.c International Clinical Psychopharmacology 29(4):p 185-196, July 2014. | DOI: 10.1097/ YIC.0000000000000023
27. The Australian public's beliefs about the causes of depression: associated factors and changes over 16 years. Pamela D Pilkington 1, Nicola J Reavley, Anthony F Jorm Affiliations expand PMID: 23688917 DOI: 10.1016/j. jad.2013.04.019
28. Preschool Education, 2022 | Australian Bureau of Statistics (abs.gov.au)
29. Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G, Martin JM, Van Beneden C., Infectious Diseases Society of America. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012 Nov 15;55(10):e86-102.
30. Matsumoto H, Shiotani A, Graham DY. Current and Future Treatment of Helicobacter pylori Infections. Adv Exp Med Biol. 2019;1149:211-225.
31. LA Leiter, RS Rosenson, E Stein, et al. Efficacy and safety of rosuvastatin 40 mg versus atorvastatin 80 mg in high-risk patients with hypercholesterolemia: Results of the POLARIS study Atherosclerosis, 194 (2) (2007), 10.1016/j.atherosclerosis.2006.12.001
32. Ferrari R. Effects of angiotensin-converting enzyme inhibition with perindopril on left ventricular remodelling and clinical outcome: results of the randomized Perindopril and Remodelling in Elderly with Acute Myocardial Infarction (PREAMI) study. Arch Intern Med. 2006;166(6):659–666
Healthcare Workforce Burnout and Turnover
KELLY HIGGINS-DEVINE: Gone are the days when our doctors and healthcare professionals are willing to work 60-plus hour weeks, sacrificing things like family time and mental wellbeing for the job. This is a good thing. Doctors are humans too, and definitely deserve some work-life balance. But it is having an impact on our healthcare system, and the state's peak body for doctors is warning it's time for a pretty big cultural change within the industry if we want to keep our healthcare system running. Dr Nick Yim is the president of the Australian Medical Association Queensland. Dr Yim, good afternoon. What are you hearing from doctors at the moment about workloads?
DR NICK YIM: What we're hearing from our doctors, our nurses, our health professionals, they're just exhausted. Over the past couple of years, they've been working harder. Our population has grown. That also means that our chronic disease is rising. And obviously that's the reliance on the healthcare sector. So they're stuffed.
KELLY HIGGINS-DEVINE: Basically they're stuffed, which I think encapsulates it nicely. So what are the key factors then driving doctors away from the profession? Is it just that it's all too much?
DR NICK YIM: You’ve highlighted the fact that gone are the days where doctors are working 60, 70 hours a week, which is a good thing. We do want doctors that are looking after themselves. They want to spend more time with their family, they do want to have that work-life balance.
So that means we do need an additional workforce. And we know unfortunately by 2030, there is going to be a worldwide shortage of healthcare workers by about 10 million.
KELLY HIGGINS-DEVINE: Ten million around the world?
DR NICK YIM: Around the world. Which is a big, big number.
KELLY HIGGINS-DEVINE: It certainly is. So how do we combat that?
DR NICK YIM: We need to talk about our workforce in Queensland. Whether you live at Gold Coast, Brisbane, all the way up north to Cairns or out west to Mount Isa, workforce is really important. You've got to recruit them, but at the same time we need to ensure that we are retaining these healthcare professionals in those regions because it's quite costly to keep retraining and retraining when people do resign and move elsewhere.
KELLY HIGGINS-DEVINE: Dr Yim, you're calling for a culture change within the healthcare system. What would that look like?
DR NICK YIM: What we're hearing from doctors in areas where there is high turnover is that often it's related to cultural change within the hospital. We are hearing from many doctors in training, consultant doctors, that bullying, harassment and discrimination is still an issue. That's something that we do need to address because doctors, healthcare workers, nurses, they do need to have a
safe environment to work. And that's something that we're hoping that the Queensland Government can address.
KELLY HIGGINS-DEVINE: It's interesting, isn't it, because we spend our kids’ childhoods telling them, don't be bullies, don't act like that, don't speak to people disrespectfully, and then they get into a profession that should be respectful and it's not.
DR NICK YIM: That's one of the concerns. It is a multifaceted issue. Most people who go to their work, they don't want to be bullies, they don't want to be harassing others. But it could be due to the pressures of workload complexity and access to services. To give you a bit of an idea, we know that the surgery waitlist is quite lengthy and that's one of the areas where there's pressure. So AMA Queensland is holding a Surgical Wait List Roundtable which is addressing those concerns, to develop strategies for regional Queensland and also metropolitan areas to see how we can address those wait lists in surgical areas.
KELLY HIGGINS-DEVINE: What are you thinking, then? What are the ideas for doing exactly that?
DR NICK YIM: It’s going to be a multistep process. It's not one model will fit everywhere. We can't use the same model in Wide Bay as in Cairns or out west. We need multiple models, different strategies. It's listening to frontline staff, the nurses, the doctors, to see what model is going to work in that region.
AMA Queensland Media Release 23 July 2024
AMA Queensland President, Dr Nick Yim, ABC Brisbane, Drive with Kelly Higgins-Devine
KELLY HIGGINS-DEVINE: You're hearing from Dr Nick Yim who's President of the Australian Medical Association Queensland. And it seems that we're going to be running out of doctors and nurses. A lot of them are looking at leaving the profession because of pressure and all the other things you've heard this afternoon, such as bullying, and that we're going to be well under the amount of medical professionals and health professionals that we're going to need. You've mentioned 2030, Dr Yim, but I think it might be before that. It feels like it's almost now.
DR NICK YIM: We do have the pressures now. I'm sure your listeners are feeling pressured - getting to see your GP, getting into the hospital-based system, getting elective surgery. There are things that have been beneficial. We have seen increased budgets announced by the Queensland Government, and incentives for doctors to enter general practice training. That's a start. But we need to ensure that we continue to invest now and maintaining that investment for the hospitals and also in primary care.
KELLY HIGGINS-DEVINE: Is it about encouraging or opening up the numbers, the provider numbers, to have more GPs?
DR NICK YIM: That is one strategy, but it's also ensuring that we are utilising the existing infrastructures that we have in place. That's the key thing. It's not just about building more and more buildings. We need to ensure that we have the workers. We've already got a lot of great buildings. We've got a lot of great facilities. We just need to ensure that those healthcare facilities are working more efficiently.
"They're stuffed."
That's AMA
Queensland President Dr Nick Yim's summation of the health workforce post pandemic. "What we're hearing from our doctors, our nurses, our health professionals, they're just exhausted. Over the past couple of years, they've been working harder. Our population has grown. That also means that our chronic disease is rising. And obviously that's the reliance on the healthcare sector. So they're stuffed."
And that's where we can invest in.
KELLY HIGGINS-DEVINE: So what does the future look like if we continue on the current trajectory?
DR NICK YIM: One of the challenges is the revolving door. In Wide Bay, my re-
gion, what we have seen is unfortunately doctors sometimes do leave after three or four years, and that affects the continuity of care for individual patients. My patients, they love to see me if they can see me every single time. I'm trying to develop that culture where we can bring in more doctors to provide that service in that individual practice, for example.
The other thing is we do need to continue to work collaboratively with all our health colleagues and also involve different models of care. That could be bringing potentially surgeons and specialists from Brisbane into the regional and rural areas and also utilise our technology. And we've have seen that with telehealth.
KELLY HIGGINS-DEVINE: Last month, the state government announced a $1.7 billion investment to grow and retain frontline staff through to 2032. Do we know how this funding is going to be used?
DR NICK YIM: It could involve incentives, different structures that could be in place. But funding utilised in one area might be a little bit different to another area, say North Queensland. So I think it needs to be individualised to each health service. And I guess the element of flexibility is clearly needed for that funding.
KELLY HIGGINS-DEVINE: Dr Yim, interesting conversation and one no doubt we're going to be looking at down the road. Thank you.
A New Era of Retirement Funding: The Benefits of Reverse Mortgages
Australia has a seniors retirement funding dilemma one that is unworthy of Australian’s who have spent a lifetime building the Australian economy and along with their own personal wealth.
We have the richest retirees in the world (defined by balance sheet networth) via their accumulation of fixed asset property, who enjoy the world’s longest lifespan, with 80% of the 6 million retirees owning their own home. Yet unworthy of Australia and unworthy of our seniors we endure the juxtaposition that 35% of retired Australians live below the OECD defined poverty line, second last in access to money, comfort, and confidence metrics in their retirement of the 23 OECD countries we are compared with.
The Australian Bureau of Statistics project the inevitable ageing of the Australian population, with 6 million retirees today becoming 7 million by 2030 and 9 million by 2040 coupled with cultural shifts in retirement expectations, in itself driving tremendous demand for seniors' equity release. For the new generation of retirees, our baby boomers, retirement life has lengthened to between 25 and 28 years on average from just 12-15 years in 1995, this generation are more active and expect more from a working life characterised by sacrifice
and good decision making with 80 percent of retirees owning their own home.
Baby boomers represent just 25% of the population with this generation owning 53% of the nation’s wealth. Data from the Productivity Commission predicts that this generation will pass on an estimated $224 billion each year in inheritances by 2050 or $3.5 trillion in total, they have the assets to live well in retirement, and The Australian Seniors Advisory Group (ASAG) plays its part in achieving that goal.
Simply put there is a great injustice for many seniors with traditional finance no longer available for those reducing their retiree income. Poverty is however unnecessary. ASAG provides a fit-for-purpose and normalized retirement funding solution releasing retiree wealth for when needed, via home equity release – specifically via reverse mortgages.
Reverse mortgages are designed for homeowners aged 60 and above, allowing them to access the equity in their property without the need to sell. Unlike traditional mortgages, reverse mortgages do not require monthly payments. The loan is typically repaid when the borrower moves out, sells the home, or passes away. Reverse mort-
gages provide retirees with a source of additional income, allowing them to maintain their lifestyle and cover unexpected expenses when they arise.
Reverse mortgages are subject to strict regulations, ensuring the protection of both the borrower and the lender, including the "No Negative Equity Guarantee" guaranteeing no debt can be passed to the next generation, the need for obligatory legal advise, life time property occupancy and offering the homeowner a choice to make regular interest repayments on the loan or not, alternatively repaying all interest at the end of the life of the loan. Reverse mortgages are now consider to be “just another loan” and a worthy solution for a generation of Australian’s we owe much to. For ASAG this is a worthy legacy.
The baby boomer generation transitioning into retirement represents just 25% of the population who own 53% of the nation’s wealth. Data from the Productivity Commission predicts that this generation will pass on an estimated $224 billion each year in inheritances by 2050 or $3.5 trillion in total.
For many in retirement, money is not the issue, access to it is.
Retirement Funding with Property Equity Release
Unlock the equity in your property to live the life you’ve earned!
No need to sell or downsize
No regular repayments required No negative equity guarantee
What are seniors using equity release for?
Buying a new car
Aged care funding Home renovations and improvements
Going on a holiday Improve cash flow
Eliminating regular debt payments
The Intersection of Medical Devices and Artificial Intelligence: Revolutionising Healthcare
Introduction
The convergence of medical devices and artificial intelligence (AI) is revolutionising healthcare. This synergy has led to advancements in diagnostics, treatment planning, and patient monitoring, making these processes more precise, personalised, and efficient. AI’s integration into medical devices enhances clinical outcomes, reduces costs, and broadens access to quality care. However, this technological progress also presents challenges that require careful consideration by clinicians, technologists, and regulators.
AI-Driven Diagnostics: The New Frontier
AI significantly impacts diagnostics by enhancing accuracy, which has traditionally relied on the expertise of healthcare professionals. AI algorithms, particularly those using deep learning, have shown remarkable proficiency in analysing medical images like X-rays, MRIs, and CT scans. A study published in Nature found that AI models outperformed radiologists in detecting breast cancer from mammograms, with fewer false positives and negatives. This capability is especially crucial in early-stage cancer detection, where early and accurate diagnosis can significantly improve patient outcomes. AI’s ability to analyse large amounts of data quickly allows for the identification of patterns and anomalies that might be overlooked by the human eye, leading to more accurate and timely diagnoses.
Personalised Treatment Plans: Tailoring Care Through AI
AI extends its influence into personalised medicine. Medical devices equipped with AI can analyse individual patient data, including genetic information, lifestyle factors, and real-time health metrics, to create tailored treatment plans. This approach shifts away from the traditional "one-size-fits-all" model of care towards a more individualised strategy that can improve outcomes and minimise adverse effects. For example, AI algorithms are being integrated into wearable devices that monitor chronic conditions like diabetes and heart disease. These devices continuously collect health data and, using AI, can predict potential complications or rec-
ommend real-time treatment adjustments. This enhances care precision and empowers patients to manage their health actively.
Enhancing Surgical Precision with AI
AI is also making significant strides in surgery, where precision is paramount. Robotic surgery, guided by AI, is becoming increasingly common, offering surgeons enhanced control and accuracy during complex procedures. AI-driven surgical robots assist in preoperative planning by analysing patient data and simulating surgical outcomes, allowing for better preparation and decision-making. During surgery, these robots provide real-time feedback and adjust techniques to optimise outcomes. The da Vinci Surgical System, though not fully autonomous, uses AI to enhance surgeon capabilities, leading to fewer complications and faster patient recovery.
Challenges and Ethical Considerations
While AI in medical devices offers numerous benefits, it also raises significant challenges and ethical considerations. Data privacy and security are primary concerns. Medical devices utilising AI often require access to sensitive patient data, which must be protected from breaches and unauthorised use. Regulations like the General Data Protection Regulation (GDPR) and the Health Insurance Portability and Accountability Act (HIPAA) aim to protect patient data, but the rapid pace of AI development may outstrip these regulations, requiring ongoing updates and oversight.
Another concern is potential bias in AI algorithms. If the data used to train these algorithms is not representative of diverse populations, it could lead to biased outcomes, exacerbating health disparities. A study in Science revealed that an AI system predicting patient treatment benefits exhibited racial bias, favoring white patients over black patients. Addressing this issue requires ensuring that AI systems are trained on diverse datasets and regularly audited for fairness and accuracy. Additionally, the rise of AI in healthcare raises questions about human oversight. While AI can assist in decision-making, it should not replace the critical judgment of healthcare professionals. The relationship between AI and clinicians
should be collaborative, with AI serving as a tool that enhances, rather than diminishes, clinical expertise.
Regulatory Landscape and Future Directions
The integration of AI into medical devices also poses regulatory challenges. Regulatory bodies like the U.S. Food and Drug Administration (FDA) are tasked with ensuring that AI-driven medical devices are safe and effective. However, the dynamic nature of AI complicates the regulatory process. The FDA is addressing these challenges by developing frameworks for regulating AI-based medical devices, including "software as a medical device" (SaMD). Looking ahead, the future of AI in medical devices is promising, with advancements expected in natural language processing, AI-driven drug discovery, and fully autonomous medical devices. As AI technology evolves, stakeholders—including healthcare providers, technologists, and regulators—must collaborate to implement these innovations safely, ethically, and equitably.
Conclusion
The integration of AI into medical devices represents a transformative shift in healthcare, offering the potential for more accurate diagnostics, personalised treatment plans, and enhanced surgical precision.
However, these benefits come with significant challenges, including data privacy, algorithmic bias, and regulatory needs. Navigating these challenges carefully is essential to ensure that AI-driven medical devices are not only innovative but also safe, ethical, and accessible to all.
References
1. McKinney, S. M., et al. (2020). "International evaluation of an AI system for breast cancer screening." Nature, 577, 89–94.
2. Hashimoto, D. A., Rosman, G., Rus, D., & Meireles, O. R. (2018). "Artificial Intelligence in Surgery: Promises and Perils." Annals of Surgery, 268(1), 70–76.
3. Obermeyer, Z., Powers, B., Vogeli, C., Mullainathan, S. (2019). "Dissecting racial bias in an algorithm used to manage the health of populations." Science, 366(6464), 447–453.
4. U.S. Food and Drug Administration (FDA). (2021). "Artificial Intelligence/Machine Learning (AI/ML)Based Software as a Medical Device (SaMD) Action Plan." Retrieved from https://www.fda.gov.
Brendan Griffiths, B.Bus, The Medical Link
WE ARE A CREATIVE AGENCY, BUILDING NARRATIVES IN ENGAGING WAYS THROUGH WEBSITE DESIGN, PHOTOGRAPHY, GRAPHIC DESIGN AND CONTENT WRITING.
