Health report shows almost half of Australians have a chronic health condition

The Australian Institute of Health and Welfare’s (AIHW) 2-yearly health report card, Australia’s health 2022 shows that Australia is generally a healthy nation compared with similar countries, notwithstanding some well-known areas for improvement. We are living longer – life expectancy at birth was 83.0 years in 2020, the sixth highest among the 38 OECD countries. Males born in 2018–2020 can expect to live 81.2 years and females 85.3 years, up from 55.2 and 58.8 years, respectively, for those born in 1901–1910. In 2020–21, almost half (47%, or 11.6 million) of Australians were estimated to have one or more common chronic health conditions (including diabetes, cancer, mental and behavioral conditions, and chronic kidney disease). Over one-third (38%) of our nation’s disease burden is due to modifiable risk factors. Two in three adults (67%) are either overweight or obese, while carrying excess weight is responsible for 8.4% of our total disease burden. The coronary heart disease death rate steadily increased throughout the first half of the 20th century, but since 1968 has fallen by 89% (from 428 deaths per 100 000 to 49 per 100 000 in 2020). Coronary heart disease remains the leading single cause of death for males and second leading for females. Seven in ten (70%) people survived at least 5 years after a cancer diagnosis during 2014–2018 – an improvement from about five in ten (52%) in 1989–1993. Generally, the higher a person’s socio-economic position, the better their health. If all Australians had experienced the same disease burden as people living in the highest socio-economic areas in 2018, the total burden could have been reduced by one-fifth (21%). In May 2021, almost three in ten adults with disability self-reported their physical health as excellent or very good, compared with 55% of adults without disability.

Medication reviews linked to a lower risk of death in aged care

Research led by the Registry of Senior Australians (ROSA) at South Australian Health and Medical Research Institute (SAHMRI) has linked medication reviews to a lower risk of death for aged care residents. The study, published by Oxford Academic, followed 57 719 residents living in aged care homes across Australia for up to a year, assessing whether they were hospitalised, went to the emergency department, or died during that period. “We found that individuals who had a medication review within a 12-month period had a 5% lower risk of death,” lead author Dr Janet Sluggett said. “There was no difference in the risk of hospitalisation between residents who had a medication review and those who hadn’t, the impact was solely based on mortality rates.” Only 22% of residents involved in this study underwent a medication review, despite all of them being eligible to access the free service. Previous studies have shown that aged care residents take an average of ten medications each day, yet only one in five receive a medication review from a pharmacist, which typically identifies up to four problems per person. Another recent ROSA study, focusing on the differences in medication use before and after a review, found use of some medications rationalised following a review. “Reviews often show which medicines can be adjusted or stopped, reducing the burden on the resident and boosting the quality of care,” Dr Sluggett said. “There’s a clear link between getting a review and a reduction in the use of some medicines, such as those for reducing reflux, which are often taken for longer than needed.” The lack of an automatic referral system means a doctor’s referral is required. A pharmacist then needs to visit the resident to make recommendations, before the doctor and nursing staff implement any changes. “The aim should be to streamline this process to make it more easily accessible for all involved,” Dr Sluggett said.

Uncovering one of the driving forces of Alzheimer disease

A Flinders University study has shown how a protein called tau, a critical factor in the development of Alzheimer disease, turns from normal to a disease state – and demonstrates how this discovery could deliver a therapeutic target. Published in Science Advances, the mouse study set out to answer whether a change at one specific site in tau would make it easier for another site to be modified. The team focused on the relationship between tau and protein kinases, which are enzymes that introduce changes in tau. The researchers conducted a large experiment that included up to 20 different changes in tau and 12 enzymes, focusing on the most abundant type of change seen in tau from the brains of patients with Alzheimer disease. While the study did discover that one change in tau does makes it easier for another change to be introduced, it was also able to identify “master sites” in tau, being specific locations that govern subsequent modifications at most of the other sites. “By modifying these master sites, we were able to drive modification at multiple other spots within tau, leading to a similar state seen in the brains of Alzheimer’s patients,” said the authors. The team will now investigate how its findings can be translated into a treatment.

Hospital readmissions for asthma on the rise among children

Hospital readmissions for asthma are increasing among children, according to research from the Murdoch Children’s Research Institute, published in the Journal of Asthma. The study found about one in three children, mostly pre-schoolers, are readmitted to hospital for asthma compared to one in five a decade ago. The study involved 767 children, aged 3 to 18 years, who were admitted to three hospitals in Victoria between 2017 and 2018 with a diagnosis of asthma. It found 34.3% were readmitted to hospital for asthma, with those aged 3 to 5 years accounting for 69.2%. Of the 767 participants, 20.6% were readmitted once and 13.7% had two or more readmissions in 12 months. “Our study highlighted gaps in the children’s asthma care,” lead author Dr Katherine Chen said. Over one-third of children had not had a review of their inhaler technique and only about a quarter were prescribed a preventer or asked to continue using it. “Almost three-quarters were discharged without a preventer medication and over 80% did not have a follow-up clinic booked at the hospital, often reserved for children with difficult-to-control asthma. Most families therefore need to navigate their child’s asthma follow-up with their GP.”

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