Samantha Chakraborty - Academia.edu (original) (raw)

Papers by Samantha Chakraborty

Objective To describe experiences of collaborations in producing living guidelines by the Austral... more Objective To describe experiences of collaborations in producing living guidelines by the Australian Living Evidence Consortium (ALEC), the World Health Organization (WHO), the National Institute for Health and Care Excellence (NICE), the Danish Health Authority (DHA), the Knowledge Institute of the Dutch Association of Medical Specialists, and the Canadian Rheumatology Association (CRA). Methods We developed a survey to collect the experiences of the collaborations in living guidelines. We collated the results and conducted a quantitative analysis for closed-ended survey questions. For open-ended questions we conducted a content analysis from the survey content. Results We included a convenience sample of twelve participants, from six living guideline collaborations across seven organisations. The consolidated results of the quantitative and content analyses were organized in the following themes: 1) facilitators of successful living collaboration, 2) barriers to successful living ...

Journal of Clinical Epidemiology

British Journal of General Practice

Paramedicine

Introduction Previous evaluations of paramedic-to-general practitioner (GP) referrals have focuse... more Introduction Previous evaluations of paramedic-to-general practitioner (GP) referrals have focused on subsequent emergency department presentations or ambulance representations; however, we aimed to appreciate patient adherence where paramedics have recommended follow-up with a GP. Methods This was a prospective cohort study of adult patients in Victoria, Australia, who were referred to a GP by a paramedic over a 28-day period in June 2021. Patients were then contacted within five days to determine subsequent GP attendance. Results Of the 752 patients who met the inclusion criteria, 47% ( n = 353) consented to participate. At the time of the survey, 65% of patients had followed up with their GP, with a further 15% booked in for a future appointment. Factors associated with the increased adjusted likelihood of the participant following up with a GP after paramedic referral included female gender (adjusted odds ratio [AOR] 2.21, 95% confidence interval [CI] 1.22–3.99, P = 0.009) and t...

Australian Journal of General Practice

Australian Journal of Primary Health, 2019

Advance care planning is a crucial issue for people with dementia and general practitioners (GPs)... more Advance care planning is a crucial issue for people with dementia and general practitioners (GPs) are ideally placed to initiate advance care planning early. However, the rates of advance care planning in Australian general practice remains low. While some international studies have shed light on the reasons behind this, research in the Australian context has been sparse. Objective: To gain a deeper understanding of the barriers and enablers of advance care planning for people with dementia among Australian GPs. Design: Qualitative research with hour-long semi-structured interviews of GPs. Deidentified audio recordings will be transcribed verbatim for thematic analysis using NVivo QSR. Setting: General practices across the south east region of metropolitan Melbourne. Participants: Practicing GPs will be recruited through the Monash Practice-Based Research Network database. Registrars will be excluded. Findings: This study is a work in progress. We expect to reach data saturation by 20 interviews. Findings will be presented under the sub-headings of: prerequisites, timely initiation, stakeholder engagement and important aspects of the advance care planning conversation. We anticipate new insights into how these factors dynamically interact with each other in the unique context of the Australian healthcare system. Implication(s) for practice: The findings of this study will identify practical ways in which advance care planning can be improved in general practice for people with dementia and lead to recommendations that will enhance advance care planning in this patient population.

Australian Journal of Primary Health, 2020

Background: Advanced (50-99%) carotid stenosis (CS) causes about 10% of all strokes and affects a... more Background: Advanced (50-99%) carotid stenosis (CS) causes about 10% of all strokes and affects about 10% of people by their eighth decade (Abbott et al. 2007). The stroke risk associated with advanced asymptomatic CS has fallen over the last 3-4 decades by >65% using medical intervention alone (lifestyle modification and medication) (Abbott 2009; Abbott et al. 2017). Medical intervention alone is now best for asymptomatic CS with improved outcomes also expected for symptomatic persons and all at risk from arterial disease (Abbott 2009; Abbott et al. 2017). However, most guidelines do not reflect the necessary shift from carotid procedures to primary care services (Abbott et al. 2015). Further, medical intervention is a combined strategy targeting different risk factors. Relevant evidence has evolved over decades across many specialties causing confusion and uncertainty over what now constitutes best medical intervention. Aim/Objectives: To create a guideline in collaboration with the International Union of Angiology that overcomes procedural biases and objectively characterises current optimal medical intervention for arterial disease prevention. Methods: Methods to overcome guideline procedural biases consist of correcting the problems with existing guidelines (Abbott et al. 2015). Therefore, our methods include: (1) limiting procedural endorsements to subgroups which benefited in relevant randomised trials; (2) acknowledging all trials of carotid surgery (endarterectomy) are outdated; (3) acknowledging trans-aortic carotid stenting causes more harm than surgery, while variant methods of carotid stenting have not been tested against current optimal medical intervention; (4) including recommendations for proven medical interventions, not just for procedures; (5) using a fair way to rank evidence applicability at the point of care; all guidelines reviewed rank only randomised trial data as best, even if it is outdated or otherwise inadequate or unnecessary to address a clinical question (Abbott et al. 2015); (6) not using procedurally biased terminology; and (7) multinational , multi-stakeholder participation (including physicians, surgeons, policy advisors, consumers, pharmacists, nurses and general medical practitioners [GP]). GPs are particularly important in this guideline creation process given their traditional practice of referring people with CS directly to a proceduralist and their critical role in orchestrating non-invasive preventive therapies, and (8) open-access publication. Methods to characterise current optimal medical intervention include performing critical comparative audits of contemporary guidelines for each of the major arterial disease risk factors. Heterogeneity in recommendations will be sought and appropriateness of recommendations tested using guidelinecited and other evidence. This novel analytical method was used with guidelines regarding carotid procedures (Abbott et al. 2015). The process revealed the nature of current best practice and many ways in which guidelines need improvement now (Abbott et al. 2015). There is evidence that critical comparative audits regarding medical interventions will also show inappropriate heterogeneity and means to improvement. For example, sampled guidelines regarding atrial fibrillation (AF) do not limit anticoagulation recommendations to those with recent AND recurrent or persistent AF. This encourages over-treatment. Further, guideline-based automated risk stratification scores give different recommendations for starting lipid lowering medication for primary prevention for the same patient risk factor profiles (Bonner et al. 2018). This implies error in evidence interpretation. Implications: GPs are particularly important in this guideline creation process, and the work's subsequent utilisation, given (1) the traditional practice of many GPs to refer people with carotid arterial disease directly to a proceduralist, and (2) the critical role of GPs in orchestrating non-invasive iv Australian Journal of Primary Health AAAPC Abstracts arterial disease prevention therapies. My presentation will be about explaining my research findings, the translational opportunities offered by this guideline associated work and extending an invitation to GPs to collaborate. Expected benefits of this guideline associated work: (1) challenging the status quo (the 'dangerous' aspect); (2) longer, heathier living for Australians and others; (3) reduced inappropriate treatment, adverse events and hospital admissions; and (4) improved healthcare, research and guideline standards. References Abbott AL (2009) Medical (nonsurgical) intervention alone is now best for prevention of stroke associated with asymptomatic severe carotid stenosis: results of a systematic review and analysis.

BMJ Open

IntroductionPractice-based research networks (PBRNs) are sustained collaborations between healthc... more IntroductionPractice-based research networks (PBRNs) are sustained collaborations between healthcare professionals, researchers and members of the community that develop, conduct and report on research relevant to local needs. While PBRNs have traditionally been focused towards primary care practices and their patients, there has been increasing interest in how they may help facilitate healthcare integration. Yet, little is known on the ways in which PBRNs can best integrate with the broader healthcare system, in particular Advanced Health Research and Translation Centres. The overall project aim is to build a sustainable collaboration between a PBRN and an Advanced Health Research and Translation Centre to generate a research platform suitable for planning, undertaking and translating research to improve care across the healthcare continuum.Methods and analysisWe will use a developmental evaluation design. Our iterative approach will be informed by a programme logic model and consi...

Australasian Journal of Paramedicine

Introduction Currently, non-transported patients who are attended to by a state-funded ambulance ... more Introduction Currently, non-transported patients who are attended to by a state-funded ambulance service in Victoria and are advised to visit their general practitioner (GP) do not have informational continuity of care, as there is no communication between the referring paramedic and GP. This research aimed to develop a functional electronic referral (e-referral) proforma from paramedics to GPs that can be used to support handover of patients’ clinical information for non-transported patients. Methods Paramedics, GPs and digital health experts were invited to participate in the study. The study design utilised an online Delphi technique, where participants responded to three rounds of surveys relating to the pertinence, feasibility, content and presentation of an e-referral tool. Questions were open-ended or requested responses on a 5-point Likert scale. Results A total of 21 clinicians participated in the study and developed an e-referral proforma. After three rounds, participants ...

The purpose of this technical review is to outline the steps undertaken to systematically review ... more The purpose of this technical review is to outline the steps undertaken to systematically review theevidence for key clinical questions for the Guideline

This Administrative report details the information required by the NHMRC in accordance with the r... more This Administrative report details the information required by the NHMRC in accordance with the requirements of theNHMRC Standards for Clinical Practice Guidelines 20113.

Medical Journal of Australia, 2021

Older people living with frailty and/or cognitive impairment who have coronavirus disease 2019 (C... more Older people living with frailty and/or cognitive impairment who have coronavirus disease 2019 (COVID‐19) experience higher rates of critical illness. There are also people who become critically ill with COVID‐19 for whom a decision is made to take a palliative approach to their care. The need for clinical guidance in these two populations resulted in the formation of the Care of Older People and Palliative Care Panel of the National COVID‐19 Clinical Evidence Taskforce in June 2020. This specialist panel consists of nursing, medical, pharmacy and allied health experts in geriatrics and palliative care from across Australia.

BMC Family Practice, 2020

Background Insomnia is a common sleep complaint, with 10% of adults in the general population exp... more Background Insomnia is a common sleep complaint, with 10% of adults in the general population experiencing insomnia disorder, defined as lasting longer than three months in DSM-5. Up to 50% of patients attending family practice experience insomnia, however despite this, symptoms of insomnia are not often screened for, or discussed within this setting. We aimed to examine barriers to the assessment and diagnosis of insomnia in family practice from both the clinician and patient perspective. Methods The present article identified research that has examined barriers to assessing insomnia from the clinician’s and the client’s perspectives following MEDLINE and Google Scholar searches, and then classified these barriers using the theoretical domains framework. Results The most common barriers from the clinician’s perspective were related to Knowledge, Skills, and the Environmental Context. From the patient perspective, barriers identified included their Beliefs about the consequences of ...

BMC Geriatrics

Objectives The transition of an older family member into a residential aged care facility (RACF) ... more Objectives The transition of an older family member into a residential aged care facility (RACF) is often challenging for both the person being admitted and their family carer. This review aimed to identify the protective and contributing factors to adverse mental health outcomes among family carers following the decision to move a family member to a RACF. Method A search of CINAHL, PubMed and PsycINFO was conducted for empirical papers published in English between 2004 and 2019, exploring the mental health or quality of life (QoL) of family carers of those recently admitted, or considering admission, to a RACF. Articles were reviewed by two authors for inclusion. Results Twenty-three studies met the inclusion criteria. Pre-existing depressive symptoms and poor subjective health were related to adverse mental health outcomes following admission. Information from the facility, support to change roles, and factors related to carer’s health and demographics, were associated with change...

Additional file 2. A summary of the steps and decisions involved in developing key clinical quest... more Additional file 2. A summary of the steps and decisions involved in developing key clinical questions for the 'Clinical guidelines for the diagnosis and management of work-related mental health conditions'.

Additional file 1. Guideline development manuals and procedures that describe methods for develop... more Additional file 1. Guideline development manuals and procedures that describe methods for developing key clinical questions for guidelines.

Additional file 2:. Mazza_et al_Additional file b. CONSORTClusterChecklistR0