NT Health Research and Publications Online

Welcome to NT Health Research and Publications Online, an open access digital repository that showcases the research projects and output of researchers working for the Northern Territory Department of Health (NT Health), while also collecting and preserving publications and multimedia produced in an official capacity, that represent the department. This service is maintained by NT Health Library Services
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4303
Projects
61
People
482
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  • Publication
    Journal Article
    Establishing a psychiatry clinic within an Australian publicly funded specialist obesity service.
    (2025-02-12)
    Brightman, Louise
    ;
    Inman, Deborah
    ;
    In January 2023, the Canberra Health Services Department of Bariatric Medicine introduced a psychiatry clinic into its model of care to optimise the management of patients with comorbid obesity and mental illness. This paper describes the scope of the psychiatry clinic and reviews patient characteristics and management during the first year of operation.This study is an outline of the clinic and a retrospective review of patient demographics, body mass index, psychiatric diagnoses and initial management. Descriptive statistics were performed (2024.LRE.00027).Clinic scope, staffing and patient eligibility were presented. Of the 22 patients referred, 20 attended initial assessment and at least one review (102 encounters). Females outnumbered males (82%). Mean age was 44 years (18-73 years). Mean body mass index was 51.74 kg/m (29.36-74.23 kg/m). Depressive and anxiety disorders were the most prevalent existing diagnoses. Trauma and stressor-related disorders and feeding and eating disorders were common new diagnoses. 75% of patients had two or more psychiatric disorders. Management comprised medications, supportive psychotherapy and referral recommendations.This is the first time the Department of Bariatric Medicine has embedded a psychiatry clinic into its model of care. The clinic provides specialist-level psychiatric care within a multi-disciplinary team which may have benefits in managing comorbid obesity and mental illness.
  • Publication
    Journal Article
    Offloading Interventions for the Management of Charcot Neuroarthropathy in Diabetes.
    (2025-02-10) ;
    Jeyaraman, Kanakamani
    ;
    Hamilton, Mark
    ;
    Falhammar, Henrik
    The use of a nonremovable patellar tendon bearing (PTB) cast in Charcot neuroarthropathy (CA) has not been well studied. We describe the offloading devices, including PTB cast used in our setting for the treatment of CA.We performed a retrospective observational study on patients with CA and diabetic foot ulcer (DFU) presenting to the multidisciplinary foot clinic at Royal Darwin Hospital, between January 2003 and June 2015. Various immobilization and offloading methods used in CA treatment and their outcomes were analyzed.Ninety-three cases of CA were included. PTB cast (n = 76) and a variety of custom-made removable devices (n = 17) were used for initial offloading. Patients treated with PTB casts were allowed to fully weightbear on the affected limb, as tolerated. Initial offloading was continued until the joint stabilized and ulcer healed (6.5±1.9 months), and then patients were transitioned to various orthotic devices and then to accommodative footwear. At the end of the whole offloading treatment (median duration 13.1 months; range 10-24), patients treated with PTB initially had better outcomes compared with patients treated with removable devices.Immobilization using PTB casting was an effective offloading method for CA with DFU. With our offloading regimen, Indigenous and non-Indigenous patients had similar outcomes.Level III, retrospective cohort study.
  • Publication
    Journal Article
    Comparison of a visiting subspecialist ophthalmology service to Royal Darwin Hospital with interstate transfers: costs and clinical outcomes of treatment.
    Objective This study aimed to compare the costs and clinical outcomes of treating patients with retinal diseases requiring surgery managed locally in Darwin through a visiting subspecialist ophthalmology service or transferred to interstate tertiary eye centres. Methods A retrospective analysis of a case series of 70 consecutive patients presenting to the Royal Darwin Hospital for vitreo-retinal surgery during the calendar years 2018 and 2019 was performed. Results Twenty-two of the 29 patients in the transfer group had a retinal detachment and five vitreous haemorrhage. The 41 patients managed in Darwin had a range of diagnoses. Surgical success, complications and costs were similar. Conclusion There were excellent clinical outcomes and a minimal insignificant difference in costs.
  • Publication
    Journal Article
    Value-based health care for Aboriginal peoples with chronic conditions in the Northern Territory: a cohort study.
    (2025-01-01) ; ;
    Ahumada-Canale, Antonio
    ;
    ; ;
    Butler, Deborah
    ;
    Objective This study aimed to investigate associations between patient activation, healthcare use and clinical outcomes for Aboriginal peoples living with a chronic condition in remote Northern Territory (NT) communities. Methods A retrospective cohort study was undertaken between 2 April 2020 and 1 April 2022 to measure activation and its associations with chronic conditions secondary prevention treatment targets and healthcare usage: hospitalisations, potentially preventable hospitalisations and patient travel. All Aboriginal peoples enrolled at NT Government health services, who had one or more preventable chronic conditions and were prescribed one or more oral chronic condition medications identified in the Primary Care Information System, were included in the study. Patient activation was defined as a 90-day medicine possession ratio ≥80%. An activated patient has the belief, knowledge, skills and behaviours to manage their chronic conditions. Results A total of 5356 patients met the inclusion criteria; 9% of these patients were activated. Activated patients were older and sicker but were significantly more likely to achieve treatment targets for glycosylated haemoglobin, blood pressure and total and low-density lipoprotein cholesterol. Activated patients used more primary healthcare and outpatient resources and had a non-significant trend for less acute care use. Conclusions The remote NT Government primary healthcare system is providing low-value chronic conditions care for patients. As identified by Aboriginal peoples, strengthening culturally appropriate self-management support could lead to more patients becoming activated, better health outcomes and decreased acute care demand.
  • Publication
    Journal Article
    Recommendations for implementing rheumatic heart disease echocardiographic detection in remote Australia: A narrative review and lesson-drawing from diabetic retinopathy screening.
    (2025-02-01)
    Jones, Benjamin
    ;
    Turner, Angus W
    ;
    Marangou, James
    ;
    ; ;
    Kaethner, Alex
    ;
    Howard, Natasha
    ;
    English, Mike
    ;
    Nagraj, Shobhana
    ;
    Australia has some communities with the highest rates of rheumatic heart disease (RHD) in the world. Echocardiographic detection of RHD through active case finding has been proposed for early detection. Lessons can be learnt from the implementation of a similar program - diabetic retinopathy screening. The aim of this paper is to identify transferable lessons from the implementation of diabetic retinopathy screening that could be applied to RHD echocardiographic detection.This paper presents a narrative review and expert recommendations.Transferable lessons from the implementation of diabetic retinopathy screening include training local staff regularly with formal certification; supplementary health promotion; program champions; general practitioner involvement; informing all staff at clinics; creating separate Medicare Benefits Schedule items for acquisition and interpretation; using echocardiography for detection and monitoring of RHD; establishing referral pathways and communication channels; local community involvement in implementation planning; and developing an adaptable program.Implementing programs successfully and sustainably in remote communities is known to be challenging. These transferable lessons from the implementation of diabetic retinopathy screening might assist in the planning of an RHD detection program.
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