Best Practice Software

Harmony Sanderson

Dry July. View from a Doctor’s Desk – Dr Lisa Surman

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Dry July

A month of sobriety every year does not reduce your lifetime risk of harm from alcohol, but does act as a circuit-breaker to help reassess your relationship with regular drinking. You may get to assess the effects it may be having on productivity, relationships and review the amount and circumstances you are drinking under (for example the automatic pouring of a larger glass of wine while cooking dinner, or sitting down to watch the television).  Research has repeatedly demonstrated that we underestimate how much we drink. A break may also highlight the social pressures we are under to consume alcohol. There has been little research into whether campaigns such as Dry July have any effect on long-lasting change in alcohol consumption, but there is some evidence from the UK of reduced consumption in the 1-2 months following participating in these campaigns. 

The short-term benefits from a month alcohol-free for regular drinkers include a more refreshing sleep. Although alcohol acts as a sedative, it is associated with increased snoring, sleep apnoea and wakening after the effect wears off at 4-6 hours. Alcohol acts as a diuretic and this effect may also interrupt sleep.

Alcohol contains significant calories and a break can be associated with weight loss and reduced restaurant bills. Although often without physical symptoms, your liver function also improves when not processing regular alcohol.

In Australia, almost 6000 deaths a year can be attributed to alcohol, with approximately 400 hospitalisations per day. Many people remain unaware that the long-term health risks associated with regular alcohol intake are not only confined to very heavy drinkers. There is a growing list of alcohol-related diseases: bowel cancer, mouth and oesophageal cancer, breast cancer, heart disease, respiratory infections, mental health problems and perhaps prostate cancer. There is also the foetal alcohol spectrum disorders occurring as a result of exposure to alcohol in the womb. Alcohol affects judgement and affects risk-taking, with injuries, vehicle accidents, drownings and violence associated.

Individual vulnerability and the context in which you drink are relevant, but in general low-risk drinking to avoid alcohol-related death is two standard drinks or less per day and a single occasion low-risk drinking is four standard drinks or less. The safest option for those thinking about pregnancy, who are pregnant and for those under 18 years old is not to drink.

The National Alcohol and Other Drug Hotline offers professional, confidential and free advice to connect you to the most appropriate services locally at 1800 250 0115 (anytime and anywhere) should you be concerned about your level of alcohol use.

Daybreak is a helpful, free App designed around a Drink Less Support Community created by the Hello Sunday Morning team, see hellosundaymorning.org for more information about the App and Facebook group promoting hang-over free Sundays, for those interested in a longer term approach to changing their relationship with alcohol.

Funds raised though Dry July are donated to cancer support organisations across Australia, with $30 million being raised for more than 75 cancer organisations since the first Dry July in 2008.

Dr Lisa Surman, CBD West Medical Centre, Perth, WA

Member of Best Practice Software’s Clinical Leadership Advisory Committee

“Often patients spend time talking about current medical and social issues, taking valuable time away from dealing with what they have really come in to discuss. One of our solutions is to direct them to news articles on our website written by a doctor in our Practice that outline current issues and offer strategies to manage the problem and links to relevant, reputable websites”.

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New software function for Australian Defence Force Post-discharge General Practitioner Health Assessment launched

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A new software function to improve efficiencies for general practices when undertaking Australian Defence Force (ADF) Post-discharge General Practitioner (GP) Health Assessments has been introduced in the latest release of Best Practice Software’s Bp Premier, entitled Indigo.

Military service is a unique experience, bringing with it camaraderie, identity and purpose. It is also physically and mentally demanding and can involve stress and risk.

DVA funds a range of specialised treatment services to meet the health needs of former serving members of the Australian Defence Force (ADF).

The ADF Post-discharge GP Health Assessment is a comprehensive health assessment available to all former ADF members – including former serving members of the permanent and reserve forces. There are no time restrictions for accessing this one-off health assessment. The assessment is funded under the Medicare Benefits Schedule health assessment items 701, 703, 705, 707.

The ADF Post-discharge GP Health Assessment assists GPs with the early identification and diagnosis of any mental and physical health concerns for ex-serving personnel. The assessment specifically screens for alcohol use, substance use and, psychological distress, including posttraumatic stress disorder. It also assists with considerations around appropriate treatments and referrals to other services, including DVA services.

A detailed Guide to the ADF Post-discharge GP Health Assessment along with a Quick Reference Guide are available online. These resources detail the key actions, treatment options and referral pathways available to doctors following the completion of the assessment. The guides and further information are available on the At-Ease Professional webpage.

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Talking About Suicide Does Not Make It Happen by Dr Lisa Surman

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Suicide prevention

Beyond Blue have released a media statement following the recent news of high profile suicides, encouraging anybody affected to reach out for support, talk to someone you trust, speak to your GP or a mental health professional or call beyondblue Support Service on 1300 22 4636.  “Don’t stay silent if you are concerned about somebody. Ask how they are really feeling. Ask if they have been thinking about taking their own lives”.

“Mental health issues can affect anyone at any time: No one is immune,” said beyondblue Chair, The Hon Julia Gillard AC.

International recognition, excellence in your chosen career, respect from your peers and public admiration are no defence when it comes to developing a mental health condition.

Talking openly about depression, anxiety and other mental health conditions helps reduce stigma, tackles discrimination and encourages those at risk of self-harm and suicide to seek support. Eight Australians of all ages, ethnicity, religion, gender identity and socioeconomic circumstances die by suicide every day. Suicide prevention starts with recognising the warning signs and taking them seriously. Beyondblue also advises us about people who have thought about suicide have told them that the most important thing family, friends and colleagues can do is listen, show they care and offer support.

The signs beyondblue lists might include:

– expressing sense of hopelessness or no hope for the future

– isolation or feeling alone – ” No one understands me”

– aggressiveness and irritability – “leave me alone”

– possessing lethal means – medication, weapons

– negative view of self -“I’m worthless”

– drastic changes in mood and behaviour

– frequently talking about death – “If I dies would you miss me?”

– self-harming behaviours like cutting

– risk-taking behaviours – “I’ll try anything, I’m not afraid to die”

– getting affairs in order, such as making funeral arrangements

– giving away things, clothes, expensive gifts

– substance abuse

– feeling like a burden to others – “you’d be better off without me”

– talking about suicide – “sometimes I feel like I just want to die”

Visit beyondblue.org.au/get-support/have-the-conversation

Dr Lisa Surman, CBD West Medical Centre, Perth, WA

Member of Best Practice Software’s Clinical Leadership Advisory Committee

“Often patients spend time talking about current medical and social issues, taking valuable time away from dealing with what they have really come in to discuss. One of our solutions is to direct them to news articles on our website written by a doctor in our Practice that outline current issues and offer strategies to manage the problem and links to relevant, reputable websites”.

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Bp Allied meet Dieticians

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Bp Allied was again represented at the 35th National Conference of Dieticians from 17th to 19th May in Sydney. Melissa and Paul had a great time meeting dieticians from around Australia. 

Winner of our Competition to win a Google Home Mini was Natalie Selever from IWC Bundaberg. Congratulations Natalie!

 

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Major Award for Best Practice Software

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Leading Australasian medical software company Best Practice Software was recognised with a major Award at the Bundaberg Regional Chambers of Commerce Business Excellence Awards on Saturday, 26th May.

Chief Operating Officer Craig Hodges said it was a great honour for the entire team at Best Practice.

“On Saturday evening I had the great honour of accepting the Professional Services Business of the Year Award at the Business Excellence Awards in Bundaberg. Judges determined that Best Practice Software met, in a joint award with a local animal hospital, the criteria of a successful business best engaged with its customers, team, products, and community” Mr Hodges said. “It’s not our systems or products or buildings or large user base in its own right that saw us win – but rather the immense contribution of a team of people, each doing their own important part in the overall picture”.

Best Practice was created in 2004 in Bundaberg Queensland, by Dr Frank Pyefinch, who brought users the benefits of a busy and successful career as a respected General Practitioner and more than a decade’s experience as Australasia’s pioneer of medical software development.

The company opened its busy Operations Hub in Bundaberg in April 2013 – the most sophisticated “nerve centre” dedicated to Medical Information Technology in the nation – and grew its team into a New Zealand operations centre in Hamilton; a modern support centre in Sydney; and a business centre in Brisbane, Queensland.

“We believe that Best Practice combines the best in people, systems and technology to help connect communities with medicine and it’s gratifying to see the panel of judges recognises the work we do and the part we play from our founding base in Bundaberg” Mr Hodges said.

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How Much Sugar Is Enough? View from a Doctor’s Desk – Dr Lisa Surman

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Sugar and healthy eating

The recent Four Corners’ episode on television discussing the obesity epidemic in Australia, and the burgeoning health-care costs associated, exposed the food, nutrition and health politics in Australia over many years and the powerful grip Big Food has on Australian food and nutrition policy. 

There have been clear links made for some time between free dietary sugars, sugary drink consumption and obesity. Evidence is strong and growing regarding the effect sugary drink taxes have in driving down consumption and incentivising manufacturers to put less sugar in their products. Taxing sugary drinks is far from the single solution to the obesity or diabetes epidemics, but is a start.

The World Health Authority (WHO) recommends adults and children limit their intake of free sugars to less than 10% of their total energy intake daily. If you are and average-sized adult with a healthy body weight, this translates to about 54 grams of sugar (approximately 12 teaspoons) per day.

Free sugars are defined as monosaccharides (glucose) and disaccharides (table sugar), added to food and drinks by the manufacturers, cooks or person. It also applies to sugars present in honey syrups, fruit juices and fruit juice concentrates. These sugars are different to those found in whole fruit and vegetables, which do not apply. Sugar added to food and drinks can have different names, all remain sugars: sucrose, glucose, corn syrup, maltose, dextrose, raw sugar, cane sugar, malt extract, fruit juice concentrate, molasses.

More than 52% of Australians are estimated to exceed these recommendations, sugars are added to processed foods and pre-packaged foods and drinks. The largest proportion of our free sugar intake comes from sugary drinks (over 50%). Australians consume more sugar-sweetened drinks than Britons who implemented a tax in 2016. Should we introduce a sugar tax, we would join 28 other countries and 7 US cities. Two years after Mexico introduced the tax, sugary drink purchases decreased by 7.6%. One 600ml bottle of sports drink contains 36g or 8 teaspoons of sugar, 600ml of coke contains 64g or 14 teaspoons of added sugar.
Sugary drinks are heavily advertised, available everywhere and promoted – they provide large numbers of kilojoules and provide no nutrients.

Changes you can make immediately to help reduce your sugar intake while waiting for some policy change include:

  • Carry and use a refillable water bottle
  • Eat fewer foods with free sugars, reduce sweets such as lollies and chocolates, cakes and biscuits
  • Don’t walk down the sugary drink aisle of the supermarket
  • Keep sparkling water or home made iced tea in the fridge
  • Avoid vending machines
  • Make some swaps – swap your cereal for a lower-sugar variety and limit the sugar you add
  • Read the labels on food – if there is more than 15g of sugar per 100g, check to see if sugar is one of the main ingredients (it will be listed as one of the first three ingredients on the ingredient panel)

Other foods high in sugar are breakfast cereals – one cup of some types of cereal can contain 30-50% of the daily sugar allowance. Many “health” foods and sugar-free recipes can be misleading – they are referring to the product being ‘sucrose-free’, but sugar derivatives such as rice-malt syrup, agave and maple syrup are still forms of sugars.

For a helpful guide for swaps, top tips, recipes and a sugary drink calculator to estimate your own intake and percentages, see livelighter.com.au

Dr Lisa Surman, CBD West Medical Centre, Perth, WA

Member of Best Practice Software’s Clinical Leadership Advisory Committee

“Often patients spend time talking about current medical and social issues, taking valuable time away from dealing with what they have really come in to discuss. One of our solutions is to direct them to news articles on our website written by a doctor in our Practice that outline current issues and offer strategies to manage the problem and links to relevant, reputable websites”.

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Influenza Update – View from a Doctor’s Desk – Dr Lisa Surman

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Flu shot
In past years there was a push to get your influenza vaccine done as soon as vaccine was available, usually in early March. Research has demonstrated that protection following vaccination starts to wane after three to four months, explaining the strong recommendations from the Australian health departments and the RACGP to have the vaccination closer to the expected ‘influenza season’. It is possible to track the current influenza notification statistics at immunisationcoalition.org.au. It is important to note that many people do not get tested for influenza and some delays may occur in reporting of confirmed influenza cases, but the statistics that are gathered do provide an understanding of influenza activity across Australia. To the start of 23 April, there have been 11,524 confirmed influenza notifications across Australia. Unfortunately, some pharmacies have not followed advice about timing and have been heavily promoting access to the 2018 influenza vaccine since February.  GP surgeries have now all ordered the various influenza vaccine supplies from the Health Department for those entitled to the free vaccine, but supplies have been slow and restricted for most surgeries, causing many people to worry about receiving their vaccine too late, which is not the case (even though the uncertainty about the timing of receiving the supplies is a frustration for both the GP staff and patients). Last year was the worst year on record for cases of influenza, with 248 000 confirmed cases, double the normal hospitalisations, and 1100 influenza-associated deaths. The new strain A(H3) was especially severe for the elderly, with nine out of ten deaths occurring in the over 65 year group. Two ‘super’ vaccines are now available for free to Australians over 65 years of age. These enhanced vaccines have been developed to improve the immunity offered by the vaccine. These vaccines have been available in other countries for many years, but are being introduced in Australia for the first time this year. The influenza viruses circulating change regularly and rapidly. The vaccine helps our immune system catch up with these changes. The current data suggests both influenza A and B strains are circulating at similar levels, including cases of Influenza A (H3N2).  Last year’s seasons in Australia and the United States were dominated by A/H3N2 strains, while B/Yamagata viruses predominated in Asia and a mix occurred in Europe. The A(H3N2) strain cause more severe epidemics affecting the entire population and the A(H1N1) tend to cause disease in children and young adults. The effectiveness of the seasonal vaccine varies from 40 to 70%, but last year provided only 33% overall and was not effective against A(H3N2) Despite the lack of full protection, and the possibility of getting the flu despite a vaccination, the seasonal influenza vaccine is the best way to protect against influenza viruses.  It is free for at-risk groups when supplies are available and otherwise available from GPs and some pharmacies immediately. Data suggests 56% of Australians don’t intend to get the ‘flu’ shot. Higher vaccination rates contribute to a healthy community. The strains contained in the 2018 routine vaccine : : A(H1N1) : A(H3N2) : B:a B/Phuket : B:a B/Brisbane You cannot get flu from the vaccination, but it is possible to have 1-2 days with muscle aches, headaches and occasionally mild fevers as a side-effect to the vaccination. AusVaxSafety is a national program to monitor the type and rate if reactions to each year’s new influenza vaccine in young children. In the 2017 flu season there were no vaccine-attributable serious events recorded. Dr Lisa Surman, CBD West Medical Centre, Perth, WA Member of Best Practice Software’s Clinical Leadership Advisory Committee “Often patients spend time talking about current medical and social issues, taking valuable time away from dealing with what they have really come in to discuss. One of our solutions is to direct them to news articles on our website written by a doctor in our Practice that outline current issues and offer strategies to manage the problem and links to relevant, reputable websites”.
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Bp Launches Connect + Evolve Software Roadshow

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For the first time in Best Practice Software’s history, the Product management team and Bp specialists will be travelling to Brisbane, Sydney and Melbourne to showcase their brand-new software innovation roadshow” Best Practice Connect and Evolve.

To entice Bp users, Best Practice will be offering all successful Practices 1,000 SMS credits, a Bp Sports Bag and most importantly, the chance to help shape the future of Best Practice Software.

Chief Operating Officer Mr Craig Hodges says he is excited for the roadshow to commence in the coming weeks.

Connect + Evolve (C+E) will feature an exciting design-led user think tank and software innovation roadshow, where our product experts will be engaging face-to-face with real users of Bp software products to gauge their thoughts, opinions, feedback (good and bad), and ideas for our products in their life. It is a fantastic opportunity for users to help guide the future direction of our software products,

We’ve publicly invited healthcare industry experts knowledgeable in using Best Practice products – including Practice Managers, General Practitioners, Nurses, Specialists and Allied Health professionals. Though we’ve launched the roadshow event in Australia, it’s our hope that we’ll embed C+E into our product design and development culture, and of course take the concept to our New Zealand market in the future. Mr Hodges said.

Bp advises users to secure their spot early in this fantastic opportunity to influence Bp’s product direction and software functionality enhancements into the future, as registrations are limited to 50 attendees per city.

Click here to register your interest today or for further information please phone the team on 1300 40 1111.

Roadshow dates: Brisbane: Tuesday, 1st May | Sydney: Thursday, 3rd May | Melbourne: Friday, 11th May

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View from a Doctor’s Desk – Dr Lisa Surman

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Coffee and Cancer? Keep Drinking Your Daily Coffee but Not Too Hot

A Californian judge has ruled that coffee companies must put a cancer warning on coffee products because acrylamide, chemical produced in the roasting process is a carcinogen under California law. Companies, including Starbucks, failed to show that the risk posed by acrylamide in coffee was insignificant. (Of interest, no warning is required on calorie-dense, nutrient poor fast foods and drinks which are linked to obesity. Obesity has convincing evidence linked to increased risk of cancer of the oesophagus, pancreas, bowel, breast, endometrium and kidney and probable evidence of links to gall bladder cancer and many metabolic and cardiovascular consequences).

No new study or evidence has been published or produced regarding the cancer risk of coffee.

Acrylamide is formed when certain foods, particularly plant-based foods that are rich in carbohydrates and low in protein, are cooked at high temperatures such as frying, roasting or baking, the major foods contributing to exposure are potato chips and crisps, cereal-based products such as biscuits and pastries and coffee.

Food Standards Australia does advise that we reduce our exposure to acrylamide. There is no direct evidence that it causes cancer in humans, but evidence that it can cause cancer in Laboratory animals. International food regulators are working to reduce acrylamide levels with new farming and processing techniques such as lower cooking temperatures, enzymes to reduce formation and raw materials with lower reducing sugar levels. Reducing acrylamide in some products such as coffee is difficult without changing the taste. The amount of acrylamide varies dramatically in the same foods depending on several factors including cooking temperature and time. This is the reason the Joint WHO Committee on Food Additives (JECFA) experts do not issue recommendations on how much of any specific food containing the substance is safe to consume. For further information on strategies to reduce exposure see foodstandards.gov.au or who.int food safety/acrylamide.

The International Agency for Research on Cancer (IARC) announced in 2016 that there is no conclusive evidence to show coffee increases cancer risk (reversing a 1991 conclusion when the carcinogenicity of coffee was first tested, classifying the drink then as being possibly carcinogenic to humans) after reviewing over 1000 human and animal studies. Concluding that it is unlikely that coffee has any substantial effect on the risk of developing cancers of the pancreas, bladder, prostate or breast and suggesting a protective effect against the development of liver and endometrial cancers.

Drinking coffee (moderate amounts have been defined as drinking three to four cups per day) outside pregnancy, is more likely to benefit our health rather than harm, according to the results published in the BMJ of a study undertaken by the University of Southampton in 2017. The research involved a meta-analysis of observational and interventional studies examining the associations between coffee consumption and any health outcome in any adult population in all countries and all settings. Drinking coffee beyond the amounts given was not associated with harm, but the benefits were less pronounced.

Coffee is one of the most consumed beverages worldwide. Roasted coffee is a complex mix of over 1000 bioactive compounds, some with potential antioxidant, anti-inflammatory, anti-fibrinolytic or anticancer effects, The key active ingredients include caffeine, chlorogenic acids, the diterpenes, cafestol and kahweol. The existing research has involved the associations between coffee as an exposure and a range of outcomes including all-cause mortality, cancer and diseases of the metabolic, cardiovascular, neurologic, musculoskeletal, gastrointestinal and liver systems and pregnancy.

Consumption of coffee was associated with a lower risk of specific cancers including prostate, endometrial, melanoma, non-melanoma skin cancer and liver cancer.

Coffee consumption also had beneficial associations with metabolic conditions such as type 2 diabetes, gout, gallstones, metabolic syndrome, hepatic fibrosis and cirrhosis and chronic liver disease. There also appeared to be a beneficial association between coffee consumption and Parkinson’s disease, depression and Alzheimer’s disease.

Overall, there was no consistent evidence of harmful associations between coffee drinking and health outcomes except in pregnancy, where high caffeine intake was associated with low birth weight, preterm birth and pregnancy loss. Pregnancy recommendations are to limit caffeine intake to under 200 mg per day (one mug of filter coffee is 140mg, one mug of instant coffee 100mg, one mug of tea provides 75mg, one can of cola 40mg) . There was also a small increase in risk of fracture in women, but there was some discrepancy in the evidence suggesting further research is needed.

Decaffeinated coffee is compositionally similar to caffeinated coffee. The review found consuming decaffeinated coffee provided the cardiovascular, reduction in risk of type 2 diabetes, reduced lung cancer risk and endometrial cancer. There were no harmful associations between decaffeinated coffee and any health outcome.

There is evidence that cancer can be initiated by constant irritation of body surfaces (like skin and the lining of the mouth and oesophagus) Extremely hot water can provide this irritation (drinking beverages above 65 degrees). A recent evidence review by IARC concluded that drinking hot beverages above 65 degrees C probably causes oesophageal cancer in humans, but the relative contribution on oesophageal cancer rates requires further research.

Dr Lisa Surman, CBD West Medical Centre, Perth, WA

Member of Best Practice Software’s Clinical Leadership Advisory Committee

Often patients spend time talking about current medical and social issues, taking valuable time away from dealing with what they have really come in to discuss. One of our solutions is to direct them to news articles on our website written by a doctor in our Practice that outline current issues and offer strategies to manage the problem and links to relevant, reputable websites.

BMJ article BMJ 2017:359:j5024.

cancerwa.asn.au re cancer myth:coffee,tea,hot beverages and cancer,

 

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Tips for a Mindful and Healthier Easter – View from a Doctor’s Desk – Dr Lisa Surman

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Easter has traditionally been a time for family gatherings and abundant food, particularly high fat and high sugar offerings such as hot cross buns and Easter eggs. The abundance of food related advertisements encourage us to believe that Easter is about eating as much as possible, particularly chocolate.

Mindfulness is about being fully conscious in the moment without making judgement; and being aware of what you are eating. A start may be about being aware of portion sizes, deciding to eat a treat and indulging away from the distractions of screens, books or talking.

Look at the food and enjoy the texture, smell and taste, the muscles used to raise the food to your mouth, the texture and taste as you chew slowly. Don’t grab and eat, try to sit down and enjoy the seasonal treats. The studies show this to be a way of feeling more satisfied with the portion you have eaten, reducing the chance of over-eating and increasing enjoyment in a guilt-free way.

Plan some non-chocolate Easter treats such as an outing to the pool, the park or a bike ride.

Be aware of controlled portion sizes – try to avoid planning to “eat all you want” and avoid planning to “eat no chocolate”. Don’t skip nutritious meals for chocolate. Try fruit dipped in chocolate, chocolate drizzled popcorn or roast nuts, banana muffins with chocolate chips and hot chocolate drinks to make a little chocolate go a long way.

Dark chocolate can provide small health benefits as cocoa is rich in antioxidants. The darker the chocolate the higher the percentage cocoa and potential benefit. Unfortunately, large amounts of chocolate contain large amounts of fats, sugar and calories. Chocolate also contains small amounts of essential nutrients such as protein, vitamin E, calcium, phosphorus, magnesium, iron and copper.

Start Easter morning with a healthy and filling breakfast, swapping chocolate eggs for poached, boiled or scrambled eggs to provide low-fat protein to reduce craving;s and add in some vegetables such as tomatoes and mushrooms on wholegrain toast . LiveLighter, a programme developed in Western Australia to encourage healthier lifestyles is highlighting the benefits of eggs and features several recipes to try out and enjoy across the weekend.

Balance any extra intake with active fun and play. Some examples of walking equivalents are 6 mini Cadbury eggs (19g) requires an average woman to walk for 19 minutes and an average man 17 minutes. A Lindt gold bunny (100g) requires 112 minutes for a woman and 99 minutes for a man.

The LiveLighter website and recipes gives some examples of meal equivalents with their recipe guide for a 100g bunny the same number of kilojoules are contained in:

– a LiveLighter Steak sandwich with caramelised onions

– a healthy quick chicken pizza

– one serve of LiveLonger’s spaghetti Bolognaise

– 2 egg omelette with a slice of toast

– 2 cheese and salad sandwiches

Wishing you a happy ” and healthy ” Easter!

Dr Lisa Surman, CBD West Medical Centre, Perth, WA

Member of Best Practice Software’s Clinical Leadership Advisory Committee

Often patients spend time talking about current medical and social issues, taking valuable time away from dealing with what they have really come in to discuss. One of our solutions is to direct them to news articles on our website written by a doctor in our Practice that outline current issues and offer strategies to manage the problem and links to relevant, reputable websites.

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