Publications by authors named "Shane Anthony"

6 Publications

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Person-centred care in osteoarthritis and inflammatory arthritis: a scoping review of people's needs outside of healthcare.

BMC Musculoskelet Disord 2021 Apr 9;22(1):341. Epub 2021 Apr 9.

Department of Epidemiology and Preventative Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia.

Background: Arthritis, regardless of cause, has significant physical, social and psychological impacts on patients. We aimed to identify the non-healthcare needs perceived by patients with inflammatory arthritis (IA) and osteoarthritis (OA), and to determine if these differ.

Methods: We electronically searched MEDLINE, PsycINFO, EMBASE and CINAHL (1990-2020) systematically to identify non-healthcare-related needs of people with IA or OA. All citations were screened and quality appraised by two reviewers. Data was extracted by a single reviewer.

Results: The search identified 7853 citations, with 31 studies included (12 for OA, 20 for IA). Six areas of need emerged and these were similar in both group These were: 1) Assistance with activities of daily living especially related to a lack of independence; 2) Social connectedness: need for social participation; 3) Financial security: worry about financial security and increased costs of health-seeking behaviours; 4) Occupational needs: desire to continue work for financial and social reasons, facilitated by flexibility of workplace conditions/environment; 5) Exercise and leisure: including limitation due to pain; 6) Transportation: limitations in ability to drive and take public transport due to mobility concerns. Many areas of need were linked; e.g. loss of employment and requiring support from family was associated with a sense of "failure" and loss of identity, as social isolation.

Conclusions: This review highlights the pervasive impact of arthritis on peoples' lives, regardless of aetiology, albeit with a limited evidence base. Improved identification and targeting of non-healthcare needs of people with arthritis is likely to improve person-centred care.
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http://dx.doi.org/10.1186/s12891-021-04190-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8035722PMC
April 2021

Duration of dexamethasone administration for the prevention of chemotherapy-induced nausea and vomiting - A systematic review and meta-analysis.

Crit Rev Oncol Hematol 2020 Aug 2;152:103012. Epub 2020 Jun 2.

Monash Health, Victoria, Australia; Monash University, Victoria, Australia.

Background: Chemotherapy-induced nausea and vomiting (CINV) is the most common non-haematological toxicity of chemotherapy.

Methods: A systematic review and meta-analysis comparing short course (1-2 days) with long course (3+ days) dexamethasone in preventing CINV was performed in accordance with the PRISMA statement.

Results: 1535 articles were screened to identify the 11 studies included in the review. Nine studies of 1892 patients were included in meta-analysis. There was no significant difference in complete response of nausea and vomiting between a short or long course of dexamethasone (RR 0.98, 95 % CI 0.89-1.07, p = 0.58). There was a lower risk of adverse events with a short course of dexamethasone (RR 0.80, 95 % CI 0.64-0.99, p = 0.04).

Conclusion: There was no significant difference between a short or long course of dexamethasone in preventing nausea or vomiting, but a short course was associated with fewer adverse effects. PROSPERO protocol: CRD42019133785.
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http://dx.doi.org/10.1016/j.critrevonc.2020.103012DOI Listing
August 2020

Higher Mucosal Healing with Tumor Necrosis Factor Inhibitors in Combination with Thiopurines Compared to Methotrexate in Crohn's Disease.

Dig Dis Sci 2019 06 17;64(6):1622-1631. Epub 2018 Dec 17.

Department of Gastroenterology and Hepatology, Eastern Health, Box Hill Hospital, Level 2, 5 Arnold Street, Box Hill, VIC, 3128, Australia.

Background: The differential impact of anti-tumor necrosis factor (anti-TNF) therapy with methotrexate versus thiopurine co-therapy on endoscopic remission remains uncertain.

Aims: To compare rates of endoscopic remission based on methotrexate or thiopurine co-therapy used with anti-TNF therapy in Crohn's disease.

Methods: A retrospective observational study at two tertiary centers between 2010 and 2016 compared endoscopic remission rates and persistence on anti-TNF therapy in combination with methotrexate versus thiopurines for at least 3 months.

Results: Of 412 patients on anti-TNF therapy, 278 (67%) received immunomodulator co-therapy for ≥ 3 months and 269 (65%) had complete data for analysis. Methotrexate was used in 77 (29%) and thiopurines in 192 (71%) patients plus either infliximab (156, 58%) or adalimumab (113, 42%), with median follow-up of 2.8 years. The methotrexate group had greater prior immunomodulator intolerance (62% vs 20%, p < 0.01). Endoscopic remission rates were higher in those treated with thiopurine compared to methotrexate co-therapy at 12 m (58% vs 17%, p < 0.01) and at last review (59% vs 40%, p = 0.03). Endoscopic remission rates were higher with thiopurines than methotrexate when combined with adalimumab (49% vs 6%, p < 0.01) but not with infliximab (65% vs 54%, p = 0.09). In multivariate analysis, thiopurine co-therapy, elevated baseline CRP, and therapeutic anti-TNF drug levels were each associated with longer persistence of co-therapy (each p < 0.05). There were no significant differences in adverse events, malignancy or infection rates.

Conclusion: In this cohort, anti-TNF and thiopurine co-therapy resulted in higher rates of mucosal healing than methotrexate, the difference is most pronounced with adalimumab and conversely with low-dose methotrexate.
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http://dx.doi.org/10.1007/s10620-018-5422-8DOI Listing
June 2019

People with low back pain perceive needs for non-biomedical services in workplace, financial, social and household domains: a systematic review.

J Physiother 2018 04 21;64(2):74-83. Epub 2018 Mar 21.

Department of Epidemiology and Preventative Medicine, School of Public Health and Preventative Medicine, Monash University, Melbourne.

Question: What needs of non-biomedical services are perceived by people with low back pain?

Design: Systematic review of qualitative and quantitative studies examining perceived needs of non-biomedical services for low back pain, identified through searching of MEDLINE, EMBASE, CINAHL and PsycINFO (1990 to 2016).

Participants: Adults with low back pain of any duration.

Data Extraction And Analysis: Descriptive data regarding study design and methodology were extracted. The preferences, expectations and satisfaction with non-biomedical services reported by people with low back pain were identified and categorised within areas of perceived need.

Results: Twenty studies (19 qualitative and one quantitative) involving 522 unique participants (total pool of 590) were included in this systematic review. Four areas emerged. Workplace: people with low back pain experience pressure to return to work despite difficulties with the demands of their occupation. They want their employers to be informed about low back pain and they desire workplace accommodations. Financial: people with low back pain want financial support, but have concerns about the inefficiencies of compensation systems and the stigma associated with financial remuneration. Social: people with low back pain report feeling disconnected from social networks and want back-specific social support. Household: people with low back pain report difficulties with household duties; however, there are few data regarding their need for auxiliary devices and domestic help.

Conclusion: People with low back pain identified work place, financial and social pressures, and difficulties with household duties as areas of need beyond their healthcare requirements that affect their ability to comply with management of their condition. Consideration of such needs may inform physiotherapists, the wider health system, social networks and the workplace to provide more relevant and effective services. [Chou L, Cicuttini FM, Urquhart DM, Anthony SN, Sullivan K, Seneviwickrama M, Briggs AM, Wluka AE (2018) People with low back pain perceive needs for non-biomedical services in workplace, financial, social and household domains: a systematic review. Journal of Physiotherapy 64: 74-83].
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http://dx.doi.org/10.1016/j.jphys.2018.02.011DOI Listing
April 2018

Antiemetic treatment in the emergency department: Patient opinions and expectations.

Emerg Med Australas 2018 Feb 23;30(1):36-41. Epub 2017 Sep 23.

Royal Melbourne Hospital, Melbourne, Victoria, Australia.

Objective: To determine patient expectations of antiemetic treatment in the ED.

Methods: Survey of adult ED patients with nausea.

Primary Outcome: expectation of antiemetic treatment as symptoms being 'totally gone', 'a lot less', 'a little less' and 'the same'.

Secondary Outcomes: comparison between expectations and symptom change when expectations were met; general views on indications for treatment, treatment satisfaction and reasons for additional medication use.

Results: Of 176 surveyed, treatment expectation was recorded by 165 (94%). These were: 'totally gone', 'a lot less' or 'a little less' for 60 (36%), 84 (51%) and 21 (13%), respectively. This pre-treatment nomination, was matched or exceeded by the reported level of symptom reduction at 30 min, for 43/87 (49%, 95% CI: 39-60) whose expectations were met, and 6/33 (18%, 95% CI: 7-35) whose were not. The majority (117/176, 66%) believed treatment should be reserved for moderate or severe nausea; 158/176 (90%) would accept treatment if offered; 130/165 (79%) expected a treatment effect by 30 min. Treatment satisfaction findings were similar to expectations being met. Further drug treatment at 30 min was desired by 29/120 (24%) who received an antiemetic drug. Most were improved, but believed additional drugs might help more. Of the 91 not wanting more treatment, most were improved and thought no more drugs were necessary.

Conclusion: Most patients expected antiemetic treatment to make symptoms at least 'a lot less'. Most also believe treatment should be reserved for moderate or severe nausea, and should take effect by 30 min.
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http://dx.doi.org/10.1111/1742-6723.12861DOI Listing
February 2018

Is low-dose amitriptyline effective in the management of chronic low back pain? Study protocol for a randomised controlled trial.

Trials 2016 10 22;17(1):514. Epub 2016 Oct 22.

Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC, 3004, Australia.

Background: Low back pain is a major clinical and public health problem, with limited evidence-based treatments. Low-dose antidepressants are commonly used to treat pain in chronic low back pain. However, their efficacy is unproven. The aim of this pragmatic, double-blind, randomised, placebo-controlled trial is to determine whether low-dose amitriptyline (an antidepressant) is more effective than placebo in reducing pain in individuals with chronic low back pain.

Methods/design: One hundred and fifty individuals with chronic low back pain will be recruited through hospital and private medical and allied health clinics, advertising in local media and posting of flyers in community locations. They will be randomly allocated to receive either low-dose amitriptyline (25 mg) or an active placebo (benztropine mesylate, 1 mg) for 6 months. The primary outcome measure of pain intensity will be assessed at baseline, 3 and 6 months using validated questionnaires. Secondary measures of self-reported low back disability, work absence and hindrance in the performance of paid/unpaid work will also be examined. Intention-to-treat analyses will be performed.

Discussion: This pragmatic, double-blind, randomised, placebo-controlled trial will provide evidence regarding the effectiveness of low-dose antidepressants compared with placebo in reducing pain, disability, work absenteeism and hindrance in work performance in individuals with chronic low back pain. This trial has major public health and clinical importance as it has the potential to provide an effective approach to the management of chronic low back pain.

Trial Registration: Australian New Zealand Clinical Trials Registry: ACTRN12612000131853 ; registered on 30 January 2012.
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http://dx.doi.org/10.1186/s13063-016-1637-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5075416PMC
October 2016