Biomedical subjects

Matthew J Leach

Publications and source records attributed to Matthew J Leach.

8 recordsLinked to original sources

PubMed2006

Evidence-based practice: a framework for clinical practice and research design.

The evidence-based practice (EBP) framework emerged in the early 1970s as a means of improving clinical practice. This shift towards EBP allowed health professionals to move from a culture of delivering care based on tradition, intuition and authority, to a situation where decisions were guided and justified by the best available evidence. Despite the many advantages of EBP, many practitioners remain cautious about embracing the model. Part of this opposition is due to a misunderstanding of EBP, which this paper aims to address.

Evidence-Based Medicine↗

PubMed2006

Using horsechestnut seed extract in the treatment of venous leg ulcers: a cost-benefit analysis.

Venous leg ulcers affect approximately 0.6% of the western population, consuming millions of healthcare dollars every year. To determine whether an alternative venous ulcer treatment using horsechestnut seed extract-- Aesculus hippocastanum-- and conventional therapy involving dressings and compression was more cost-effective than using conventional therapy alone, a 12-week cost-benefit analysis of horsechestnut seed extract therapy was conducted. The study, using data from a 12-week prospective, randomized, placebo-controlled trial conducted in South Australia in 2002-2004, involved 54 patients with venous ulceration who received treatment through a large South Australian district nursing service. Taking into account the cost of horsechestnut seed extract, dressing materials, travel, staff salaries, and infrastructure for each patient, horsechestnut seed extract therapy combined with conventional therapy was found to be more cost-effective than conventional therapy alone with an average savings of AUD 95 in organizational costs and AUD 10 in dressing materials per patient. This study confirms that dressing change frequency has a significant impact on the total cost of wound care and suggests that district nursing service operation efficiency may be enhanced through the use of horsechestnut seed extract as a result of less frequent nursing visits. Further study of this treatment modality is warranted.

Aesculus↗

PubMed2006

Wound management: using Levine's conservation model to guide practice.

Effective wound management is needed not only to generate positive patient outcomes, but also to reduce healthcare expenditure and demand on healthcare services. Implementing Levine's four-principled conservation model--which addresses conservation of energy, structural integrity, personal integrity, and social integrity--can provide clinical and financial benefits, as illustrated in the care of venous leg ulceration. Using Levine's model as a theoretical framework for wound management also can contribute to good nursing practices, enhancing a care approach that embraces wholeness and health along with cost effective care. Understanding how Levine's model can improve patient care is further elucidated by discussing each of the principles in relation to wound management.

Activities of Daily Living↗

PubMed2005

Rapport: a key to treatment success.

The therapeutic relationship is a concept often ignored in current literature. As such, the importance of good patient rapport may be overlooked. To address these concerns, the following paper highlights the effects that strong therapeutic relationships may have on patient satisfaction, treatment compliance and client outcomes. Strategies that practitioners can employ to facilitate the development of good patient rapport are also discussed.

Adult↗

PubMed2004

The clinical feasibility of natural medicine, venotonic therapy and horsechestnut seed extract in the treatment of venous leg ulceration: a descriptive survey.

BACKGROUND: The primary treatment of choice for venous leg ulceration (VLU) is compression therapy; however, serious clinical issues demand the development of new treatments. An extract believed to promote VLU healing is Horsechestnut Seed Extract (HCSE). METHODS: The clinical feasibility of HCSE in VLU was explored in a two-stage design. The second stage presented here, was a descriptive survey exploring current opinion and utilisation of natural therapies, venotonics and HCSE in VLU. A questionnaire mailed to 122 district nurses, 73 medical practitioners (MPs) and 53 clients with VLU resulted in a response rate of 32, 31.5 and 81 per cent, respectively. RESULTS: Natural therapy and HCSE use for VLU was minimal in all groups. Half of all groups supported venotonics, with a similar proportion of nurses and clients utilising venotonics in practice. MPs were however less likely to utilise venotonics for VLU. CONCLUSION: Whilst clinicians indicate that clinical evidence may influence the utilisation of HCSE in clinical practice, the evidence currently does not exist. Positive findings from well-designed trials may ameliorate the integration of natural medicine into mainstream practice.

Adult↗

PubMed2004

Public, nurse and medical practitioner attitude and practice of natural medicine.

In the past 20 years, the popularity of natural medicine has increased, with nurses and medical practitioners being amongst several groups of clinicians expressing a widespread interest in natural therapies. It is argued that the degree of natural therapy use and the attitudes of these practitioners toward natural medicine may not only influence patient exposure to these therapies, but also have some bearing on the future use of natural medicine. Hence, in a critical review of recent studies, the utilisation of natural therapies and the attitudes of nurses, medical practitioners and the public toward natural medicine are explored.

Adolescent↗

PubMed2004

A critical review of natural therapies in wound management.

The use of natural medicine by both the general population and the nursing profession is increasing. Also referred to as unconventional, alternative, and complementary, these therapies often are derived from natural sources and facilitate improvements in health and well being by supporting innate healing processes of the body. Although the application of natural therapies in wound management is still in its infancy, several--honey, larval therapy, aromatherapy, herbal medicine, homeopathy, nutrition, and mind-body-spirit techniques--are demonstrating potential benefit in the management of acute and chronic wounds. Existing evidence of safety and effectiveness is predominantly based on the results of in vivo studies; confirmation from well-designed clinical trials is deficient. Consequently, clinical research is needed to examine these therapies to address the escalating incidence of chronic wounds in a climate of increasing healthcare costs.

Complementary Therapies↗

PubMed2003

Barriers to conducting randomised controlled trials: lessons learnt from the Horsechestnut & Venous Leg Ulcer Trial (HAVLUT).

The RCT is considered the gold standard for testing a therapeutic intervention. However, the conduct of an RCT is not without numerous obstacles. As illustrated through the recent Horsechestnut and Venous Leg Ulcer Trial (HAVLUT), these barriers can be attributed to randomisation, recruitment, retention, blinding and sampling procedures, and to gate keeping. These obstacles, together with strategies to prevent and overcome them, are detailed throughout this article, and are aimed at ameliorating the future design and conduct of RCTs.

Aesculus↗