Reducing Antibiotic Use In Primary Care: A Cluster Randomised Trial To Evaluate The Effectiveness Of Decision Aids About Antibiotic Use For Acute Respiratory Infections
Funder
National Health and Medical Research Council
Funding Amount
$325,500.00
Summary
Antibiotic resistance is a worldwide crisis. It means antibiotics no longer work. Reducing their use is critical. Acute respiratory infections (eg ear infections, sore throats, cough) are a target for reducing use as they are the most common reason that general practitioners (GPs) prescribe antibiotics, despite being usually not needed. This trial will test if decision aids reduce antibiotic use, by helping GPs and patients to discuss their benefits and harms and jointly decide about their use.
The Centre For Research Excellence In Minimising Antibiotic Resistance For Acute Respiratory Infections [CREMARA]
Funder
National Health and Medical Research Council
Funding Amount
$2,455,000.00
Summary
Antibiotic resistance is threat to international health. Most antibiotics are prescribed for acute respiratory infections. The Centre for Research Excellence in Minimising Antibiotic Resistance for Acute Respiratory Infections focuses on the major contributors to resistance: antibiotic overuse and person-to-person transfer of antibiotic resistance genes. Research will inform the design, evaluation and translation of urgently needed interventions, aimed at clinicians, patients and policy-makers.
A Randomised Placebo-controlled Trial Of Antibiotics To Prevent Urinary Tract Infection In Children
Funder
National Health and Medical Research Council
Funding Amount
$735,000.00
Summary
This study is needed to determine whether a common clinical practice long-term antibiotic treatment for children following urinary tract infection (UTI) - is safe and effective in preventing further UTI and if so, whether all appropriate children are being treated. UTI will affect about 10% of Australian children by high school age (88,000 children per year). Because UTI may damage the kidneys, the management priority for children with UTI has been prevention of further infection. Currently this ....This study is needed to determine whether a common clinical practice long-term antibiotic treatment for children following urinary tract infection (UTI) - is safe and effective in preventing further UTI and if so, whether all appropriate children are being treated. UTI will affect about 10% of Australian children by high school age (88,000 children per year). Because UTI may damage the kidneys, the management priority for children with UTI has been prevention of further infection. Currently this means the identification of children thought to be most at risk of recurrent UTI by renal tract imaging. Those found to have reflux of urine from the bladder to the kidney (present in about 30% of those with UTI) are then placed on antibiotics fro 2-5 years. Unfortunately there has never been a properly designed trial to test whether antibiotics do really prevent UTI and if so, whether children with reflux are the appropriate and only group requiring treatment. Long term antibiotics may in fact do more harm than good because of side effects like skin, bowel and blood problems and because resistant bacteria may develop. The design of this study involves the random allocation of placebo or antibiotic (cotrimoxazole, the usual antibiotic given in this case) to about 800 children after their first symptomatic UTI. These children are treated and followed for one year to determine the rate of futher UTI in both groups. Any difference in outcome between the two groups of children will be because of the antibiotic treatment. This study may prove long-term antibiotics are ineffective and therefore should not be routinely used. In this case investigation of children to detect vesicoureteric reflux would serve little purpose and should be abandoned. Alternatively antibiotic treatment may be shown as effective treatment for preventing further UTI and in this case the study will clearly identify those children who will benefit.Read moreRead less
Testing, Translation And Uptake Of Evidence In General Practice: A Systems Approach To Rapid Translation
Funder
National Health and Medical Research Council
Funding Amount
$2,411,050.00
Summary
Testing, Translation & Uptake of Evidence in General Practice: A systems approach. Though General Practice is the frontline of Australia’s health system, new research findings are often ignored by busy GPs, resulting in suboptimal care. We plan to improve this by: A. A network of influential GPs practices to test new research, B. Practice support units who provide GP and patient summaries of new research, C. Active transfer of successful new practices via social media, guidelines, and courses.
The number of Australians with dementia is increasing and so therefore is the frequency of people with dementia presenting to general practice. There is a recent evidence based clinical practice guideline to inform the diagnosis and management of people with dementia and the support of their carers. Many of the recommendations from this guideline are relevant to Australian general practitioners. Strategies to implement guidelines into practice are needed in all areas of health care, but changing ....The number of Australians with dementia is increasing and so therefore is the frequency of people with dementia presenting to general practice. There is a recent evidence based clinical practice guideline to inform the diagnosis and management of people with dementia and the support of their carers. Many of the recommendations from this guideline are relevant to Australian general practitioners. Strategies to implement guidelines into practice are needed in all areas of health care, but changing clinical practice is complex and a body of research developing methods of identifying barriers to specific practice changes is emerging. This project aims to support GPs in improving the general practice based care of people with dementia, and so improve their quality of life. In addition we aim to contribute to the body of knowledge about how to bring about practice change and implement a clinical practice guideline. We plan to design a strategy for implementing this new guideline into practice, working with GPs to change their practice where needed. We will test the effect of this strategy on the care of people with dementia, on their quality of life and on that of their carers.Read moreRead less
Increasing Value, Reducing Waste From Incomplete Or Unusable Reports Of Medical Research
Funder
National Health and Medical Research Council
Funding Amount
$788,486.00
Summary
We estimated that the avoidable waste in research - from design flaws, non-publication, and inadequate reporting - results in over $85 Billion annual loss. I will research innovations to reduce this waste. My focus is particularly on non-drug interventions - exercises, dietary changes, self-monitoring, e-health applications – which are often effective but more difficult to use in clinical practice, and being compiled in my recently founded Handbook of Non-Drug Interventions (see RACGP website).
SEA-URCHIN: South East Asia - Using Research For Change In Hospital-acquired Infection In Neonates
Funder
National Health and Medical Research Council
Funding Amount
$2,303,773.00
Summary
Each year, more than one million babies die from infection before they reach one month of age. Proven and inexpensive practices to prevent and treat infection exist but they are not always followed (eg hand washing). This research will evaluate the impact of tailored implementation strategies on rates of infection and death in the neonatal units of nine hospitals in four counties in South East Asia. Staff from these units will work with Australian partners to devise, implement and evaluate diffe ....Each year, more than one million babies die from infection before they reach one month of age. Proven and inexpensive practices to prevent and treat infection exist but they are not always followed (eg hand washing). This research will evaluate the impact of tailored implementation strategies on rates of infection and death in the neonatal units of nine hospitals in four counties in South East Asia. Staff from these units will work with Australian partners to devise, implement and evaluate different strategies.Read moreRead less
The Impact Of Evidence Based Guidelines And Standardisation Of Clinical Practice Upon Patient Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$32,003.00
Summary
Over the last decade there has been a significant move toward evidence based clinical care and clinical guidelines in medical care. Despite this movement there are numerous clinical situations where evidence for any treatment is scant and where large gaps between the evidence and current practice exist. My research seeks to explore the barriers that exist in the health system that impede the uptake of evidence into practice and methods to improve patient outcomes where the evidence is poor.