Increasing The Use Of Long-acting Reversible Contraception: The Australian Contraceptive ChOice PRoject (ACCORd)
Funder
National Health and Medical Research Council
Funding Amount
$726,144.00
Summary
Of all reversible contraceptive methods, long-acting reversible contraceptives (LARCs), such as intrauterine devices and hormone implants, are by far the most highly effective at preventing pregnancy. However, the prescription and use of LARCs amongst Australian women who are at risk of pregnancy is very low. To increase the uptake of LARCs, our study will trial a complex intervention that involves providing counselling to women and developing rapid referral pathways to LARC insertion.
A Longitudinal Study To Determine Aetiology Of The Condition Known As Breast Thrush In Lactating Women
Funder
National Health and Medical Research Council
Funding Amount
$775,147.00
Summary
This project looks at 2 common breast problems in breastfeeding women: breast thrush and mastitis (bacterial infection). Some health professionals believe breast thrush is caused by Candida albicans (thrush) while others believe it is caused by the bacteria Staphylococcus aureus (golden staph). This study will follow a group of women to determine if S. aureus or C. albicans is the cause of breast thrush and to describe the transmission of these organisms between mother and baby .
A Perntership Intervention Trial To Redress TreatmentDelay And Improve Outcomes In Rural Cancer Patients
Funder
National Health and Medical Research Council
Funding Amount
$1,258,784.00
Summary
Improving the poor outcomes in Australian cancer patients living in rural and remote areas is a national priority, but there is as yet insufficient evidence on how the problem is best tackled. In this project, partner organisations that deliver cancer services in non-metropolitan WA will team with experienced researchers to develop a ‘best prospects’ package of interventions targeting the community, medical and other health practitioners and patients with cancer; and to evaluate the effectivenes ....Improving the poor outcomes in Australian cancer patients living in rural and remote areas is a national priority, but there is as yet insufficient evidence on how the problem is best tackled. In this project, partner organisations that deliver cancer services in non-metropolitan WA will team with experienced researchers to develop a ‘best prospects’ package of interventions targeting the community, medical and other health practitioners and patients with cancer; and to evaluate the effectiveness of the package using a scientifically valid randomised controlled trial.Read moreRead less
A Cluster Randomised Controlled Trial Of Nurse And General Practitioner Partnership For Care Of COPD
Funder
National Health and Medical Research Council
Funding Amount
$449,377.00
Summary
Chronic Obstructive Pulmonary Disease (COPD) is a chronic disease that can progress to severe disability and use of hospital services. It is an important cause of both death and disability in Australia. Specifically it is the third leading cause of disease burden after heart disease and stroke. Smoking is the most important cause of the disease and there is strong evidence that smoking cessation will largely prevent progression of COPD. National evidence based guidelines for management of COPD w ....Chronic Obstructive Pulmonary Disease (COPD) is a chronic disease that can progress to severe disability and use of hospital services. It is an important cause of both death and disability in Australia. Specifically it is the third leading cause of disease burden after heart disease and stroke. Smoking is the most important cause of the disease and there is strong evidence that smoking cessation will largely prevent progression of COPD. National evidence based guidelines for management of COPD were published in 2003 but these need to be implemented in the community. General practice is well placed to have a key role in early intervention and evidence based management of COPD. There is evidence that specialised nurses working in collaboration with GPs can improve the care the chronic illnesses including COPD. Care Plans with input from health professionals from a range of disciplines have been recommended for COPD but there are barriers to implementing these in general practice. This project brings together nurse assistance and care planning in a model of care designed to deliver best practice management of COPD in the community. The aim of this research is to evaluate the impact of anurse and GP partnership for care of COPD. We will examine the effect on quality of care and health outcomes at 6 and 12 months follow up. Our hypothesis is that the use of a nurse to work as a team with the patient and GP to develop and implement a care plan based on clinical practice guidelines will improve the quality of care received and have a beneficial effect on the patients' respiratory and overall health. This research will be of major significance for improving COPD care in the community and will have far reaching implications for both policy and practice. It will also define a new role for nurses and GPs working in partnership.Read moreRead less
A Randomised Controlled Trial Of Evidence Based Medicine In The Management Of Hypertension
Funder
National Health and Medical Research Council
Funding Amount
$319,475.00
Summary
Hypertension is a major condition managed in general practice. The condition is under diagnosed and under treated. Where hypertension is treated, it is often with drugs that are expensive rather than with equally efficacious inexpensive drugs. Hypertension is associated with higher risk of stroke, coronary artery disease, cardiac failure, renal disease and peripheral vascular disease. Clear evidence-based information has been available for some years that provide reasonably guidelines to practit ....Hypertension is a major condition managed in general practice. The condition is under diagnosed and under treated. Where hypertension is treated, it is often with drugs that are expensive rather than with equally efficacious inexpensive drugs. Hypertension is associated with higher risk of stroke, coronary artery disease, cardiac failure, renal disease and peripheral vascular disease. Clear evidence-based information has been available for some years that provide reasonably guidelines to practitioners of the treatment thresholds for hypertension. However, the incorporation of this evidence into general practice has been slow. This project will build upon extensive pilot work to create a system to collect diagnostic, treatment and outcome data from general practice patients. The use of peer-compared feedback, particularly related to a readily understandable health outcome measure such as blood pressure, can change clinical behaviour when provided to the treating clinician. The aim of this project is to show whether or not training in the use of an evidence-based guideline to assist doctors in the decision of whether or not to initiate antihypertensive treatment, and to provide guidance on the type of treatment, leads to better outcomes than that of feedback alone. A cost-benefit analysis will clarify the impact of guideline implementation on health care costs. The incorporation into the cost-benefit analysis of patients perceptions of treatment by doctors using a guideline will show how such practice, compared with standard care, is valued by patients. While the project will focus on hypertension, the database members will continue to develop the research capability of the database, and expand it to incorporate a range of evidence-based information to improve the quality of care for other conditions. The database could achieve an expanding and sustainable influence on the quality of primary health care.Read moreRead less
Women's Evaluation Of A Randomised Controlled Trial For Abuse And Violence In General Practice
Funder
National Health and Medical Research Council
Funding Amount
$679,718.00
Summary
Domestic violence or intimate partner abuse (physical, emotional or sexual) is a common hidden problem for women attending general practice. It has major emotional and physical consequences for abused women of child bearing age and as a result they use medical services more frequently than non abused women. Doctors are often the first professional person that abused women tell and women report that doctors who have good communication skills encourage disclosure. This study will evaluate a brief ....Domestic violence or intimate partner abuse (physical, emotional or sexual) is a common hidden problem for women attending general practice. It has major emotional and physical consequences for abused women of child bearing age and as a result they use medical services more frequently than non abused women. Doctors are often the first professional person that abused women tell and women report that doctors who have good communication skills encourage disclosure. This study will evaluate a brief counselling intervention for abused women in general practice using a randomised controlled trial. General practice staff (general practitioners and-or practice nurses) will be randomised either to be intensively trained to deliver the intervention and their practice systems improved for care of abused women or to be given information to ensure minimum safe practice and deliver 'usual care' to abused women. The primary aim of the intervention is to increase abused women's safety behaviours and planning and improve their mental health and quality of life. Secondary aims include increasing their readiness for change and action with regard to abuse, and their comfort to discuss abuse with general practitioners-practice nurses and general practitioners-practice nurses inquiry about safety. It is not expected that in a twelve month period that any intervention with women will be able to decrease the abuse women experience as women cannot control their partners' behaviour and to leave is not necessarily going to end the violence and abuse. Rather, the intervention and outcomes will look at women's pathway and decision making around seeking safety and non-violence. A cost effective analysis will also be undertaken using health service use by women and costs of the intervention.Read moreRead less
The Diamond Cohort Study - Better Management Of Those At Risk Of Persistent And Disabling Depression
Funder
National Health and Medical Research Council
Funding Amount
$1,563,309.00
Summary
Diamond began in 2005 to follow over 500 people with depressive symptoms to document and describe the nature and course of depression and its’ management over a decade of a participant’s life. Our findings will help us to understand the factors associated with depression recovery, relapse and persistence. We will inform clinical practice by developing a tool to assist GPs to identify those at risk of persistent and disabling depression, to enable better treatments.
The Common Risk Factor Approach To Assess Relationships Between Dental Caries And Adiposity In Disadvantaged Preschool Children
Funder
National Health and Medical Research Council
Funding Amount
$346,449.00
Summary
Dental decay and obesity in early childhood continues to be a significant health concern in Australian children. Current evidence suggests that these diseases are highly prevalent among children living in disadvantaged areas but the evidence of the relationship is limited. This increases their risk to carry the burden in adulthood. The present proposal uses a "common risk factor approach" to explore relationships between dental decay and obesity in disadvantaged preschool children in Australia.
Implementing Guidelines To Routinely Prevent Chronic Disease In General Practice
Funder
National Health and Medical Research Council
Funding Amount
$764,446.00
Summary
High quality, evidence-based guidelines for preventive activities and for the implementation of prevention in general practice have been developed by the Royal Australian College of General Practitioners and other bodies, yet available information suggests that many patients miss out on evidence-based preventive care. This project aims to evaluate current practice and develop a model of practice aimed at improving the implementation of preventive guidelines in general practice.