A Randomised Trial Of A Clinical Prediction Tool For Targeting Depression Care (Target-D)
Funder
National Health and Medical Research Council
Funding Amount
$944,774.00
Summary
The Target-D Study uses a novel clinical prediction tool to test a new approach to depression care in general practice based upon sub-grouping patients into low, medium and high risk of ongoing depression. Participants will be randomly allocated to targeted treatments based upon their risk profile or to usual general practice care. We will measure whether the new approach results in greater improvements in depressive symptoms, quality of life and functioning and whether there are cost benefits.
Strengthening Health Systems Through The Use Of Process Evaluations Of Complex Interventions
Funder
National Health and Medical Research Council
Funding Amount
$61,383.00
Summary
A strong primary health care is vital to improve health and health equity globally. This is pertinent in a growing age of non-communicable diseases for which there is effective prevention strategies available. It is important to understand for whom, how and why these strategies can work in a primary health care setting (such as better understanding patients' and health providers' perspectives) through process evaluations. Research to build on process evaluation methods is crucial.
The Role Of Spirometry In Managing Chronic Respiratory Diseases In General Practice
Funder
National Health and Medical Research Council
Funding Amount
$487,427.00
Summary
This study will compare the use of spirometry (a lung function test) in general practice, with and without feedback of results, against the delivery of usual medical care without spirometry. If positive, the trial will result in better health outcomes for patients with chronic respiratory disease.
The Influence Of Acupuncture On Reducing Women's Pain From Primary Dysmenorrhoea: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$310,875.00
Summary
Dysmenorrhoea refers to painful uterine cramps during menstruation. It is a common condition that affects as many as 50 percent of women. Severe menstrual pain can lead to an absence from work, or attending school, or interference with day to day lives. This condition is commonly treated with non-steroidal anti-inflammatory drugs or the oral contraceptive pill. Studies suggest that between 30-50 percent of the adult population use some form of complementary medicine. Acupuncture, the insertion o ....Dysmenorrhoea refers to painful uterine cramps during menstruation. It is a common condition that affects as many as 50 percent of women. Severe menstrual pain can lead to an absence from work, or attending school, or interference with day to day lives. This condition is commonly treated with non-steroidal anti-inflammatory drugs or the oral contraceptive pill. Studies suggest that between 30-50 percent of the adult population use some form of complementary medicine. Acupuncture, the insertion of fine needles, into specific areas of the body is increasingly being used to treat a number of conditions. It has been indicated in several non-clinical studies and two small clinical trials to be effective with treating dysmenorrhoea. Evidence from the Cochrane systematic review of acupuncture to treat primary dysmenorrhoea concluded acupuncture may be helpful. This study assesses whether women with dysmenorrhoea can be successfully treated using acupuncture. Women experiencing dysmenorrhoea with no underlying pelvic pathology will be offered the opportunity to take part in the trial. Women interested in taking part will be randomly allocated into one of two groups. One group of women will receive acupuncture, a second group will receive control (sham) acupuncture. The second study group involves the insertion of needles away from acupuncture points. Women will receive the treatment intervention for three menstrual cycles and then followed up for a further six months. Women will be asked to report on the pain they experience during menses and to report any time taken off from work or school, disruption with day to day activities, or the need for additional pain relief. In 2005 we expect to report on the effectiveness of this treatment on dysmenorrhoea and whether this treatment is acceptable to women. If the results are positive, it is hoped this will become an option available to women for the management of their dysmenorrhoea.Read moreRead less
The OPTIMISE Project: Collaborative Improvement Of Primary Health Care Delivery To The Australian Refugee Community
Funder
National Health and Medical Research Council
Funding Amount
$1,022,303.00
Summary
Identifying and addressing the health needs of refugees arriving in Australia can be difficult amidst current primary care system limitations. Our team will build the capacity of frontline health services for providing comprehensive, evidence-based care to this vulnerable community, while addressing system gaps in health service access and coordination. Our framework for effective, practical and sustainable primary health care delivery will improve health outcomes for refugees nationally.
A Randomised Controlled Trial To Evaluate The Effectiveness And Cost-effectiveness Of Chlamydia Testing In General Practice.
Funder
National Health and Medical Research Council
Funding Amount
$1,377,557.00
Summary
Chlamydia is a very common sexually transmissible infection in Australia that can lead to infertility in women. About 4% of young adults have it. Most people with chlamydia do not have any symptoms and will be unaware they have it. Chlamydia is easy to diagnose and treat, but it is not known whether regular testing can reduce its spread. We propose to conduct a trial to evaluate whether annual testing for 16 to 29 year olds works and whether it would be a good use of public health funds.
Implementing Clinical Practice Guidelines In General Practice: A Cluster Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$426,000.00
Summary
Evidence based clinical practice guidelines have the potential to improve clinical practice through providing health care workers with the most reliable information on which to base their treatment decisions. Many governments and organisations are investing significantly in the development of guidelines for common and important clinical disorders. To date, however, we do not fully understand how to increase the uptake of guidelines and facilitate health care workers to change their practice in l ....Evidence based clinical practice guidelines have the potential to improve clinical practice through providing health care workers with the most reliable information on which to base their treatment decisions. Many governments and organisations are investing significantly in the development of guidelines for common and important clinical disorders. To date, however, we do not fully understand how to increase the uptake of guidelines and facilitate health care workers to change their practice in line with the guideline's recommendations. This project aims to work with general practitioners to develop a method or strategy to increase the uptake of guidelines for the treatment of acute low back pain, particularly to reduce the number of patients who are unnecessarily x-rayed, and to increase advice to stay active. The effectiveness of the developed strategy will be tested by randomly assigning general practice clinics to either receive the intervention or to have access to the guidelines without any extra interventions (such as training and reminders) to help doctors change their practice. Both the doctor's practice, and patient outcomes of pain and disability will be measured to determine not only if the doctors followed the guidelines, but whether this resulted in an improvement in patient outcome. The findings of this study will help us understand the best ways to improve adhesion to guidelines and so has the potential to be applied to other conditions presenting to general practice where there are recommendations not currently being implemented into practice.Read moreRead less
DESPATCH: DElivering Stroke Prevention For Atrial Fibrillation: Assisting Evidence-based CHoice In Primary Care
Funder
National Health and Medical Research Council
Funding Amount
$561,447.00
Summary
Non-valvular atrial fibrillation (NVAF) is a common heart condition associated with a major risk of fatal and disabling stroke. Inexpensive anticoagulant medication has been proven to reduce all-causes of death and stroke in patients with NVAF. Anticoagulant treatment for NVAF is substantially under-used resulting in avoidable patient deaths and disabling stroke. The National Institute of Clinical Studies of Australia summarised the large, unrealised benefit of anticoagulation, stating that 'eac ....Non-valvular atrial fibrillation (NVAF) is a common heart condition associated with a major risk of fatal and disabling stroke. Inexpensive anticoagulant medication has been proven to reduce all-causes of death and stroke in patients with NVAF. Anticoagulant treatment for NVAF is substantially under-used resulting in avoidable patient deaths and disabling stroke. The National Institute of Clinical Studies of Australia summarised the large, unrealised benefit of anticoagulation, stating that 'each year, for every 1000 patients with NVAF given anticoagulants, we can assume that about 25 fewer people will experience a stroke and 12 fewer will die from a stroke than would be the case if they were not given them'. Despite this realisation, there is a lack of evidence to support any strategy to improve the care of patients with NVAF. This study seeks to optimise the management of NVAF in general practice. The DESPATCH study will employ a rigorous randomised design to evaluate an innovative educational intervention intended to overcome barriers to the best management of NVAF. If successful, DESPATCH will inform policy and practice aimed at overcoming barriers to best practice for the large and growing number of people with NVAF to reduce the risk of fatal and disabling stroke.Read moreRead less
Women's Evaluation Of Abuse And Violence Care Randomised Controlled Trial- Long Term Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$284,391.00
Summary
Domestic violence has major health consequences and is a common hidden problem for women attending general practice. The project evaluates if a general practice intervention involving screening women for partner abuse, health provider education and brief counselling for women decreases partner abuse experienced and improves women's mental, physical health, parenting skills & quality of life long term (2 & 3 years after intervention). Further, to understand long term whether it is cost effective.
Randomised Controlled Trial Of A Brief GP Intervention To Reduce Overweight In Victorian Primary School Children
Funder
National Health and Medical Research Council
Funding Amount
$662,600.00
Summary
Childhood overweight and obesity is one of the most pressing public health problems of our time. The aim of this study is to lower the levels of overweight and mild obesity in children aged 5-9 years, through sustainable family and child nutritional and-or physical activity behavioural choices that can be implemented by general practitioners (GPs). This trial addresses the urgent need identified in the 2003 NHMRC Clinical Practice Guidelines for the Management of Overweight and Obesity in Childr ....Childhood overweight and obesity is one of the most pressing public health problems of our time. The aim of this study is to lower the levels of overweight and mild obesity in children aged 5-9 years, through sustainable family and child nutritional and-or physical activity behavioural choices that can be implemented by general practitioners (GPs). This trial addresses the urgent need identified in the 2003 NHMRC Clinical Practice Guidelines for the Management of Overweight and Obesity in Children and Adolescents for simple, well-designed intervention studies which can be translated into usual clinical practice. Effective and coordinated universal prevention, secondary prevention and management services will all be needed to reduce the problem, and a great deal of research is needed in all of these. This proposal addresses the most neglected area of research - secondary prevention in the primary care sector. Through our previous research, we have already showed that this approach is feasible and acceptable to families and GPs. Our multidisciplinary research team is well-established, and we are not aware of any other research team in Australia that has the capacity and expertise to conduct this research at this point in time. In this randomised controlled trial, we expect a halving in the rate of gain in BMI over 6 and 12 months. This would equate to the average participant achieving a BMI of 25 (verging on overweight) rather than 30 (obese) by adulthood. If effective, we expect the following outcomes: 1) The adoption and maintenance of healthy lifestyle behaviours in that segment of the population which has most to gain over a lifetime - overweight and obese children 2) Documentation that general practitioners can make a significant contribution to combating the childhood obesity epidemic 3) A replicable, feasible, cost-effective primary care approach to childhood overweight-obesity tailored to the Australian health care system.Read moreRead less