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QUality Improvement In Primary Care To Prevent Hospitalisations And Improve Effectiveness And Efficiency Of Care For People Living With Heart Disease (QUEL)
Funder
National Health and Medical Research Council
Funding Amount
$828,305.00
Summary
Heart disease accounts for a great number of deaths and admissions to hospital. We aim to improve ongoing prevention for people with heart disease by supporting general practices to use their data and provide more systematic care. We propose a randomised trial to determine whether a practice level strategy reduces cardiovascular events and hospitalisations and saves money. The research will directly inform government decision-making and policy regarding primary care incentive payment programs.
Evaluation Of A Financial Incentive To Improve The Use Of Preventive Medicines By People With Asthma
Funder
National Health and Medical Research Council
Funding Amount
$137,860.00
Summary
Rising costs are threatening the future viability of the Pharmaceutical Benefits Scheme. New approaches are needed to address this challenge, including developing financial incentives for consumers to use effective low cost medicines in preference to higher cost alternatives. This study will develop a consumer incentive for use of low cost asthma preventer medicines, model the economic effects of this and bring together stakeholders to examine the policy and practice changes needed to implement ....Rising costs are threatening the future viability of the Pharmaceutical Benefits Scheme. New approaches are needed to address this challenge, including developing financial incentives for consumers to use effective low cost medicines in preference to higher cost alternatives. This study will develop a consumer incentive for use of low cost asthma preventer medicines, model the economic effects of this and bring together stakeholders to examine the policy and practice changes needed to implement the incentive.Read moreRead less
Systematic Practice-based Asthma Care In The Australian Setting
Funder
National Health and Medical Research Council
Funding Amount
$563,625.00
Summary
Asthma is an illness which increasingly is affecting the health and quality of life of millions of Australians. Much effort has been focused in recent years on ways of improving the management of those people who suffer from moderate and severe asthma. A recent government initiative has been to promote the use of the 3+ Visit Plan, which encourages a more proactive, systematic approach to assessing and treating asthma in general practice. There is currently no evidence about exactly how practice ....Asthma is an illness which increasingly is affecting the health and quality of life of millions of Australians. Much effort has been focused in recent years on ways of improving the management of those people who suffer from moderate and severe asthma. A recent government initiative has been to promote the use of the 3+ Visit Plan, which encourages a more proactive, systematic approach to assessing and treating asthma in general practice. There is currently no evidence about exactly how practices can best be organized to provide this systematic care, in a way which improves the process of care and the health outcomes for patients. This study aims to evaluate the effectiveness of changing aspects of practice organization and structure, such as setting up registers of asthma patients, providing recalls or reminders to patients to come in for regular review, having the GPs provide education and self-management skills to patients, focusing on the contributions which practice staff can make to the process, and initiating quality assurance measures such as audit and feedback to the GPs about their quality of care. We anticipate that these changes will provide positive benefits for the patients, but will also investigate what it costs the practices, patients and government to bring these changes about, within the perspective of efficiency and cost-effectiveness. The evidence generated by this study will provide an excellent base for providing advice to policy makers, as well as contributing to the development of best-practice models of care for asthma patients in general practice.Read moreRead less
EFFECTIVENESS OF INFLUENZA AND PNEUMOCOCCAL VACCINATION IN PREVENTING HOSPITALISATION DUE TO PNEUMONIA IN OLDER PERSONS
Funder
National Health and Medical Research Council
Funding Amount
$258,475.00
Summary
Flu and pneumococcus remain important causes of illness and death in Australia. They can cause pneumonia and severe respiratory illness, including death, especially in older people. This is because natural immunity against infections tends to decrease with age. Vaccination against flu and pneumococcus is therefore recommended for all persons aged 65 years or older, but only in Victoria are both vaccines publicly funded. The Victorian initiative appears to have had a marked impact on improving va ....Flu and pneumococcus remain important causes of illness and death in Australia. They can cause pneumonia and severe respiratory illness, including death, especially in older people. This is because natural immunity against infections tends to decrease with age. Vaccination against flu and pneumococcus is therefore recommended for all persons aged 65 years or older, but only in Victoria are both vaccines publicly funded. The Victorian initiative appears to have had a marked impact on improving vaccination coverage, but its impact on disease has never been assessed. This study will estimate vaccination coverage, missed vaccination opportunities, effectiveness of flu and pneumococcal vaccines in preventing hospitalisation for pneumonia, and cost-effectiveness of the currently funded vaccination program in this age group. This is considered a priority because of the serious but preventable nature of the diseases caused by these infections. This study will improve awareness of the importance of vaccination among individuals, and given the high estimated vaccine coverage in older Victorians, is well placed to provide the first available evidence for or against effectiveness and cost-effectiveness of flu and pneumococcal vaccination in older Australians. The results may have major implications for public health policy in Victoria and elsewhere in Australia.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
The First Placebo-controlled Trial Of Paracetamol For Back Pain.
Funder
National Health and Medical Research Council
Funding Amount
$626,021.00
Summary
Each year in Australia over $1Billion is spent on treatments for low back pain. An important approach to solving this problem is to evaluate back pain treatments that are readily available, safe, cheap and effective. Our previous work suggests that regular paracetamol may be such a treatment. We propose to conduct the first ever placebo controlled trial of paracetamol for acute low back pain in a large clinical trial.
Examination of the integration and diffusion of Aboriginal voices in public health collaboratives. Does the integration of Aboriginal voices in governance processes of public health collaboratives influence equity of access in service delivery? Improving access to services is a key priority in order to improve the wellbeing of Aboriginal people. However there is no rigorous scientific evidence base driving current integration reforms. This project will use innovative methodologies (mathematical, ....Examination of the integration and diffusion of Aboriginal voices in public health collaboratives. Does the integration of Aboriginal voices in governance processes of public health collaboratives influence equity of access in service delivery? Improving access to services is a key priority in order to improve the wellbeing of Aboriginal people. However there is no rigorous scientific evidence base driving current integration reforms. This project will use innovative methodologies (mathematical, visual, and vocal) which will lead to a performance indicator framework of the relationships between integration, collaboration, equity and access to services within a social model of health. This is a way to move from assessments of Aboriginal participation processes as 'bad, poor and no' to 'good, green and go'.Read moreRead less
The impact and cost of short-term health staffing in remote communities. This project aims to examine the impact of the increasing levels of short-term health staffing in remote communities upon service acceptability to patients, workload and attitudes of long-term resident primary health care staff, and the effectiveness and cost of health services. There is a dearth of information about this 'fly in/fly out' (FIFO) workforce in remote communities, which have the worst health outcomes in the co ....The impact and cost of short-term health staffing in remote communities. This project aims to examine the impact of the increasing levels of short-term health staffing in remote communities upon service acceptability to patients, workload and attitudes of long-term resident primary health care staff, and the effectiveness and cost of health services. There is a dearth of information about this 'fly in/fly out' (FIFO) workforce in remote communities, which have the worst health outcomes in the country. The project aims to inform consumers, health practitioners, health service planners and policy-makers about the impact of FIFO, as well as to contribute to the development of strategies designed to stabilise the remote health workforce.Read moreRead less
Staffing practices in Aboriginal primary health care services. This project aims to generate new knowledge about the impact of short-term staffing in remote Aboriginal Community Controlled Health Services on service acceptability to patients, workload and attitudes of long-term staff and the effectiveness and cost of services. The project intends to compare these results to recent findings about the impact of short-term staffing in government-run clinics, in order to quantify and describe the po ....Staffing practices in Aboriginal primary health care services. This project aims to generate new knowledge about the impact of short-term staffing in remote Aboriginal Community Controlled Health Services on service acceptability to patients, workload and attitudes of long-term staff and the effectiveness and cost of services. The project intends to compare these results to recent findings about the impact of short-term staffing in government-run clinics, in order to quantify and describe the potential positive effect of community control. Expected outcomes include rigorous evidence about the 'fly in/fly out' workforce and the impact of community control which can inform new policy that will stabilise the remote health workforce, save money and contribute to 'closing the gap' in health outcomes.Read moreRead less
Strengthening Indigenous adolescent mental health and wellbeing. Using Continous Quality Improvement processes, the research will collaboratively conceptualise, design, implement and evaluate the effectiveness of new approaches to mental health service delivery for adolescents aged 10-24 in three regionally diverse Indigenous Primary Healthcare Services. Expected research outcomes are a rigorous assessment of the impact and economic benefits of making quality improvements to mental health servic ....Strengthening Indigenous adolescent mental health and wellbeing. Using Continous Quality Improvement processes, the research will collaboratively conceptualise, design, implement and evaluate the effectiveness of new approaches to mental health service delivery for adolescents aged 10-24 in three regionally diverse Indigenous Primary Healthcare Services. Expected research outcomes are a rigorous assessment of the impact and economic benefits of making quality improvements to mental health services for Indigenous adolescents, Key benefits are 1) A locally-responsive adolescent mental health screening instrument; 2) Comprehensive evidence-informed service model in adolescent mental healthcare; 3) Best practice protocol for developing and managing adolescent mental health as a service delivery stream. Read moreRead less