Detection And Management Of Depression In General Practice Patients With Chronic Manifestations Of Ischaemic Heart Disea
Funder
National Health and Medical Research Council
Funding Amount
$499,797.00
Summary
This research will investigate the impact of ischemic heart disease on the prevalence and severity of patients with depression. This will be done via a 12 month general practice based program of 1) systematic screening for depression 2) informing general practitioners of best-practice guidelines for management of depression in these patients, and 3) providing the treating general practitioner with patient-specific, psychiatric advice.
Which Heart Failure Intervention Is Most Cost Effective In Reducing Hospital Care (WHICH? II) Trial: A Multicentre, Randomised Trial Of Standard Versus Intensified Management Of Metropolitan And Regional-dwelling Patients With Heart Failure
Funder
National Health and Medical Research Council
Funding Amount
$1,891,210.00
Summary
Chronic heart failure (CHF) management programs are now the gold-standard to cost-effectively care for thousands of Australians hospitalised with CHF each year. We’ve shown that home-based management is most cost-effective in reducing hospital stay in CHF. The Which Intervention is most Cost-effective in reducing Hospital care (WHICH? II) Trial, a multicentre, randomised study, will determine if more intensive care (via home visits and remote care contacts) further improves poor outcomes in CHF.
Which Heart Failure Intervention Is Most Cost-effective And Consumer Friendly In Reducing Hospital Care: The Which
Funder
National Health and Medical Research Council
Funding Amount
$921,640.00
Summary
Chronic heart failure (CHF) is a costly, debilitating and deadly condition that has reached near epidemic proportions in Australia. In the absence of a permanent cure for CHF, the number of people affected by CHF has risen beyond 350,000 and is expected to increase by 20-30% in the next 20 years. We recently reviewed the benefits of applying nurse-led, CHF management programs (CHF-MPs) to typically old and fragile patients, in whom recurrent hospital admissions and a premature death are common. ....Chronic heart failure (CHF) is a costly, debilitating and deadly condition that has reached near epidemic proportions in Australia. In the absence of a permanent cure for CHF, the number of people affected by CHF has risen beyond 350,000 and is expected to increase by 20-30% in the next 20 years. We recently reviewed the benefits of applying nurse-led, CHF management programs (CHF-MPs) to typically old and fragile patients, in whom recurrent hospital admissions and a premature death are common. We confirmed the results of pioneering Australian research that CHF-MPs dramatically improve health outcomes in CHF. CHF-MPs now form part of the recommended gold-standard management of CHF. However, we also have evidence that only a small proportion of patients are exposed to a CHF-MP in Australia. Residual issues such as consumer preference and the cost of applying these programs are hindering their wide-spread application. The WHICH? Study addresses this _road block� to implementing a potentially valuable health care service by tackling a number of critical issues: which form of CHF-MP (home or specialist clinic-based follow-up), will produce the best health outcomes, save the most money and meet the needs of consumers at the same time? To answer this question, we will undertake a randomised, head-to-head study of a home versus clinic-based CHF-MP, in 1000 recently hospitalised CHF patients recruited from SA, VIC, NSW and QLD. Patterns and of health care and consumer preferences and quality of life will then be compared for these two different forms of CHF-MP from a combined health economic, health policy and consumer perspective to determine the best form of CHF-MP to be applied. A _consensus� vision for applying an Australia-wide service will then be developed. The potential impact of the results of the study will then be modelled on the status of Australian CHF-MPs in the year 2010 and a blue-print for action devised.Read moreRead less
CKD-FIX: A Randomised, Controlled Trial Of Allopurinol In The Slowing Of Kidney Disease Progression
Funder
National Health and Medical Research Council
Funding Amount
$1,917,147.00
Summary
Chronic kidney disease (CKD) is a major public health problem affecting over 1.5 million Australians and is associated with increased risk of death, heart disease and progression to end-stage kidney disease (ESKD). Current treatments to slow progression to ESKD are limited. The CKD-FIX trial aims to find out whether treatment with allopurinol, a commonly used drug for gout prevention, safely and effectively slows CKD progression. This could lead to significant health and economic benefits.
Enhancing Erythropoietin Therapy In Ischaemia-reperfusion Injury Of Heart And Kidney
Funder
National Health and Medical Research Council
Funding Amount
$361,021.00
Summary
Heart attacks and kidney disease from a lack of blood flow are common causes of morbidity and have poor treatment options. Erythropoietin (epo) is a useful new treatment, but there remain some caveats to its use in humans: eg. it may cause excessive scarring during repair. Use of epo with an anti-inflammatory drug may decrease scarring and provide benefit to long-term health. We plan to carefully define the biomolecular pathways of injury and repair, to better plan this therapy for human use.
Rapidly giving intravenous fluid to prevent or treat shock (fluid resuscitation) is one of the commonest treatments given to critically ill patients. Current guidelines recommend crystalloid solutions but it is unknown whether any particular crystalloid is better than others. This trial will determine whether the use of one of two crystalloid fluids, saline or PlasmaLyte, reduces the risk of organ injuries, such as kidney failure, and improves patients chances of surviving critically illness.
The END RHD CRE: Developing An Endgame For Rheumatic Heart Disease In Australia
Funder
National Health and Medical Research Council
Funding Amount
$2,601,147.00
Summary
Rheumatic heart disease (RHD) is caused by an abnormal immune reaction to some bacterial infections. Although RHD is rare in developed countries, Indigenous Australians still live with the burden of RHD. The END RHD CRE will explore risk factors for RHD, prevention with antibiotics, management of RHD and the potential for vaccine development. Individuals and communities experiencing RHD are integral partners to this work. The CRE will establish a strategy for ending RHD in Australia.
Innovative Health Programs To Reduce Inequality In Heart Disease
Funder
National Health and Medical Research Council
Funding Amount
$876,005.00
Summary
As part of his Senior NHMRC Fellowship, Prof Simon Stewart, a world-renowned health services researcher, will lead an internationally linked team of researchers from a broad range of health disciplines to undertake a program of research designed to improve the lives of those most vulnerable to heart disease and poor health outcomes. His program of research will focus on Indigenous Australians, patients with complex forms of heart disease and urban African communities in economic transition.
Evaluating The Genetic Contribution To Rheumatic Heart Disease Pathogenesis In Australian Aboriginal And Torres Strait Islander Communities
Funder
National Health and Medical Research Council
Funding Amount
$1,782,074.00
Summary
Rheumatic heart disease is highly prevalent in Aboriginal people in Australia and leads to early cardiac disease. Despite decades of research, the underlying genetic mechanisms for why it occurs are not well understood. We are conducting a genetic study to better understand why some people are susceptible to RHD and others are not. The study will involve substantial Aboriginal leadership and consultation and will be a model for the conduct of genetic studies in Aboriginal populations.
Urotensin-II In Human Heart: Investigation Of Mechanisms Involved In Cardiac Function
Funder
National Health and Medical Research Council
Funding Amount
$255,990.00
Summary
The normal function of the body is maintained by naturally occurring compounds. Some for example affect the heart, fine tuning it to make it beat faster or slower, or beat with greater or less force when required in different situations in health and disease. We were the first to show just recently that a small protein which occurs naturally in the body, called urotensin-II can affect the way the heart beats. We showed that extremely tiny amounts increase the force of the heart beat. Our finding ....The normal function of the body is maintained by naturally occurring compounds. Some for example affect the heart, fine tuning it to make it beat faster or slower, or beat with greater or less force when required in different situations in health and disease. We were the first to show just recently that a small protein which occurs naturally in the body, called urotensin-II can affect the way the heart beats. We showed that extremely tiny amounts increase the force of the heart beat. Our findings indicate that urotensin-II is the most potent heart stimulator identified to date. In patients with heart failure, short term stimulation of heart contraction is beneficial, supplying the heart and other organs with vital oxygen and nutrients. However, in the long term excessive stimulation causes worsening of the patients condition. Very little is currently known about the way in which urotensin-II alters heart function. The goal of our study is to understand the mechanism involved in urotensin-II mediated effects on the heart. This will involve identifying the location of urotensin-II and its receptors in the heart, and determining what signalling changes occur after the interaction of urotensin-II with its receptors. Urotensin-II must first be cleaved from a larger drug. We will determine where in the heart this cleavage occurs and whether the process is crucial to the ability of urotensin-II to stimulate contraction of the heart. Since stimulators of heart contraction are detrimental to patients with heart failure in the long term, we will determine whether these patients have more urotensin-II in their blood than patients who do not have heart failure. If the levels of urotensin-II are higher in heart failure patients, it may indicate a need to interfere with the interaction of urotensin-II with its receptors.Read moreRead less