Mortality Among Opioid Dependent Persons In Pharmacotherapy, NSW 1985-2006
Funder
National Health and Medical Research Council
Funding Amount
$148,757.00
Summary
Heroin dependence is a long term condition associated with high rates of death, illness and injury. Death rates are much higher than the general Australian population and the causes of death include drug intoxication or overdose, trauma, suicide, complications from blood born viruses such as Hepatitis C and HIV-AIDS and other medical complications of a chaotic drug-using lifestyle. As a part of a harm minimisation approach to heroin dependence, maintenance opioid pharmacotherapies seek to stabil ....Heroin dependence is a long term condition associated with high rates of death, illness and injury. Death rates are much higher than the general Australian population and the causes of death include drug intoxication or overdose, trauma, suicide, complications from blood born viruses such as Hepatitis C and HIV-AIDS and other medical complications of a chaotic drug-using lifestyle. As a part of a harm minimisation approach to heroin dependence, maintenance opioid pharmacotherapies seek to stabilise a chaotic heroin-using lifestyle by providing a regular dose of a legal, high quality opioid under medical supervision. Maintenance treatment uses long-acting opioids such as methadone and buprenorphine to provide consistent blood opioid levels so the client avoids the constant and disruptive cycles of opioid intoxication and withdrawal. Clients in regular maintenance treatments have lower death rates than untreated heroin dependent people and better outcomes with regards to drug use. However, death still occurs in methadone and buprenorphine treatment and minimising death rates is an important goal of treatment programs. This is a large longitudinal study looking at all NSW methadone and buprenorphine clients between 1985 and 2006, an estimated 44,000 people. In particular, the study looks at their mortality. It is a data linkage project, in that it uses two existing databases (a treatment database and a mortality database) and combines the information for each subject to get a better picture of how long methadone and buprenorphine clients survive, how much maintenance treatment they have received, and what the clients die of. This is the first time the mortality of all NSW methadone and buprenorphine recipients will be examined in a systematic way. It will allow us to compare the mortality of subjects receiving methadone and buprenorphine treatments and look at changes in mortality rates and causes of death over time. This will be an important policy resource.Read moreRead less
An Examination Of The Causes Of Mortality Following Imprisonment In New South Wales Using Data-linkage.
Funder
National Health and Medical Research Council
Funding Amount
$205,500.00
Summary
Prisoner populations are characterised by poor health status including infectious diseases, injury, risk taking behaviours (eg. smoking and self-harm), mental illness, and substance abuse. Serosurveys of blood borne viruses such as hepatitis C and hepatitis B conducted in Australian and overseas prison settings have found that over one third of inmates have been exposed to these viruses with higher rates detected in injecting drug users and female inmates. Few attempts have been made to examine ....Prisoner populations are characterised by poor health status including infectious diseases, injury, risk taking behaviours (eg. smoking and self-harm), mental illness, and substance abuse. Serosurveys of blood borne viruses such as hepatitis C and hepatitis B conducted in Australian and overseas prison settings have found that over one third of inmates have been exposed to these viruses with higher rates detected in injecting drug users and female inmates. Few attempts have been made to examine the causes of mortality among prisoners following release from detention. Most interest has focused on overdoses in the period immediately following release; the aim of this study will examine all causes of death among individuals exposed to the correctional environment and compare these to death rates for NSW. Correctional centres house a largely male (94% in NSW) population with backgrounds of disadvantage in all areas, including Indigenous Australians, people of lower socio-economic status, those with a mental illness, and the intellectually disabled. There are currently over 21,000 (June 2001) prisoners detained in Australian correctional centres with approximately 39% housed in NSW. Fifteen percent of the NSW prisoners are Indigenous but comprise only 2% of the general population. The aims of this project will be to: (1) Identify all causes of death among ex-prisoners in NSW for the period 1985 to 2001; (2). Compare death rates in the study group with those in the NSW community; (3) Correlate pre-release health information contained in medical records with specific causes of death; (4) Compare causes of mortality among various sub-groups eg. injecting drug users, the mentally ill, violent offenders, and the intellectually disabled; (5) Examine causes of mortality between Indigenous and non-Indigenous inmates; and (6) use this information to develop pre-release programmes aimed at reducing excess mortality among this group.Read moreRead less
A Case-cohort Study Of New Risk Factors For Cardiovascular Diseases In Busselton
Funder
National Health and Medical Research Council
Funding Amount
$197,349.00
Summary
Cardiovascular diseases account for about half of all deaths and for considerable use of health care resources. While several risk factors for cardiovascular disease, such as smoking, high blood pressure, high cholesterol, overweight and diabetes, are well-established, these do not fully explain all cardiovascular disease. In recent years, some new potential risk factors for cardiovascular disease have been identified. This study aims to examine these new risk factors in an Australian population ....Cardiovascular diseases account for about half of all deaths and for considerable use of health care resources. While several risk factors for cardiovascular disease, such as smoking, high blood pressure, high cholesterol, overweight and diabetes, are well-established, these do not fully explain all cardiovascular disease. In recent years, some new potential risk factors for cardiovascular disease have been identified. This study aims to examine these new risk factors in an Australian population. Using information collected by the Busselton Health Surveys over the last 20 years, we aim to determine whether people who had these risk factors in 1978 were more likely to develop cardiovascular disease over the following years. Since all the information needed has already been collected in the course of earlier health surveys, this study will be particularly cost-effective. We expect that results from this study will increase our understanding of the causes of cardiovascular disease, and may suggest some simple tests to help identify those people who may be at higher risk of heart disease and most likely to benefit from intervention.Read moreRead less
Investigating Best Practice Primary Care For Older Australians With Diabetes Using Data Linkage
Funder
National Health and Medical Research Council
Funding Amount
$522,278.00
Summary
This study will use data linkage to examine questions about health service use by older Australians to manage chronic conditions such as diabetes. It will lead to a better understanding of the uptake of community based care initiatives and incentives through general practice, the factors that assist or impede uptake, and the impact of these on patient outcomes such as hospitalisation. The research findings will address important questions of interest to practitioners and policy advisors.