Measuring Patient Preferences For Treatment Of Colorectal Cancer Using Discrete Choice Modelling
Funder
National Health and Medical Research Council
Funding Amount
$188,912.00
Summary
Around the world, governments, medical professional bodies, individual clinicians and patients are trying to make decisions in health care more rationally. More of these decisions are 'informed' by evidence-based medicine, which depends on a systematic review of all relevant evidence of acceptable scientific rigour. This kind of systematic review has been conducted for the management of colorectal cancer. Patients making choices about possible treatment for colorectal cancer will then have the b ....Around the world, governments, medical professional bodies, individual clinicians and patients are trying to make decisions in health care more rationally. More of these decisions are 'informed' by evidence-based medicine, which depends on a systematic review of all relevant evidence of acceptable scientific rigour. This kind of systematic review has been conducted for the management of colorectal cancer. Patients making choices about possible treatment for colorectal cancer will then have the best 'evidence-based' information to hand. But not enough is known about what aspects of the treatment options matter most to patients. Choosing between different treatment options involves weighing up or trading-off different factors associated with each therapy. Depending on the clinical stage of their cancer, patients may have to choose between the type and size of surgical operation, whether or not to have chemotherapy and-or radiotherapy, the side effects of treatment, the chance of a recurrence of the disease and an early death as well as their quality of life. This research project will ask patients who have already been treated for their colorectal cancer what kind of tradeoffs they make between factors such as disease-free survival, toxicity of treatment and longer term quality of life. This will be done using hypothetical clinical scenarios comparing one type of treatment to another. In this way, the hypothetical choices will be informed by the patient's experience with treatment without asking them to reflect or dwell directly on their own treatment choices. The answers to the hypothetical choice questions can be used to assess what factors in treatment are most important to patients and by how much. This information can then be used by clinicians when presenting evidence-based information on treatment for patients newly diagnosed colorectal cancer.Read moreRead less
Preparing Cancer Patients For Clinical Decision Making: A Randomised Trial Of Preconsultation Preparation Packages.
Funder
National Health and Medical Research Council
Funding Amount
$228,427.00
Summary
Most cancer patients in Australia now expect and are told their cancer diagnosis. There is considerable variation in the extent to which patients are informed about treatment options and are involved in treatment decisions. It can be argued that a treatment decision should be based on the oncologist's knowledge and the patient's preference. Two possible models can achieve this optimal outcome: the oncologist decides treatment on the basis of information passed on to him-her from the patient (the ....Most cancer patients in Australia now expect and are told their cancer diagnosis. There is considerable variation in the extent to which patients are informed about treatment options and are involved in treatment decisions. It can be argued that a treatment decision should be based on the oncologist's knowledge and the patient's preference. Two possible models can achieve this optimal outcome: the oncologist decides treatment on the basis of information passed on to him-her from the patient (the enabled doctor), and the patient chooses treatment based on informaton provided by the doctor (the empowered patient). We have developed a booklet on 'how treatment decisions are made'. In a randomised trial, patients seeing an oncologist for the first time are given the booklet and shown a video of ' their' oncologist interviewing an actor patient. The subsequent consultation is audiotaped to study the effect of these interventions on patient and doctor behaviour. The results of this trial will inform the development of our new patient educational materials. We now plan to develop consultation preparation packages. Patients will be sent information at least 48 hours before their first appointment with an oncologist with the goal of helping patients to achieve their preferred involvement in the consultation. The complete package will contain four components : a booklet on how treatment decisions are made including an outline of the two treatment decision models, a question prompt sheet and recommendation to prepare a list of questions, a booklet on Patient Rights, and an introduction to the Cancer Centre. The effects of the total package, and of just the Cancer Centre component on patient preferences for information and involvement in medical decisions, their consultation behaviour, and patient and doctor satisfaction with decision making will be studied in a randomised trial with control patients receiving no preparatory materials.Read moreRead less
Understanding And Preventing Avoidable Readmissions: Development Of A Patient Centered And Disease Specific Screening Tool
Funder
National Health and Medical Research Council
Funding Amount
$100,000.00
Summary
This study aims to develop a screenings tool to prevent unplanned re-admissions, based on specific patient centred and disease specific factors. We will include index admission data (367,782 in 2015) of five MACH hospitals. The cohort will be divided into a group for index derivation and a group for internal validation. Variables on patient and admission characteristics are based on literature. After internal validation we will validate the tool externally and implement it in clinical practice
Fundamental flaws in the design and reporting of research outcomes can undermine evidence-based medicine, impede patient-centred care, cause harm to patients, and result in a waste of research dollars. Our 3-year multinational project engages with patients, caregivers, clinicians, researchers and policy makers, to establish core outcomes in haemodialysis. This will ensure that patient-centred outcomes are consistently measured and reported in haemodialysis trials and other forms of research.
Caring For Clinician Health And Wellbeing; Protecting Patients From Harm
Funder
National Health and Medical Research Council
Funding Amount
$1,281,125.00
Summary
Doctors and other clinicians care for the health of others but their own health can also suffer. In turn, unwell clinicians may place patients at risk of harm. My research will analyse ten years of data from the Medical Board and other regulators, interview clinicians who have had a serious illness, and work with international experts to develop solutions. Together, this work will help hospitals and regulators to better protect the health of clinicians and safeguard patients from avoidable harm.
Centre Of Research Excellence: Partnering With Patients With Chronic Kidney Disease To Transform Care And Outcomes (CRE-PACT)
Funder
National Health and Medical Research Council
Funding Amount
$2,500,000.00
Summary
CRE-PACT will partner with patients to generate and translate new high-priority evidence to improve outcomes that are important to people living with chronic kidney disease (CKD). We will address the topics and questions most important to patients. We will build the next generation of research leaders and a community of research-ready patient-partners. There will be an integrated pathway for evidence translation and implementation at a global scale to improve patient-centred outcomes.
Enhancing Communication Between Medical Oncologists And Patients With Advanced Malignancy Considering Clinical Trial Participation, With A Focus On CALD Populations
Funder
National Health and Medical Research Council
Funding Amount
$92,335.00
Summary
In the advanced stages of cancer, some patients will need to choose between multiple options - they might wish to pay for an expensive but unfunded drug, they may consider taking part in a clinical trial or opt to stay at home and focus on the time they have. This project will aim to help patients make these difficult decisions with their clinicians, and will have a focus on those from culturally and linguistically diverse backgrounds as they face additional barriers to trial entry.
Patient-centred Volunteer Program For People With Dementia: A Stepped Wedge Cluster Randomised Controlled Trial Of The MyCare Ageing Program
Funder
National Health and Medical Research Council
Funding Amount
$645,205.00
Summary
The MyCare Ageing program provides hospitalised patients with dementia and/or delirium with tailored emotional and practical support via trained volunteers in hospital and in the transition home. This project will provide critical information on whether MyCare Ageing works to reduce future hospitalisations and prevent poor patient outcomes, the factors that impact on how the program is delivered in hospital and in the community, and whether the program is cost-effective.
INTroducing A Care Bundle To Prevent Pressure Injury (the INTACT Trial)
Funder
National Health and Medical Research Council
Funding Amount
$1,093,250.00
Summary
In Australia, hospital acquired pressure injuries (i.e. bedsores) range from 7.4% – 17.4%. A care bundle is a structured group of interventions associated with improved patient outcomes. The aim of this 3-year cluster randomised controlled trial is to provide rigorous evidence regarding the effect of a patient centred pressure injury prevention care bundle on the development of pressure injuries in patients at risk of developing a hospital acquired pressure injury.