Diabetes affects over one million Australians and is an increasing health problem in Australia and worldwide. Diabetes can damage small blood vessels, harming the kidneys and eyes and large blood vessels leading to heart attack, stroke and leg amputation. The research team leading this Centre for Clinical Research Excellence (CCRE) has wide experience in diabetes research and includes experts in diabetes management in hospitals and in the community setting of general practice. There is special e ....Diabetes affects over one million Australians and is an increasing health problem in Australia and worldwide. Diabetes can damage small blood vessels, harming the kidneys and eyes and large blood vessels leading to heart attack, stroke and leg amputation. The research team leading this Centre for Clinical Research Excellence (CCRE) has wide experience in diabetes research and includes experts in diabetes management in hospitals and in the community setting of general practice. There is special expertise in eye disease and in dietary management of diabetes. The research team will conduct research into diabetes, both type 1 diabetes, which usual starts in childhood, and type 2 diabetes that generally affects middle aged or older people, although increasingly is occurring in younger adults as the population becomes more obese. We will focus on the complications, which are common to both types of diabetes, looking for ways to detect them early and prevent them. Our studies will involve groups of up to 10,000 people with diabetes, sometimes followed over 5 or more years. Indigenous Australian groups will be included in the studies as they have a high rates of diabetes and its complications. We will also study ways in which people with type 2 diabetes can be more involved in improving the management of their illness. An exciting part of the study program will involve patients having transplants of insulin producing human islet cells. Although this treatment will be available for only a few patients, it is an important advance towards future treatments using human cells. The CCRE will have a very strong focus on recruiting and training the next generation of doctors and other clinicians involved in diabetes research, including nurses, dietitians and optometrists.Read moreRead less
Can Self-management Education Programs Improve Outcomes Of People With Osteoarthritis?
Funder
National Health and Medical Research Council
Funding Amount
$343,874.00
Summary
Arthritis is a very common disease associated with pain, disability and poor quality of life. An important way that people with arthritis can deal with the disease is through using a variety of self-management behaviours and coping strategies as well as becoming well informed about the best available treatments. A specific course was developed in he US to help people self-manage. It has been available in Australia for 20 years through Arthritis Foundations and has become their core business. Tre ....Arthritis is a very common disease associated with pain, disability and poor quality of life. An important way that people with arthritis can deal with the disease is through using a variety of self-management behaviours and coping strategies as well as becoming well informed about the best available treatments. A specific course was developed in he US to help people self-manage. It has been available in Australia for 20 years through Arthritis Foundations and has become their core business. Treatment guidelines used by doctors to treat people with arthritis regularly recommend that patients should be referred to such courses. Although the course is widely distributed, the evidence scientific evidence regarding its effectiveness is patchy, and some overviews suggest it is not useful at all. Confusion exists regarding the value of the course. While treatment guidelines advise doctors to refer patients to the program by very few GPs, Rheumatologist or Orthopaedic surgeons do refer. The proposed study is a large controlled trial which will provide essential evidence to inform patients, doctors and policy makers on the benefits of the course. It will involve people with well defined moderate to severe arthritis who have consulted a surgeon or rheumatologist. People will be randomised to receive the intervention (two hours per week, six session course including an 'arthritis self-help' book) will be compared with people in a control group (who only receive the book without instruction). People will be followed for 1 year to see if the course improves quality of life, health behaviours, and whether less health care resources (ie attendance at doctors or less medication use) are used. The results of this study will be influential in determining government policy as the number of people with chronic diseases like arthritis is rapidly growing and the acute healthcare system, including hospitals, are poorly equipped to deal with this growing problem.Read moreRead less
An Integrated Health-sector Strategy To Combat COPD And Asthma In Vietnam: A Pragmatic Stepped Intervention Cluster Randomized Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,894,349.00
Summary
Chronic lung diseases are a major challenge for resource limited settings. In Vietnam, where smoking rates in males are around 50%, there is an urgent need for better strategies to prevent and treat chronic obstructive pulmonary disease (COPD) and asthma. We will perform a study of a low-cost integrated intervention including a health-system based smoking cessation program and the targeted use of proven therapy for COPD and asthma - inhaled corticosteroids - to reduce the burden of lung disease.
Inflammometry In Stable COPD; A Randomised Controlled Trial (RCT)
Funder
National Health and Medical Research Council
Funding Amount
$743,351.00
Summary
COPD is a common condition associated with many clinical consequences that negatively impact on quality of life. The burden of illness from COPD remains high despite current treatment. There is an urgent need to improve management of COPD and we propose that individualized management targeted to airway and systemic inflammation will do this. This study will examine the effect of targeted anti-inflammatory treatment in patients with COPD and will examine the role of a simple blood test to assess ....COPD is a common condition associated with many clinical consequences that negatively impact on quality of life. The burden of illness from COPD remains high despite current treatment. There is an urgent need to improve management of COPD and we propose that individualized management targeted to airway and systemic inflammation will do this. This study will examine the effect of targeted anti-inflammatory treatment in patients with COPD and will examine the role of a simple blood test to assess and manage COPD.Read moreRead less
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.
A Comprehensive Self-Management Programme For Chronic Obstructive Pulmonary Disease In The Community
Funder
National Health and Medical Research Council
Funding Amount
$391,610.00
Summary
Chronic obstructive pulmonary disease (COPD) is the third leading cause of burden of disease in Australia. It has a major impact on sufferers, their carers and society. This study introduces a new model of community care, based on case management, mentoring to improve self-efficacy and information systems to deliver information and closely monitor disease status. This will improve the quality of life of sufferers, develop healthcare networks and decrease healthcare utilisation.
Fenofibrate In The Management Of AbdoMinal Aortic AnEurysm (FAME)
Funder
National Health and Medical Research Council
Funding Amount
$455,713.00
Summary
Approximately 5% of men and 1% of women aged over 60 years develop weakening of the main abdominal artery. Currently the management of artery weakening is focused on surgery with no effective medications available. In this study we will assess whether a drug which limits artery weakening in pre-clinical testing also shows evidence of inhibiting processes important in artery damage in patients. We believe this is a critical next step in the assessment of a promising new treatment.
Activating Primary Care COPD Patients With Multi-morbidity (APCOM) Pilot Project
Funder
National Health and Medical Research Council
Funding Amount
$78,309.00
Summary
The Activating Primary Care COPD Patients with Multi-morbidity (APCOM) pilot project aims to empower primary care patients with chronic obstructive pulmonary disease and other co-existing chronic conditions. This will be done by means of a tailored, practice nurse-delivered, self-management intervention designed to improve the participants' disease awareness and coping skills.
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