The Development And Evaluation Of Management Strategies Designed To Address Poly-morbidity In Older People: Implications
Funder
National Health and Medical Research Council
Funding Amount
$2,150,705.00
Summary
Medicines are used to prevent or manage the symptoms of chronic disease, and thus their appropriate use impacts significantly on the quality of life of the elderly. Poly-morbidity, multiple chronic health problems affecting the one individual, is a common and increasing issue in our ageing population. In Australia, 60% of 65 year olds have 2 or more chronic conditions, while 80% of 85 year olds have 4 or more chronic conditions. As a result, medicine use is almost universal in the older populati ....Medicines are used to prevent or manage the symptoms of chronic disease, and thus their appropriate use impacts significantly on the quality of life of the elderly. Poly-morbidity, multiple chronic health problems affecting the one individual, is a common and increasing issue in our ageing population. In Australia, 60% of 65 year olds have 2 or more chronic conditions, while 80% of 85 year olds have 4 or more chronic conditions. As a result, medicine use is almost universal in the older population and it is common for older patients to take multiple medications concurrently. There are no studies which report on current patterns of care and their outcomes in these patients. The use of individual disease-specific management guidelines may be problematic for those with poly-morbidity. Disease specific treatment guidelines often fail to take into account complexities that arise when patients suffer from more than one chronic disease particularly when it is common for one treatment to be both beneficial and harmful in the same person. In addition, the evidence for medicine-based treatment often comes from studies on younger people. Consequently, older patients with lower tolerance are at a greater risk of adverse drug reactions and are admitted to hospital as a result of such reactions at a disproportionately high rate. The aim of this study is to establish a methodology, by examination of two health databases, for developing guidelines to achieve the best possible outcomes for older Australians with common combinations of chronic conditions. This research will provide a better understanding of the consequences of current patterns of care for older people with multiple chronic conditions, and enable the development of improved approaches to care. We will demonstrate the methodology using selected commonly occurring combinations of chronic conditions in older Australians. More realistic guidelines generated by undertaking this analysis in these major population databases will reduce the extent to which the elderly are placed at risk of adverse drug reactions, and better enable health care practitioners, in consultation with their elderly patients, to ensure the best possible health and quality of life outcomes for many older Australian patients who suffer from two or more chronic conditions.Read moreRead less
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
Optimising Prevention And The Management Of Care For Australians With Or At Risk Of Serious And Continuing Chronic Illne
Funder
National Health and Medical Research Council
Funding Amount
$3,760,301.00
Summary
The project aims to study three prototype conditions - cardiovascular disease, diabetes and chronic obstructive pulmonary disease - in people aged 45 to 85 in the Sydney West Area Health Service and the Australian Capital Territory with a view to implementing and evaluating new models of care and developing policies that observe accurately the current state of the art technologies, discern the gaps in knowledge, locate the barriers to optimality and engage policy makers in practical proposals ab ....The project aims to study three prototype conditions - cardiovascular disease, diabetes and chronic obstructive pulmonary disease - in people aged 45 to 85 in the Sydney West Area Health Service and the Australian Capital Territory with a view to implementing and evaluating new models of care and developing policies that observe accurately the current state of the art technologies, discern the gaps in knowledge, locate the barriers to optimality and engage policy makers in practical proposals about how best to use the currently available resources to achieve better health outcomes.Read moreRead less
The Pacific OPIC Study - A Four Country Study Of Obesity Prevention In Communities
Funder
National Health and Medical Research Council
Funding Amount
$1,600,580.00
Summary
Obesity is a rapidly escalating, worldwide epidemic. Many countries recognise the need to prevent obesity but there is insufficient evidence about what interventions work. The Pacific Obesity Prevention in Communities (OPIC) Project will provide data on the effectiveness of a range of interventions to prevent obesity among young people in Fiji, Tonga, New Zealand and Australia. Prevention research is particularly required in countries such as Fiji and Tonga because their prevalence of obesity is ....Obesity is a rapidly escalating, worldwide epidemic. Many countries recognise the need to prevent obesity but there is insufficient evidence about what interventions work. The Pacific Obesity Prevention in Communities (OPIC) Project will provide data on the effectiveness of a range of interventions to prevent obesity among young people in Fiji, Tonga, New Zealand and Australia. Prevention research is particularly required in countries such as Fiji and Tonga because their prevalence of obesity is extremely high. The interventions used in this project will be culturally appropriate and include at least 1000 young people in each intervention group. The outcomes of this project will be applicable to both low- and high-income countries. This project will lead to a greater understanding of the socio-cultural, policy, and economic contexts and provide crucial evidence for public health action to prevent obesity.Read moreRead less
Strenthening The Contribution Of Australian General Practice To The Control Of Pandemic Influenza
Funder
National Health and Medical Research Council
Funding Amount
$110,257.00
Summary
Most primary and preventive care in Australia occurs in general practice. Australian general practice will therefore have a critical role to play in control efforts during an influenza pandemic, and also in sustaining other primary health care activities. After an initial surge in attendances, there may be a decline in attendance, as Australians become more reluctant to congregate in a place where they may become ill. This study seeks to complement the Australian Pandemic Influenza Management Pl ....Most primary and preventive care in Australia occurs in general practice. Australian general practice will therefore have a critical role to play in control efforts during an influenza pandemic, and also in sustaining other primary health care activities. After an initial surge in attendances, there may be a decline in attendance, as Australians become more reluctant to congregate in a place where they may become ill. This study seeks to complement the Australian Pandemic Influenza Management Plan by developing a range of action plans for use by general practitioners and public health authorities to support essential primary health care functions through a pandemic, and maximize general practice's contribution to control efforts. A range of methods will be used, including systematic review of existing literature, economic modeling of the Medicare costs and savings of different models of health care, interviews with key informants who have helped develop disaster response plans for general practice, or who are in positions of leadership. The project will culminate in the development of a simulation exercise to be used as a self-assessment tool for general practitioners, and a summit of general practice stakeholders who will help to finalise agreed action plans for the general practice response to pandemic influenza.Read moreRead less
Understanding The Dynamics Of The Medical Workforce To Improve Population Health And Equity Of Access: The Australian Lo
Funder
National Health and Medical Research Council
Funding Amount
$2,278,544.00
Summary
The health workforce is now a key area of government policy. The ageing of the medical workforce, combined with more women entering medicine and changes in doctors preferences over their work-life balance, are all likely to have important effects on the ability of health care system to provide good quality and accessible health care. However, there is little knowledge or understanding of how and why doctors make decisions on how many hours they work, their location of work, including working in ....The health workforce is now a key area of government policy. The ageing of the medical workforce, combined with more women entering medicine and changes in doctors preferences over their work-life balance, are all likely to have important effects on the ability of health care system to provide good quality and accessible health care. However, there is little knowledge or understanding of how and why doctors make decisions on how many hours they work, their location of work, including working in rural and remote areas, and decisions to leave the medical workforce and retire. These decisions have important effects on the population�s access to health care and therefore on their health status and quality of care received. The aim of this research is to examine those factors influencing doctors� labour supply decisions through the establishment of the Australian Longitudinal Survey of Doctors (ALSD). The survey will track 5,500 doctors over an initial four year period. The research will provide a rigorous analysis of medical workforce decisions that underpin workforce distribution and the working patterns of doctors. The survey will be used to evaluate and simulate policy changes and provide important evidence to support future policy developments.Read moreRead less
Assessment To Service Outcomes - Care Pathways For Older Australians With Dementia, CVD And Arthritis
Funder
National Health and Medical Research Council
Funding Amount
$656,029.00
Summary
The project aims to use existing data source to answer questions similar to �What happens to people after they have been assessed and recommended for aged care? in respect of service delivery for people with one of the three chronic conditions dementia, arthritis or cardiovascular disease. The project is to provide information about issues such as �bed blockers� and determine if the outcomes are different for people who have been assessed for aged care while they are in hospital. It is to chart ....The project aims to use existing data source to answer questions similar to �What happens to people after they have been assessed and recommended for aged care? in respect of service delivery for people with one of the three chronic conditions dementia, arthritis or cardiovascular disease. The project is to provide information about issues such as �bed blockers� and determine if the outcomes are different for people who have been assessed for aged care while they are in hospital. It is to chart changes in service use over time and examine factors that affect the type of care used by older people.Read moreRead less