Controlled Clinical Trial Of Desensitization To Chronic Pain
Funder
National Health and Medical Research Council
Funding Amount
$349,149.00
Summary
An estimated 17.1% of males and 20.0% of females in NSW report having chronic pain. Chronic pain sufferers are major users of health services, with frequent medical consultations and high pharmacological consumption. A recent NSW population-based study found that 78% of pain sufferers had consulted at least one healthcare practitioner in the previous 6 months about their pain, and 71% of those sampled were taking regular oral analgesic medications. Disability due to chronic pain is often associa ....An estimated 17.1% of males and 20.0% of females in NSW report having chronic pain. Chronic pain sufferers are major users of health services, with frequent medical consultations and high pharmacological consumption. A recent NSW population-based study found that 78% of pain sufferers had consulted at least one healthcare practitioner in the previous 6 months about their pain, and 71% of those sampled were taking regular oral analgesic medications. Disability due to chronic pain is often associated with higher levels of distress and use of healthcare services. Unfortunately, at present there are no lasting curative treatments for most chronic pain conditions and most people with these conditions are told they have to learn to live with their ongoing pain. One of the most effective ways of teaching chronic pain sufferers to live with their pain are known as cognitive behavioural therapy (CBT) interventions. But even though many find these methods helpful, a significant proportion of cases remain distressed by their pain. This places them at higher risk of relapse and further treatment seeking. If this group of pain sufferers could be taught more effective ways of minimising their pain-related distress, their overall functional and long-term quality of life goals could be maximised. The study has the potential to achieve a major improvement in outcomes for distressed patients with disabling chronic pain, traditionally a very intractable group. The study would also have important implications for the prevention of disability associated with persisting pain. If successful, it could alter the ways in which many health professionals advise patients to cope with their chronic pain, especially in relation to the use of the common modalities of relaxation and distraction techniques, as well as the use of pain reducing interventions. The study represents the first major clinical test of an alternative to these traditional modalities.Read moreRead less
Referral Of Men Newly Diagnosed With Prostate Cancer To A Telephone-based Support Program
Funder
National Health and Medical Research Council
Funding Amount
$299,125.00
Summary
Cancer diagnosis and treatments are stressors of major proportions. There is compelling evidence that providing information, education and counselling services helps reduce emotional distress and improves quality of life among newly-diagnosed cancer patients. The public health challenge for improving the supportive care of cancer patients is to find a cost-effective way to deliver these services to this population. Our response to this challenge is to test an innovative program that involves the ....Cancer diagnosis and treatments are stressors of major proportions. There is compelling evidence that providing information, education and counselling services helps reduce emotional distress and improves quality of life among newly-diagnosed cancer patients. The public health challenge for improving the supportive care of cancer patients is to find a cost-effective way to deliver these services to this population. Our response to this challenge is to test an innovative program that involves the cancer specialist referring newly-diagnosed cancer patients to the Cancer Council Victoria's telephone information service staffed by nurse counsellors, as an integral part of the patient's treatment management. The program involves the nurse counsellor contacting patients and providing information and support at key times in the first six months after diagnosis. In this study, we will focus on prostate and male colorectal patients. The most common registrable cancers in males are prostate and colorectal cancer; male cancer patients are a group known to underutilise support services and among whom less research has been conducted on ways to improve adjustment to a cancer diagnosis and treatment. If effective, this program could provide a way for supportive care to be included among cancer patients, even those treated in rural centres, or where a multidisciplinary team is not yet available.Read moreRead less
A Comparative Clinical Efficacy Trial Of Treatments For Melancholia
Funder
National Health and Medical Research Council
Funding Amount
$309,711.00
Summary
This study seeks to improve treatment of melancholic depression by comparing three treatments, i) a selective serotonin reuptake inhibitor (SSRI), ii) cognitive behaviour therapy (CBT) and, iii) a broad-spectrum antidepressant sequencing treatment approach. We hypothesize that the latter will be superior to both i) SSRI monotherapy, and ii) CBT monotherapy, over a 12-week trial period. Comparisons will be made with the US-based Sequenced Treatment Alternatives to Relieve Depression trial.
Single-focussed Versus Integrated Cognitive Behaviour Therapy For Co-occurring Depression And Alcohol Use Problems
Funder
National Health and Medical Research Council
Funding Amount
$777,500.00
Summary
This study is significant and timely in that it proposes a large-scale randomised controlled trial of cognitive behaviour therapy (CBT) for people with co-occurring depression and alcohol use problems. To date, very few researchers have conducted research within this population, whose complex presentation makes it difficult for treatment providers to select and deliver effective treatment programs. Thus, although rates of depressive disorders and alcohol use problems are on the increase in our c ....This study is significant and timely in that it proposes a large-scale randomised controlled trial of cognitive behaviour therapy (CBT) for people with co-occurring depression and alcohol use problems. To date, very few researchers have conducted research within this population, whose complex presentation makes it difficult for treatment providers to select and deliver effective treatment programs. Thus, although rates of depressive disorders and alcohol use problems are on the increase in our community, it is still not clear how best to manage and treat this group of people. Typically, people will often receive treatment for one part of their presentation, for example their depression or alcohol use problem. However, it is uncommon for the two conditions to be treated in an integrated way. This is certainly true for psychological treatments. Research programs to date have explored effective treatments for depression and alcohol use in the absence of the co-occurring condition. Currently it is not known how well people with co-occurring alcohol use problems and depression respond to treatments with a singular focus. Furthermore, it is not known whether integrating both alcohol use and depressive treatment approaches provides any additional benefit. This study is therefore significant, as it is one of the first to explore effective treatment approaches among people with co-occurring depressive and alcohol use problems. Resolution of these issues will better inform the treatment choices of clinicians practicing in both mental health and alcohol-other drug settings. Importantly, this will potentially improve the match between treatment and people with depression and substance use problems, a clinically prevalent population encountered in community settings.Read moreRead less
Impact Of Genetic Testing For Breast Cancer Predisposition On Psychological Adjustment And Related Health Behaviours.
Funder
National Health and Medical Research Council
Funding Amount
$96,897.00
Summary
This Australia-wide, longitudinal study will examine the psychological effects of testing for breast cancer predisposing genes in women with a strong family history of breast cancer. Mutation detection carries with it the possibility of improving survival through increased emphasis on screening and prevention, while those found to be non-carriers can return to population screening levels, alleviating both their anxiety and the costs associated with greater vigilance. Preventative surgery is now ....This Australia-wide, longitudinal study will examine the psychological effects of testing for breast cancer predisposing genes in women with a strong family history of breast cancer. Mutation detection carries with it the possibility of improving survival through increased emphasis on screening and prevention, while those found to be non-carriers can return to population screening levels, alleviating both their anxiety and the costs associated with greater vigilance. Preventative surgery is now known to significantly reduce risk in women with a strong family history of breast cancer. Whether these potential benefits are realised in practice needs to be evaluated, as do potential psychological harms, if any. Predictive genetic testing for hereditary breast cancer has become technically possible before its impact on psychological outcomes has been evaluated. As yet there are no Australian data on the impact of predisposition testing in any potentially treatable adult onset conditions and only preliminary overseas data. Results from this study may therefore have application to other potentially treatable adult onset conditions. Changes before and after testing in psychological status will be studied (using established methodology) over a 2-year period to identify when negative outcomes are most likely to occur. In addition, this study aims to identify factors that facilitate or hinder psychological adjustment so as to inform clinical decisions about testing and to allow appropriate interventions to be devised. Assessment of individual's preferences for the amount of information they receive will allow tailoring of information to maximise the benefit of educational materials and potentially minimise distress. Factors which influence women's decisions to undertake prophylactic surgery and their satisfaction with those procedures will be assessed.Read moreRead less
Living In A Rural Community:determinants And Consequences Of Mental Health And Wellbeing.
Funder
National Health and Medical Research Council
Funding Amount
$729,415.00
Summary
Th e proposed study will investigate individual, family and community factors associated with the mental health and wellbeing of residents in rural communties of NSW. It will also examine rural residents' perceptions of their mental health needs and their access and utilisation of health services. The study will be conducted in 3 rural Area Health Services in NSW (Greater Western,Hunter New England and North Coast) comprising 70% of the rural population of NSW. These health regions encompass rur ....Th e proposed study will investigate individual, family and community factors associated with the mental health and wellbeing of residents in rural communties of NSW. It will also examine rural residents' perceptions of their mental health needs and their access and utilisation of health services. The study will be conducted in 3 rural Area Health Services in NSW (Greater Western,Hunter New England and North Coast) comprising 70% of the rural population of NSW. These health regions encompass rural, remote and coastal NSW. We aim to conduct the mail and telephone survey on adults residing in 4000 households across the 3 regions. Unique aspects of the study include: i) Examination of a diverse range of rural communities which will provide the opportunity to investigate the influence and interaction of specific community characteristics on mental health. These community factors will include social and economic factors, severity of rural environmental stress (eg drought), and the levels of access to health and other services. ii) Focus on the household and its members so as to examine the mental health needs of family groups in rural communities. This cross-sectional study will form the baseline for a longitudinal study investigating the changes experienced by rural families over time and the impact of such change on mental health outcomes.Read moreRead less
MALE OSTEOPOROSIS: A POPULATION-BASED STUDY IN GEELONG
Funder
National Health and Medical Research Council
Funding Amount
$432,645.00
Summary
Osteoporosis is a term used to indicate that bones have become thin and fragile. During the ageing process bone fragility increases and fractures occur more easily and more often. Fractures may also occur during normal daily activities, with fractures of the spine, forearm and hip being common. However, many other sites may fracture. This is a serious problem because fractures cause pain, disability and, sometimes, death. Although previously overshadowed by its effect in women, osteoporosis is i ....Osteoporosis is a term used to indicate that bones have become thin and fragile. During the ageing process bone fragility increases and fractures occur more easily and more often. Fractures may also occur during normal daily activities, with fractures of the spine, forearm and hip being common. However, many other sites may fracture. This is a serious problem because fractures cause pain, disability and, sometimes, death. Although previously overshadowed by its effect in women, osteoporosis is increasingly being recognised in men. In Australia, 39% of all fractures occur in men and prognosis for fracture in men is worse than in women. A consequence of increasing male longevity is that osteoporosis will affect a growing number of Australian men. It is anticipated that between 1996 and 2051, the number of men with fracture will double, with a 4-fold increase in the number of male hip fractures. Unless the problem of osteoporosis in men is addressed and effective interventions are implemented, the substantial health burden imposed by age-related fractures will continue to escalate. In this case-control study of fracture risk in men, men with fractures (cases) will be identified prospectively for 3 years from radiological reports. Controls will be selected concurrently, at random from electoral rolls. Anticipated number of cases and controls are 800 and 1400, respectively. Cases and controls will be characterised for risk factors for fracture: bone density and bone geometry will be measured, serum samples collected, and diet, lifestyle and medical history documented by questionnaire. The advantage of this type of data is that information from patients with fracture will be used to tell us about the risk of fracture in healthy, unaffected men and about the characteristics of the Australian male population at risk for fracture. The information can be used in decision making for the individual and in policy making for the whole population.Read moreRead less