Health, Economic, Psychological And Social Impact Of Educating Carers Of Patients With Advanced Pulmonary Disease (APD)
Funder
National Health and Medical Research Council
Funding Amount
$605,452.00
Summary
Our study aims to understand the health, economic and social costs associated with caring for patients with advanced pulmonary disease (APD) and to determine health, economic and social impact of improving the skills of caregivers of patients with APD has on patients and their carers. Patients with APD are a large population at high risk of health resource use, unnecessary medication use and emergency admission to hospital or residential care facilities. Although previous research has identified ....Our study aims to understand the health, economic and social costs associated with caring for patients with advanced pulmonary disease (APD) and to determine health, economic and social impact of improving the skills of caregivers of patients with APD has on patients and their carers. Patients with APD are a large population at high risk of health resource use, unnecessary medication use and emergency admission to hospital or residential care facilities. Although previous research has identified difficulties experienced by caregivers of the elderly in general, very little research has been undertaken with carers of patients with APD. The study will compare the usual practice of educating patients with APD who commence home oxygen therapy (HOT), and their carers, against a more detailed and individually targeted education program that increases the skills of patients and carers. This study has the potential to reduce hospital-residential care readmission, reduce carer distress, improve patient outcomes, reduce adverse effects of oxygen therapy and medication use, and minimize inappropriate presentation to tertiary care emergency departments.Read moreRead less
Gabapentin In The Treatment Of Idiopathic Chronic Cough: A Randomised Double-blind Placebo-controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$331,229.00
Summary
Better treatment approaches are needed to address the significant quality of life impairment associated with chronic cough. We propose to conduct a double-blind, placebo controlled study comparing the efficacy (and safety) of oral gabapentin therapy on cough reflex severity and cough-specific quality of life in people with idiopathic cough. The advantages are a strong design, use of objective assessment techniques, and investigation of a new treatment modality for cough.
Multi-centre RDBC Trial Of Oxygen Vs Air For Relief Of Breathlessness In Terminally-ill Patients With Intractable Dyspno
Funder
National Health and Medical Research Council
Funding Amount
$149,701.00
Summary
This study will compare the effects of oxygen and air in the relief of breathlessness in patients at the end of life who do not currently qualify for home oxygen. This landmark study will provide accurate information about any benefits that oxygen offers for breathlessness in this setting. This international multi-site study will ask 226 people to participate using either oxygen or air for 7 days while keeping a diary. We will measure breathlessness, quality of life, anxiety and side effects exp ....This study will compare the effects of oxygen and air in the relief of breathlessness in patients at the end of life who do not currently qualify for home oxygen. This landmark study will provide accurate information about any benefits that oxygen offers for breathlessness in this setting. This international multi-site study will ask 226 people to participate using either oxygen or air for 7 days while keeping a diary. We will measure breathlessness, quality of life, anxiety and side effects experienced.Read moreRead less
The AMAZES Study: Asthma And Macrolides: The AZithromycin Efficacy And Safety Study
Funder
National Health and Medical Research Council
Funding Amount
$3,157,566.00
Summary
Asthma is a health priority for Australia where better and new treatment approaches are needed. This project tests the benefit of a common antibiotic for use in asthma. We propose to conduct a large-scale, multicentre, double-blind, placebo controlled study comparing the efficacy (and safety) of the addition of oral low dose azithromycin to maintenance asthma therapy on the incidence of asthma exacerbations and clinical asthma status in participants with asthma.
Parent Initiated Oral Prednisolone For Acute Asthma In Children Aged 5-11 Years: Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$139,250.00
Summary
The objective of this trial is to determine whether parents should commence prednisolone (a steroid anti-inflammatory drug) for an asthma attack in their child without waiting to see a doctor first. This strategy could be described as parent initiated prednisolone in asthma (PIPA). PIPA is an important consideration in every child's asthma management plan, but because of a lack of research evidence the role of PIPA is not clarified in any of the international asthma guidelines. Hence prednisolon ....The objective of this trial is to determine whether parents should commence prednisolone (a steroid anti-inflammatory drug) for an asthma attack in their child without waiting to see a doctor first. This strategy could be described as parent initiated prednisolone in asthma (PIPA). PIPA is an important consideration in every child's asthma management plan, but because of a lack of research evidence the role of PIPA is not clarified in any of the international asthma guidelines. Hence prednisolone is rarely commenced without waiting for a preceding medical review. PIPA has the potential to significantly reduce the health and economic burden of the disease by increasing the proportion of asthma exacerbations managed at home rather than in the emergency department or hospital. Prednisolone has been shown to be an effective drug when it is given to children with an asthma attack that is severe enough for them to attend hospital. Whilst it would seem logical that PIPA should be an effective strategy it is important to recognise that mild attacks are far more common than severe ones, and the promotion of PIPA as standard practice would be associated with a significant increase in the frequency prednisolone administration. As such it is important to determine if prednisolone is safe and effective when commenced in the home setting. The PIPA trial has many unique features: It is community based, where the vast majority of asthmatic children are managed. The eligibility criteria and dosing schedule have been chosen to mimic 'real world' management and it will be easy for clinicians and families to interpret and apply the results. A very large number of children will be involved (308) which has been made feasible by the trial setting and recruitment methods. Furthermore the protocol has been designed in accordance with the highest standards specified by the international research community and has been submitted to 'The Lancet' for pre-trial publication.Read moreRead less
The Clinical Effectiveness Of A Simple New Treatment For Supine-dependent Obstructive Sleep Apnoea
Funder
National Health and Medical Research Council
Funding Amount
$529,178.00
Summary
Obstructive sleep apnoea is a common and debilitating breathing problem in sleep with serious effects on sleep and health. A third of patients could be very simply treated by avoiding sleeping on their back. Existing treatments are uncomfortable, often not used and better options are needed. This project will test symptom relief and treatment adherence with a new comfortable low cost supine avoidance therapy against current best practice treatment.
Amoxycillin For Persistent Nasal Discharge In Rural And Remote Aboriginal Children: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$226,738.00
Summary
Aboriginal children have the highest rates of acute and chronic respiratory diseases ever documented. While the underlying cause is socioeconomic disadvantage, the features of poverty that result in disease are not clear. Our current understanding of important risk factors like overcrowding, malnutrition and smoke exposure cannot completely explain the excessively high rates of disease seen in rural and remote Aboriginal communities. This randomised, double-blind, placebo-controlled clinical tri ....Aboriginal children have the highest rates of acute and chronic respiratory diseases ever documented. While the underlying cause is socioeconomic disadvantage, the features of poverty that result in disease are not clear. Our current understanding of important risk factors like overcrowding, malnutrition and smoke exposure cannot completely explain the excessively high rates of disease seen in rural and remote Aboriginal communities. This randomised, double-blind, placebo-controlled clinical trial will measure the impact of antibiotic treatment on persistent nasal discharge and rates of transmission of bacterial respiratory pathogens. An innovative study design will test the efficacy of twice daily doses of amoxycillin on newly developed clinical and bacteriological outcome measures. Both the investigators and the Aboriginal community have considerable experience in conducting this type of research and are committed to using a cooperative model of clinical research to reduce disease burden. Ongoing training of Aboriginal health workers in the principles of clinical epidemiology is an essential component of this process. This study will make an important contribution to the medical literature. Despite the deaths of around 10,000 children children from acute respiratory infections each day, very little is known about how antibiotics affect the transmission of some of the principal causative organisms. This project will greatly assist the development of appropriate antibiotic prescribing practices in high-risk populations.Read moreRead less
The Sleep Apnea Cardio Vascular Endpoints (SAVE) Study
Funder
National Health and Medical Research Council
Funding Amount
$1,177,047.00
Summary
Obstructive sleep apnea (OSA) affects 7% of the population and is increasing with the global epidemic of obesity. Research suggests that OSA may be a cause of premature cardiovascular (CV) disease, but definitive proof is lacking. This 5-year trial will answer this question by comparing the rate of CV events (eg stroke, heart attack) in OSA patients who are treated, versus those not treated, with CPAP. The results may lead to a new medical approach to the prevention of CV disease.
A Randomised Controlled Trial Of CPAP Versus Oral Appliance In Obstructive Sleep Apnoea
Funder
National Health and Medical Research Council
Funding Amount
$416,155.00
Summary
Obstructive sleep apnoea (OSA) is a very common disorder, affecting approximately 25% of women and 9% of men in the middle-aged workforce . It is characterised by repetitive, complete or partial closure of the throat passage during sleep, resulting in sleep disturbance and low oxygen levels. When associated with symptoms, termed Obstructive Sleep Apnoea Syndrome, it occurs in 4% of men and 2% of women in middle age. OSA is recognised as a serious public health problem. Continuous Positive Airway ....Obstructive sleep apnoea (OSA) is a very common disorder, affecting approximately 25% of women and 9% of men in the middle-aged workforce . It is characterised by repetitive, complete or partial closure of the throat passage during sleep, resulting in sleep disturbance and low oxygen levels. When associated with symptoms, termed Obstructive Sleep Apnoea Syndrome, it occurs in 4% of men and 2% of women in middle age. OSA is recognised as a serious public health problem. Continuous Positive Airway Pressure is the gold standard treatment, and has been demonstrated to produce major health benefits. However, there is growing evidence supporting the use of oral appliances to treat OSA, which are potentially simpler to use. It is thought that these work by enlarging the throat passage. Recent practice guidelines recommend their use as a first line treatment for mild to moderate OSA. The aim of this project is to directly compare the health benefits achievable with these therapies, taking into account patient compliance and preference, and will assist in the development of protocols for the use of these treatments in clinical practice.Read moreRead less