Acute Bronchitis In General Practice: What Factors Predict A Poor Outcome And Can Antibiotics Help?
Funder
National Health and Medical Research Council
Funding Amount
$393,750.00
Summary
In Australia acute bronchitis is one of the commonest reasons for patients to attend their general practitioner. It can have considerable impact on patients lives with patients coughing on average for two weeks, with a third spending some time in bed and a quarter not returning to their usual activities for many weeks. If they attend a general practitioner (GP) it is likely they will receive antibiotics. But researchers believe that antibiotics are over prescribed for this condition and the emer ....In Australia acute bronchitis is one of the commonest reasons for patients to attend their general practitioner. It can have considerable impact on patients lives with patients coughing on average for two weeks, with a third spending some time in bed and a quarter not returning to their usual activities for many weeks. If they attend a general practitioner (GP) it is likely they will receive antibiotics. But researchers believe that antibiotics are over prescribed for this condition and the emergence of bacterial resistance is a real concern to health authorities. GPs are therefore being urged to reduce the prescription of antibioics for this common condition. But surveys by the National Prescribing Service (NPS) indicate that this is one area where GPs find it difficult to meet national recommendations. In part this may be because GPs do not wish to undertreat or miss a serious respiratory illness. Also results from randomised controlled trials examining the effectiveness of antibiotics for acute bronchitis suggest some benefit from treatment, at least in some patients. However it is not clear who these patients are and how much benefit they would get from receiving antibiotics. This creates a great deal of uncertainity for GPs who then opt for a 'just in case prescription' for everyone presenting with acute bronchitis. Our study will re-examine the symptoms, and clinical findings of patients presenting to their GP with acute cough and explore the impact of this common illness on patients lives. We will determine who does and does not benefit from antibiotics, and give guidance to GPs about the symptoms, clinical findings and investigations that predict a poorer outcome. Evidence from this study will be incorporated into treatment guidelines for acute bronchitis leading to more rational and effective management of this common problem.Read moreRead less
Knowledge, Attitude And Practice Of Parents And Primary Care Providers In The Prevention And Management Of Respiratory Tract Infections In Young Children
Funder
National Health and Medical Research Council
Funding Amount
$84,782.00
Summary
Respiratory tract infections (RTIs) account for over 6 million GP visits each year in Australia and children <5 years of age are especially vulnerable. Although preventive and management activities, such as flu vaccinations and hand-washing, have been shown to be efficacious, programs which target RTIs in young children are limited. This proposal aims to understand the current knowledge, attitudes and practice of parents and providers in the prevention and management of RTIs in young children ....Respiratory tract infections (RTIs) account for over 6 million GP visits each year in Australia and children <5 years of age are especially vulnerable. Although preventive and management activities, such as flu vaccinations and hand-washing, have been shown to be efficacious, programs which target RTIs in young children are limited. This proposal aims to understand the current knowledge, attitudes and practice of parents and providers in the prevention and management of RTIs in young children.Read moreRead less
Self-management Support By Trained Health Mentors For People With Chronic Obstructive Pulmonary Disease In The Community
Funder
National Health and Medical Research Council
Funding Amount
$354,380.00
Summary
Chronic Obstructive Pulmonary Disease (COPD) is characterised by persisting limitation to airflow and is usually caused by smoking. This disease significantly reduces quality of life and life expectancy. This fellowship will support full assessment of a new model of community self-management support, health mentoring by trained nurses, for people with COPD that aims to improve their quality of life, decrease health care costs and empower patients to better manage their own disease.
Reducing Antibiotic Use In Primary Care: A Cluster Randomised Trial To Evaluate The Effectiveness Of Decision Aids About Antibiotic Use For Acute Respiratory Infections
Funder
National Health and Medical Research Council
Funding Amount
$325,500.00
Summary
Antibiotic resistance is a worldwide crisis. It means antibiotics no longer work. Reducing their use is critical. Acute respiratory infections (eg ear infections, sore throats, cough) are a target for reducing use as they are the most common reason that general practitioners (GPs) prescribe antibiotics, despite being usually not needed. This trial will test if decision aids reduce antibiotic use, by helping GPs and patients to discuss their benefits and harms and jointly decide about their use.
After the questions: outcomes of routine screening for domestic violence in NSW Health services. Recent research indicates that domestic violence is the leading contributor to death, disability and illness in women aged 15-44 in Australia and leads to health costs of $314 m annually (VicHealth 2004, Access Economics 2004). Routine screening is a low cost measure aimed at prevention and early intervention for domestic violence, which has been successfully introduced for women entering antenatal, ....After the questions: outcomes of routine screening for domestic violence in NSW Health services. Recent research indicates that domestic violence is the leading contributor to death, disability and illness in women aged 15-44 in Australia and leads to health costs of $314 m annually (VicHealth 2004, Access Economics 2004). Routine screening is a low cost measure aimed at prevention and early intervention for domestic violence, which has been successfully introduced for women entering antenatal, early childhood, mental health and drug and alcohol services operated by NSW Health. The research will be the first study of its size to consider the outcomes of routine screening for domestic violence in public health settings in the Australian context.Read moreRead less
Assessing Bone Quality and Health: Experimental imaging, structural characterisation, and mechanical modelling of bone in 3D. Age-related bone fractures due to osteoporosis impose a significant social and economic problem on our increasingly aging population. The assessment of bone quality is important in the diagnosis of age related bone fragility and for studying the efficacy of therapeutic intervens. In this proposal a unique interdisciplinary group with expertise in bone and mineral research ....Assessing Bone Quality and Health: Experimental imaging, structural characterisation, and mechanical modelling of bone in 3D. Age-related bone fractures due to osteoporosis impose a significant social and economic problem on our increasingly aging population. The assessment of bone quality is important in the diagnosis of age related bone fragility and for studying the efficacy of therapeutic intervens. In this proposal a unique interdisciplinary group with expertise in bone and mineral research, experimental 3D imaging and the characterisation and modelling of complex materials will tackle the problem of assessing bone quality and health. The proposed research will greatly improve our assessment of the mechanical competence of bone.Read moreRead less
Preventing Chronic Disease In Patients With Low Health Literacy Using E-health And Teamwork In Primary Health Care.
Funder
National Health and Medical Research Council
Funding Amount
$1,264,893.00
Summary
This study will evaluate whether an innovative intervention tailored to patients’ health literacy improves preventive care for vulnerable and disadvantaged patients in general practice. It will use e-health to support practice nurses to reduce their patients’ risk of chronic disease.
The Centre For Research Excellence In Minimising Antibiotic Resistance For Acute Respiratory Infections [CREMARA]
Funder
National Health and Medical Research Council
Funding Amount
$2,455,000.00
Summary
Antibiotic resistance is threat to international health. Most antibiotics are prescribed for acute respiratory infections. The Centre for Research Excellence in Minimising Antibiotic Resistance for Acute Respiratory Infections focuses on the major contributors to resistance: antibiotic overuse and person-to-person transfer of antibiotic resistance genes. Research will inform the design, evaluation and translation of urgently needed interventions, aimed at clinicians, patients and policy-makers.
The Influence Of Acupuncture On Reducing Women's Pain From Primary Dysmenorrhoea: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$310,875.00
Summary
Dysmenorrhoea refers to painful uterine cramps during menstruation. It is a common condition that affects as many as 50 percent of women. Severe menstrual pain can lead to an absence from work, or attending school, or interference with day to day lives. This condition is commonly treated with non-steroidal anti-inflammatory drugs or the oral contraceptive pill. Studies suggest that between 30-50 percent of the adult population use some form of complementary medicine. Acupuncture, the insertion o ....Dysmenorrhoea refers to painful uterine cramps during menstruation. It is a common condition that affects as many as 50 percent of women. Severe menstrual pain can lead to an absence from work, or attending school, or interference with day to day lives. This condition is commonly treated with non-steroidal anti-inflammatory drugs or the oral contraceptive pill. Studies suggest that between 30-50 percent of the adult population use some form of complementary medicine. Acupuncture, the insertion of fine needles, into specific areas of the body is increasingly being used to treat a number of conditions. It has been indicated in several non-clinical studies and two small clinical trials to be effective with treating dysmenorrhoea. Evidence from the Cochrane systematic review of acupuncture to treat primary dysmenorrhoea concluded acupuncture may be helpful. This study assesses whether women with dysmenorrhoea can be successfully treated using acupuncture. Women experiencing dysmenorrhoea with no underlying pelvic pathology will be offered the opportunity to take part in the trial. Women interested in taking part will be randomly allocated into one of two groups. One group of women will receive acupuncture, a second group will receive control (sham) acupuncture. The second study group involves the insertion of needles away from acupuncture points. Women will receive the treatment intervention for three menstrual cycles and then followed up for a further six months. Women will be asked to report on the pain they experience during menses and to report any time taken off from work or school, disruption with day to day activities, or the need for additional pain relief. In 2005 we expect to report on the effectiveness of this treatment on dysmenorrhoea and whether this treatment is acceptable to women. If the results are positive, it is hoped this will become an option available to women for the management of their dysmenorrhoea.Read moreRead less