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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.
Determination Of Irradiation Dose Efficacy For Use In Impaction Grafting At Revision Joint Replacement
Funder
National Health and Medical Research Council
Funding Amount
$411,517.00
Summary
Primary hip replacement is a successful intervention for hip disease, but 10-15% of hip prostheses fail and require revision surgery within 10-15 years. At the time of revision, significant bone loss around the failed prosthesis is not uncommon. A bone reconstruction procedure, called impaction grafting, where donor bone is minced and placed in the areas of deficient bone before implanting the new prosthesis, has shown to give good results at more than ten years in some centres. A high incidence ....Primary hip replacement is a successful intervention for hip disease, but 10-15% of hip prostheses fail and require revision surgery within 10-15 years. At the time of revision, significant bone loss around the failed prosthesis is not uncommon. A bone reconstruction procedure, called impaction grafting, where donor bone is minced and placed in the areas of deficient bone before implanting the new prosthesis, has shown to give good results at more than ten years in some centres. A high incidence of early complications of this procedure have included loss of fixation within the bone. Fracture of the bone around prostheses has also reported in some centres. These events require more surgery, putting the patient at higher risk greater complications and longer rehabilitations. Recent improvements in surgical technique and donor bone preparation have improved results. A current debate questions whether the dose of irradiation can be reduced from 25 kGy, while maintaining sterility of allografts. The risk of bacterial contamination in allografts is low, and irradiation reduces the mechanical strength of the graft, contributing to complications when irradiated bone is used. The benefits of decontaminating the bone may be outweighed by the higher risk for failure due to poor bone quality and resulting prosthesis instability. We will use ISO standards to test the validity of radiation dose for sterilising bone ex vivo. In the absence of controlled human studies, our aim is also to compare the results of impaction grafting with non-irradiated bone versus bone irradiated at current doses used by Australian bone banks, and lower doses indicated by ex vivo testing. We will use a large animal model of revision hip replacement, with precise measures of prosthesis stability. The results of this study will guide clinical decisions regarding the efficacy of current bone graft preparation procedures and the use of irradiated bone in human hip replacement surgery.Read moreRead less
The Risks And Benefits Of Contemporary Total Hip Replacement
Funder
National Health and Medical Research Council
Funding Amount
$493,530.00
Summary
The number of hip replacements undertaken in Australia is steadily increasing. The most common complications of hip replacements are dislocation and loosening due to bone loss around the implant, requiring complex and expensive revision surgery. This study will investigate the incidence of dislocation and, using a new diagnostic imaging technique, the incidence and amount of bone loss around a relatively new prosthetic material, the outcomes of which are not known despite its increasing use.
Maximum Acceptable Risk Of Complication In Total Knee Arthroplasty (MARKA) Study: Using Discreet Choice Experiments To Elicit Patient And Surgeon Perception Of Acceptable Risk In Total Knee Arthroplasty
Funder
National Health and Medical Research Council
Funding Amount
$465,199.00
Summary
Patient expectation is the strongest predictor of satisfaction following total knee replacement. Dissatisfaction with surgery is reported in approximately 1 in 5 patients undergoing knee replacement. Unrealistic patient expectations and uninformed perceptions of potential benefits, risks and limitations of surgery lead to dissatisfaction in many cases. This study will examine the “risk-benefit” preferences in patients and surgeons considering total knee replacement as a treatment option for end- ....Patient expectation is the strongest predictor of satisfaction following total knee replacement. Dissatisfaction with surgery is reported in approximately 1 in 5 patients undergoing knee replacement. Unrealistic patient expectations and uninformed perceptions of potential benefits, risks and limitations of surgery lead to dissatisfaction in many cases. This study will examine the “risk-benefit” preferences in patients and surgeons considering total knee replacement as a treatment option for end-stage osteoarthritis.Read moreRead less
Improving Rehabilitation Outcomes Through Self-Management: My Therapy
Funder
National Health and Medical Research Council
Funding Amount
$743,438.00
Summary
We must ensure patients have enough therapy practice for the best inpatient rehabilitation outcomes. During rehabilitation, we know patients don't often receive enough therapy and actually spend most of the day sitting and lying down. My Therapy was designed to increase independent practice of therapy exercises during rehabilitation, in addition to usual care, without additional staff. Through My Therapy, patients achieved 100 extra minutes of weekly therapy participation and better function.
Improving patient health outcomes in acute care hospital settings using mobile wireless technology and handheld computers. This project will investigate the use of wireless handheld computers, in three acute care clinical units located at Southern Health and the Royal Women's Hospital, to determine the impact on patient safety and quality of care. There is a need for real time point-of-care access (and input) to patient information, nursing reference information, and drug information for nurses ....Improving patient health outcomes in acute care hospital settings using mobile wireless technology and handheld computers. This project will investigate the use of wireless handheld computers, in three acute care clinical units located at Southern Health and the Royal Women's Hospital, to determine the impact on patient safety and quality of care. There is a need for real time point-of-care access (and input) to patient information, nursing reference information, and drug information for nurses in Australian hospitals. This project aims to address this need by providing nurses with wireless handheld access to such resources. This project is extremely significant, as the outcomes will provide nurses, in Australia and overseas, a set of guidelines for managing wireless handheld computers in clinical units, to enhance patient safety and quality of care.Read moreRead less
Footwear For Self-managing Knee Osteoarthritis Symptoms: The Footstep Trial
Funder
National Health and Medical Research Council
Funding Amount
$590,532.00
Summary
Self-management of symptoms is an important part of treatment for people with knee osteoarthritis. Footwear influences forces across the knee joint and it is unclear which types of shoes are best to minimise arthritis symptoms. This study will compare the effects of flat flexible shoes to stable supportive shoe styles on pain and physical function over 6 months in people with painful knee osteoarthritis.
Harnessing Information Technology To Improve Self-management Behaviours And Health Outcome In People With Heart Failure: A Smarthome Ecosystem Living Lab Study
Funder
National Health and Medical Research Council
Funding Amount
$1,120,226.00
Summary
The burden of heart failure in Australia is substantial. Management of heart failure is complex and requires self-management of symptoms and behaviour change, which requires ongoing education and support to achieve. Current approaches for supporting self-management do not meet the needs of people with heart failure or the healthcare system. This Australian first project aims to co-design an intelligent smart home ecosystem (Smart Heart) to support the management for people with heart failure.
Stroke is a medical emergency. Admission to a stroke unit; administration of clot busting therapy to eligible patients; and treatment of fever, raised blood sugar and swallowing difficulties are therapies with demonstrated evidence to reduce death and disability. Our study will rigorously evaluate an organisational intervention to deliver these initiatives in Emergency Departments. We hypothesise this will deliver further significant improvements in 90-day health outcomes and patient recovery.
A Multi-centre RCT To Prevent Secondary Falls In Older People Presenting To The Emergency Department With A Fall
Funder
National Health and Medical Research Council
Funding Amount
$1,534,471.00
Summary
Falls are a leading cause for presentation to Emergency Departments (EDs) by older patients. More than 50% who present to ED with a fall injury have fallen in the previous year. RESPOND is an innovative post-ED discharge program designed to reduce secondary falls in older people. RESPOND extends current falls prevention research and practice by incorporating patient-centred education with behaviour change strategies proven to be effective in the secondary prevention of cardiovascular events.