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Patient non-compliance, such as the failure to take prescribed medicines, reduces the potential benefits of healthcare and represents a major cost to the public healthcare system. A financial incentive for patient compliance is one method which has been used to attempt to reduce this public health cost. However, the use of financial incentives has been viewed as unethical. This thesis aims to critically evaluate the main ethical objections to the use of such incentives.
A Randomized Placebo-controlled Trial Of A Herbal Preparation In Functional Dyspepsia:
Funder
National Health and Medical Research Council
Funding Amount
$643,680.00
Summary
Functional dyspepsia is characterisd by relapsing upper abdominal symptoms (pain, early satietation, fullness, bloating) without identifiable cause if routine diagnostic measures are utilised. This condition is highly prevalent affecting between 10 and 25 % of the population and causes substantial costs to the society due to medical consultations, diagnostic work-up and treatment. So far, treatments with chemically defined medication are disappointing with only a small proportion of patients exp ....Functional dyspepsia is characterisd by relapsing upper abdominal symptoms (pain, early satietation, fullness, bloating) without identifiable cause if routine diagnostic measures are utilised. This condition is highly prevalent affecting between 10 and 25 % of the population and causes substantial costs to the society due to medical consultations, diagnostic work-up and treatment. So far, treatments with chemically defined medication are disappointing with only a small proportion of patients experiencing sufficient relief. More recently, some herbal preparations have been tested in Europe in clinical trials and found to be effective, but comparisons with chemically defined treatments. However, data from Australia are lacking. In addition no study has been conducted so far that assessed and compared the cost-efficacy of a herbal preparations and a chemically defined treatment. Thus this project aims to assess and compare the effects of a standardised herbal preparation (STW-9) and-or a proton pump inhibitor on the relief of symptoms and the cost-efficacy in patients suffering from functional dyspepsia. In addition, we will assess whether there is an association between the clinical response (complete or substantial improvement of symptoms) and the symptom pattern, the changes of the sensitivity of the stomach (as assessed with a standardised nutrient challenge) and we will elucidate the role of specific receptor channels called Transient Receptor Potential (TRP) channels that are involved in the manifestation of abdominal sysmptoms such as pain or discomfort. This study will establish the cost-efficacy of a standardised herbal preparation (as compared to the stablshed treatment standard), allows to identify subgroups of patients who will most likely respond to therapy and gain insights into the underlying mechanisms. Thus, this study bears the potential to substantially improve the quality of care and cost efficacy of treatment of patients with this highly prevalent disease.Read moreRead less
A Randomised Trial To Implement Systematic Distress Screening And Structured Care For Callers Using Cancer Councils' Telephone Services
Funder
National Health and Medical Research Council
Funding Amount
$289,279.00
Summary
Distress interferes with the ability to cope with cancer, its symptoms and treatment. Checking for distress and offering the right type of support should help reduce distress. In collaboration with state Cancer Councils, this study will test the costs and benefits of putting structured care into practice for people using Cancer Council telephone support services.
Understanding Health Service System Needs For People With Intellectual Disability
Funder
National Health and Medical Research Council
Funding Amount
$1,216,389.00
Summary
The health of people with intellectual disability (ID) is one of the poorest of any group in Australia. People with ID experience higher rates of ill health, poor access to responsive health services and premature death. Our research will develop the first comprehensive profile of health, health service and medicines use and costs for people with ID, and will examine the impact of the National Disability Insurance Scheme (NDIS) on these metrics.
The Impact Of Hospital-based Aged Care And Dementia Services On Outcomes For People With Dementia Admitted To Hospital-a
Funder
National Health and Medical Research Council
Funding Amount
$1,308,580.00
Summary
This research explores how hospital based aged care and dementia services influence outcomes for people with dementia who are admitted to hospital. Using detailed data for NSW public hospitals, it will provide information about the kinds of hospital based aged care and dementia services available to assist people with dementia, and how the level and mix of these services is associated with different patient outcomes, including lower rates of admission to hospital. There is considerable evidence ....This research explores how hospital based aged care and dementia services influence outcomes for people with dementia who are admitted to hospital. Using detailed data for NSW public hospitals, it will provide information about the kinds of hospital based aged care and dementia services available to assist people with dementia, and how the level and mix of these services is associated with different patient outcomes, including lower rates of admission to hospital. There is considerable evidence that there are many hazards for people with dementia when they are hospitalized. The project will result in recommendations about the types of services and their features which produce better outcomes for people with dementia. Every stage of the research will be guided and informed by an Expert Panel comprising representatives of dementia service consumers, aged care providers, health service planning staff and key researchers. The Panel will provide contextual information about the service environment and how it affects people with dementia. Details of the patient's complete hospital stay can be investigated by linking existing administrative datasets. Data about hospital services will be gathered through a census of NSW hospitals, supplemented with in-depth interviews with key stakeholders and small group expert discussions with experts in each Area Health Service. The research team will also visit selected hospital sites. Multilevel modelling techniques will test for statistical associations between hospital based dementia services and care outcomes including admission rates to hospital, total length of hospital stay, mortality, admission rates to hospital, and the level of patient dependency on entry to residential aged care. The model will include the influence of regional variations in the provision of community aged care packages and residential aged care and the availability of informal care. The project will include a focus on the outcomes for people with co-morbidities and for people from different culturally and linguistically diverse backgrounds.Read moreRead less
Meeting The Needs Of The Elderly: Implementing The Palliatve Approach For People With Declining Health In Homeandhostel
Funder
National Health and Medical Research Council
Funding Amount
$83,456.00
Summary
This study aims to understand the extent to which a palliative approach is being used in the organisation and provision of care to elderly people with complex needs in home and hostel settings. It will identify current practices of aged care staff in the management of elderly people whose care needs are becoming increasingly more complex and not amendable to cure. In addition this study will explore the experiences of elderly people receiving this care. A model of the provision of a palliative a ....This study aims to understand the extent to which a palliative approach is being used in the organisation and provision of care to elderly people with complex needs in home and hostel settings. It will identify current practices of aged care staff in the management of elderly people whose care needs are becoming increasingly more complex and not amendable to cure. In addition this study will explore the experiences of elderly people receiving this care. A model of the provision of a palliative approach in this group of elderly Australians will be developed.Read moreRead less
Patient-centred Volunteer Program For People With Dementia: A Stepped Wedge Cluster Randomised Controlled Trial Of The MyCare Ageing Program
Funder
National Health and Medical Research Council
Funding Amount
$645,205.00
Summary
The MyCare Ageing program provides hospitalised patients with dementia and/or delirium with tailored emotional and practical support via trained volunteers in hospital and in the transition home. This project will provide critical information on whether MyCare Ageing works to reduce future hospitalisations and prevent poor patient outcomes, the factors that impact on how the program is delivered in hospital and in the community, and whether the program is cost-effective.
Improving Mental Health And Quality Of Life In Families Affected By Paediatric Cancer.
Funder
National Health and Medical Research Council
Funding Amount
$421,747.00
Summary
My program aims to improve mental health and quality of life in families affected by paediatric cancer. The program covers three themes: 1) Trial of novel behavioural medicine interventions to prevent poor mental and physical health outcomes; 2) Discovery of the psychosocial impact of genetic technologies for young people affected by cancer; and 3) Evaluation of the impact of paediatric cancer on under-researched, but critical, facets of family life. My work spans the full cancer trajectory, fro ....My program aims to improve mental health and quality of life in families affected by paediatric cancer. The program covers three themes: 1) Trial of novel behavioural medicine interventions to prevent poor mental and physical health outcomes; 2) Discovery of the psychosocial impact of genetic technologies for young people affected by cancer; and 3) Evaluation of the impact of paediatric cancer on under-researched, but critical, facets of family life. My work spans the full cancer trajectory, from diagnosis to survivorship or bereavement.Read moreRead less