Increasing Cardiovascular Risk Assessment In First Degree Relatives Of Patients With Premature Heart Disease: An RCT
Funder
National Health and Medical Research Council
Funding Amount
$113,972.00
Summary
Family history is a risk factor for ischaemic heart disease (IHD), especially if the history includes early onset disease. Families share both genetic and environmental risk factors, many of which can be modified to reduce the risk of heart disease. The aim of this project is to trial an intervention to promote heart disese risk assessment among the relatives of patients with premature heart disease. This is a first step toward prevention of heart disease in these families.
Evaluating And Disseminating The Implementation Success Of A Surgical Training Program
Funder
National Health and Medical Research Council
Funding Amount
$181,065.00
Summary
Removal of the uterus (hysterectomy) is the most commonly performed major surgical procedure in women (30,000/yr in Australia). Internationally, only about 25% of hysterectomies are still performed through an open abdominal approach, compared to 40% in Australia. This means that too many women in Australia will suffer unnecessary side-effects, pain and long recovery, keeping them away from their family and usual tasks longer than necessary.
Using Healthcare Wisely: Reducing Inappropriate Use Of Tests And Treatments
Funder
National Health and Medical Research Council
Funding Amount
$9,578,895.00
Summary
Overdiagnosis and overtreatment as unintended consequences of modern healthcare due to expanded disease definitions labelling people with mild problems or at low risk of illness, diagnostic tests identifying inconsequential abnormalities and screening programs detecting disease that won’t progress. The result is much harm and unsustainable overuse. We will research the prevalence, causes and consequences of overdiagnosis and overtreatment, evaluate solutions and widely disseminate findings.
Translating Risk Models To Improve Prevention And Early Diagnosis Of Cancer In Primary Care
Funder
National Health and Medical Research Council
Funding Amount
$479,882.00
Summary
Primary care plays a key role in prevention and early diagnosis of cancer. This fellowship will apply evidence about cancer risk to help GPs provide tailored advice to patients about preventing common cancers. It will also use new risk tools to assess people with symptoms suggestive of cancer to support earlier diagnosis. The research extends to studies relating to how people interpret symptoms and ways of promoting earlier presentation to the GP in patients who are at higher risk of cancer.
The CRISP Trial: An RCT Of Risk Assessment And Decision Support To Implement Risk-stratified Colorectal Cancer Screening In Primary Care.
Funder
National Health and Medical Research Council
Funding Amount
$936,641.00
Summary
There is a mismatch between people’s use of bowel cancer screening tests through faecal occult blood testing or colonoscopy and their individual risk of bowel cancer. Building on the work of our NHMRC Centre for Research Excellence (CRE) on Optimising Colorectal Cancer Screening, this trial will test the effect of an electronic risk assessment tool, implemented in general practice, on use of the most appropriate screening test for bowel cancer based on a person’s risk of developing the condition
Improving Implementation Of Guideline Recommendations For Early Detection And Prevention Of Cancer In General Practice
Funder
National Health and Medical Research Council
Funding Amount
$277,205.00
Summary
An intervention targeting key barriers to preventive care will be implemented in 3 general practices. A multiple baseline design will be used to evaluate the success of the intervention. Key outcomes will include the proportion of eligible patients within each practice for whom 3 or more health risk behaviours have been assessed in accordance with guidelines recommendations; and the proportion of eligible patients who have been screened appropriately for breast, cervical and bowel cancer.
Prevention And Management Of Chronic Disease In Primary Health Care
Funder
National Health and Medical Research Council
Funding Amount
$898,008.00
Summary
Over the past 10 years, Mark Harris has developed and led an innovate program of research on better ways to prevent and manage chronic disease in primary health care. This has included research on early intervention to assess and reduce the risk factors for these conditions involving innovative approaches to patient education; team based care; information and decision support systems. This research is now being extended to focus on disadvantaged groups and communities.
Ankle Brachial Index Determination By Oscillometric Method IN General Practice (ABIDING)
Funder
National Health and Medical Research Council
Funding Amount
$128,935.00
Summary
People who have peripheral arterial disease (PAD) have blockages of the circulation to their legs. If you have PAD you have blood vessel disease throughout the body and are very likely to have a heart attack or experience a stroke. PAD can be diagnosed simply by comparing the blood pressure in the arms and legs. Until now this needed a special costly instrument. New blood pressure machines can do this without this instrument. We want to know how reliably this can be done by practice nurses.
DESPATCH: DElivering Stroke Prevention For Atrial Fibrillation: Assisting Evidence-based CHoice In Primary Care
Funder
National Health and Medical Research Council
Funding Amount
$561,447.00
Summary
Non-valvular atrial fibrillation (NVAF) is a common heart condition associated with a major risk of fatal and disabling stroke. Inexpensive anticoagulant medication has been proven to reduce all-causes of death and stroke in patients with NVAF. Anticoagulant treatment for NVAF is substantially under-used resulting in avoidable patient deaths and disabling stroke. The National Institute of Clinical Studies of Australia summarised the large, unrealised benefit of anticoagulation, stating that 'eac ....Non-valvular atrial fibrillation (NVAF) is a common heart condition associated with a major risk of fatal and disabling stroke. Inexpensive anticoagulant medication has been proven to reduce all-causes of death and stroke in patients with NVAF. Anticoagulant treatment for NVAF is substantially under-used resulting in avoidable patient deaths and disabling stroke. The National Institute of Clinical Studies of Australia summarised the large, unrealised benefit of anticoagulation, stating that 'each year, for every 1000 patients with NVAF given anticoagulants, we can assume that about 25 fewer people will experience a stroke and 12 fewer will die from a stroke than would be the case if they were not given them'. Despite this realisation, there is a lack of evidence to support any strategy to improve the care of patients with NVAF. This study seeks to optimise the management of NVAF in general practice. The DESPATCH study will employ a rigorous randomised design to evaluate an innovative educational intervention intended to overcome barriers to the best management of NVAF. If successful, DESPATCH will inform policy and practice aimed at overcoming barriers to best practice for the large and growing number of people with NVAF to reduce the risk of fatal and disabling stroke.Read moreRead less
Randomised Controlled Trial Of A Brief GP Intervention To Reduce Overweight In Victorian Primary School Children
Funder
National Health and Medical Research Council
Funding Amount
$662,600.00
Summary
Childhood overweight and obesity is one of the most pressing public health problems of our time. The aim of this study is to lower the levels of overweight and mild obesity in children aged 5-9 years, through sustainable family and child nutritional and-or physical activity behavioural choices that can be implemented by general practitioners (GPs). This trial addresses the urgent need identified in the 2003 NHMRC Clinical Practice Guidelines for the Management of Overweight and Obesity in Childr ....Childhood overweight and obesity is one of the most pressing public health problems of our time. The aim of this study is to lower the levels of overweight and mild obesity in children aged 5-9 years, through sustainable family and child nutritional and-or physical activity behavioural choices that can be implemented by general practitioners (GPs). This trial addresses the urgent need identified in the 2003 NHMRC Clinical Practice Guidelines for the Management of Overweight and Obesity in Children and Adolescents for simple, well-designed intervention studies which can be translated into usual clinical practice. Effective and coordinated universal prevention, secondary prevention and management services will all be needed to reduce the problem, and a great deal of research is needed in all of these. This proposal addresses the most neglected area of research - secondary prevention in the primary care sector. Through our previous research, we have already showed that this approach is feasible and acceptable to families and GPs. Our multidisciplinary research team is well-established, and we are not aware of any other research team in Australia that has the capacity and expertise to conduct this research at this point in time. In this randomised controlled trial, we expect a halving in the rate of gain in BMI over 6 and 12 months. This would equate to the average participant achieving a BMI of 25 (verging on overweight) rather than 30 (obese) by adulthood. If effective, we expect the following outcomes: 1) The adoption and maintenance of healthy lifestyle behaviours in that segment of the population which has most to gain over a lifetime - overweight and obese children 2) Documentation that general practitioners can make a significant contribution to combating the childhood obesity epidemic 3) A replicable, feasible, cost-effective primary care approach to childhood overweight-obesity tailored to the Australian health care system.Read moreRead less