Preparing Cancer Patients For Clinical Decision Making: A Randomised Trial Of Preconsultation Preparation Packages.
Funder
National Health and Medical Research Council
Funding Amount
$228,427.00
Summary
Most cancer patients in Australia now expect and are told their cancer diagnosis. There is considerable variation in the extent to which patients are informed about treatment options and are involved in treatment decisions. It can be argued that a treatment decision should be based on the oncologist's knowledge and the patient's preference. Two possible models can achieve this optimal outcome: the oncologist decides treatment on the basis of information passed on to him-her from the patient (the ....Most cancer patients in Australia now expect and are told their cancer diagnosis. There is considerable variation in the extent to which patients are informed about treatment options and are involved in treatment decisions. It can be argued that a treatment decision should be based on the oncologist's knowledge and the patient's preference. Two possible models can achieve this optimal outcome: the oncologist decides treatment on the basis of information passed on to him-her from the patient (the enabled doctor), and the patient chooses treatment based on informaton provided by the doctor (the empowered patient). We have developed a booklet on 'how treatment decisions are made'. In a randomised trial, patients seeing an oncologist for the first time are given the booklet and shown a video of ' their' oncologist interviewing an actor patient. The subsequent consultation is audiotaped to study the effect of these interventions on patient and doctor behaviour. The results of this trial will inform the development of our new patient educational materials. We now plan to develop consultation preparation packages. Patients will be sent information at least 48 hours before their first appointment with an oncologist with the goal of helping patients to achieve their preferred involvement in the consultation. The complete package will contain four components : a booklet on how treatment decisions are made including an outline of the two treatment decision models, a question prompt sheet and recommendation to prepare a list of questions, a booklet on Patient Rights, and an introduction to the Cancer Centre. The effects of the total package, and of just the Cancer Centre component on patient preferences for information and involvement in medical decisions, their consultation behaviour, and patient and doctor satisfaction with decision making will be studied in a randomised trial with control patients receiving no preparatory materials.Read moreRead less
What Do Australians Think About Privacy And Participation In Epidemiological Research?
Funder
National Health and Medical Research Council
Funding Amount
$443,015.00
Summary
There is very little research available, in Australia or internationally, about what the general public considers privacy to be; or how important privacy protection is in the context of high and low risk epidemiological studies. We also know little about what affects willingness to participate in epidemiological research. Our research will provide an evidence base, and develop resources for the legislature, the NHMRC, ethics committees and researchers.
Health Care Priorities: The Community's Preferences For Using Community Preferences
Funder
National Health and Medical Research Council
Funding Amount
$52,355.00
Summary
Determining how health care resources should be allocated - often termed rationing or priority setting - has traditionally been carried out by health care personnel, usually doctors but increasingly managers. More recently there has been a move to involve the general public in this process. Much of the research in this area has focussed on the methods used to elicit community preferences. While this is an important area of investigation, a prior issue of how community members feel about the use ....Determining how health care resources should be allocated - often termed rationing or priority setting - has traditionally been carried out by health care personnel, usually doctors but increasingly managers. More recently there has been a move to involve the general public in this process. Much of the research in this area has focussed on the methods used to elicit community preferences. While this is an important area of investigation, a prior issue of how community members feel about the use of their preferences in informing health care priorities needs to be investigated. Four specific questions will be addressed in this study: (i) do members of the general public feel that, as individuals, they have a legitimate role to play in informing priority decisions in health care? if so why? if not, why not? (ii) does the nature-level-setting of the decisions for which priorities are to be set affect whether individual members of the public would wish to participate in the priority setting process? (e.g. different health services, medical procedures-treatments, diseases) (iii) whose preferences should be used if not the community's? (iv) faced ex post with the preferences of the community and the preferences (possibly different) of health service decision makers (i.e. Oexperts'), does this knowledge affect preferences for having community preferences count? A number of health authorities are currently looking for ways of engaging local communities in health care decision making. This study will indicate the appropriate levels at which community preferences are to be elicited and the type of decisions and settings in which they are most relevant.Read moreRead less
Using Health Literacy (HL) Approaches To Develop And Apply Interventions To Improve Health Services And Generate Equitable Health Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$697,209.00
Summary
Health literacy is the ability to find, understand and use health information and healthcare services effectively. The Fellowship will advance the understanding of health literacy. It will determine how poor health literacy might cause health inequalities and with this information, develop and test interventions to improve the response of the healthcare system. The research will make it easier for disadvantaged and vulnerable people to get care, be understood and have their needs recognised and ....Health literacy is the ability to find, understand and use health information and healthcare services effectively. The Fellowship will advance the understanding of health literacy. It will determine how poor health literacy might cause health inequalities and with this information, develop and test interventions to improve the response of the healthcare system. The research will make it easier for disadvantaged and vulnerable people to get care, be understood and have their needs recognised and met.Read moreRead less
Evaluation Of A Financial Incentive To Improve The Use Of Preventive Medicines By People With Asthma
Funder
National Health and Medical Research Council
Funding Amount
$137,860.00
Summary
Rising costs are threatening the future viability of the Pharmaceutical Benefits Scheme. New approaches are needed to address this challenge, including developing financial incentives for consumers to use effective low cost medicines in preference to higher cost alternatives. This study will develop a consumer incentive for use of low cost asthma preventer medicines, model the economic effects of this and bring together stakeholders to examine the policy and practice changes needed to implement ....Rising costs are threatening the future viability of the Pharmaceutical Benefits Scheme. New approaches are needed to address this challenge, including developing financial incentives for consumers to use effective low cost medicines in preference to higher cost alternatives. This study will develop a consumer incentive for use of low cost asthma preventer medicines, model the economic effects of this and bring together stakeholders to examine the policy and practice changes needed to implement the incentive.Read moreRead less
Improving Population Health By A Multidisciplinary, Multi-method Focus Kindey Disease Of The Young, The Old And Of Indigen
Funder
National Health and Medical Research Council
Funding Amount
$2,625,261.00
Summary
Drawing together a multidisciplinary team of experts in their field (epidemiology, biostatistics, health services research, health economics, clinical medicine, and qualitative research) this grant will develop 8-10 promising young population researchers by a targeted program of research and training. Using data from multiple well funded, large scale studies the team investigators will engage in two types of research; methods research and applied research. The methods research will include socio ....Drawing together a multidisciplinary team of experts in their field (epidemiology, biostatistics, health services research, health economics, clinical medicine, and qualitative research) this grant will develop 8-10 promising young population researchers by a targeted program of research and training. Using data from multiple well funded, large scale studies the team investigators will engage in two types of research; methods research and applied research. The methods research will include socioeconomic determinants of disease, systematic reviews of tests and interventions, community and patient preference elicitation, cost effectiveness modeling, and monitoring to support intervention decisions in population health. The applied research will include quantifying the effect of kidney disease on non-kidney outcomes, modeling the effect of better kidney care on population health, and preventing kidney disease in the young, old and in Aboriginal and Torres Strait Islander people. Kidney disease has been chosen because it is the interest of many of the lead applicant team, because there are excellent existing population-based databases and because it is an example of chronic disease which has a much bigger impact than on just kidney-related health outcomes alone. The training program is structured and covers initial evaluation of the goals, skills and aspirations of the team investigators, development of personal training programs, modular coursework learning from units provided by the School of Public Health at the University of Sydney, mentoring, co-mentoring, rotational placement, skills and methods support, evaluation and limited direct research funding.Read moreRead less