Targeted Ablation Of Sensory Neurons And Glial Cells With A View To Relieving Neuropathic Pain.
Funder
National Health and Medical Research Council
Funding Amount
$280,910.00
Summary
In Australia more than half of chronic pain patients are diagnosed with neuropathic pain resulting from nerve injury. This type of pain persists long after injury has healed and is associated with spontaneous bursts of excruciating pain and altered sensory processing symptoms which can make even the light touch of clothing intolerable. Neuropathic pain is highly resistant to even the most intense and drastic pain treatments. Much research has been devoted to understanding neuropathic pain in ter ....In Australia more than half of chronic pain patients are diagnosed with neuropathic pain resulting from nerve injury. This type of pain persists long after injury has healed and is associated with spontaneous bursts of excruciating pain and altered sensory processing symptoms which can make even the light touch of clothing intolerable. Neuropathic pain is highly resistant to even the most intense and drastic pain treatments. Much research has been devoted to understanding neuropathic pain in terms of changes in nerve cell (neuron) structure, function and chemistry. Whilst we have learned a lot about how neurons contribute to neuropathic pain, it has since become clear that cells other than neurons (namely neuronal support cells called glia) also play a significant role in the production and continuation of pain after nerve injury. Thus, it may be that pain therapies which currently focus on stopping or minimising the changes in neurons after nerve injury are only doing half the job when it comes to relieving such pain. Targeted therapies aim to affect or kill particular groups of cells with the hope of further understanding their role in the disease progression or eliminating their contribution to the disease state to produce relief. This can be done using a toxin linked to a vehicle that only binds to a particular cell type and which, upon uptake, causes the cell to suicide. Targeting neurons and glia responsible for neuropathic pain may hold a key to relieving this pain state. This project aims to further understand the contributions of neurons and glia to the production of neuropathic pain and aims to determine the effectiveness of synergistic targeted therapies that kill both the neurons and glia responsible for neuropathic pain production. It is hoped that killing these cells will effectively remove their input to the production and continuation of neuropathic pain and may offer a new avenue for neuropathic pain treatment in the future.Read moreRead less
An Evaluation Of The Validity Of Measureing Salivary Oxycodone Concentrations For Pharmacokinetic Studies In Patients
Funder
National Health and Medical Research Council
Funding Amount
$49,135.00
Summary
In many countries, oxycodone is replacing morphine as the opioid of first choice for the treatment of moderate to severe pain. Despite this, very little is known about how the drug is processed in the body or how its ability to control pain is affected by such factors as other drugs, age or organ function. Studies to determine this usually require multiple blood tests from individual patients over set time periods. Our team is able to measure drug levels in saliva and has shown this to be a vali ....In many countries, oxycodone is replacing morphine as the opioid of first choice for the treatment of moderate to severe pain. Despite this, very little is known about how the drug is processed in the body or how its ability to control pain is affected by such factors as other drugs, age or organ function. Studies to determine this usually require multiple blood tests from individual patients over set time periods. Our team is able to measure drug levels in saliva and has shown this to be a valid substitute for the measurement of drug levels in blood. Furthermore, one of us has developed a computer modelling system that shows how drugs are handled in the body using only a few samples from each patient. Palliative care patients are generally frail and unwell. We are reluctant to expose them to invasive tests such as repeated blood sampling. If we can prove that saliva sampling is as good as blood sampling, we will have identified a simple non-invasive means of greatly increasing our knowledge of oxycodone and how it behaves in individual patients. This in turn may allow us to tailor drug doses according to the unique characteristics of each patient and to optimise their pain control.Read moreRead less
Adouble-blind Placebo Contorolled Study Of Subcutaneous Ketamine In The Management Of Cancer Pain
Funder
National Health and Medical Research Council
Funding Amount
$50,000.00
Summary
Palliative care teams are studying an anaesthetic, ketamine, used at low doses for cancer pain which is not responsive to opioid drugs. Clinical experience suggests ketamine may help in neuropathic pain, which is due to nerve damage and is common in cancer. The study involves five days of treatment at three doses of ketamine, to see how well pain is controlled on each dose. The highest dose given will be that which gives good pain control. The study compares ketamine with a placebo, and patients ....Palliative care teams are studying an anaesthetic, ketamine, used at low doses for cancer pain which is not responsive to opioid drugs. Clinical experience suggests ketamine may help in neuropathic pain, which is due to nerve damage and is common in cancer. The study involves five days of treatment at three doses of ketamine, to see how well pain is controlled on each dose. The highest dose given will be that which gives good pain control. The study compares ketamine with a placebo, and patients keep on their usual pain medicines. Participants are randomised to have ketamine or the placebo. The study looks at pain control, quality of life, ketamine side effects, and change in need for usual pain medicines. This is the first national clinical study of a new palliative care research network, the Palliative Care Clinical Trials Collaborative (PaCCSC). It is hoped that if ketamine is proven safe and effective in difficult cancer pain, it will be more easily available for cancer patients.Read moreRead less
Developing And Testing A Pain Management Program For Family Caregivers Of Advanced Cancer Patients
Funder
National Health and Medical Research Council
Funding Amount
$119,500.00
Summary
To improve cancer patients' and family carers' knowledge and attitudes about pain management. A secondary aim is to examine the effect of a pain education program (PEP) on patients' actual pain experiences. This study builds on pilot data indicating that a pain education program (PEP) for family carers of cancer patients in a home based palliative service is effective in improving family carers' knowledge of pain management and family carers' attitudes toward managing the patient's pain. The PEP ....To improve cancer patients' and family carers' knowledge and attitudes about pain management. A secondary aim is to examine the effect of a pain education program (PEP) on patients' actual pain experiences. This study builds on pilot data indicating that a pain education program (PEP) for family carers of cancer patients in a home based palliative service is effective in improving family carers' knowledge of pain management and family carers' attitudes toward managing the patient's pain. The PEP will be tested with both patients with progressive or recurrent cancer and their family carers, taking into account three recommendations arising from the pilot study: Both patients and family carers should be included in the education sessions to ensure that they receive the same information because the attitudes and behaviours of those close to the patient can directly influence outcomes; Recruitment should occur at an early stage of the illness rather than the palliative stage so that patients will be well enough to participate in the education sessions and the information provided will be useful for a longer period of time; Education sessions should be short and be delivered in the outpatient oncology settings, which is more cost-effective and typical of the way that the intervention will be delivered in practice, if found to be effective.Read moreRead less
Physical, Lifestyle And Psychosocial Determinants Of Spinal Pain Development In Adolescents
Funder
National Health and Medical Research Council
Funding Amount
$682,800.00
Summary
This project aims to understand the development of back and neck pain in adolescence. By the age of 16 around half of all adolescents have suffered back pain and one third have suffered neck pain. For many adolescents this pain is disabling and over a third of sufferers miss school, miss recreation and seek medical help. The current understanding of back and neck pain in adolescence is quite limited - restricting the effectiveness of initiatives to prevent adolescents having to suffer spinal pai ....This project aims to understand the development of back and neck pain in adolescence. By the age of 16 around half of all adolescents have suffered back pain and one third have suffered neck pain. For many adolescents this pain is disabling and over a third of sufferers miss school, miss recreation and seek medical help. The current understanding of back and neck pain in adolescence is quite limited - restricting the effectiveness of initiatives to prevent adolescents having to suffer spinal pain and of treatment of those adolescents unlucky enough to have an episode. Better understanding and interventions for adolescent spinal pain will also have longer term implications by reducing adult spinal pain. Four out of 5 adults will experience spinal pain. In the USA treating adult back pain is the 4th largest health care cost. Many adults with chronic back pain had their first episode during adolescence. A better understanding of spinal pain in adolescence may help prevent it developing into a lifelong disability. We will collect information from 2,000 adolescents on their experience of back and neck pain and on potential physical, lifestyle and psychosocial risk factors. We believe factors such as their posture, muscle capacity, TV and computer use, mental health and social situation all combine to influence whether a person develops back or neck pain. The project is unique as it will not only collect a broad range of information during adolescence, but will also make use of a large database of health, developmental and psychosocial information already collected from these children since birth. With a better understanding of the development of spinal pain we will be able to develop guidelines to help prevent these problems. We will also be able to develop better treatment plans for sub-groups of adolescents with a particular combination of risk factors. Together these initiatives will assist in understanding and breaking the pathway to chronic spinal pain.Read moreRead less
A Randomised Clinical Trial To Test A Pain Education Program For Patients With Cancer And Their Family Carers
Funder
National Health and Medical Research Council
Funding Amount
$150,000.00
Summary
This study seeks to improve cancer patients' and family carers' knowledge and attitudes toward pain management. A pain education program will be offered to patients with recurrent or progressive cancer and their primary family carers. The study addresses a palliative care concern that impacts upon a large number of Australians each year. The study has the potential to provide a brief, standardised protocol that could be taught and integrated into usual practice and to reduce health care costs fo ....This study seeks to improve cancer patients' and family carers' knowledge and attitudes toward pain management. A pain education program will be offered to patients with recurrent or progressive cancer and their primary family carers. The study addresses a palliative care concern that impacts upon a large number of Australians each year. The study has the potential to provide a brief, standardised protocol that could be taught and integrated into usual practice and to reduce health care costs for advanced cancer patients.Read moreRead less
A Randomised Controlled Trial Of A Promising New Treatment For Chronic Whiplash
Funder
National Health and Medical Research Council
Funding Amount
$620,556.00
Summary
Following a whiplash injury about one third of people develop persisting pain and disability i.e. chronic whiplash. In a series of pilot trials we have developed a new physiotherapy treatment for chronic whiplash. Initial results are very promising. We now propose to definitively establish the effectiveness of this new treatment in a large clinical trial. At the same time we will evaluate the cost-effectiveness of the treatment.