Determining Critical Points In The Potential Palliative Care Pathway In The Last Year Of Life
Funder
National Health and Medical Research Council
Funding Amount
$356,461.00
Summary
People with serious illnesses who are approaching the end of their lives undergo a journey where, along the way, they experience several critical points. Although we know these critical points are crucial to how they might access the best kind of care, we are unsure exactly when these points may occur and how they may vary for different kinds of people. We need to know when is the best time to start withdrawing invasive and purely curative treatments, when are discussions about approaching death ....People with serious illnesses who are approaching the end of their lives undergo a journey where, along the way, they experience several critical points. Although we know these critical points are crucial to how they might access the best kind of care, we are unsure exactly when these points may occur and how they may vary for different kinds of people. We need to know when is the best time to start withdrawing invasive and purely curative treatments, when are discussions about approaching death best introduced and how we can care for people from a diverse range of backgrounds and beliefs within our current health care system. We also need to identify and promote the best possible ways of supporting patients at the end of life and their families as they negotiate the often complex path towards a good death. With this kind of information, health care practitioners, particularly those involved in palliative care, can design better services that put in place pathways where assessment of patient and family needs, referral to the most appropriate services and coordination of all the aspects of care are easy to understand and access for all people. This kind of care can be expensive so we need to use the money allocated to palliative care wisely. This can be achieved with thoughtful research that identifies those most in need, at the time of most need and investigates the best approaches to alleviating pain in suffering in the weeks and months before death. A fair and equitable health care system is not just about keeping people healthy, but also about dealing humanely with the inevitability of deathRead moreRead less
Development And Implementation Of An Educational Program To Guide Palliative Care For People With Motor Neurone Disease
Funder
National Health and Medical Research Council
Funding Amount
$258,525.00
Summary
The project aims to improve the quality of care for people with MND and their family carers through the development, testing and implementation of an educational program for health professionals and other service providers focused on the palliative care needs of this population. The project is taking place in three sites: Western Australia, Victoria and South Australia, in collaboration with the MND associations in the three states. The effectiveness of the flexible model of care provided to peo ....The project aims to improve the quality of care for people with MND and their family carers through the development, testing and implementation of an educational program for health professionals and other service providers focused on the palliative care needs of this population. The project is taking place in three sites: Western Australia, Victoria and South Australia, in collaboration with the MND associations in the three states. The effectiveness of the flexible model of care provided to people with MND and their carers as a result of the implementation of the MND Education Program will be assessed and a national implementation plan will be developed.Read moreRead less
Early Intervention For Amnestic Mild Cognitive Impairment : A Randomised Trial Of Memory Management
Funder
National Health and Medical Research Council
Funding Amount
$577,556.00
Summary
It is increasingly recognised that Alzheimer’s disease can emerge slowly over years and persons presenting with memory impairment, or mild cognitive impairment (MCI), are at increased risk of developing Alzheimer’s disease. Following diagnosis of MCI, active management through symptomatic drug treatment remains equivocal, therefore, memory impairment continues to be troublesome and patients and families are seeking interventions that offer improvement in quality of life. Cognitive interventions ....It is increasingly recognised that Alzheimer’s disease can emerge slowly over years and persons presenting with memory impairment, or mild cognitive impairment (MCI), are at increased risk of developing Alzheimer’s disease. Following diagnosis of MCI, active management through symptomatic drug treatment remains equivocal, therefore, memory impairment continues to be troublesome and patients and families are seeking interventions that offer improvement in quality of life. Cognitive interventions are low cost and, where effective, can provide a stand-alone intervention or add value to the pharmacological approach. The primary aim of this study is to evaluate whether an early intervention program of memory training is effective in improving use of memory strategies in everyday life, and whether this has psychological and emotional benefits for individuals with MCI and their families. We will evaluate through a randomised controlled trial the efficacy of a memory-group program which will involve the family and patient, rather than just the person with MCI, in developing increased awareness of memory issues and specific strategies to prevent memory failures. Over successive cohorts recruited from memory clinics, families will be randomly assigned to either an immediate intervention or a delayed intervention (waiting-list control) group. We will also recruit a sample of healthy older adults who will be similarly randomised into early and late intervention groups. Healthy older adults will provide a means of establishing whether any improvements in the MCI groups are (i) to the same extent as healthy older adults and (ii) to normative levels. Evaluation will be at pre- and post-intervention and at six months follow-up on tests of memory, questionnaires of knowledge and use of memory strategies in everyday life, and appraisal of level of wellbeing. Information about memory and systematic training in compensatory memory skills are expected to significantly improve the capacity of patients and families to cope with everyday memory difficulties. Through active participation in the management of memory impairment, it is expected that the level of wellbeing will increase, for both patient and families.Read moreRead less
Strengthening Community Based Paliative Care Services: Towards A Better Understanding Of Medical Aspects Of Caring For C
Funder
National Health and Medical Research Council
Funding Amount
$68,892.00
Summary
Caring for children [and their families] in the palliative phase of an illness offers unique challenges. Community based palliative care programs provide a predominantly adult focused service, their experience with children being limited by smaller numbers. This study aims to better characterize the medical aspects of caring for terminally ill children in Australia, thru the use of a parental survey in a large representative cohort at the Royal Children's Hospital, Melbourne (RCH). The focus wil ....Caring for children [and their families] in the palliative phase of an illness offers unique challenges. Community based palliative care programs provide a predominantly adult focused service, their experience with children being limited by smaller numbers. This study aims to better characterize the medical aspects of caring for terminally ill children in Australia, thru the use of a parental survey in a large representative cohort at the Royal Children's Hospital, Melbourne (RCH). The focus will be to identify issues relating to symptom assessment and management, family and caregiver support and psychosocial-bereavement support. The knowledge gained will be used to redesign-strengthen links between paediatric hospitals and community based palliative care programs.Read moreRead less
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
The Pacific OPIC Study - A Four Country Study Of Obesity Prevention In Communities
Funder
National Health and Medical Research Council
Funding Amount
$1,600,580.00
Summary
Obesity is a rapidly escalating, worldwide epidemic. Many countries recognise the need to prevent obesity but there is insufficient evidence about what interventions work. The Pacific Obesity Prevention in Communities (OPIC) Project will provide data on the effectiveness of a range of interventions to prevent obesity among young people in Fiji, Tonga, New Zealand and Australia. Prevention research is particularly required in countries such as Fiji and Tonga because their prevalence of obesity is ....Obesity is a rapidly escalating, worldwide epidemic. Many countries recognise the need to prevent obesity but there is insufficient evidence about what interventions work. The Pacific Obesity Prevention in Communities (OPIC) Project will provide data on the effectiveness of a range of interventions to prevent obesity among young people in Fiji, Tonga, New Zealand and Australia. Prevention research is particularly required in countries such as Fiji and Tonga because their prevalence of obesity is extremely high. The interventions used in this project will be culturally appropriate and include at least 1000 young people in each intervention group. The outcomes of this project will be applicable to both low- and high-income countries. This project will lead to a greater understanding of the socio-cultural, policy, and economic contexts and provide crucial evidence for public health action to prevent obesity.Read moreRead less
The number of Australians with dementia is increasing and so therefore is the frequency of people with dementia presenting to general practice. There is a recent evidence based clinical practice guideline to inform the diagnosis and management of people with dementia and the support of their carers. Many of the recommendations from this guideline are relevant to Australian general practitioners. Strategies to implement guidelines into practice are needed in all areas of health care, but changing ....The number of Australians with dementia is increasing and so therefore is the frequency of people with dementia presenting to general practice. There is a recent evidence based clinical practice guideline to inform the diagnosis and management of people with dementia and the support of their carers. Many of the recommendations from this guideline are relevant to Australian general practitioners. Strategies to implement guidelines into practice are needed in all areas of health care, but changing clinical practice is complex and a body of research developing methods of identifying barriers to specific practice changes is emerging. This project aims to support GPs in improving the general practice based care of people with dementia, and so improve their quality of life. In addition we aim to contribute to the body of knowledge about how to bring about practice change and implement a clinical practice guideline. We plan to design a strategy for implementing this new guideline into practice, working with GPs to change their practice where needed. We will test the effect of this strategy on the care of people with dementia, on their quality of life and on that of their carers.Read moreRead less