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
Deconstructing DTCA: Towards A Differentiated Policy Response To Direct-to-Consumer Advertising In Australia.
Funder
National Health and Medical Research Council
Funding Amount
$190,760.00
Summary
Spending on prescription pharmaceuticals is the fastest growing part of the health budget. In recent years attention has shifted to the impact of direct-to-consumer advertising (DTCA) on consumer demand and drug costs. Although DTCA is prohibited in Australia, it is clear that different types of DTCA are occurring. This study will examine the nature and range of DTCA, review the benefits and harms of DTCA, and identify the perspectives of major stakeholders regarding DTCA. The study will culmina ....Spending on prescription pharmaceuticals is the fastest growing part of the health budget. In recent years attention has shifted to the impact of direct-to-consumer advertising (DTCA) on consumer demand and drug costs. Although DTCA is prohibited in Australia, it is clear that different types of DTCA are occurring. This study will examine the nature and range of DTCA, review the benefits and harms of DTCA, and identify the perspectives of major stakeholders regarding DTCA. The study will culminate in a national workshop which will develop a differentiated set of recommendations for responding to different types and modes of DTCA. This is likely to lead to better health policy and to resources that may assist consumers and health professionals deal with DTCA.Read moreRead less
Investigation Of The Mechanisms Involved In Consolidation Of Memory By Beta 3 Adrenoceptoragonists.
Funder
National Health and Medical Research Council
Funding Amount
$241,018.00
Summary
The inability to form new memories is a major and increasingly prevalent health problem for an aging population. In addition to aging, the inability to form new memories is associated with serious medical conditions including Alzheimer's Disease and diabetes. Common to these conditions is the inability to consolidate memories. Memories are intact for a short while (30 minutes) after the event to be remembered, but memory does not pass on into permanent storage. We have been able to achieve memor ....The inability to form new memories is a major and increasingly prevalent health problem for an aging population. In addition to aging, the inability to form new memories is associated with serious medical conditions including Alzheimer's Disease and diabetes. Common to these conditions is the inability to consolidate memories. Memories are intact for a short while (30 minutes) after the event to be remembered, but memory does not pass on into permanent storage. We have been able to achieve memory consolidation in a particular learning task, which is not normally remembered, by injection of drugs acting on novel receptors (beta 3 adrenoceptors) in the brain of day old chicks. These drugs mimic the action of noradrenaline at beta-3 adrenoceptors. There are a number of ways in which memory consolidation can be enhanced, and we will compare the effects of beta-3 drugs with other potential drugs acting at other types of noradrenaline receptors. One of the actions of beta-3 agonists is related to the uptake of glucose into cells in the brain. We will investigate whether the mechanism of beta-3 enhancement of memory involves the uptake of glucose in brain tissue and studies in cultures of individual cell types will show us which cells are involved. Although this work is done using young chicks, there is no reason to suppose that the basic memory mechanisms at the level of the nerve cell should be different in birds or mammals. There are distinct advantages to using chicks in this research as they can form a long lasting memory for an experience lasting only 10 seconds, and they will discriminate between different colours as part of their learning. This research is aimed at understanding the processes involved in and influencing memory formation. If we are going to develop drugs to alleviate the cognitive problems of old age and more serious cognitive diseases, we need to understand more about the basic mechanisms of memory formation in the normal animal.Read moreRead less
Effects Of Current And Plain Cigarette Package Design On Smokers Cigarette Evaluation
Funder
National Health and Medical Research Council
Funding Amount
$654,339.00
Summary
This project proposes to better understand the role of cigarette pack design on consumers' judgements that some cigarettes are safer than others. Three experimental studies are proposed, which will evaluate the influence of pack branding and colours, the potential impact of plain packaging, and the effect of larger size health warnings on consumer perceptions of cigarette health risks.
Investigation Of Tobacco Industry Efforts To Counteract Tobacco Control In Australia, 1970-2000
Funder
National Health and Medical Research Council
Funding Amount
$333,225.00
Summary
Tobacco use continues to be both the most important preventable cause of premature death and a key determinant of health inequity in Australia. Tobacco is a legally sold product which addicts many of its consumers, mostly as adolescents, and then kills half of them when used as intended. Comprehensive policy change, product regulation and litigation is required to put a halt to the tobacco industry's decades of avoidance, delay and disruption of tobacco control. In an interview for the Wall Stre ....Tobacco use continues to be both the most important preventable cause of premature death and a key determinant of health inequity in Australia. Tobacco is a legally sold product which addicts many of its consumers, mostly as adolescents, and then kills half of them when used as intended. Comprehensive policy change, product regulation and litigation is required to put a halt to the tobacco industry's decades of avoidance, delay and disruption of tobacco control. In an interview for the Wall Street Journal in 1995, Stan Glantz, from the University of California at San Francisco, equated the tobacco industry with other disease vectors: If you want to do something about malaria, you have to study mosquitoes and if you want to do something about lung cancer, you have to study the tobacco industry. Regulatory changes can only be justified by specific local evidence of both the private plans and knowledge of the tobacco industry to attack tobacco control and their public statements and actions designed to mislead consumers and effectively prevent or delay tobacco control. This study will document the public actions and statements of the tobacco industry in Australia between 1970 and 2000. It will draw on interviews with and personal records of tobacco control experts and former state and federal health ministers; as well as tobacco retail trade publications; print media reports; material obtained via Freedom of Information from State and Federal Health Departments; Federal Cabinet papers released under the 30 year rule (ie papers are available from prior 1972); and radio and television reports. It will complement a parallel study of the tobacco industry's internal documents. The outcome will be provision of strategically vital evidence to support effective tobacco control advocacy, policy formation, regulation and litigation in Australia, in the face of continuing industry countermeasures.Read moreRead less