An Open-label Extension Of A Randomised Clinical Trail Of Intravitreal Triamcinolone For Diabetic Macular Oedema
Funder
National Health and Medical Research Council
Funding Amount
$167,733.00
Summary
A 25 fold increase in the risk of going blind on diagnosis of diabetes is one of the most daunting threats that patients face. Most cases of vision impairment in diabetes are due to macular oedema that persists or recurs after laser treatment. There are now a number of uncontrolled, anecdotal reports that intravitreal triamcinolone (IVTA) is highly effective for the treatment of diabetic macular edema which is refractory to conventional laser treatment. We commenced the first placebo-controlled, ....A 25 fold increase in the risk of going blind on diagnosis of diabetes is one of the most daunting threats that patients face. Most cases of vision impairment in diabetes are due to macular oedema that persists or recurs after laser treatment. There are now a number of uncontrolled, anecdotal reports that intravitreal triamcinolone (IVTA) is highly effective for the treatment of diabetic macular edema which is refractory to conventional laser treatment. We commenced the first placebo-controlled, double masked clinical trial of intravitreal triamcinolone for refractory macular oedema in 2002. The 3 month results from this study provide the first scientific proof of principle that intravitreal triamcinolone reduces macular thickness and improves vision. The two year results will be available in March 2005, but confidential interim analysis of efficacy data in September 2004 suggested that the beneficial effect of triamcinolone treatment persisted. Thus it appears that treatment with intravitreal triamcinolone may be the most significant development for the prevention of blindness in people with diabetes since the introduction of laser treatment. It would also be a highly cost-effective intervention that could be administered by general ophthalmologists. The treatment cannot be recommended for routine use, however, until its long term efficacy and safety have been established. Since we already have a well studied group of patients who have received treatment for 2 years, we are in a unique position to extend the study in order to provide the long-term (5-year) safety and efficacy data that does not appear to be forthcoming from any other source. The results of this study will significantly improve knowledge of long-term outcomes of local high dose steroids for diabetic macular oedema, allowing the treatment to be used more rationally. Thus the study is very likely to directly reduce the risk of blindness in people with diabetes.Read moreRead less
Television Advertising To Promote NHMRC Guidelines For Low Risk Alcohol Consumption: Experimental Study
Funder
National Health and Medical Research Council
Funding Amount
$670,013.00
Summary
This project aims to experimentally assess the impact of television advertising that promotes the 2009 NHMRC Guidelines on alcohol consumption, on adults' (aged 18-64) estimates of drinking levels that incur an increased risk of short and long term harm. The Guidelines advise that adults should limit consumption to 2 standard drinks/day to reduce the risk of lifetime harm, and to 4 standard drinks on any single drinking occasion to reduce the risk of short-term harm from that occasion.
Evidence-based Approaches For Lifestyle Interventions To Improve Physical And Cognitive Functions In Old Age.
Funder
National Health and Medical Research Council
Funding Amount
$351,886.00
Summary
As Australia’s population ages, our public health system faces the challenge of an increase in chronic conditions. Many of these can be prevented or better managed by regular physical activity. New public health recommendations have evolved to strongly encourage all adults to engage in physical activity as an integral part of their “lifestyle”. My research will expand the evidence for endorsing the benefits of this “lifestyle” approach for the physical and cognitive functions of older people.
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
Can Self-management Education Programs Improve Outcomes Of People With Osteoarthritis?
Funder
National Health and Medical Research Council
Funding Amount
$343,874.00
Summary
Arthritis is a very common disease associated with pain, disability and poor quality of life. An important way that people with arthritis can deal with the disease is through using a variety of self-management behaviours and coping strategies as well as becoming well informed about the best available treatments. A specific course was developed in he US to help people self-manage. It has been available in Australia for 20 years through Arthritis Foundations and has become their core business. Tre ....Arthritis is a very common disease associated with pain, disability and poor quality of life. An important way that people with arthritis can deal with the disease is through using a variety of self-management behaviours and coping strategies as well as becoming well informed about the best available treatments. A specific course was developed in he US to help people self-manage. It has been available in Australia for 20 years through Arthritis Foundations and has become their core business. Treatment guidelines used by doctors to treat people with arthritis regularly recommend that patients should be referred to such courses. Although the course is widely distributed, the evidence scientific evidence regarding its effectiveness is patchy, and some overviews suggest it is not useful at all. Confusion exists regarding the value of the course. While treatment guidelines advise doctors to refer patients to the program by very few GPs, Rheumatologist or Orthopaedic surgeons do refer. The proposed study is a large controlled trial which will provide essential evidence to inform patients, doctors and policy makers on the benefits of the course. It will involve people with well defined moderate to severe arthritis who have consulted a surgeon or rheumatologist. People will be randomised to receive the intervention (two hours per week, six session course including an 'arthritis self-help' book) will be compared with people in a control group (who only receive the book without instruction). People will be followed for 1 year to see if the course improves quality of life, health behaviours, and whether less health care resources (ie attendance at doctors or less medication use) are used. The results of this study will be influential in determining government policy as the number of people with chronic diseases like arthritis is rapidly growing and the acute healthcare system, including hospitals, are poorly equipped to deal with this growing problem.Read moreRead less