Which Heart Failure Intervention Is Most Cost-effective And Consumer Friendly In Reducing Hospital Care: The Which
Funder
National Health and Medical Research Council
Funding Amount
$921,640.00
Summary
Chronic heart failure (CHF) is a costly, debilitating and deadly condition that has reached near epidemic proportions in Australia. In the absence of a permanent cure for CHF, the number of people affected by CHF has risen beyond 350,000 and is expected to increase by 20-30% in the next 20 years. We recently reviewed the benefits of applying nurse-led, CHF management programs (CHF-MPs) to typically old and fragile patients, in whom recurrent hospital admissions and a premature death are common. ....Chronic heart failure (CHF) is a costly, debilitating and deadly condition that has reached near epidemic proportions in Australia. In the absence of a permanent cure for CHF, the number of people affected by CHF has risen beyond 350,000 and is expected to increase by 20-30% in the next 20 years. We recently reviewed the benefits of applying nurse-led, CHF management programs (CHF-MPs) to typically old and fragile patients, in whom recurrent hospital admissions and a premature death are common. We confirmed the results of pioneering Australian research that CHF-MPs dramatically improve health outcomes in CHF. CHF-MPs now form part of the recommended gold-standard management of CHF. However, we also have evidence that only a small proportion of patients are exposed to a CHF-MP in Australia. Residual issues such as consumer preference and the cost of applying these programs are hindering their wide-spread application. The WHICH? Study addresses this _road block� to implementing a potentially valuable health care service by tackling a number of critical issues: which form of CHF-MP (home or specialist clinic-based follow-up), will produce the best health outcomes, save the most money and meet the needs of consumers at the same time? To answer this question, we will undertake a randomised, head-to-head study of a home versus clinic-based CHF-MP, in 1000 recently hospitalised CHF patients recruited from SA, VIC, NSW and QLD. Patterns and of health care and consumer preferences and quality of life will then be compared for these two different forms of CHF-MP from a combined health economic, health policy and consumer perspective to determine the best form of CHF-MP to be applied. A _consensus� vision for applying an Australia-wide service will then be developed. The potential impact of the results of the study will then be modelled on the status of Australian CHF-MPs in the year 2010 and a blue-print for action devised.Read moreRead less
Involving children in social research: balancing the risks and benefits. There is a growing consensus that children's involvement in social research is important, but considerable uncertainty remains around children's inclusion in research on 'sensitive' issues, reflecting concerns about how to balance children's protection with their participation. Key to this are deeply embedded assumptions and beliefs about children and childhood, especially concerning notions of capacity, agency, vulnerabili ....Involving children in social research: balancing the risks and benefits. There is a growing consensus that children's involvement in social research is important, but considerable uncertainty remains around children's inclusion in research on 'sensitive' issues, reflecting concerns about how to balance children's protection with their participation. Key to this are deeply embedded assumptions and beliefs about children and childhood, especially concerning notions of capacity, agency, vulnerability, dependency and the like. This project aims to better understand and address the tensions between the protection of children and their participation in research, and to explore how ethics committees, parents, other gatekeepers and children themselves manage and navigate these tensions.Read moreRead less
The impacts of industry restructuring. This project aims to shed light on how Australia's workforce and communities will engage with the world of work in a future shaped by new business models and disruptive technologies. Using the closure of the automotive industry as a lens into this topic, the project will provide new insights into how displaced workers find work, use services, relate to others, and reshape their futures. It sheds light on the community-wide impacts of restructuring, providin ....The impacts of industry restructuring. This project aims to shed light on how Australia's workforce and communities will engage with the world of work in a future shaped by new business models and disruptive technologies. Using the closure of the automotive industry as a lens into this topic, the project will provide new insights into how displaced workers find work, use services, relate to others, and reshape their futures. It sheds light on the community-wide impacts of restructuring, providing new perspectives on how local resources and public policies best advance the process of adjustment.Read moreRead less
A new quality of life instrument with older people for economic evaluation. This project aims to develop and validate a new preference-based quality-of-life instrument with applications in aged-care. The new instrument will be developed with older people receiving aged care services, and will focus upon incorporating their values into the measurement and valuation of quality of life for economic evaluation. The new instrument will have immediate applications in quality assessment and economic ev ....A new quality of life instrument with older people for economic evaluation. This project aims to develop and validate a new preference-based quality-of-life instrument with applications in aged-care. The new instrument will be developed with older people receiving aged care services, and will focus upon incorporating their values into the measurement and valuation of quality of life for economic evaluation. The new instrument will have immediate applications in quality assessment and economic evaluation, improving the quality of life and wellbeing of older Australians, and will assist in determining the relative cost effectiveness of new and existing services.
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Socio-cultural Factors and the Use of Therapeutic Opioids in Indonesia. This project aims to determine how legal, policy and socio-cultural factors influence the use of therapeutic opioids in Indonesia. The project expects to generate a nuanced understanding of the impact of non-medical considerations in contested areas of health policy through its multidisciplinary and multi-scalar approach. We expect outcomes to include a robust model of influences on decision-making that can be applied in Ind ....Socio-cultural Factors and the Use of Therapeutic Opioids in Indonesia. This project aims to determine how legal, policy and socio-cultural factors influence the use of therapeutic opioids in Indonesia. The project expects to generate a nuanced understanding of the impact of non-medical considerations in contested areas of health policy through its multidisciplinary and multi-scalar approach. We expect outcomes to include a robust model of influences on decision-making that can be applied in Indonesia and adapted for use in other national contexts. This should provide significant benefits, including an innovative training program to empower doctors and pharmacists to make evidence-based decisions about the potential risks and benefits, both medical and social, of opioid-based treatment options.Read moreRead less
Estimating use of tobacco and nicotine products through wastewater analysis. This project aims to equip the Australian public health and security sector with a tool to accurately measure tobacco consumption in the general population. Specific human biomarkers in urine will be identified using non-target approaches and their pharmacokinetics quantified. The new data will address critical gaps in our knowledge on the population-level excretion of biomarkers for the consumption of tobacco and alter ....Estimating use of tobacco and nicotine products through wastewater analysis. This project aims to equip the Australian public health and security sector with a tool to accurately measure tobacco consumption in the general population. Specific human biomarkers in urine will be identified using non-target approaches and their pharmacokinetics quantified. The new data will address critical gaps in our knowledge on the population-level excretion of biomarkers for the consumption of tobacco and alternative nicotine products. The outcomes of this project will provide reliable, cost-effective estimates of tobacco consumption for use with wastewater-based epidemiology assessments. This will enable changes in tobacco use to be accurately evaluated for the first time and improve the efficacy of tobacco control measures.Read moreRead less
Innovative Health Programs To Reduce Inequality In Heart Disease
Funder
National Health and Medical Research Council
Funding Amount
$876,005.00
Summary
As part of his Senior NHMRC Fellowship, Prof Simon Stewart, a world-renowned health services researcher, will lead an internationally linked team of researchers from a broad range of health disciplines to undertake a program of research designed to improve the lives of those most vulnerable to heart disease and poor health outcomes. His program of research will focus on Indigenous Australians, patients with complex forms of heart disease and urban African communities in economic transition.
Emerging from the shadows: the evaluation of intervention strategies to reduce social isolation amongst the aged. Social isolation imposes a high cost on affected individuals and the community at large. This project will determine what interventions work in addressing social isolation amongst the older population.
Understanding engagement to regulate the commercial determinants of health. This project aims to generate new knowledge on how government and non-government organisations can prevent
poor health via their effective regulation of harmful commodity industries, specifically alcohol and highly-processed
food. The significance of this project is its innovative approach to regulation, with a focus on engagement
processes between state and non-state actors for the management of harmful commodities. Exp ....Understanding engagement to regulate the commercial determinants of health. This project aims to generate new knowledge on how government and non-government organisations can prevent
poor health via their effective regulation of harmful commodity industries, specifically alcohol and highly-processed
food. The significance of this project is its innovative approach to regulation, with a focus on engagement
processes between state and non-state actors for the management of harmful commodities. Expected outcomes
include improved methodologies in the field of health governance, and enhanced capacity among Partner
organisations to engage effectively with different industries. These outcomes should benefit health policy
prevention goals.Read moreRead less
The Kids in Communities Study: national investigation of community level effects on children's developmental outcomes. This project (a cross-disciplinary collaboration) will investigate community level factors influencing early childhood developmental outcomes using a mixed methods approach in up to 10 communities across Australia. This will result in a potential set of measures or indicators that reflect communities that are good for children.