Mortality Among Opioid Dependent Persons In Pharmacotherapy, NSW 1985-2006
Funder
National Health and Medical Research Council
Funding Amount
$148,757.00
Summary
Heroin dependence is a long term condition associated with high rates of death, illness and injury. Death rates are much higher than the general Australian population and the causes of death include drug intoxication or overdose, trauma, suicide, complications from blood born viruses such as Hepatitis C and HIV-AIDS and other medical complications of a chaotic drug-using lifestyle. As a part of a harm minimisation approach to heroin dependence, maintenance opioid pharmacotherapies seek to stabil ....Heroin dependence is a long term condition associated with high rates of death, illness and injury. Death rates are much higher than the general Australian population and the causes of death include drug intoxication or overdose, trauma, suicide, complications from blood born viruses such as Hepatitis C and HIV-AIDS and other medical complications of a chaotic drug-using lifestyle. As a part of a harm minimisation approach to heroin dependence, maintenance opioid pharmacotherapies seek to stabilise a chaotic heroin-using lifestyle by providing a regular dose of a legal, high quality opioid under medical supervision. Maintenance treatment uses long-acting opioids such as methadone and buprenorphine to provide consistent blood opioid levels so the client avoids the constant and disruptive cycles of opioid intoxication and withdrawal. Clients in regular maintenance treatments have lower death rates than untreated heroin dependent people and better outcomes with regards to drug use. However, death still occurs in methadone and buprenorphine treatment and minimising death rates is an important goal of treatment programs. This is a large longitudinal study looking at all NSW methadone and buprenorphine clients between 1985 and 2006, an estimated 44,000 people. In particular, the study looks at their mortality. It is a data linkage project, in that it uses two existing databases (a treatment database and a mortality database) and combines the information for each subject to get a better picture of how long methadone and buprenorphine clients survive, how much maintenance treatment they have received, and what the clients die of. This is the first time the mortality of all NSW methadone and buprenorphine recipients will be examined in a systematic way. It will allow us to compare the mortality of subjects receiving methadone and buprenorphine treatments and look at changes in mortality rates and causes of death over time. This will be an important policy resource.Read moreRead less
Opioid Dependent Persons In Pharmacotherapy: Blood Borne Viruses And Cancer Risk
Funder
National Health and Medical Research Council
Funding Amount
$88,495.00
Summary
Opioid dependent persons in pharmacotherapy in NSW are at increased risk of death from cancer. We will examine the occurrence of infection with hepatitis and HIV among this high-risk population using data linkage. We will define the relationship between infection, the duration, frequency and type of pharmacotherapy, and cancer risk. The findings will guide effective strategies that will reduce cancer incidence and mortality among this group, and minimise the associated health care costs.
Obesity, Overweight And Hospitalisation: Identifying Targets For Interventions To Prevent Adverse Health Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$603,755.00
Summary
Obesity is an important and rapidly increasing health problem, especially in indigenous communities. The proposed project investigates how obesity affects the risk of hospital admission in Indigenous and non-Indigenous Australians, including providing evidence regarding the nature of the hospitalisation, the cost and whether specific groups are at a higher risk of obesity-related hospitalisation. In doing so it aims to identify targets for intervention to reduce obesity-related hospitalisation
A Population Based Linked Data Analysis Of The Prognostic Determinants Of Out Of Hospital Cardiac Arrest
Funder
National Health and Medical Research Council
Funding Amount
$174,000.00
Summary
Heart disease, resulting in a cardiac arrest, is the largest single cause of death for men and women in Australia, accounting alone for almost a quarter of all deaths. Despite the scope of the problem, there is a paucity of objective data about the factors that determine outcomes in the short-term and long-term. This study will capitalise on the unique research potential of the WA Data Linkage Project to combine the WA Cardiac Arrest Register with existing health service data and death records, ....Heart disease, resulting in a cardiac arrest, is the largest single cause of death for men and women in Australia, accounting alone for almost a quarter of all deaths. Despite the scope of the problem, there is a paucity of objective data about the factors that determine outcomes in the short-term and long-term. This study will capitalise on the unique research potential of the WA Data Linkage Project to combine the WA Cardiac Arrest Register with existing health service data and death records, to describe the outcomes of out-of-hospital cardiac arrest in Perth WA. Both morbidity and mortality will be described and compared to patients with similar health conditions, but who do not experience a cardiac arrest. More specifically this study will address questions such as 'what is the effect of age, gender, pre-existing illness and socio-economic status on survival from out-of-hospital cardiac arrest?' and What is the long-term survival and health status for initial survivors of out-of-hospital cardiac arrest?' This project will both identify those factors associated with best outcome as well as identify a profile of persons who are 'at risk' of experiencing a further cardiac arrest. Such information is important for the evaluation of current resuscitative practices as well as providing the basis for future planning initiatives.Read moreRead less
Use And Adequacy Of Diabetic Retinopathy Screening: A Whole Population Linked Data Study
Funder
National Health and Medical Research Council
Funding Amount
$219,382.00
Summary
Diabetes and its health complications are major public health issues presently facing Australia. Currently, around 7% of Australians have diabetes and it is estimated that 300 million people will be diabetic within 20-years. One major complication of diabetes is diabetic retinopathy, which is the most common cause of blindness in working-age adults. Although early treatment can prevent vision loss from diabetic retinopathy, often there are no visual symptoms until the condition is more advanced ....Diabetes and its health complications are major public health issues presently facing Australia. Currently, around 7% of Australians have diabetes and it is estimated that 300 million people will be diabetic within 20-years. One major complication of diabetes is diabetic retinopathy, which is the most common cause of blindness in working-age adults. Although early treatment can prevent vision loss from diabetic retinopathy, often there are no visual symptoms until the condition is more advanced and less treatable. Consequently, it is vital that people with diabetes have their eyes examined regularly. We aim to investigate the use of eye services by people with diabetes. The WA Data Linkage System provides the unique opportunity to efficiently examine the benefits of specialist eye care in diabetics within WA over a 17-year period. The study period encompasses the introduction of NHMRC guidelines for diabetic retinopathy screening in 1997. This will enable us to examine the effectiveness of these guidelines in increasing ophthalmic services use by people with diabetes. Evaluating these trends will provide important data on the effectiveness of policy and NHMRC guidelines in improving diabetic eye care, which has never been comprehensively investigated. Early intervention can prevent and delay vision loss from diabetic retinopathy, substantially reducing the personal and community burden from diabetes. The identification of poorly screened groups will enable more targeted programs to improve the use of ophthalmic series, which in turn may reduce the risk of: i) eye surgery related to diabetes, ii) injury resulting from diabetes-related vision disorder or iii) blindness. The feasibility of using linked health data to evaluate eye screening in diabetics will enable future work addressing processes of care in the prevention of other diabetic complications to be undertaken quickly and cost-effectively.Read moreRead less
Morbidity, Mortality And Health Service Use Among Criminal Offenders: A Western Australian Population-based Study
Funder
National Health and Medical Research Council
Funding Amount
$133,750.00
Summary
This study will focus on the health of criminal offenders, as a most likely marginalised and neglected section of the community, in order to identify areas of need that if addressed will possess benefits for both offenders and the general community. A research team will apply their public health, criminology and forensic psychology expertise, in partnership with the WA Police Service, to provide information on the health outcomes and health service use of adult offenders in WA. Four themes will ....This study will focus on the health of criminal offenders, as a most likely marginalised and neglected section of the community, in order to identify areas of need that if addressed will possess benefits for both offenders and the general community. A research team will apply their public health, criminology and forensic psychology expertise, in partnership with the WA Police Service, to provide information on the health outcomes and health service use of adult offenders in WA. Four themes will be explored: (1) Health Status, to estimate the prevalence of overall and cause-specific hospital-treated morbidity (2) Mortality, to estimate the prevalence of overall and cause-specific mortality, (3) Health Service Use, focussing on both the rate of primary and secondary health service use; and (4) Inequalities In Health Outcomes, firstly comparing the health outcomes of adult offenders with the general WA population, and secondly, comparing the health outcomes of adult offenders based on sanction severity and custodial setting. This investigation is one of only a few worldwide to study health among criminal offenders. Offenders are a neglected section of the Australian health system. Responding to their needs is not possible without an understanding of their health outcomes and the disparities that exist. An important public health opportunity therefore exists to investigate the health of this socially disadvantaged group. This study will provide more detailed data regarding offender-health than currently exists internationally or nationally. Results can be used by health and-or justice administrators as indicators of program and service performance, and potentially lead to improved collaboration between these sectors. The methods used for outcome evaluation can be used readily for the routine evaluation of health performance indicators for offenders.Read moreRead less
The WA Safety And Quality Of Surgical Care Project: Improving The Safety, Quality And Provision Of Surgical Care.
Funder
National Health and Medical Research Council
Funding Amount
$583,500.00
Summary
The basis of this application is a three-year project which aims to improve the safety, quality and the provision of surgical care. This application constitutes the core of the WA Safety and Quality of Surgical Care Project (SQSCP), which was established in 1996 to evaluate the clinical epidemiology, health care utilisation, patient safety and health outcomes following admission to hospital for specific surgical and medical procedures in Western Australia (WA). The study will use data from the W ....The basis of this application is a three-year project which aims to improve the safety, quality and the provision of surgical care. This application constitutes the core of the WA Safety and Quality of Surgical Care Project (SQSCP), which was established in 1996 to evaluate the clinical epidemiology, health care utilisation, patient safety and health outcomes following admission to hospital for specific surgical and medical procedures in Western Australia (WA). The study will use data from the WA Data Linkage System, which brings together 15 million records from hospital morbidity, death, cancer, midwives notification and mental health databases. Surgical procedures have been selected for review based on national priorities and after consultation with the WA Branch of the Royal Australasian College of Surgeons (RACS) and other clinical Colleges. This application proposes to continue the core research activities of the SQSCP. A special focus will be on the use of minimally invasive surgical techniques including laparoscopic, endoscopic and endoluminal procedures, which have increased dramatically during the last decade. The study will also evaluate differences in the outcomes of surgical care in rural and metropolitan settings. The findings of the SQSCP will be comprehensively disseminated to surgeons, the RACS, hospital managers, health policy makers and consumers. The rationale of this project is that by providing high quality data on the epidemiology, utilisation and outcomes of surgical care, we will be able to increase the knowledge-base that will contribute to improvements in the safety, quality and provision of surgical care in Australia and internationally. The aims of the SQSCP are consistent with national health priorities and the recommendations of the Taskforce on Quality of Australian Health Care Study, the Australian Council for Safety and Quality in Health Care and the National Institute of Clinical Studies.Read moreRead less