Consumer Co-payments For Subsidised Medicines: Impact On Access And Health Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$465,838.00
Summary
Expenditure on pharmaceuticals subsidised under the Pharmaceutical Benefits Scheme (PBS) in Australia was >$6.5b in 2003-04. In efforts to ensure that medicine costs remain affordable, the government instituted cost-effectiveness assessments for listing, brand premium policies and generic substitution and consumer copayments. International research suggests copayments may affect vulnerable populations(1-4) and impact adversely on medicine use(10). In Australia, dispensings of essential and di ....Expenditure on pharmaceuticals subsidised under the Pharmaceutical Benefits Scheme (PBS) in Australia was >$6.5b in 2003-04. In efforts to ensure that medicine costs remain affordable, the government instituted cost-effectiveness assessments for listing, brand premium policies and generic substitution and consumer copayments. International research suggests copayments may affect vulnerable populations(1-4) and impact adversely on medicine use(10). In Australia, dispensings of essential and discretionary medicines fell immediately after the introduction of copayments for concessional card holders in 1991(5). Subsequent analysis found that low income general beneficiaries bore the greatest burden of copayments, with PBS expenditure accounting for 7.4% of their income, compared with 2.4% for those with high incomes(6). Costs appear to be becoming a barrier to medicine use in Australia, with a 2005 survey of 702 Australian adults who required regular medications finding 22% did not fill a prescription because of cost in the last 2 years(7). Similar results were reported in 2002 for 23% of 844 sicker Australian adults(8). A regional survey of 420 households found 20% reported they did not purchase all of their prescription medicines due to costs(9). Apart from the initial analysis of medication changes in 1991 as a result of copayment introduction(5), no Australian study has assessed the impact of these on medication use, nor on the impact of any changes in medication use on health outcomes. While copayments may effectively reduce the cost burden of the PBS to government, they may have an unintended negative effect if costs are generated elsewhere in the health system through increased hospitalisations or emergency department attendances as a result of omission of medicines. This research will explore the association between increasing copayments, medication and health service utilisation, information critical for informing policy on increasing consumer copayments.Read moreRead less
Investigating The Relationships Between Cannabis And Other Drug Use, Mental Health, Early-life Factors And Life-course Outcomes: Integrative Analyses Of Data From Four Australasian Cohort Studies
Funder
National Health and Medical Research Council
Funding Amount
$292,097.00
Summary
The current study will be the first of its kind to use integrative data analyses _ a highly innovative approach _ to pool data from four large and long-running Australasian cohort studies to better understand the link between cannabis use and later-life outcomes. Dramatically improved knowledge of these relationships will create a clearer picture of the interventions required to reduce the harms associated with cannabis use.
Mortality Among Injecting Drugs Users - A Follow-up Study Of Injecting Drug User Cohorts.
Funder
National Health and Medical Research Council
Funding Amount
$47,500.00
Summary
This study will follow-up injecting drug users that participated in research in the 1990s and 2000s to examine mortality rates in these groups over time. Identifying information from these studies will be cross-referenced with National Death Index data to determine participants that died and the dates of their death. This study will be the first in Australia to determine mortality rates over time in a defined cohort of injecting drug users outside drug treatment settings. Studying a defined grou ....This study will follow-up injecting drug users that participated in research in the 1990s and 2000s to examine mortality rates in these groups over time. Identifying information from these studies will be cross-referenced with National Death Index data to determine participants that died and the dates of their death. This study will be the first in Australia to determine mortality rates over time in a defined cohort of injecting drug users outside drug treatment settings. Studying a defined group overcomes some of the problems associated with mortality rate estimates based simply on the number of injecting drug-related deaths. Although the number of deaths can be found, the number of people at risk of injecting drug-related death is unclear because of the hidden nature of drug use and the dynamic characteristics of drug use and drug markets. The examination of mortality trends among injecting drug users over time can provide insights regarding changes in drug use patterns and markets. For example, this study will examine changes in injecting drug use mortality across periods of high heroin availability in the late '90s and periods of interrupted heroin supply - the heroin 'drought' - from 2000 onwards. In addition, factors related to injecting drug-related mortality can be explored by comparing the characteristics of injecting drug users that died and those that survived, such as drug use and drug treatment histories, co-morbidities such as mental illness and socio-demographic backgrounds. This information can inform overdose prevention and harm reduction strategies by identifying individuals most at risk of injecting drug-related mortality. This study will also draw attention to the significant public health burden of injecting drug use. In addition, by comparing the results from this study with other similar studies from overseas, we can more reliably compare mortality among groups of Australian injecting drug users with their peers in other countries.Read moreRead less
Improving Asthma Control: General Practice Strategies To Optimise Medication Adherence
Funder
National Health and Medical Research Council
Funding Amount
$460,820.00
Summary
Asthma is a major health problem for Australia. Many patients have frequent symptoms and need urgent health care because they do not use a preventer inhaler regularly. This may be intentional e.g. fear of side-effects, and-or unintentional e.g. forgetting. This real-life study will test two simple strategies for GPs to improve their patients' use of preventer medications, to improve asthma control. Innovative technology will allow GPs to tailor the approach to each patient during a normal visit.
Cognitive Pharmaceutical Services To Mental Health Patients
Funder
National Health and Medical Research Council
Funding Amount
$88,473.00
Summary
It is estimated that more than 450 million people are suffering from a mental illness at any one time. Medications are the main method of treatment for people with mental illnesses. The types of medications used for mental illnesses are commonly associated with side effects and high rates of discontinuation. The aim of this research is to develop a pharmacy management service, in conjunction with other health care professionals, to help patients and their carers to manage their medications.
Long-term Outcome Of Individuals Who Had A First-episode Psychosis
Funder
National Health and Medical Research Council
Funding Amount
$1,344,905.00
Summary
The long-term illness course and outcomes of patients treated for first episode psychosis are poorly understood especially in terms of important domains such as social and vocational functioning, physical health, and quality of life. This treated cohort study of a sample of 786 patients, 15 years after their first episode of psychosis will be one of the longest and largest conducted to date. Results of the study will inform clinical practice and policy development.
Revolutionising Alcohol Dependence Treatment: Targeting Individual Genetic And Psychological Risk Through Clinical Decision Support Systems
Funder
National Health and Medical Research Council
Funding Amount
$446,023.00
Summary
Alcohol misuse impacts significantly Australia’s health. More effective treatments are needed. Computer-based, decision-making tools improve treatment outcomes. Based on genetic and psychological prognostic information provided by these decision-making tools, individual patient’s strengths and weaknesses can be identified and targeted in treatment. We expect this will significantly improve treatment outcomes in this chronic, relapsing condition.
Impact Of Parental Alcohol, Tobacco And Other Substance Use On Infant Development And Family Functioning
Funder
National Health and Medical Research Council
Funding Amount
$1,996,525.00
Summary
The current study will be the first large-scale Australian birth cohort study to comprehensively examine the effects of substance use in pregnant women and their partners during the prenatal period on infant developement and family functioning. Dramatically improved knowledge of these effects will provide evidence-based direction to the development of public health policy and community interventions that aim to improve the health and wellbeing of Australian children and families.
The Impact Of Electronic Medication Administration Records (e-MAR) On Medication Administration Safety And Nurses' Work
Funder
National Health and Medical Research Council
Funding Amount
$735,675.00
Summary
The demands on health systems, both nationally and internationally, are growing, exacerbated by an ageing population and health workforce shortages. The incorporation of information technology into new health care delivery models promises both improvements in the safety and efficiency of care delivery. Medication errors are one of the most significant safety issues for health care systems. Medication management occupies a significant amount of nurses' time, and is also fraught with error potenti ....The demands on health systems, both nationally and internationally, are growing, exacerbated by an ageing population and health workforce shortages. The incorporation of information technology into new health care delivery models promises both improvements in the safety and efficiency of care delivery. Medication errors are one of the most significant safety issues for health care systems. Medication management occupies a significant amount of nurses' time, and is also fraught with error potential. One-third of all medication errors that cause patient harm arise from medication administration errors (MAEs). Electronic medication administration records (e-MARs) provide the potential to make the administration of medications safer for patients by reducing error rates, and also by allowing nurses to more efficiently manage medication tasks. However there is very limited research from Australia or overseas which has examined whether they computerised system work and in fact reduce error rates or save nurses time. In this project we will conduct prospective, controlled observational studies to determine the effectiveness of an electronic medication administration record (e-MAR) to reduce MAEs and the amount of time nurses spend in the medication administration process. The project will apply innovative data collection tools using PDA software purpose-built for these studies which have undergone extensive pilot testing in clinical settings. The results will have important implications for hospitals across Australia and internationally as they consider the implementation of e-MARs. This research will provide the first comprehensive data of medication administration errors in Australia against which future preventative error strategies can be evaluated. The results will provide the evidence needed to develop recommendations about how to reduce MAEs and improve the design of e-MARs.Read moreRead less