Choice Or Chance: The Social Context Of Contraceptive Use By Women With HCV And Their Reproductive & Sexual Health Needs
Funder
National Health and Medical Research Council
Funding Amount
$260,150.00
Summary
Hepatitis C is a growing health concern, with 1% of the Australian population now HCV positive, and signs that it is increasing more quickly among women of child-bearing age. This study builds upon recent research that shows that Australia women with Hepatitis C have low levels of contraception even though they have specific contraceptive needs relating to concerns about the risks of vertical transmission, the effects of the diease on their children and the use of Ribavirin, a teratogen, in HCV ....Hepatitis C is a growing health concern, with 1% of the Australian population now HCV positive, and signs that it is increasing more quickly among women of child-bearing age. This study builds upon recent research that shows that Australia women with Hepatitis C have low levels of contraception even though they have specific contraceptive needs relating to concerns about the risks of vertical transmission, the effects of the diease on their children and the use of Ribavirin, a teratogen, in HCV treatment. This study aims to elucidate the reasons for this low level of contraception among women with Hepatitis C through interviews with them (and in some cases their partners) about the complex array of practices and understandings, within the contexts of their lives, that influence their contraceptive and reproductive behaviours. The public health outcomes of this research include the development of contraceptive information that is relevant to the specific needs of women with Hepatitis C and the identification of barriers to family planning and reproductive health services for these women.Read moreRead less
Understanding The Barriers To Improved Access, Engagement And Retention Of Methamphetamine Users In Health Services
Funder
National Health and Medical Research Council
Funding Amount
$788,291.00
Summary
Drug surveys show widespread use of methamphetamine. Its regular use, particularly via injection, is associated with a range of serious harms, including drug dependence, psychosis, viral infection and violence. In order to improve access, engagement and retention of methamphetamine injectors in drug treatment and other health services, and thereby reduce these harms, further research is urgently needed to better understand their healthcare needs and the existing barriers to service utilisation.
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
ADHD Grown-up: Genetic And Environmental Determinants Of The Adult Outcomes Of Childhood ADHD And Comorbid Conditions
Funder
National Health and Medical Research Council
Funding Amount
$289,542.00
Summary
ADHD remains a controversial issue especially in adulthood. There are many related behavioural problems including substance abuse, anxiety, depression, and personality disorders. Australia is such a focus for twin research that many twin families have taken part in several studies of different aspects of mental health over the years. This grant allows us to link the various datasets to create a unique longitudinal genetic resource and to examine the longterm outcomes.
Effect Of Naltrexone Treatment On Mental Health And Other Health Outcomes : A Record Linkage Study.
Funder
National Health and Medical Research Council
Funding Amount
$111,625.00
Summary
Research has shown that heroin use is an increasing habit of Australia's youth with morbidity and mortality rates for regular heroin users significantly greater than that for the general population. Despite the introduction of a number of treatment options to combat the problem, the management of dependent heroin use has proved problematic. This application addresses an issue of considerable importance and controversy in recent years, namely, the impact of naltrexone and methadone treatment on m ....Research has shown that heroin use is an increasing habit of Australia's youth with morbidity and mortality rates for regular heroin users significantly greater than that for the general population. Despite the introduction of a number of treatment options to combat the problem, the management of dependent heroin use has proved problematic. This application addresses an issue of considerable importance and controversy in recent years, namely, the impact of naltrexone and methadone treatment on morbidity and mortality among persons who are heroin dependent. The study will be carried out using a unique system of linked hospital records from the Western Australian Health Services Research Linkage Unit at the Department of Health Western Australia (DHWA). Through this system hospital, mental health and death records derived from different sources, but related to the same individual are electronically linked. Hence, record linkage provides an independent method for obtaining information on treatment outcomes which is free from subjective bias. In the current study records from heroin users who entered naltrexone maintenance and a smaller group who entered methadone maintenance will be linked to the DHWA database. Collectively these data will be used to quantify morbidity, hospital episodes, mental health issues and mortality in heroin users following commencement of naltrexone maintenance treatment. Data will also be used to compare positive and negative outcomes for individuals on naltrexone with those on methadone. The results will be used to advocate on behalf of this vulnerable population in a country that prides itself on universal access to high quality health services. It is anticipated that this study will have a substantial beneficial impact on the management of illicit drug use policy and as well as contributing new research methods, findings and international knowledge.Read moreRead less
Suicide Ideation, Attempts, Help-seeking Behaviour And Compliance Within The Gold Coast District
Funder
National Health and Medical Research Council
Funding Amount
$111,320.00
Summary
In response to increasing suicide rates in Australia, and abroad, the Australian Government has embraced a nationally coordinated approach to suicide prevention. The National Suicide Prevention Strategy identifies the need for suicide prevention efforts that are based on research evidence. The Australia Institute for Suicide Research and Prevention, in cooperation with the World Health Organisation, is planning to undertake a study to examine suicidal behaviour in the community. Specifically the ....In response to increasing suicide rates in Australia, and abroad, the Australian Government has embraced a nationally coordinated approach to suicide prevention. The National Suicide Prevention Strategy identifies the need for suicide prevention efforts that are based on research evidence. The Australia Institute for Suicide Research and Prevention, in cooperation with the World Health Organisation, is planning to undertake a study to examine suicidal behaviour in the community. Specifically the study will focus on two areas: (a) the willingness of people who displaying suicidal behaviour to seek help and reasons why some people do not seek help, and (b) The compliance with medical treatment among people who seek help following an attempted suicide and the reasons why some of these people do not comply with medical advice. 15,000 people who permanently reside in the Gold Coast Health District will be telephoned at random and asked to participate in the study. Eligible people who agree to participate will be mailed a paper questionnaire. The data gathered in the duty will be examined to gain greater insight into what happens to people following the development or suicidal behaviour. Pilot studies have already revealed that 15% of people in the Gold Coast District have thought about suicide at some time in their lives and as many as 5% have attempted suicide. It is hoped that this study will provide valuable information that can help design more effective suicide prevention programs.Read moreRead less
Population Based Estimates Of MBS, PBS And Hospital Utilisation Rates Using Prevalent Chronic Disease Denominators
Funder
National Health and Medical Research Council
Funding Amount
$246,000.00
Summary
This project will use hospital morbidity and mortality data from the WA Data Linkage System, linked to the Medicare Benefits Scheme and Pharmaceutical Benefits Scheme databases to produce measures of disease occurrence and health service utilisation within the Western Australian population according to indices of social and geographical disadvantage. The first objective will involve establishing teams of clinicians and researchers who will work together to develop and validate lists of MBS and P ....This project will use hospital morbidity and mortality data from the WA Data Linkage System, linked to the Medicare Benefits Scheme and Pharmaceutical Benefits Scheme databases to produce measures of disease occurrence and health service utilisation within the Western Australian population according to indices of social and geographical disadvantage. The first objective will involve establishing teams of clinicians and researchers who will work together to develop and validate lists of MBS and PBS item numbers that are indicative of specified chronic diseases. This information will then be used to identify patients with these conditions from the MBS and PBS databases during the period 1990-2003 and this method of case ascertainment will be compared with the use of the Hospital morbidity data system alone. Once groups of patients have been identified, their utilisation rates of MBS, PBS and hospital services will be calculated. The effect of social and geographical indices on the occurrence of disease and the utilisation of services will also be studied. Trends over time in health status and health service utilisation are vital to the evidence-based planning and evaluation of health services and to the provision of an equitable and accessible health service which is based on the needs of the community. The work will represent the first time that the utilisation of Australian MBS and PBS itemised services is measured in diagnostically defined groups of patients with chronic diseases.Read moreRead less