The Effect Of Glucosamine Sulphate On Structural Disease Progression In Knee Osteoarthritis
Funder
National Health and Medical Research Council
Funding Amount
$1,250,214.00
Summary
Osteoarthritis (OA) is a joint disease characterized by a progressive loss of cartilage and joint space resulting in increasing pain and difficulty performing usual daily activities. OA is the leading health problem amongst older Australians and a National Health Priority area. There is no known cure for OA and no intervention demonstrated to slow disease progression or delay time to joint replacement surgery. Currently patients are managed symptomatically with all clinical guidelines recommendi ....Osteoarthritis (OA) is a joint disease characterized by a progressive loss of cartilage and joint space resulting in increasing pain and difficulty performing usual daily activities. OA is the leading health problem amongst older Australians and a National Health Priority area. There is no known cure for OA and no intervention demonstrated to slow disease progression or delay time to joint replacement surgery. Currently patients are managed symptomatically with all clinical guidelines recommending paracetamol as 'the preferred long term oral analgesic'. This recommendation is based on the increased risk of serious gastrointestinal, cardiovascular and renal diseases with long-term NSAIDs use in older people. However, NSAIDs appear to provide better pain relief for patients with more than mild joint pain. Amongst patients with OA, there is much demand for the dietary supplement glucosamine sulphate. Product marketing has led to the belief that glucosamine is able to slow the rate of joint destruction and cartilage loss and help ease joint pain with, in contrast to NSAIDs, little risk of side effects. However, the few trials conducted to date have been inconclusive. If the marketing claims are unjustified, many older people are wasting limited financial resources and due to unrealistic expectations of the benefit of glucosamine, placing a lower priority on lifestyle changes of proven effectiveness, such as regular exercise and weight loss. A total of 900 patients with knee OA will be randomly allocated to glucosamine sulphate or matching placebo capsules for two years. The main outcomes will be the rate of joint space narrowing, use of NSAIDs and physical disability. If glucosamine results in slowing disease progression or in reducing NSAIDs consumption, the widespread use of this product would effectively decrease pain, disability and NSAIDs-related illnesses amongst the increasing number of people with OA.Read moreRead less
Can Preventive Care Activities In General Practice Be Sustained When Financial Incentives And External Audit Plus Feedback Are Removed? A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,201,443.00
Summary
There is increasing debate about the effectiveness of incentive payments and audit plus feedback on the clinical behaviour of general practitioners (GPs). Governments both in Australia and the UK are raising the threshold targets for payment eligibility making it more difficult for GPs to get payments. We will conduct a trial that will investigate the impact of removing financial incentives and/or external audit plus feedback on the preventive care activities of GPs.
Translating Risk Models To Improve Prevention And Early Diagnosis Of Cancer In Primary Care
Funder
National Health and Medical Research Council
Funding Amount
$479,882.00
Summary
Primary care plays a key role in prevention and early diagnosis of cancer. This fellowship will apply evidence about cancer risk to help GPs provide tailored advice to patients about preventing common cancers. It will also use new risk tools to assess people with symptoms suggestive of cancer to support earlier diagnosis. The research extends to studies relating to how people interpret symptoms and ways of promoting earlier presentation to the GP in patients who are at higher risk of cancer.
A Randomised Trial Of A Clinical Prediction Tool For Targeting Depression Care (Target-D)
Funder
National Health and Medical Research Council
Funding Amount
$944,774.00
Summary
The Target-D Study uses a novel clinical prediction tool to test a new approach to depression care in general practice based upon sub-grouping patients into low, medium and high risk of ongoing depression. Participants will be randomly allocated to targeted treatments based upon their risk profile or to usual general practice care. We will measure whether the new approach results in greater improvements in depressive symptoms, quality of life and functioning and whether there are cost benefits.
Increasing The Use Of Long-acting Reversible Contraception: The Australian Contraceptive ChOice PRoject (ACCORd)
Funder
National Health and Medical Research Council
Funding Amount
$726,144.00
Summary
Of all reversible contraceptive methods, long-acting reversible contraceptives (LARCs), such as intrauterine devices and hormone implants, are by far the most highly effective at preventing pregnancy. However, the prescription and use of LARCs amongst Australian women who are at risk of pregnancy is very low. To increase the uptake of LARCs, our study will trial a complex intervention that involves providing counselling to women and developing rapid referral pathways to LARC insertion.
Strengthening Health Systems Through The Use Of Process Evaluations Of Complex Interventions
Funder
National Health and Medical Research Council
Funding Amount
$61,383.00
Summary
A strong primary health care is vital to improve health and health equity globally. This is pertinent in a growing age of non-communicable diseases for which there is effective prevention strategies available. It is important to understand for whom, how and why these strategies can work in a primary health care setting (such as better understanding patients' and health providers' perspectives) through process evaluations. Research to build on process evaluation methods is crucial.
The Role Of Spirometry In Managing Chronic Respiratory Diseases In General Practice
Funder
National Health and Medical Research Council
Funding Amount
$487,427.00
Summary
This study will compare the use of spirometry (a lung function test) in general practice, with and without feedback of results, against the delivery of usual medical care without spirometry. If positive, the trial will result in better health outcomes for patients with chronic respiratory disease.
The Influence Of Acupuncture On Reducing Women's Pain From Primary Dysmenorrhoea: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$310,875.00
Summary
Dysmenorrhoea refers to painful uterine cramps during menstruation. It is a common condition that affects as many as 50 percent of women. Severe menstrual pain can lead to an absence from work, or attending school, or interference with day to day lives. This condition is commonly treated with non-steroidal anti-inflammatory drugs or the oral contraceptive pill. Studies suggest that between 30-50 percent of the adult population use some form of complementary medicine. Acupuncture, the insertion o ....Dysmenorrhoea refers to painful uterine cramps during menstruation. It is a common condition that affects as many as 50 percent of women. Severe menstrual pain can lead to an absence from work, or attending school, or interference with day to day lives. This condition is commonly treated with non-steroidal anti-inflammatory drugs or the oral contraceptive pill. Studies suggest that between 30-50 percent of the adult population use some form of complementary medicine. Acupuncture, the insertion of fine needles, into specific areas of the body is increasingly being used to treat a number of conditions. It has been indicated in several non-clinical studies and two small clinical trials to be effective with treating dysmenorrhoea. Evidence from the Cochrane systematic review of acupuncture to treat primary dysmenorrhoea concluded acupuncture may be helpful. This study assesses whether women with dysmenorrhoea can be successfully treated using acupuncture. Women experiencing dysmenorrhoea with no underlying pelvic pathology will be offered the opportunity to take part in the trial. Women interested in taking part will be randomly allocated into one of two groups. One group of women will receive acupuncture, a second group will receive control (sham) acupuncture. The second study group involves the insertion of needles away from acupuncture points. Women will receive the treatment intervention for three menstrual cycles and then followed up for a further six months. Women will be asked to report on the pain they experience during menses and to report any time taken off from work or school, disruption with day to day activities, or the need for additional pain relief. In 2005 we expect to report on the effectiveness of this treatment on dysmenorrhoea and whether this treatment is acceptable to women. If the results are positive, it is hoped this will become an option available to women for the management of their dysmenorrhoea.Read moreRead less
The OPTIMISE Project: Collaborative Improvement Of Primary Health Care Delivery To The Australian Refugee Community
Funder
National Health and Medical Research Council
Funding Amount
$1,022,303.00
Summary
Identifying and addressing the health needs of refugees arriving in Australia can be difficult amidst current primary care system limitations. Our team will build the capacity of frontline health services for providing comprehensive, evidence-based care to this vulnerable community, while addressing system gaps in health service access and coordination. Our framework for effective, practical and sustainable primary health care delivery will improve health outcomes for refugees nationally.
A Phase II Trial Of Follow-up Of Men With Prostate Cancer In Primary Care.
Funder
National Health and Medical Research Council
Funding Amount
$584,465.00
Summary
This study aims to develop and test a novel model of shared care for the follow-up of men with prostate cancer. Men treated for prostate cancer experience distressing and ongoing side-effects of treatment and significant psychological issues. Current models of care fail to address adequately these issues. The new model is designed to improve the care received and therefore the quality of life of men after treatment for prostate cancer.