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The findings of this study have demonstrated that a comprehensive multi disciplinary patient education program with the multimedia patient education module, in line with adult learning principles, had a positive impact on informing and preparing patients for major joint surgery, the management of their post operative pain and their six week recovery period. The intervention participants reported a statistically significant greater level of preparedness for surgery than the control group. The pre admission education group goals were to give the patient a consistent message from the multi disciplinary team, offer opportunities to ask questions, participate in discussions, to understand the role of nurses, allied health staff, surgeons and anaesthetists and engage the patient in their self efficacy, their pain management and to take an active role in their rehabilitation. A second statistically significant outcome was the intervention group patients reported the pre admission information also prepared them to a greater degree with the management of their post operative pain when compared to the control group. Regarding the secondary outcome of in-patient length of stay, the intevention patients had a 0.4 day less than the control group, it was nor statistically significant and as many factors impact length of stay it is not possible to conclude that greater study numbers would have made it significant. These findings illustrate the significance to the patient of a comprehensive pre admission program. Establishing realistic expectations of patient surgical outcomes, promoting active involvement in pain management, rehabilitation and discharge can all contribute to a more positive experience in-hospital experience and recuperative episode. This in turn may have benefits to the organisation through a decreased length of stay, the improved utilisation of staff expertise and the growth of their positive corporate image and reputation.

Aims: The primary aim of the present study is to improve the maintenance of weight loss in obese adults. To do so, it will combine the most promising approaches suggested by previous research, namely, (i) motivational enhancement therapy (MET) and (ii) instructing the support partners of obese patients in the strategies of MET. Given the prevalence of obesity, any feasible solution will need to limit the need for patients to have intensive, ongoing healthcare. By enhancing the self-motivation of patients to control their weight over time and improving the quality of social support patients have for weight control, this double-faceted approach aims to improve the maintenance of weight loss while minimising the need of patients for ongoing healthcare service utilisation. Method: The current study entails a two-arm randomised controlled trial in which obese patients will receive a one-year cognitive-behavioural weight control intervention augmented by MET; this intervention will be implemented with and without the inclusion of support partners. A total of 150 patients from Canberra and Sydney will participate in the study (75 in each of the two treatment conditions), yielding an estimated power of 80%. The inclusion criteria include 18-70 years of age, a body mass index between 30-60, and the availability of one support partner to attend sessions. Patients will be excluded if they have psychiatric or medical conditions that would preclude full participation in the study, are currently receiving treatment for obesity or treatments known to affect weight, or are pregnant. A comprehensive battery of medical, behavioral and psychological measures will be administered at baseline, post-treatment and at a one-year follow-up to evaluate the effectiveness of the various interventions. Treatment will consist of 26 sessions for patients and, in the conditions targeting social support, 10 sessions for support partners over a 12-month period. All treatments will be manual-based and treatment fidelity checks and quality control will be undertaken.

This randomised controlled trial examined the effectiveness of the Cool Teens computerised program for anxious adolescents compared to a comparable wait list condition. It was hypothesised that the adolescents who received the Cool Teens program would demonstrate significant reductions in anxiety and that these improvements would be sustained at follow up, as compared to the adolescents who underwent the wait period.

The purpose of this study is to investigate whether Aclasta is effective in treating osteoporosis caused by AED use.

This study aims to conduct a blinded, randomised, placebo-controlled trial to determine the effectiveness of hyperbaric oxygen therapy for patients with non-healing venous leg ulcers on progress in wound healing, pain, quality of life and cost effectiveness of care. Study Therapy: Active - Oxygen at 2.4 atmospheres absolute for 110 minutes in the Hyperbaric Chamber. Placebo - Exact time replica of the treatment protocol using air pressurised to 1.2 ATA then decreased to 1.0 ATA. This is repeated in a cyclical routine through the “compression/decompression” phases of the treatment protocol. The patient is maintained at 1.0 ATA through the 85 minute “treatment” phase. Study Population: Male and female adults with non-healing venous leg ulcers and who fit with the study inclusion/exclusion criteria will be recruited into the study. To complete 58 study participants in the HBOT blinded study, at least 84 volunteers will need to be enrolled into the four week pre-HBOT treatment assessment period. No. Centres: 1. Wesley Centre for Hyperbaric Medicine Study Design: The study has a randomised, double-blind, placebo controlled design. Study Duration: Total of 16 weeks including the four weeks prior to and six weeks following the HBOT intervention of six weeks duration. Objectives of the Study: To determine the effectiveness of hyperbaric oxygen therapy for study participants with non-healing venous leg ulcers on progress in wound healing, pain, quality of life and cost effectiveness of care. Study Endpoints: (Primary and Secondary) Primary wound healing outcome measure will be the incidence of complete wound closure at the completion of the study (12 weeks after initiation of the HBOT study). Secondary outcomes will include time to healing, ulcer area percentage reduction and differences in PUSH scores. The primary safety endpoints will be incidence of treatment emergent adverse events. Study participants are assessed prior to commencing HBOT and then at every treatment for adverse effects e.g. ear barotrauma, oxygen toxicity effects (seizures, myopic visual effects). These side effects are all temporary changes. Quality of Life data will be measured at the beginning and end of the 16-week study.

Evaluate the Health Related Quality of Life (HRQOL) associated with pulmonary metastasectomy (PM) (specifically: dyspnoea, cough, chest pain, pain interference, fatigue, physical functioning, role functioning, social functioning, satisfaction with social discretionary activities and satisfaction with social roles, emotional functioning, depression, anxiety and overall HRQOL).

In 2008-2009 the Ambulance Service of NSW responded to 672,000 emergency incidents. For the same period, “falls” was the reported problem to triple zero operators in almost 90,000 cases with those 65+ comprising 58% of all fallers. The non-conveyance rate for older fallers is 23% however little is known about the outcomes for these people. Work undertaken in the UK reported similar rates of non-conveyance and also demonstrated that 47% of older people not conveyed following a fall are re-attended by the Ambulance Service within two weeks. This study proposes to test the hypothesis that: rapid, timely and tailored intervention in older people who are not conveyed to hospital following a fall will lead to a significant reduction in future falls, fall related injury and unplanned use of emergency and acute hospital services. A randomised controlled trial design (n=234) will be used to test the impact of rapid access to a comprehensive assessment and intervention program. The study population will consist of people aged 65+ years who live in Randwick, Botany or Waverly, are attended by an ambulance as a result of a fall and who are considered to be appropriate to be left at home. Follow-up telephone contact will be made with all non-conveyed fallers initially to establish that there has been no acute deterioration in their health or level of function following their fall. Consenting patients will undergo a baseline assessment in their home within 72hrs of initial attendance and be provided with a written report with regard to falls risk factors identified. Intervention: The intervention group will receive falls prevention strategies based on the risk factors identified. The clinical researcher will pro-actively work with the older person to ensure that risk factors are addressed and interventions carried out. This will involve close liaison with the local Post Acute Care Service who will be part of delivering interventions including an evidence based exercise program and home safety assessment. Follow-up: Both the control and intervention groups will be followed up using monthly calendars and reply paid envelopes for a period of 6 months. Information will be collected with respect to falls, fall related injury, subsequent use of the ambulance service or hospital system and any visits to health care providers in the community. At the end of the six months, all participants will be reassessed by a researcher blinded to group allocation. Outcomes: The primary outcome measure will be the number of fallers and falls in the 6 month follow up period (measured using falls calendar data) Additional secondary outcome measures include: Number of falls requiring ED attendance and/or hospitalisation measured using calendar data and corroborated with NSW Centre for Health Record Linkage (CHeReL) data), Use of NSW Ambulance Service including time on scene (routinely collected Ambulance Service data) and re-attendance rates, Any ED presentation or hospitalisation including DRG and LOS data (measured using calendar data and corroborated with CHeReL data), Use of community services – GP visits, HMRs, ACAT referrals, use of PACS services etc (measured using monthly calendar data), Uptake and adherence to recommendations (based on initial and final assessments), Quality of Life at baseline and follow-up measured using the EQ5D

Mentalization based therapy (MBT) is a psychological treatment to develop a person’s capacity to focus their attention on, and understand thoughts and emotions, and to help with more accurate interpretation of their and other people’s behaviour, and in turn improve interaction with other people. This study’s aim is to determine whether taking a MBT approach in conjunction with a recovery-based model of care (‘Strengths’ model: a model of care that emphasizes and supports a person’s potential for recovery) is of benefit to patients of St Vincent’s Mental Health (SVMH) who have a history of recurrent, self-harm and who suffer with Borderline Personality Disorder. The benefits that will be looked for include whether there are reduced episodes of significant self-harm (that is requiring consultation by a medical practitioner) and suicidal behaviour in participants of the study and also, whether there are reduced presentations to/attendances at the Emergency Department or psychiatric inpatient admissions and the impact on the length of any admission to a psychiatric inpatient unit . In addition, there will be assessment of participants day to day psychological functioning based on questionnaires completed by participants as well as assessment by the study’s investigators. Participating case managers working at SVMH will use the MBT approach in patients under their care and with their patient’s consent, and at a frequency determined by the case manager in consultation and agreement with the patient according to their mental state and level of distress or stress. Any discordance between the case manager and patient regarding the frequency of contact will be respectfully discussed and considered by the case manager in the context of the professional relationship. This could involve several meetings per week at times of crisis. The treatment would be focused on helping the patient reinstate a mentalizing approach during crises. Telephone contacts would be employed and active follow-up occur if participants (patients) were not able to attend appointments. The frequency of contacts and meetings will be recorded. A crisis plan (that is a mutually agreed approach between case manager and patient regarding how the patient (participant) would cope during a time of significant distress or stress) would be developed by the patient and the case manager. Participating case managers using the MBT approach will be supervised fortnightly by a MBT trained therapist. The training for case managers using the MBT approach would be two half days training by SPECTRUM (Victorian statewide personality disorders service) staff prior to study commencement. There would be an additional two hour training for participating case managers, two months into the study. Participating case managers will also be invited to attend a focus group, 3 monthly for a duration of 12 months, discussing their experience of using a MBT approach in combination with the ‘Strengths’ model of care; these focus groups will be de-identified in terms of individual, patient details, to preserve their confidentiality and privacy.

The study aims to investigate whether using iLogic inReach (superDimension) virtual bronchoscopy software to pre-plan lung biopsy procedures results in more accurate diagnosis of lung lesions as well as shorter procedure times and lower complication rates when compared to conventional planning of lung biopsy procedures using digital copies of CT scans

Aim: To determine the efficacy and tolerability of low doses of slow release nicotinic acid as a phosphate binder in haemodialysis patients with persistently high serum phosphate levels. Phosphate accumulates in patients with renal failure. A high phosphate level has been associated with higher mortality. Patients with end stage renal failure on dialysis often need to take medications to reduce serum phosphate. Unfortunately, these medications have complex dosing regimes, often cause side effects and are expensive. This leads to poor compliance and poor correction of serum phosphate. Nicotinic acid has been shown to have phosphate lowering effects. We propose to investigate the efficacy, safety and tolerability of a low dose of a once daily novel sustained release preparation of nicotinic acid (Slo niacin) in patients with end stage renal failure on haemodialysis who have problems with high phosphate levels.