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ACCHOs have an important role to play in reducing the impact of diabetes on Indigenous people. This study aims to trial a strategy for helping ACCHOs improve screening for diabetes and diabetes care. Existing data such as rates of HbA1c testing and outcomes of these tests will be used to assess whether the strategy is successful

The purpose of the study is to assess whether a high dose, stabilised green-lipped mussel extract is effective in the treatment of osteoarthritis of the knee, assessed by pain, mobility, gastrointestinal function and quality of life measures. We hypothesis that altered gut function (i.e. such as constipation, diarrhoea, reflux, bloating) may affect how successful green-lipped mussel is in improving the knee pain and mobility. Gut function may be altered due to the underlying condition of osteoarthritis, medication intake or altered gut flora.

Vitamin D deficiency and insufficiency has been detected in the general community and is likely to be present in cardiac intensive care unit patients. This may impact recovery from surgery and rehospitalisation risk. The primary aim of this study is to identify the prevalence of vitamin D deficiency and insufficiency in cardiac ICU patients presenting to the Alfred Hospital. Secondary aims are to identify whether vitamin D deficiency or insufficiency is associated with longer ICU stay, longer ventilation time and/or APACHE 3 scores showing deterioration. And also to ascertain whether supplementation with 4000IU of vitamin D daily restores serum levels to within normal range.

Cellulitis is a common, painful and disabling condition where bacterial infection spreads under the skin to cause a red, hot swollen leg. The current standard treatment of cellulitis is antibiotics to kill the responsible bacteria. This treatment is usually successful, however, most people require antibtiotic treatment, rest and time off work for 10-14 days. A single unblinded small RCT of ibuprofen as adjunctive therapy has previously shown that patients receiving ibuprofen had substantially more rapid regression of cellulitis than those receiving antibiotics alone, with no increase in adverse effects. We plan to conduct a pilot double-blinded randomised controlled trial of adjunctive ibuprofen versus placebo in patients with uncomplicated lower limb cellulitis to determine if this strategy leads to more rapid resolution of inflammation than standard therapy alone.

This study aims to determine whether a drug called Riluzole can prevent chemotherapy-induced nerve injury in patients with colorectal cancer. Who is it for? You can join this study if you are aged 18-80 years and are scheduled to undergo chemotherapy with the drug, oxaliplatin, for the treatment of colorectal cancer. Trial details In this study, participants are randomly (by chance) divided into two groups. One group will take the study drug, Riluzole, at a dose of 50 mg oral tablet twice daily for the duration of chemotherapy treatment (4-6 months), and for 2 weeks following treatment cessation. The other group will receive a placebo (sham) treatment consisting of lactose tablets. During the trial, participants will not know whether they are receiving the active drug or placebo. Participants will be assessed at regular intervals over 2 years to assess their nerve function, quality of life, and cancer-related outcomes.

ATAHC II is a prospective longitudinal study of natural history and treatment outcomes following response-guided treatment of recent HCV infection. The main aim of the study is to identify the optimal therapeutic strategy for patients with recently acquired HCV infection. Eligible subjects will be offered HCV treatment with pegylated interferon alfa-2a with or without ribavirin, depending on their HIV status and their duration of infection. The duration of treatment will be guided by the subject’s virological response to treatment and will range from 8 weeks to 48 weeks. Subjects who are not eligible for HCV treatment or chose not to receive HCV treatment will be followed at regular intervals for 2 years

Subarachnoid haemorrhage (SAH) accounts for 5% of all strokes, yet 30% of people affected with SAH will die within 90 days and survivors are often disabled. Unlike ischaemic stroke, there is a relatively higher risk of SAH in younger age groups, yet risk factors are ill-defined. Therefore, determining health service variables impacting on outcomes will inform policy and practice. It is now feasible to examine SAH care and its outcomes on a large scale at a relatively modest cost. We will analyse linked routinely collected morbidity and mortality data to explore outcomes and patterns of care in SAH on a large scale. The study will describe discharge destinations and readmissions and be able to quantify the effect of hospital services according to different models of care, resources and settings (eg principal and non-principal referral, neurosurgical vs non-neurosurgical) and neurovascular interventions. Such a large-scale analysis of services and care patterns will be of international significance informing bed-side care and health service planning to improve individual, health service and societal outcomes. We hypothesise that the risk of 30-day, 90-day and 12 month all-cause mortality will be correlated with health service delivery for patients with SAH. Specifically, patients with SAH admitted to a hospital offering a neurosurgical unit will have a reduced risk of all-cause and disease-specific mortality and spend less time in hospital in the year after a SAH. There will be significant variation in all-cause and disease-specific mortality and hospital re-admission according to: hospital type (eg principal referral versus other, rural versus urban location), caseload, and patient and disease characteristics. We will identify emergency presentations and hospital separations for SAH in New South Wales from July 2000 until June 2010. Data from these sources will be linked to the NSW Registry of Birth, Deaths and Marriages (fact of death) and ABS Causes of Death data.

A high salt intake is a neglected risk factor for heart disease and stroke. Recently attention has been drawn to the potential reduction in death and disease a decrease of 3g salt/day can bring. The aim of this study is to translate knowledge into practice by substantiating dietetic practice in salt reduction in individuals with hypertension at increased risk of cardiovascular disease. Cardiovascular disease is a significant burdens for individuals and for the Australian health care system potentially leading to early death or disability. Keeping blood pressure well controlled has a key role in the prevention of cardiovascular disease. Salt reduction can greatly assist blood pressure control but there are no studies evaluating the most effective education strategies to help people with hypertension implement and maintain salt reduction. This study will help fill this gap. The expected outcomes are that a lower salt intake of 6g/day is sustainable and will reduce blood pressure by 3-5mmHg SBP/day.

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.