ANZCTR search results

The growing burden of chronic conditions has been the catalyst for the development of scalable, cost-effective chronic disease management and prevention programmes. Patient narrative communication, or storytelling, is emerging as a component of these programs despite a dearth of quantitative research, utilising rigorous study methods, to examine the effect they have on behaviour change. This thesis presents the findings of a randomized-controlled trial (RCT) which evaluated the impact of patient narratives on the study outcomes, self-efficacy and self-care behaviours.

Dyspnoea is a source of physical and psychological distress, and is one of the most commonly feared aspects of the dying process. By definition, people with severe primary pulmonary hypertension have breathlessness, despite maximal therapy and recent advances in therapies for primary pulmonary hypertension. In parallel with attempting to treat the underlying pathology causing breathlessness, the sensation of breathlessness itself must be ameliorated. For many participants there comes a point when there are no further identifiable reversible components of the disease and the full focus of care moves to reducing the subjective sensation of breathlessness. Opioids have been studied for the relief of breathlessness predominantly in people with chronic obstructive pulmonary disease although people with cancer and heart failure have been included. [Abernethy, Miriam Johnson] A meta-analysis verified that overall there is benefit from the use of morphine in people with refractory breathlessness. [Jennings] This prospective, randomised, placebo-controlled, double-blind, cross-over study is modelled on a study successfully undertaken by some members of this research team. The study proposes to specifically study people with primary pulmonary hypertension for whom breathlessness is a significant symptomatic problem to establish whether there is benefit from sustained release morphine, and if so, what magnitude of benefit, and the clinical characteristics of those who are most likely to respond to this intervention. Any toxicity will also be carefully monitored.Study participants will receive either Kapanol 20mg and Coloxyl and Senna 1 to 2 tablets, or kapanol placebo and coloxyl and senna placebo for one week, will receive no intervention medication for the second week then will receive the alternative intervention combination for the third week.

This study aims to determine if administering Etanercept via the epidural route, will be more effective than placebo at reducing pain scores associated with lubosacral radiculopathy (Sciatica).

The primary aim of this trial is to compare the outcomes and adverse events of two different physiotherapy treatment approaches for people with clinical and radiological confirmation of lumbar disc herniation with associated radiculopathy. A secondary aim is to determine the perspectives of participants on the functional restoration program utilised in the trial.

Weight gain has been associated with increased inflammation, and fish oil supplementation has been shown to possess anti-inflammatory properties. This study is investigating whether fish oil supplementation may reduce inflammation and assist weight loss and weight loss maintenance

The study will determine the range of oral doses of vitamin D that are necessary to raise blood levels of vitamin D to an extent that may have positive effects in patients with rheumatoid arthritis. This study will not examine rheumatoid arthritis outcomes, but the results will be used to plan a later study with rheumatoid patients to examine the effects of vitamin D.

Falls and falls-related injuries are a serious public health issue affecting people aged 65 years and over. It is estimated that 1 in 3 people over the age of 65 will fall every year. Falls are the leading cause of injury-related hospitalization and death in persons older than 65 years of age. They are often the key precipitating factor in leading to admission to an residential aged care (RAC) facility. People living in RAC have a higher rate of falls than older people living in the community. They are generally frailer with greater muscle weakness than their peers living independently at home. There are usually a number of causes of falls. Risk factors that contribute to falls include gait and balance disorders, visual problems, cognitive impairment, and the use of certain medications. Improving lower limb muscle strength and balance using exercise is an effective treatment in falls prevention. In the presence of osteoporosis, the incidence of fracture following a fall increases sharply. Once a person has sustained a fracture due to osteoporosis they are four times more likely to sustain another fracture in the proceeding 12 months than the non-fracture population. Recent interest has emerged on the use of Mechanical Whole Body Vibration (WBV) as a potential therapy that may produce improvements in muscle strength, bone mineral density and balance. WBV works by stimulating the stretch reflex causing a contract - relax cycle of muscle. Given the benefits that WBV has been shown to provide to muscle strength, balance and bone mineral density it has the potential to play an important role in falls prevention particularly in frail older people who have difficulty participating in an active exercise program. It has been suggested that 5 minutes of WBV provides benefits equating with 30 minutes of traditional exercise. This may more achievable in the older person. This study aims to assess the effects of WBV on the muscle strength, balance and falls of older residents living in a RAC facility. Participants who meet the criteria to participate in the study will have their balance and muscle strength assessed prior to commencing the study. Previous falls history will be recorded. All participants will perform a targeted group exercise program aimed at improving lower limb strength and balance. The exercise program will be run two times per week for 8 weeks with each session lasting approximately 30 minutes. Half of the participants will perform additional WBV exercise 3 times per week for 8 weeks under the supervision of a qualified physiotherapist who is experienced in the use of WBV exercise. Each WBV exercise session will be a maximum 10 minutes. At the end of the 8 weeks participants will have their muscle strength and balance reassessed. Information on Falls will be collected for a further 6 months.

This study looks at which types of exercise are most useful in reducing the side effects of hormonal therapy for prostate cancer. Who is it for? You can join this study if you are a man being treated for prostate cancer with androgen deprivation therapy (ADT) to reduce your level of male hormones. Trial details Participants will be divided into three groups. One group will undertake resistance/impact loading exercise. Sessions are 60 minutes each, twice weekly over 12 months. The second group will undertake resistance/cardiovascular exercise. Sessions are 60 minutes each, twice weekly over 6 months. The third group will be provided with a printed booklet with information about exercise for the initial 6-month period, and in the second 6-month period undertake twice weekly cycling exercise sessions. Participants in this group will be also offered a 3-month resistance exercise program following the completion of the second 6-month period. The study will measure cardio-respiratory capacity (maximum oxygen capacity), bone mineral density, blood pressure and artery stiffness, muscle function and other indicators of well-being before, during and immediately after the program. The use of androgen deprivation therapy (ADT) is accompanied by a number of side effects. This study will investigate the effects of exercise on reversing musculoskeletal and cardiovascular related side effects.

Certain types of asthmatics do not respond well to usual medications. It is likely that this is due to the type of inflammatory cells found in the airways. Asthmatics with low levels of eosinophils and high levels of neutrophils may respond better if treated with a class of antibiotics called macrolides. Long-term use of macrolides helps people with a variety of types of inflammation in the lung. As yet, it is unknown whether this will help in asthmatics. The main purpose of this study is to see whether taking two Azithromycin (a macrolide) tablets three times per week for 48 weeks will help people with asthma. It is hypothesised that taking the Azithromycin will reduce the number of asthma exacerbations (or 'attacks'), decrease the general daily symptoms experienced and improve health status.

A previous intervention project saw patients with potentially suboptimal management of their asthma identified from their dispensed medication history – in particular, a high rate of provision of reliever compared with preventer medication for asthma. These patients were sent educational material from their community pharmacists and advised to seek a review of their asthma management from their general practitioner. The intervention resulted in a three-fold improvement in the management of asthma, measured by a significant shift towards more patients using preventer medications and relying less heavily on their reliever medications.1 There were also significant improvements in self-reported asthma control and asthma-related quality of life. This project is examining the long-term sustainability of the previously funded asthma intervention program by performing a 12-month follow-up and data analysis. If the effects of this low-cost, high-value intervention are sustained, it is envisaged that it will significantly impact on health policy in asthma management. If the effects are not sustained, further analysis of the data will be undertaken to determine frequency of the intervention required to gain sustained improvements. In addition, patients, community pharmacists and general practitioners will be invited to participate in qualitative face-to-face interviews to determine the perceived feasibility of the community pharmacy intervention on a national scale. Identification of key barriers and enables to the implementation of the intervention will lead to an improved process if necessary, with a higher level of satisfaction among the target population.