ANZCTR search results

Sometimes drugs such as morphine help people who have severe lung disease feel less breathless when the course of the disease cannot be treated. Although morphine is frequently prescribed, there are limited data to quantify the benefit in this setting. There is growing evidence that different causes of breathlessness can lead to a variety of uncomfortable sensations (for example, “feeling tight” vs. “feeling suffocating”). Because of the recent availability of once daily morphine capsules, we are now able to do this important study and answer questions that will affect the quality of life of tens of thousands of people.

To evaluate the efficacy of n-acetyl cysteine treatment in individuals with bipolar disorder who are continuing treatment as usual with the adjuct of n-acetyl cysteine treatment.

In Australia and internationally, there is concern about the growing proportion of women being delivered by caesarean section. There is evidence of increased risk of placenta accreta and percreta in subsequent pregnancies, and decreased fertility; and significant resource implications. Randomised controlled trials (RCT) of continuity of midwifery care have reported reduced caesareans, and other interventions in labour. They have also found increased satisfaction, with no statistically significant differences in perinatal morbidity or mortality. One Australian RCT comparing continuity of care (team midwifery) with standard care demonstrated a decrease in women having caesarean birth from 18% to 13%. RCTs conducted in the UK and in Australia have largely measured the effect of teams of care providers (commonly 6-12 midwives) with very few testing caseload care. We want to determine whether caseload (one on one) midwifery care decreases the proportion of women having a caesarean section birth, compared with women in ‘standard’ care models (for women at low risk of medical complications). We will also explore other outcomes such as rates of instrumental vaginal births, analgesia, perineal trauma and induction of labour; postnatal depression; satisfaction with care; the proportion breastfeeding at 6 weeks and 6 months; smoking; andthe cost of this model. A final area is about midwives: to explore how this model affects midwives.

To determine whether the administration of Erlotinib (maintenance treatment) after first line chemotherapy in patients with ovarian cancer can provide improved outcomes in terms of progression-free survival, compared with the standard approach of observation alone. Roche only will be supplying the drug.

We developed a video to prepare patients for chemotherapy and assist them to self manage side effect. The purpose of this study was to see if patients who watched the video would report: higher confidence in dealing with treatment side effects, lower anxiety, and fewer unmet needs.

Chronic heart failure (CHF) is a costly and debilitating condition. The benefits of applying nurse led CHF management programs (CHF-MPs) has shown that they improve health outcomes in CHF, especially in prolonging survival & reducing hospital readmission. The aim of WHICH? is to determine whether clinic based or home based programs produce the best outcomes. A randomised study of 1000 patients is proposed. Patterns of health care and quality of life will then be compared. The perspective examined will be health, economic, health policy and consumer.

Whilst the long-term effects of chemotherapy and hormonal therapy with tamoxifen on sexual function and quality of life of women with breast cancer has been well documented, less is known about the impact of aromatase inhibitors (AIs) on a woman’s sexual functioning. Common sexual issues raised have included vaginal dryness, painful sexual intercourse (dyspareunia) and a reduction in libido. AIs have largely replaced tamoxifen as choice of hormonal treatment in post-menopausal women and as there will an increasing number of women on AIs, it is important to document the impact of AI use on sexual functioning. The result of this study will raise the awareness of the potential effects of AI use and sexual dysfunction for both the physician and patient.

The Practitioner Asthma Communication and Education (PACE) Australia study is a collaborative project of the University of Sydney, The Woolcock Institute of Medical Research, The Royal Children’s Hospital, Melbourne and the University of Michigan, funded by the Australian Government Department of Health and Ageing. The aim of the study was to assess the impact of an evidence–based paediatric asthma program for GPs on GP practice and family health outcomes. We recruited a total of 150 GPs and 221 patients from western and central Sydney. We performed a randomised controlled trial with intervention GPs randomly allocated to receive the PACE workshops. Comparison GPs did not receive the PACE workshops until the end of the study. The PACE workshops comprised two 3-hour interactive sessions led by asthma experts. These sessions focussed on best practice approaches to paediatric asthma management and communication strategies with parents. Outcome measures for both GPs and patients were determined at baseline and 12 months. Following the PACE Australia workshops: 1. GPs reported increased use of the recommended communication strategies with their patients; increased use of the Asthma Cycle of Care item numbers and more frequent provision of written asthma action plans. 2. Families of intervention GPs reported increased receipt of asthma action plans and spacer devices, as well as more appropriate medication use. The program resulted in significant improvements in the way in which GPs manage asthma consultations, particularly with regard to doctor-patient communication and adherence to asthma management guidelines with a resultant improvement in key patient outcomes. The PACE Australia workshops were highly rated by all participating GPs. Here’s what some GPs said: “Improved my communication with patients and my knowledge and use of asthma devices.” “I have been able to provide more useful education to the patients by using the models provided at the workshop.” “I have been more interactive with parents & child, involving child more in treatment planning.”

The purpose of this study is to evaluate whether the timing of breast cancer surgery during a woman’s menstrual cycle affects her ultimate outcome- the likelihood of recurrence of breast cancer or death from breast cancer. This study involves taking a small sample of blood from the woman close to her surgery to evaluate her menstrual phase on the basis of hormones in her blood. The woman will then go on to have whichever treatments for her breast cancer that she decides with her doctor. The woman will be observed for at least 5 years and information regarding her treatment and disease progression will be submitted.

Radiotherapy is an effective treatment for people with cancer that has spread to their bones and is causing problems. Sometimes, a second course of radiation is required. This international randomised trial will determine if it is better for a second course of radiation to be done as one large treatment, or as several smaller treatments.