ANZCTR search results

Study examining how effective a psychological therapy called acceptance and commitment therapy is for people with persisting symptoms of severe mental illnesses such as schizophrenia.

Background People living in rural Australia are more likely to die in hospital following an acute myocardial infarction (AMI i.e. “heart attack”) than people in major cities (Moon & Phillips 2007). This disparity is partly due to lower uptake of National Heart Foundation (NHF) guidelines for the administration of thrombolytic drugs. One-third of eligible patients in rural areas do not receive this life-saving intervention (Kinsman et al. 2007). Clinical pathways are structured, locally developed multidisciplinary care plans for specific clinical problems that take into account local resources and availability of doctors. They are an important tool for linking evidence to practice and can enhance adherence to guidelines for use of thrombolytic drugs (Campbell et al.1998). Given that outcomes after AMI in rural settings are poor and that clinical pathways can improve outcomes this study trialled an evidence-based clinical pathway implementation process and its impact on AMI treatment in rural hospitals. Participants Six Victorian rural hospitals participated. Pairs of hospitals were matched according to the anticipated number of eligible patients and randomly allocated to either the intervention (n=3) or control (n=3) sites. Method The intervention sites participated in a 6 month implementation process. The 5 step evidence-based intervention involved: (1) Engaging clinicians, (2) Clinical pathway development, (3) Reminders, (4) Education, and (5) Audit and feedback. The control group received hard copies of the relevant NHF guidelines. Medical records of all patients diagnosed with AMI attending the 6 hospitals during the study period were identified using International Statistical Classification of Diseases (ICD-10) codes. The records were then audited using a standardised data protocol (approximate total of 600 records across 6 sites). Data included type of AMI, gender, and age. The audit also checked whether criteria for use of a thrombolytic drug were met, and if so, whether one was administered and the time in minutes from presentation to administration. Results The implementation of the clinical pathway had no impact on process measures. Conclusion Interventions to narrow the evidence-practice gap for the management of chest pain in rural settings require further evaluation if the gap in outcomes between rural and urban settings is to be reduced.

The intervention trial is completed and is being analysed. The primary purpose of the study was to compare the effect of drinking red wine or de-alcoholised red wine on blood pressure and fatty acid metabolites involved in blood pressure regulation. This study specifically tests the effect of the alcohol in red wine compared with the polyphenols in red wine.

Delirium is a common medical problem characterized by changes in medical function. It occurs in older patients with severe illness. Studies suggest that hospital staff do not always identify that a patients has delirium and so identification and treatment of causes as well as appropriate nursing management may be delayed. This project has been funded by Queensland Health. In this project, all patients aged over 65 years will be assessed for the presence of delirium and their risk of developing delirium. Patients wiith established delirium or an intermediate -high risk assessment will be admitted directly from the Emergency Department to the intervention ward. The intervention ward will be modified to provide an appropriate sensory environment. Patients will then undergo comprehensive medical, nursing and allied health assessment with regard to modifiable risk factors. Treatment will be conducted according to Clinical Practice Guidelines for the Management of Delirium in Older People. Nursing assistants, volunteers and carers will form a valuable part of the intervention. Outcomes of care with this method will be compared to the usual medical, nursing and multidisciplinary care currently provided on the other medical wards.

This 5-year, randomised controlled trial is evaluating a telephone-delivered physical activity, weight loss and glycaemic control intervention targeting patients with type 2 diabetes, recruited from the primary care setting, and compared to usual care.

Older people have higher rates of hospital admission than the general population and higher rates of readmission due to complications and falls. During hospitalisation, older people experience significant functional decline which impairs their future independence and quality of life. Current models of discharge planning and follow-up care do not address the need to prevent deconditioning or functional decline. This study aims to compare the effectiveness of innovative strategies including exercise and/or in-home and telephone follow-up for community-based older people at risk of readmission. Results will determine effective strategies to reduce readmissions and improve functional status, independence and psycho-social well-being

A 26 week study to assess the efficacy of 17 beta-oestradiol and drosperinone on cognitive function in healthy postmenopausal women aged 45-55 years.