ANZCTR search results

This is an innovative project, utilising a largely untapped health resource - community pharmacists and their computerised prescription data - to help identify patients with chronic obstructive pulmonary disease (COPD) as evidenced by their use of Spiriva (tiotropium). The project objective is to understand the drivers and barriers of persistence with respiratory medication, specifically Spiriva. A software application that extracts data from the market leading pharmacy dispensing software system in Australia (WiniFRED Dispense; PCA/NU Systems), developed by the research team, will be modified to identify patients with COPD as evidenced by use of Spiriva. Community pharmacies throughout Tasmania will be recruited and will install the application. In one pass through the complete data set the dispensing history will be interrogated and a list of patients (who are aged over 40 years or age is unknown) identified as having received Spiriva in the previous 12-month period will be generated. Patients will be identified as “persistent” (those to whom those to whom Spiriva was dispensed at least nine times in the preceding 12-month period, including at least two units in the past 90 days) or “non-persistent” (those for whom Spiriva was dispensed between one and four times (inclusive) in the preceding six-month period, with nil dispensings in the subsequent 65 days). The participating pharmacist will examine the dispensing information for each patient identified and will be able to exclude patients from being sent an invitation to participate if they believe the patient is aged under 40 years, is residing in an aged care facility, is deceased, is significantly cognitively impaired and would not understand the letter, or would be alarmed excessively by receiving the letter and participating in the project. Patients deemed suitable for inclusion will be sent a letter by the community pharmacist, to invite them to participate, along with patient information sheets and consent forms. All consenting patients will be subsequently sent questionnaires by the researchers, assessing anxiety and depression, illness perception, health-related quality of life, and medication adherence. Half of the patients will participate in qualitative interviews addressing patient characteristics, diagnosis, treatment choice, day-to-day management, fulfillment, and persistence with therapy. Project deliverables will include utilising key dispensing information to identify key barriers and predictors of poor persistence to Spiriva, and the development of belief/behaviour maps for identified patients, leading to a clear set of recommendations regarding persistence triggers amongst patient types.

This project aims to utilise a computerised solution within community pharmacy to identify patients whose asthma may not be optimally managed, and then implement and evaluate multidisciplinary educational interventions. A software application that extracts data from the market leading pharmacy dispensing software system in Australia (WiniFRED Dispense; PCA/NU Systems) developed by the Research Team will be refined. The intervention study will be conducted across three states: Tasmania, Victoria and South Australia, and community pharmacists using the WiniFRED Dispense System will be personally invited to participate by letter. Participating pharmacies will install the software application that will generate a list of patients who have received six or more canisters of short-acting beta-2 agonists in the preceding 12 months. This indicates that the patient may be using on average three or more inhalations per day of reliever medication, which isin excess of contemporary guidelines for optimal asthma control. Identified patients will be randomised to an intervention or control group. Intervention patients will either receive a mailed personalised letter and intervention pack or an ‘alert flag’ will be placed in their personal details within the dispensing system so that the pharmacist can give them an intervention pack with appropriate counselling on their next visit to the pharmacy. Each intervention will involve encouragement of patients to seek a review of their asthma management from their GP. The intervention pack will consist of the following information: - a computer-generated personalised letter - an educational leaflet about asthma - asthma control, quality of life, and medication adherence questionnaires - a computer-generated letter (and medication history) to give to their GP - a GP satisfaction/perception survey of the intervention to give to their GP. Control patients will receive usual care until follow-up, 12 months later. At this time they will receive an intervention pack and all intervention patients will receive repeat asthma-related questionnaires. Changes in asthma medication usage and questionnaire scores will be examined. We recently conducted a pilot study in Tasmania which demonstrated major improvements in the use of preventer medication at follow-up.

This study aims to investigate the effects of multivitamin, mineral and herbal supplementation on cognitive performance in older adults. It is hypothesized that performance on cognitive tasks will improve in the multivitamin group compared with the placebo group. The study also aims to investigate some of the physiological correlates of cognitive performance (brain electrical activity, cardiovascular function, blood markers) in order to gain further insight to possible mechanisms of cognitive improvement through supplementation.

Falls are among the most common cause of injury and hospital admissions in older people in Australia, and due to the ageing of the population, are a major public health concern. The detection of factors associated with falls may allow clinicians and professionals to implement effective falls prevention programs targeted to those at greatest risk, such as older people with knee osteoarthritis (knee OA). This study will assess the falls risk of individuals with knee osteoarthritis before and at 4 and 12 months following knee replacement surgery using the a series of validated tests (the Physiological Profile Assessment). Additionally, this study will investigate walking patterns (including the minimum foot clearance and the swing limb kinematics and kinetics) in patients with knee osteoarthritis (prior to undergoing knee replacement and 4 and 12 months following surgery) and compare them to an asymptomatic age-matched control group. As such this study will identify the balance and gait characteristics that may predispose older people with knee osteoarthritis to tripping and falling. The research hypotheses are: (i) Patients with knee osteoarthritis will demonstrate different falls risk before and after knee replacement. (ii) Patients with knee osteoarthritis will demonstrate altered minimum toe clearance and swing limb mechanics compared to age matched controls. (iii) Patients with knee osteoarthritis will show different minimum toe clearance and swing limb biomechanics before and after knee replacement surgery.

This research aims to investigate the effects on distress of a modified mindfulness based stress reduction (MBSR) program for patients about to undergo radiation therapy (RT) for the first time. Research questions: 1. Do mindfulness groups significantly reduce the distress (anxiety, depressive symptoms) of cancer patients undergoing radiotherapy? 2. What is the feasibility of routine delivery of an adjunctive psycho-oncology intervention (like the mindfulness groups) in the radiation oncology setting? 3. Are open groups (i.e. groups where members can start and finish at different times) an appropriate way for delivering mindfulness groups to this population? 4. If the mindfulness groups intervention is shown to be effective how can it be generalised to benefit a wider population e.g. significant others and carers of the patient, and patients who are receiving other treatments like chemotherapy.

This study is a randomised controlled trial investigating the effectiveness of physiotherapy supervised pelvic floor muscle training (PFMT) for pelvic organ prolapse. The hypothesis is that PFMT for prolapse will effective in reducing prolapse severity and symptoms.

Chronic Obstructive Pulmonary Disease (COPD) is a major contributor to the burden of disease in Australia. Increasing prevalence of chronic diseases has seen a shift in patient care paradigms towards disease specific programmes that focus on self-management. This new model for COPD care involving mentoring by trained nurses to increase self-efficacy aims to improve the health-related quality of life of people with COPD, while reducing associated healthcare costs through the early identification and treatment of acute exacerbations. Research Plan: A randomised study of participants with COPD recruited from general practices compares the model with usual care. Participants recruited to the active arm will have an individual management plan developed by the research team in consultation with their general practitioner. Nurses, trained in methods to improve self-efficacy, will work in partnership with participants to achieve behavioural change through a cycle of goal setting and action planning, focussing on health behaviours identified in the management plan. Outcomes will include health-related quality of life, self-efficacy, healthcare utilisation, lung function and physical activity.

This study will monitor whether you develop tearing and if so, how frequent and severe this complaint is. It will involve assessment of theeyes before start chemotherapy, during and at the end of treatment.

This 12month low intensity, randomised controlled intervention is delivered in conjunction with primary schools. It builds on the exisiting community efforts to control the prevalence of obesity and related disorders. It addresses barriers to attendance and is low cost and adaptable to communities