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Background: Pain is the leading reason for patients to seek health care, accounting for up to 78% of presentations to the emergency department (ED). Appropriate pain management is the key to quality patient care. Despite effective pain management being a major treatment goal, the underutilisation of pain relief in ED remains prevalent. Aims: This study aims to investigate the impact of pain relief being prescribed in the ED and its effect on the pain scores for patients who have been discharged from the ED with a fracture in a long bone. This study will also investigate whether stronger pain relief are prescribed to patients and used following discharge from the emergency department. Participants: patients of age 17 or older with a long-bone fractures discharged from the hospital. Methods: Follow-up phone survey conducted at one week post-discharge from the ED. The survey will include questions about type of analgesia received and/or prescribed, filling of prescriptions, other pain medications used, adequacy of pain relief within the Emergency Department and following discharge, non-pharmacological pain relief, and interference with activities of daily living and side effects. Expected outcomes: 1) To improve understanding of analgesia prescribing practices of patients discharged from the emergency department within the NSLHD. 2) To improve care of patients with long-bone fractures with improved clinician and nursing awareness of severity of pain and analgesia.

The Triple E study aims to test four strategies for increasing teenagers' use of and engagement with health apps to find out which strategy, or combination of strategies, works best. The app used in the study is called the Health4Life app and is designed to help teenagers improve the 'Big 6' health behaviours that prevent the development of cardiovascular diseases in later life. These health behaviours include, healthy eating, physical activity, sleep, limiting screen time, and avoiding alcohol and tobacco. The strategies tested in the study to improve uptake of and engagement with the app include gamification, access to a health coach, providing health factsheets to parents of the teenage in the study, and text message prompts. It is hypothesised that each of the strategies will be associated with greater app uptake and engagement. No hypothesis is made as to which combination of strategies will be feasible and acceptable, nor which combination will be associated with the greatest uptake and engagement. The study also aims to test whether the uptake and engagement strategies are associated with improvements in participants' 'Big 6' health behaviours. No hypothesis is made as to whether there might be associations between the strategies and participants’ health behaviours.

Mild traumatic brain injury (mTBI) results in a range of debilitating symptoms including cognitive, sensory, and emotional deficits, sleep disturbances, and headaches. Despite increased awareness of the socioeconomic costs and risks of poor outcome, the clinical management of mTBI remains notoriously difficult because there are still no evidence-based interventions for individuals across the lifespan. Current treatment options for mTBI are sparse and not evidence-based, with the standard treatment for mTBI still being rest until asymptomatic. Initial studies led by members of our team have identified subthreshold aerobic exercise as a promising intervention for mTBI in adolescents. Findings from these studies show that this intervention may result in faster recovery and reduced incidence of persisting post-concussion symptoms; thereby allowing individuals to return to per-injury activities sooner. This intervention protocol is also straight forward and applicable in a vast range of clinical setting. However, studies are now required to extend and validate this subthreshold exercise intervention protocol as an effective mTBI intervention in adults. To address this knowledge gap, our complementary and interdisciplinary research team now propose a clinical trial to examine subthreshold aerobic exercise intervention in mTBI patients. We hypothesise that exercise intervention will improve recovery in mTBI patients. Based on these findings we will develop and distribute protocols/guidelines for both adolescent and adult mTBI patients that can be accessed and applied in clinical settings across Australia.

Mycophenolate is an immunosuppressant that is widely used as a treatment for systemic lupus erythematosus (SLE). Its biological effects involve a reduction in immune cell functions, which in turn reduce systemic or organ related inflammation and damage. The benefits of using mycophenolate in SLE need to be carefully balanced against unintended side effects such as increased risk of infection or blunting of vaccine responses. One strategy to counteract these effects is the temporary withdrawal of the immunosuppressant, which allows for the immune system to recover and effectively respond to a vaccine or infection. Our study will examine the effects of withdrawing mycophenolate for a short period in SLE patients. Our hypothesis is that this temporary withdrawal will result in an improvement in the immune responses to the influenza vaccination while maintaining disease control.

We aim to examine the feasibility of a new guided parent-delivered CBT-P (GPD-CBT-P) whose child is aged between 7 and 12 years of age in terms of recruitment through educational settings and retention rates. In addition, we will gather data how GPD-CBT-P performs against waitlist control for change over 18-weeks post-randomisation on self-report (parent and child) measures of perfectionism, stress, depressive symptoms, and body image disturbance. In addition, this will be the first occasion that academic outcomes (satisfaction and self-efficacy) will be examined in a randomised controlled trial design. This is a feasibility trial that will provide a plausible range of point estimates of the efficacy of GPD-CBT-P on standardised continuous symptom measures for our secondary aim. In this way, we can refine the treatment manual and contribute to the design. As a feasibility study we do not pose hypotheses but will examine our primary outcomes (number of enquiries, number recruited into the trial, number completing first assessment, number randomised, number retained in treatment, number of completed assessments at each timepoint, percentage of homework tasks completed between sessions, total hours of guidance used by each family), as well as the perceived treatment credibility, acceptability and effectiveness, and the between group effect sizes (95% confidence intervals) for our measures.

The main purpose of this research is to evaluate the feasibility of a two-week education module designed to inform individuals living with type 1 diabetes how to assess device generated data. This education module has been created by endocrinologists, diabetes educators, industry, dieticians, psychologists, community engagement and education specialists. The researchers will also evaluate participant’s satisfaction with the module and satisfaction in the management of their diabetes, as well as looking at their blood glucose control after the education module. Involvement will last around 26-28 weeks and will involve 7 visits, and at least 4 of these visits will occur at the clinical trial site. Participants will be asked to wear a continuous glucose monitor, and a keep a study diary at specified times over the course of the trial.

During general anaesthesia muscle relaxant drugs are administered to make airway management and surgery easier. Muscle relaxants are usually reversed with neostigmine at the end of the operation. A newer drug, sugammadex, reverses muscle relaxants more rapidly than neostigmine, but is not clear whether sugammadex results in fewer postoperative complications than neostigmine. We are conducting a large multi-centre randomised controlled trial to investigate whether sugammadex is associated with fewer postoperative lung complications than neostigmine.

Chronic pain is one of the most common chronic conditions in Australia and the prevalence is on the rise. It is estimated that by 2050, the prevalence of chronic pain will rise to 5.23 million Australians. People with chronic pain suffer not only physically, but also financially and emotionally. One of the eight goals identified by Painaustralia in the National Strategic Action Plan for Pain Management (2021) is for “People living with pain have timely access to consumer-centered best practice pain management including self-management, early intervention strategies and interdisciplinary care and support”. Chronic pain can have a significant impact on mental health and they commonly occur together. Depression and anxiety are the most common comorbidities associated with chronic pain in Australia at 44.6%, followed by osteoarthritis and degenerative arthritis (29.3%) and hypertension(25.1%). Nearly half of the patients with chronic pain presenting for treatment suffer from major depression. Major depression in people with chronic pain often leads to reduced functioning, poorer treatment response, and increased healthcare costs. Breathing intervention is an effective self-management for a range of medical and mental health conditions. To date, there has not been a reported randomized control trial examining the effectiveness of a breathing intervention for adults with a range of chronic pain types. This research aims to examine the efficacy of telehealth-based group breathing intervention on patient-reported outcomes in patients with chronic pain as compared to usual care. The research question for this trial is “In people living with chronic pain, what is the effect of a telehealth-based group intervention on mood, pain intensity and interference, catastrophising, and self-efficacy compared with no breathing intervention within a 12-month period?”. The hypothesis of this randomised control trial is “telehealth-based group breathing intervention is beneficial for improving patient-reported outcomes in adults living with chronic pain”. Once consented to participate this research, participants will be randomized to either treatment (telehealth breathing intervention group) or usual care (control group). Patient reported outcomes will be collected at baseline, 4 weeks post-initiation of treatment, 8 weeks post-initiation of treatment, and 6 months post-initiation of treatment.

The proposed study will deliver an existing validated and empirically supported Cognitive Behaviour Therapy (CBT) program, Exploring Feelings - Anxiety, for anxious young autistic children. The program will be slightly extended based on the results for an earlier study, by way of the inclusion of two additional sessions specifically focused on social skills. A within-subjects design with repeated measures will be used to evaluate changes in levels of anxiety across the delivery of the program. Delivery of pre- and post-intervention assessments along with session-by-session measures will allow the researchers to explore (a) changes in anxiety levels from before to after intervention delivery, and (b) if any changes that do occur are more likely at certain timepoints of the intervention, pointing towards particular components of the intervention as being more helpful than others.

The purpose of this study is to evaluate the survivorship (revision rates) and patient reported outcomes (PROMs) following implantation of the Insignia hip stem in patients undergoing cementless total hip replacement surgery compared to currently available stems used for the same type of surgery. It is hypothesised the 2-year survivorship of the Insignia stem is noninferior to the benchmark survivorship of similar stems used in the same type of surgery.