ANZCTR search results

Antipsychotics are commonly prescribed for behavioural and psychological symptoms of dementia (BPSD) and delirium despite serious short and long term risks. Australian guidelines recommend limiting use in these situations to 12 weeks due to evidence of increase risk of stroke and sudden death with prolonged prescribing; however the prevalence of use beyond this time frame is high. A Macquarie University study cited at the 2020 Australian Royal Commission into Aged Care Quality and Safety, showed 65% (n=5825) of aged care facility residents prescribed antipsychotics for BPSD, remained on treatment for an average of 30 weeks. Pervasive and inappropriate use of antipsychotics (among other ‘restrictive practices’) was a key finding of the Royal Commission’s Interim Report, negatively impacting patient outcomes, quality and dignity of life. Reducing antipsychotic use requires multifactorial approaches including systems to support non-pharmacological interventions. Whilst not all of these are addressed in this study, increasing patient/carer understanding of evidence base and best practice use of antipsychotics addresses a key element, centered on patient/carer empowerment. This project aims to evaluate the impact of changes to hospital standard care, including increased GP and specific patient/carer engagement on the use of antipsychotics after hospital discharge. We predict it will have an impact of reducing antipsychotics prescribed (either dose or complete deprescribing) at 12 weeks after hospital discharge.

Chronic Low Back Pain (CLBP) is a major health issue worldwide. Pain-related fear and activity avoidance are the most recognised barriers to recovery. Virtual Reality-based Cognitive Behavioural Therapy (VR-CBT) is an emerging exercise and education approach designed to better target fear and activity avoidance through graded exposure to movement by simulating an engaging environment, and reinforcing positive pain beliefs through education and augmented video feedback on performance. This project aims to evaluate the outcomes of VR-CBT on 1: fear-avoidance beliefs, reported pain; and 2: trunk movement; and 3: physical activity, in individuals with CLBP. The participants will be a single cohort of 37 individuals (18-65 years) with CLBP and at least moderate fear avoidance beliefs, quality of life and pain severity. These participants will be recruited through the RBWH Physiotherapy Department. This will be a repeated measures single-arm study. The expected outcomes are: the addition of VR-CBT to standardized PNE alone will reduce reported pain and fear-avoidance beliefs, increase trunk movement and walking speed, and increase physical activity levels during daily life among individuals with CLBP and pain-related fear of movement.

This study attempts to harness advances in machine learning and artificial intelligence to faciliate monitoring of symptom fluctuations in Parkinson's disease. Participants will be asked to draw a spiral while wearing a smart watch with accelerometer function in both 'on' and 'off' state, based on clinical assessment. These samples will be used to train the algorithm, and an independent set of samples used for validation of the algorithm.

Utilising group singing intervention via Telehealth, conducted by as Speech Pathologist and a Music Therapist, we aim to improve vocal intensity (as defined by dB SPL) in patients with Parkinson's Disease

Low Phospholipid Associated Cholelithiasis (LPAC) is a cause of post-operative pain and recurrent gallstones after gallbladder removal (cholecystectomy). This is a randomised control trial of a medication called ursodeoxycholic acid in patients with LPAC to prevent pain post gallbladder surgery, improve quality of life, reduce hospital presentations and patient use of strong narcotic painkillers. This trial is a crossover trial where participants will be randomised to undergo a 1 year experimental (ursodeoxycholic acid) or control arm (placebo). The experimental or control arm will be prescribed a daily dose of 10mg/kg of ursodeoxycholic acid or placebo. Participants will then undergo a 2 week washout period before crossing over to the opposite arm to complete the study. The dose will be prescribed at 10mg/kg daily and can be titrated to a maximum of 20mg/kg daily at the discretion of the treating clinician. The primary study outcome is number of episodes of biliary pain. Secondary outcomes include quality of life, hospitalisations, liver ultrasound findings.

Vitamin B12 is a water-soluble vitamin found in fish, eggs, meat and milk. An adequate level of B12 blood concentration is necessary to prevent anaemia, cognitive impairment and neuropathy. B12 deficiency in older people is common. Symptoms include changes in mood and dizziness. It is important therefore that B12 deficiency is promptly treated, particularly in residents of aged care facilities who fall at a greater rate than the general population. Detection is complicated in cases of functional deficiency where B12 is within normal levels. Negative conditions of B12 deficiency can potentially be reversed by administering vitamin B supplements. Due to potential issues with the ageing gastrointestinal tract of the older adult, there is a requirement for an intervention using B12 supplements that bypass the gut. This study will investigate the effect of B12 supplementation in the form of skin patches on falls risk and mood in residents living in aged care facilities. As nurses are the primary clinicians involved in the reduction of falls in residents, demonstrating that falls risk in older people is impacted by the application of a non-prescription vitamin B12 patch could have major implications for nursing practice and public health policy.

This study aims to investigate the feasibility of implementing a whole-of-lifestyle intervention, the Younger Women’s Wellness after Cancer Program (YWWACP), to promote health-related quality of life. Who is it for? You may be eligible for this study if you are a woman aged 18-50 years inclusive, have completed any intensive treatment (surgery, chemotherapy, radiotherapy) for breast cancer in the previous 24 months and have no metastatic disease. Study details Participants will be randomly allocated to either a control arm who will receive standard care, or an intervention arm who will receive materials for a 12-week program designed to help them self-manage their chronic disease risk. They will also have three 30-60 minute individual, video consultations at weeks 1, 6 and 12 with a registered nurse. Participants will be asked to complete a variety of questionnaires throughout the program. Data from this study will go towards assisting the design of future programs to decrease the likelihood of treatment-related chronic disease for women with breast cancer.

This study aims to detect if there is a difference between activating your deep core muscles or your outer abdominal muscles in reducing the seperation of the abdominal muscles in women with diastasis of the rectus abdominis muscles following vaginal childbirth.

Overall study hypothesis: That increasing levels of resilience for low socio-economic status (SES) smokers who are contemplating quitting will help them quit smoking cigarettes. This study is likely to have an impact on improving the poorer health of lower SES populations by reducing smoking and increasing resilience, mental wellbeing, confidence, self-esteem and self-efficacy. This will address the high smoking prevalence rates in lower SES areas and the limited number of studies that have addressed this health problem in this target population. The cost-effectiveness analysis of the interventions will also provide important information to policy-makers. This study will utilise a Randomised Controlled Trial (RCT) design with one control group and three intervention groups. Once consented, participants will be randomised to one of these four groups: 1.) Arm 1-Mindfulness-integrated CBT (MiCBT) plus peer-support; 2.) Arm 2-Mindfulness Training (MT) plus peer-support, 3.) Arm 3-Setting Realistic Goals (SRG) plus peer-support 4.) Control. This will enable the study to determine which of the interventions works best when compared to the control group and also when compared to each other.

Obstructive sleep apnoea (OSA) is associated with increased risk of cardiovascular disease including hypertension, and screening for this condition and treatment may help reduce those risks. Furthermore, undiagnosed OSA is also linked to increased risk of postoperative complications in patients undergoing major surgery. Opportunities to screen using simplified diagnostic devices may be an important approach to addressing this clinical burden. Conventionally, the diagnosis of OSA is conducted by laboratory polysomnography (PSG) . A number of simplified devices are emerging commercially including single use disposable single or dual channel home monitoring. Single use disposable devices may emerge as the most convenient method for screening for OSA, especially in the home setting, however formal validation against PSG has not been previosly performed. The NightOwl is a small dual channel device that acquires data from a single fingertip and is now TGA registered as a single-use device in addition to a previously validated reusable option. The purpose of this study is to validate the single-use NightOwl compared to its reusable counterpart and the gold standard laboratory PSG for the diagnosis of OSA. Findings of this study will inform models of care that may include screening for OSA. This may be important in the clinical assessment of operative risk in those suspected of OSA undergoing major surgery.