ANZCTR search results

Musculoskeletal conditions, low back pain, neck pain/whiplash and osteoarthritis of the knee are one of the highest contributors to years lost to disease. The PACE intervention aims to identify patients at risk of poor prognosis to improve their management in primary health care settings. Patients identified as low risk will receive minimal intervention (up to 3 sessions of guideline based care advice and exercises). Those identified as medium to high risk will be referred to a specialist musculoskeletal clinician who will undertake a more complex examination of individual physical, psychological and pain factors. The specialist clinician will then liaise with the patient and the primary health care practitioner to decide further care. We hypothesize that implementation of this novel musculoskeletal clinical care pathway will result in improved health outcomes and be more cost-effective. If successful PACE will be a useful addition to primary care musculoskeletal care management.. This study will include embedded observational studies that will evaluate patient perceptions, experience, health professional practice and inter-professional collaboration

The purpose of this study is to promote widespread uptake of evidence based, best practice falls prevention in Australian residential aged care facilities. It is hypothesised that by employing implementation strategies such as education, conducting audits and facilitating system change to improve the timely identification of residents, we will see an increase in the use of vitamin D supplements by residents. It is anticipated that this will then assist with a reduction in falls over the long term in Australian residential aged care facilities.

This study will follow-up drivers who have a diagnosis of dementia for a period of 2 years - which is the period after diagnosis in which many people with dementia stop driving. The primary objective is to identify the factors which are associated with participants deciding to give up driving and also to record how both the participant and the carers feel about the changes in the participants driving over the two year period following a diagnosis of dementia or Alzheimer’s disease.

Impaired arm and hand function is a common and often devastating problem for stroke survivors. Regaining lost movement in the arm/hand is more difficult to achieve than walking, with only 5% of people with hemiplegia regaining functional use of their hand. This devastating outcome could potentially be addressed, however we do not yet know how to best increase movement in the arm and hand after stroke for patients with spasticity. There is a lack of randomized controlled trials of botulinum toxin A (BoNT-A) with a group who does not receive therapy in some dose, and so whether gains were achieved through BoNT-A or a combination of the BoNT-A and therapy cannot be determined from the studies to date.The research project is testing whether intense therapy given after botulinum toxin injections into the arm is more helpful than just the injections alone.

Whiplash-associated disorder (WAD) represents a significant public health problem, resulting in substantial social and economic costs throughout the industrialized world. Chronic WAD is a bio-psycho-social condition. And though education is an effective intervention for people with WAD, providing access to such interventions is a major challenge. The randomised control trial aims to investigate whether simple reminders about self-management sent via mobile phone text message improves health outcomes in people with chronic WAD. This is pilot for a randomised controlled trial with three months follow-up to evaluate the feasibility, acceptability and effect on health outcomes of repeated reminders sent via mobile phone text messages compared to usual care. A total of 50 patients, with chronic WAD will be randomised to either standard care or the TEXT WAD intervention. The participants will be identified through Personal Injury Registry, Motor Accident Authority, NSW. The intervention group will receive two weekly text messages that provide information, reassurance, support, and recommendations for “act usual” and physical activity. The primary endpoint is change in score of Neck Disability Index. Process outcomes related to acceptability and feasibility of TEXT WAD will also be collected. Text messaging has potential as a cheap, safe and simple method to support and educate people with chronic WAD. However, its effectiveness and feasibility in practice must be proven in a well-designed and rigorously conducted trial.

This project's hypotheses are that early access to vocational rehabilitation services for in-patients in NSW spinal units will increase return to work rates and have a positive impact on general health and well being of the participants. This study will also have other components to complement the quantitative aspect namely a qualitative sub-evaluation (investigating the perspective of the participants and rehabilitation staff), a process sub-evaluation (with reference to the implementation of the intervention), and a cost sub-evaluation.

A limited amount is known about the key determinants of the health and social outcomes for people who have sustained an injury as a result of a land transport crash and, in particular, the extent to which determinants specifically related to the compensation process are relevant. The proposed investigation will seek to: 1) Identify individual and system factors influencing the health and social outcomes of people who have sustained an injury related to a land transport crash and who seek compensation through a compulsory third party (CTP) compensation scheme; 2) Identify individual and system factors influencing the health and social outcomes of people who have sustained a non­compensable injury in a land transport crash in NSW; 3) Identify the key factors that explain the differences between those who apply for compensation and those who are eligible to apply but do not. There are a number of domains, which relate to the individual and the system, which will be explored: ­ Characteristics related to the individual that influence the likelihood of applying for compensation ­ Characteristics related to the health service experience process ­ Characteristics related to the claims process ­ Characteristics related to the liability and fault process ­ Characteristics related to the legal representation process The study will utilise an inception cohort design, with a sample size of 1,500 participants aged 17 years or older, who are injured as a result of a crash involving a motorised vehicle in NSW and who have been diagnosed with an injury within 28 days of the crash. Recruitment will be through metropolitan and rural hospital emergency departments, general practitioners, physiotherapy clinics, police crash records and the Motor Accidents Authority claims database. People with severe injury, those unable to give consent due to cognitive impairment, those with minor localised soft tissue injury, those with a self harm related injury or those where a family member has died as a result of the crash, will be excluded. Data about health and social recovery outcomes and variables that potentially influence these outcomes will be collected by questionnaire administered by telephone or by written questionnaire for people who are deaf or prefer to complete a written questionnaire. There will be a focus on key variables identified in the literature that are associated with health outcomes. The questionnaire will be no longer than 45 minutes and be conducted at baseline (within 28 days of the motor vehicle crash), 6, 12 and 24 months post­injury. Detailed statistical analyses will explore the associations and interactions between the measured variables and health and social recovery outcomes.

This is a randomised trial of a multifactorial interdisciplinary intervention for pre frailty. The intervention has previously been shown to be effective in frailty older people (see ACTRN12608000250336, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=82814).

The aim of this clinical trial is to determine whether a novel starch (butyrylated high amylose maize starch, Starplus B) can protect against colorectal cancer. Butyrate is normally produced in the colon by the fermentation of dietary fibre, and Starplus B can increase the concentration of butyrate in the colon. Laboratory and animal experiments suggest butyrate from dietary Starplus B may reduce the risk of developing colon cancer. The study is a double blind, randomised controlled trial involving 120 volunteers likely to develop a genetic form of colon cancer (familial adenomatosis polyposis, FAP). FAP patients usually have most of their colon surgically removed by their early 20’s, and require regular follow-up colonoscopies to ensure they do not develop tumours in their residual rectum. After a baseline colonoscopy the FAP volunteers consume either Starplus B or placebo starch for 6 months, and then undergo a colonoscopy to assess the number and size of polyps and to sample the lining of the colon for analysis. The volunteers then consume the other starch for 6 months, and undergo a further colonoscopy. As the FAP gene mutation also occurs in the majority of sporadic (common) colorectal cancer, the study may identify a dietary chemo-preventative supplement which is likely to benefit the wider community who are at risk of developing sporadic colorectal cancer.

This study will assess the effect and overall survival outcomes of radiotherapy following mastectomy in women with breast cancer. Who is it for? You may be eligible to join this study if you are a female with confirmed unilateral breast cancer with 'intermediate risk' of loco-regional recurrence following mastectomy. Trial details Participants in this trial will be randomly (by chance) allocated to one of two groups. Participants in one group will undergo radiotherapy 5 days a week for 3-5 weeks commencing 12 weeks after mastectomy or 6 weeks after adjuvant chemotherapy. Participants in the other group will receive standard of care and observation only. Participants are followed up twice in the first year, and then annually for 10 years in order to asses the study endpoints.