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Current Research

PC4 Current Research

The PC4 Research Portfolio has been themed into three priority areas:

CHEST Australia: a Phase II randomised controlled trial of a complex intervention to promote consulting with symptoms of cancer – CI Jon Emery

Lung cancer is the leading cause of cancer deaths in Australia. Testing novel approaches to earlier diagnosis of lung cancer to improve outcomes has been identified as a research priority by Cancer Australia. This phase II randomised controlled trial builds on a Scottish trial of a theoretically-based intervention aimed at promoting earlier help-seeking in people at higher risk of lung cancer and increasing health literacy among adults at high risk of lung cancer.

Current status:

Funded; Open to recruitment

For more information contact:

Trial coordinator & PhD Candidate Sonya Murray, School of Primary, Aboriginal and Rural Health Care, The University of Western Australia (sonya.murray@uwa.edu.au, +61 8 9346 7237)

Reducing cervical cancer risks: a toolkit for young women – CI Lyndal Trevena

This project will develop an evidence-based decision tool for women aged 19-26, and evaluate its effect on Pap test consultation length, HPV knowledge, uptake of tests and vaccine and provider communication. The tool will be delivered online prior to the consultation, and will be a one-stop source of information for cervical cancer prevention. Women will ideally learn to access the tool before their Pap test every two years, and they can be made aware in advance of their consultation of new technologies and options available to them. The preparation of patients before the consultation is an important model that will be tested in this study and could be transferable to other aspects of general practice.

Current status:

Funded; Open to recruitment

For more information contact:

Study coordinator Mbathio Dieng, Sydney School of Public Health, The University of Sydney (mdieng@health.usyd.edu.au, +61 2 9351 3137)

BEST Australia - A Phase II Study of Non-Endoscopic Screening for Barrett’s Oesophagus – CIs Alex Boussioutas & Jon Emery

Collaborators from UWA and The University of Melbourne are currently working with the University of Cambridge on studies of a sponge capsule and novel assay for mini chromosome maintenance (Mcm) proteins to screen high risk populations for Barrett’s oesophagus (BO), the pre-cursor lesion of oesophageal cancer. They aim to determine the feasibility of developing the assay in Australia and will examine the acceptability of the screening test to inform a future international multisite screening trial.

Current status:

Funded; Open to recruitment

For more information contact:

Clinical research coordinator Brie Jelbart, The University of Melbourne (brie.jelbart@unimelb.edu.au, +61 3 8344 6729)

Should I take low-dose aspirin? – CI Lyndal Trevena

Recently new evidence has emerged for daily low-dose aspirin in cancer prevention. The challenge is identifying patients for whom the benefit-risk ratio is most favourable. The project aims to develop the ‘Optimise’ model decision tool, assess the effect of the tool on self-reported aspirin-taking behaviour, and assess the short-term impact of the intervention on CVD, cancer and bleeding outcomes using linked health administrative data.

Current status:

Funded

For more information contact:

Chief Investigator Lyndal Trevena, School of Public Health, The University of Sydney (lyndalt@health.usyd.edu.au, +61 2 9351 7788)

iPrevent - Development and pilot testing of an evidence-based, tailored, computerised risk assessment and decision support tool for women at increased risk of breast cancer to facilitate discussions about prevention and screening measures – CI Kelly-Anne Phillips

While many factors influence breast cancer risk, family history, mammographic density and a personal history of certain types of breast disease are the most important. There is evidence that a tailored decision aid will help educate women, and their clinicians, on their personal risks and the relative pros and cons of each of the available measures to reduce that risk. This research will assess the needs of potential end users and then program and pilot a prototype decision aid tool, with a plan to subsequently assess the tool in a randomised controlled trial.

Funding stage:

Funded

For more information contact:

Chief Investigator Kelly-Anne Phillips, Peter MacCallum Cancer Centre (kelly.phillips@petermac.org, +61 3 9656 1118)

Improving the early diagnosis and detection of cancer in primary care – CI Jon Emery

A core element of primary care’s role in cancer care is the assessment of cancer risk. Julia Hippisley-Cox has recently reported QCancer models, which predict risks of different cancers according to baseline risk factors, current symptoms and specific clinical conditions. The overall agenda of this study is to trial the implementation of the QCancer risk models in primary care and assess their effect on diagnostic intervals and clinical decision making for patients with suspected cancer.

Current status:

In development

For more information contact:

Research Fellow Peggy Chiang, Department of General Practice, The University of Melbourne (chiangp@unimelb.edu.au, +61 3 8344 9046)

Exploring patient and health system factors in timely diagnosis of cancer in CALD communities – CI Jon Emery

Migrants diagnosed with cancer in Australia often have poorer outcomes than comparable non-migrant groups. This project will apply a mixed-methods approach to explore diagnostic pathways and time to diagnosis in patients with colorectal, lung or breast cancer from culturally and linguistically diverse (CALD) communities, focusing initially on people of Vietnamese or Arabic background.

Current status:

In development

For more information contact:

Chief Investigator Jon Emery, Department of General Practice, The University of Melbourne (jon.emery@unimelb.edu.au, +61 3 9035 8018)

LEAD: A mixed methods study to overcome barriers to Early Diagnosis for Lung cancer – CI Danielle Mazza

Aims to: Evaluate the current practice of GPs and health care providers regarding the early detection and referral of patients who have or may have lung cancer; Identify barriers and facilitators to timely and appropriate initial diagnosis and referral; Compare and contrast diagnosis and health care pathway of CALD patient groups from metropolitan areas and those from rural and regional locations; Design a framework and intervention/s for a future trial to improve the early detection and referral of lung cancer in GP and acute health care settings.

Current status:

In development

For more information contact:

Chief Investigator Danielle Mazza, School of Primary Health Care, Monash University (danielle.mazza@monash.edu, +61 3 9902 4496)

Applying risk markers to prostate cancer screening (SNPs) – CI Jon Emery

This project is on the role of single nucleotide polymorphisms (SNP) testing to rationalise prostate specific antigen (PSA) screening for prostate cancer. A meta-analysis of six trials on PSA screening showed that screening resulted in a 46% increased likelihood of men being diagnosed; however, this diagnosis had no significant impact on all-cause or disease-specific mortality. The aim of this study is to determine the potential clinical utility of SNP testing to inform PSA screening.

Current status:

In development

For more information contact:

Chief Investigator Jon Emery, Department of General Practice, The University of Melbourne (jon.emery@unimelb.edu.au, +61 3 9035 8018)

PROCARE: Phase II trial of primary care-based follow up for prostate cancer – CI Jon Emery

This phase I/II study is set within the Medical Research Council (MRC) framework for the development and evaluation of complex interventions. Its aims are to: Develop a shared-care model of follow-up for men with potentially cured prostate cancer. Operationalise and optimise the intervention, establish acceptability of the intervention and randomisation, confirm the suitability of outcome measures and inform final design of a future phase III trial. Estimate the potential effect size and coefficient of variation on which to base power calculations for a national, adequately powered phase III trial, for which further funding will be sought.

Current status:

Funded; Open to recruitment

For more information contact:

Study coordinator Juanita Doorey, School of Primary, Aboriginal and Rural Health Care, The University of Western Australia (juanita.doorey@uwa.edu.au, 08 9346 7251)

Physical activity for women with metastatic breast cancer – CI Sharon Kilbreath

The exercise intervention will comprise an 8-week program of 16 structured exercise sessions with a personal trainer to focus on low-intensity aerobic training, low-impact muscle strengthening and endurance training. In addition, women will be prescribed a home-based "lifestyle" walking program with feedback derived from a pedometer for the days of the week when not seeing the trainer, but where the trainer will follow-up and motivate the "lifestyle" component.

Current status:

Funded; Open to recruitment

For more information contact:

Chief Investigator Sharon Kilbreath, Faculty of Health Sciences, The University of Sydney (sharon.kilbreath@sydney.edu.au, +61 2 9351 9272)

The effect of a nurse-led Haematology Survivorship Clinic on patient reported anxiety and unmet information needs: pilot randomised controlled trial - CIs Leanne Monterosso & David Joske

This project will implement individual self-management care plans for haematology survivors in order to reduce patient reported unmet informational needs through the provision of evidence-based, tailored information. Self-management plans will address optimal physical recovery, nutrition and physical activity recommendations, returning to work, sexual functioning, and psychological support, with the aim of reducing anxiety levels.

Current status:

Funded

For more information contact:

Chief Investigator Leanne Monterosso, School of Nursing and Midwifery, The University of Notre Dame (leanne.monterosso@nd.edu.au, +61 8 9333 9765)

Evaluating a shared care pathway intervention to reduce chemotherapy outpatients’ unplanned presentations to hospital - CI Kate White

Despite on-site education programs and literature for patients, unmanaged side effects from chemotherapy remain problematic for many outpatients and are associated with poorer outcomes and increased health service use among cancer patients. The study seeks to address this challenge through a shared care clinical pathway intervention which optimises existing services. The aims of the study are to assess the impact of the pathway on the number of unplanned presentations to hospital for chemotherapy outpatients as well as patient psychosocial and functional health outcomes, and determine the cost-effectiveness of the pathway.

Current status:

Funded

For more information contact:

Chief Investigator Kate White, Sydney Nursing School, The University of Sydney (kate.white@sydney.edu.au, +61 2 9515 6327)

Development of an intervention to improve cancer survivorship using QCCAT data systems - CI Geoff Mitchell

The study will utilise the Queensland Cancer Control Analysis Team (QCCAT)’s internet-based applications that allow for the linking and sharing of patient information between clinicians and facilities. In order to enhance communication between health professionals and facilitate cancer surveillance we propose the development of SCPs for the GP (and patient), which uses Queensland Oncology Online (QOOL) data entered by the oncology multidisciplinary team, an automated email (or mail) reminder to GP and/or patient of surveillance test appointments, and an electronic-report from the GP to the consulting oncologist on cancer-specific patient care tailored to the oncologist’s requirements.

Current status:

Funded

For more information contact:

Researcher Hugh Senior, School of Medicine, The University of Queensland (h.senior@uq.edu.au, +61 7 3381 1577)

Defining a role for GP’s and patients in Multidisciplinary Team (MDT) decisions for cancer care – CI Lyndal Trevena

Both local and international studies have identified better communication between primary and secondary care as being an integral issue for improved cancer treatment. This project will develop a template to record the discussions and recommendation of cancer Multidisciplinary Team (MDT) meetings in order to enhance the documentation and value of these meetings, and potentially improve communication between health professionals involved in implementing and continuing cancer patient care.

Current status:

Pilot funded

For more information contact:

Chief Investigator Lyndal Trevena, School of Public Health, The University of Sydney (lyndalt@health.usyd.edu.au, +61 2 9351 7788)

Bone health after cancer – a primary care approach – CI Bogda Koczwara

Many cancer survivors are at risk of bone loss and currently there are gaps in delivery of effective therapeutic strategies for management. This study aims to develop and test a model of assessment and risk stratification of cancer survivors’ bone health and a management pathway that can be delivered in the primary care setting in order to identify barriers to delivery.

Current status:

Pilot funded

For more information contact:

Chief Investigator Bogda Koczwara, Dept. of Medical Oncology, Flinders Medical Centre (bogda.koczwara@flinders.edu.au, +61 8 8204 8997)

Rehabilitation and early return to work after cancer – CI Bogda Koczwara

This study investigates a hypothesis that an early approach to rehabilitation of cancer patients in the early shared care setting can lead to earlier and more successful return to work (both paid and upaid) and better health outcomes of cancer survivors. The study would also explore the feasibility of delivering shared care at the early stage of cancer care as this approach would potentially impact on the overall model of shared care between specialists and general practitioners.

Current status:

Pilot funded

For more information contact:

Chief Investigator Bogda Koczwara, Dept. of Medical Oncology, Flinders Medical Centre (bogda.koczwara@flinders.edu.au, +61 8 8204 8997)

PC-ProC: The effects of phytotherapeutic combination in men with biochemically recurrent prostate cancer – a pilot study - CI Marie Pirotta

The aim of this pilot study is to investigate the feasibility of a fully-powered randomised controlled trial of the effect of a supplement containing a combination of phytotherapeutic agents – polyphenols (resveratrol, green tea catechins, curcumin) and glucosinolates (broccoli sprout extract) - on decreasing the rate of rise of PSA and PSA doubling time (DT) in men with biochemically-recurrent prostate cancer following local therapy.

Current status:

In development

For more information contact:

Chief Investigator Marie Pirotta, Department of General Practice, University of Melbourne (m.pirotta@unimelb.edu.au, +61 3 8344 9723)

Improving physical and psychosocial functioning of breast and prostate cancer survivors through tailored nutrition and exercise intervention – a randomised controlled trial - CI Bogda Koczwara

Cancer survivors are at greater risk of functional impairment than age matched controls, and have higher unmet needs. These in turn may lead to difficulties in return to employment, impaired ability to perform activities of daily living and poor quality of life. This study examines the impact of an exercise and nutrition intervention, delivered using methodology shown to be effective in other chronic disease groups, on the functional outcomes of cancer survivors and evaluates its long term impact and cost effectiveness.

Current status:

In development

For more information contact:

Chief Investigator Bogda Koczwara, School of Medicine, Flinders University (bogda.koczwara@flinders.edu.au, +61 8 8204 8997)

Queensland enhanced survival trial in post-acute cancer (QUESTPAC) – CI Geoff Mitchell

The University of Queensland in collaboration with the Queensland Cancer Control Analysis Team (QCCAT) of Queensland Health plan to more effectively utilise a Queensland Health web-based data sharing system with data entered from hospital oncology departments to develop tailored and individualized survivorship care plans for Breast and Colorectal cancer survivors. A needs assessment tool will also be developed for post-acute survivors of breast and colorectal cancers. In addition, a complementary Meeting Colorectal and Breast Cancer Survivors Needs resource kit for GPs will outlining the types of problems that might arise and link GPs to evidence based strategies and resources that might help address the problems.

Current status:

In development

For more information contact:

Researcher Hugh Senior, School of Medicine, The University of Queensland (h.senior@uq.edu.au, +61 7 3381 1577)

Achieving needs-based end-of-life services for people with cancer: a prospective, longitudinal study – CI Patsy Yates

Our over-arching goals are to quantify the health and support needs of patients with advanced cancer and their primary informal carers in the 6 months before death and to map patients’ movements within and between health and care services during this time. This is the first prospective study conducted in Australia to determine how patients with advanced cancer and their primary informal carers use and experience health services towards the end of life. By linking patient reported data with data from a range of administrative sources, this study will provide the evidence base needed to enable planning and delivery of appropriate and accessible health services for people with advanced cancer at end of life.

Current status:

Funded; Closed to recruitment

For more information contact:

Study manager Shirley Connell, School of Nursing, Queensland University of Technology (se.connell@qut.edu.au, +61 7 3138 6110)

Single patient trials (SPT) of paracetamol for pain in palliative care patients on regular opioids - CI Geoff Mitchell

_This trial examines the feasibility of aggregating multiple SPTs to gain a population estimate of the efficacy of paracetamol in pain where the patient is on regular opioids.

Current status:

Funded; Open to recruitment

For more information contact:

Study manager Sue Ann Carmont, School of Medicine, The University of Queensland (s.carmont@uq.edu.au; +61 7 3365 5014)

Developing end of life care skills for general practice: what patients want from primary care - CI Geoff Mitchell

GPs are well placed to identify people with life-threatening illnesses as well as the needs of such patients and their carers. This project will consult patients, carers, GPs, and key stakeholders in order to determine what those most affected need from their primary care providers. This will add to our understanding of how primary care should manage the end of life phase. Furthermore, it will identify key indicators of quality in end of life care which will be used to develop a routine data collection tool to assess quality of care.

Current status:

Pilot funded

For more information contact:

Chief Investigator Geoff Mitchell, Faculty of Medicine and Health Sciences, The University of Queensland (g.mitchell@uq.edu.au; +61 7 3381 1578)

Can death from chronic life limiting illnesses be predicted? - CI Joel Rhee

Palliative care cannot be provided appropriately if patients are not identified as having a life limiting illness. The challenge is to ensure that the people who may die in the foreseeable future are identified so that planning can take place. This study will test the ability of GPs to predict which patients will die within twelve months, with and without clinical guidelines. Once a person is identified as being at risk of dying, their needs specific to end of life care, and specific to their medical condition can be addressed.

Current status:

Pilot funded; Closed to recruitment

For more information contact:

Chief Investigator Joel Rhee, School of Public Health and Community Medicine, The University of New South Wales (j.rhee@unsw.edu.au, +61 2 9385 3502)

Community nursing in cancer care – a descriptive study of the current involvement of community nurses in cancer care in Sydney, NSW - CI Kate White

Aims to describe the current typical involvement of community nurses in cancer care in Sydney, NSW in order to identify whether there are potential gaps and/or opportunities for improvement, with the longer term aim of identifying potential interventions to improve the involvement of community nurses in cancer care.

Current status:

In development

For more information contact:

Chief Investigator Kate White, Sydney Nursing School, The University of Sydney (kate.white@sydney.edu.au, +61 2 9515 6327)

Evaluating non-pharmacological self-management interventions to reduce cancer-related dyspnoea experienced by patients in primary care settings - CI Patsy Yates

Dyspnoea, or breathlessness, is a common and distressing symptom experienced by many people with advanced progressive diseases. This study will evaluate the effectiveness in cancer patients of community nurse delivered non-pharmacological self management interventions for (1) promoting sustained engagement in use of the self management behaviours; (2) reducing dyspnoea.

Current status:

In development

For more information contact:

Chief Investigator Patsy Yates, School of Nursing, Queensland University of Technology (p.yates@qut.edu.au, +61 7 3138 3835)

 
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