A randomised trial of a web-based toolkit for applying evidence in the general practice cervical cancer prevention visit.
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, provider communication and consumer decisional conflict. The tool will be delivered via paper and/or 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:
We plan to start the cervical cancer trial in early 2010. The website development is almost complete.
Primary Investigator:
A/Prof Lyndal Trevena
My healthcheck: An interactive decision aid for prioritising health-check activities
This project will develop and test a web-based ‘meta-decision aid’ for tailoring and prioritising preventive activities recommended by the RACGP guidelines for individuals. It will include modelling for cancer screening and other preventive behaviours, cardiovascular risk reduction and mental health activities in a ‘whole-patient’ approach. The aid will calculate personal benefit-risk ratios for individuals aged 20-69 years and elicit patient values for these, producing a prioritised preventive activity list. The effect of the aid on translating evidence into practice will be measured via a randomised controlled trial. We hypothesise that compared with standard information, the ‘meta-decision-aid’ will result in more patients adopting preventive health behaviours that will maximise their health.
Current status:
The ‘My healthcheck’ software is now installed on our server, after extensive delays with the software developer in the UK. The trial is ready to commence and expected to be completed mid-2010.
Primary Investigator:
A/Prof Lyndal Trevena
Evaluation of a non-endoscopic screening tool for the diagnosis of Barrett’s oesophagus (BEST-Australia)
The UWA group are currently working with the University of Cambridge on studies of a sponge capsule and novel assay for mini chromosome maintenance proteins to screen high risk populations for Barrett’s oesophagus, the pre-cursor lesion of oesophageal cancer. This study is funded by the NHMRC and commenced in 2009. We aim to determine the feasibility of developing the assay in Australia, working with the Peter MacCallum Cancer Centre, Melbourne to conduct studies examining acceptability of the screening test recruiting patients from VicReN to inform a future international multisite screening trial
Current status:
Ethics approval received on 15 May 2009. Practice recruitment through VicReN is completed. Await final legal agreement between University of Melbourne and MRC before commencing patient recruitment.
Primary Investigator:
Prof Jon Emery
Use of complementary medicines (CAM) after diagnosis of a common cancer
Current data on CAM use in patients living with cancer in Australia are lacking. Dr Pirotta is conducting a national survey of all medicine use, with some qualitative data collection, to investigate adverse reactions and drug interactions between CAM and prescribed pharmaceuticals. This research will provide an excellent platform to determine the most commonly used CAMs in people with cancer to investigate in future trials, where little evidence for their use is available
Current status:
The first 3 batches of surveys have been mailed – a total of 2,500. The response rate for the first 1500 is approximately 40%. Validation telephone interviews to explore the use of the one day diary to accurately capture medicines usage have been undertaken with 45 participants and this data is currently being analysed.
Primary Investigator:
Dr Marie Pirotta
Single patient trials (SPT) of methylphenidate for fatigue in advanced cancer
This trial examines the feasibility of aggregating multiple SPTs to gain a population estimate of the efficacy of methylphenidate in the management of fatigue in patients with advanced cancer.
Current status:
Preliminary work is completed and recruitment for the full trial has commenced, with three patients recruited in the last two weeks.
Primary Investigator:
Prof Geoff Mitchell
Identification of criteria for early detection of lymphoedema
Experts believe that the optimal time for intervention is prior to the development of moderate-severe lymphoedema. Severe lymphoedema cannot be cured and the associated sequelae, such as infection and cellulitis, are both serious and costly to treat. This research aims to validate novel screening tools and criteria that would clearly flag early changes indicative of lymphoedema
Current status:
Protocols piloted; study commenced and 8 women tested
Primary Investigator:
A/Prof Sharon Kilbreath
RCT of a GP-based intervention to improve the outcomes for carers of patients with advanced cancer
This trial tests an intervention to address the needs of caregivers in advanced cancer, aiming to support carers and reduce hospital admissions due to carer fatigue.
Current status:
Caregiver recruitment continues (88 to date), and now includes a third site, with another oncology outpatient unit with ethics being considered. We will recruit till July 2010, and the project concludes at the end of March 2011.
Primary Investigator:
Prof Geoff Mitchell
Evaluation of the Western Australian Cancer Nurse Coordination (CNC) role: An exploratory study
This three-phase study aims to provide a preliminary evaluation of how the CNC role contributes to meeting the objectives of the Western Australian Cancer Services Framework, provide benchmarks for future role evaluation and a foundation for a rigorous ongoing evaluation framework.
Current status:
Phase 1 complete. Phase 2 almost completed.
Primary Investigator:
A/Professor Monterosso
Factors impacting on treatment decisions of cancer patients in rural Western Australia
This pilot project will use qualitative research methods to explore the experiences of rural people with cancer. Specifically, it will explore the reasons that people living in rural areas may refuse treatment or elect to have treatment close to home that may not represent the best treatment option.
Current status:
Ethics approvals obtained. Data collection phase in preparation.(funded by the Cancer and Palliative Care Network).
Primary & PC4 Co-investigator:
Dr Ruth McConigley and A/Prof Leanne Monterosso
Time spent in an unstable palliative care phase: Factors affecting the variability between services in Western Australia
This project aims to understand what factors contribute to this large variability between services, both in proportions and length of stay, in seven services in Western Australia. Findings will make a significant contribution to understanding and minimising these differences at the state and national levels, and thus contribute to improved clinical outcomes.
Current status:
Multi site ethics approvals in train (funded by the Cancer and Palliative Care Network).
Primary & PC4 Associate investigator:
Professor Samar Aoun, A/Prof Leanne Monterosso
Improving rural cancer outcomes (IRCO)
This work forms part of a broader body of research in WA exploring reasons for poorer outcomes in rural cancer patients. The aim is to develop a multi-level complex intervention to redress delays in symptom appraisal, GP diagnosis and referral and access to optimal treatments for rural patients with cancer.
Current status:
30 patients recruited into Development phase of study.
Primary Investigator:
Prof Jon Emery
