The Medical journal of Australia
-
Randomized Controlled Trial Multicenter Study
Economic evaluation of Indigenous health worker management of poorly controlled type 2 diabetes in north Queensland.
To conduct an economic evaluation of intensive management by Indigenous health workers (IHWs) of Indigenous adults with poorly controlled type 2 diabetes in rural and remote north Queensland. ⋯ Relative to the high cost of the intervention, the IHW-S model as implemented is probably a poor investment. Incremental cost-effectiveness might be improved by a higher caseload per IHW, a longer evaluation time frame, and improved service integration. Further approaches to improving chronic disease outcomes in this very unwell population need to be explored, including holistic approaches that address the complex psychosocial, pathophysiological and environmental problems of highly disadvantaged populations.
-
Randomized Controlled Trial Multicenter Study
Socio-demographic and structural barriers to being tested for chlamydia in general practice.
To investigate socio-demographic and structural factors associated with not providing a specimen for chlamydia testing following a request by a general practitioner. ⋯ One in five young people did not submit a specimen for chlamydia testing despite their GP requesting it. This highlights the need for clinics to establish systems which ensure that men and those aged 16-19 years undertake chlamydia tests requested by a GP.
-
Randomized Controlled Trial
The Value of Audio Devices in the Endoscopy Room (VADER) study: a randomised controlled trial.
To evaluate the effect of Star Wars music (SWM) compared with endoscopist-selected popular music (PM) on quality outcomes in colonoscopy. ⋯ SWM compared with PM improves key quality outcomes in colonoscopy, despite poorer bowel preparation.
-
Randomized Controlled Trial
Coordinated care versus standard care in hospital admissions of people with chronic illness: a randomised controlled trial.
To determine whether Care Navigation (CN), a nurse-led hospital-based coordinated care intervention, reduced the use of hospital services and improved quality of life for patients with chronic illness. ⋯ CN did not improve quality of life or reduce unplanned hospital presentations or admissions despite community health services almost doubling. Future service development should explore potential benefits of linking navigated intrahospital care to ongoing, proactive care planning and delivery in the community.
-
Randomized Controlled Trial
Facilitators and barriers to implementation of a pragmatic clinical trial in Aboriginal health services.
To identify facilitators and barriers to clinical trial implementation in Aboriginal health services. ⋯ Despite strong community and health service support, major investments in time and resources are needed to ensure successful implementation and minimal disruption to already overstretched, routine services. Trial budgets will necessarily be inflated as a result. Funding agencies need to consider these additional resource demands when supporting trials of a similar nature.