Sydney, Tuesday 2 April, 2019 –  The HCF Research Foundation has today announced seven recipients of over $1 million in research grants, with funded projects aiming to improve the delivery of health services in Australia.

The independent research projects will address key healthcare issues including aged care, pain management and the improvement of the hospital discharge process to enhance patient knowledge.

The HCF Research Foundation grants range in value from $80,000 to $274,000 and aim to drive improvements in the quality, safety, appropriateness and cost effectiveness of health care in Australia.

Lisa McIntyre, HCF’s Research Foundation Chair, says the 2019 grants highlight emerging issues that impact health and patient outcomes.

“The recurring theme in these projects is efficiency and the importance of reducing low value care. Aged care, pain management and patient literacy are all prime areas for improving health service delivery,” said Ms McIntyre.

Improving quality care for older Australians

According to Lisa McIntyre, improving the delivery of health services to elderly Australians is a key focus of this year’s grant recipients.

“The ongoing Aged Care Royal Commission has highlighted significant challenges in the delivery of aged care and we are pleased that a number of independent projects have been funded that focus on the health of older Australians,” said Ms McIntyre.

Professor Luke Bereznicki from the University of Tasmania has received funding for a project that will examine the prevention of adverse drug reactions in elderly patients.

“Increases in life expectancy, the prevalence of chronic disease in older age groups and the number of medicines used to treat them raises the risk that older people will experience an adverse reaction,” said Professor Bereznicki.

“With the support of the HCF Research Foundation, we will examine the effectiveness of risk assessments focussed on reducing adverse drug reactions during hospitalisation and in the 12 months after discharge.” 

Professor Gustavo Duque from The University of Melbourne has also received funding for a project that aims to improve the prevention of in-hospital hip fractures for patients aged over 75.
“This funding will help us investigate the efficacy of external hip protector devices to prevent in-hospital hip fractures,” said Professor Duque.

“Hospital-acquired complications are a significant issue for older Australians. We want older patients to be visiting hospital to improve their health and not leave with an additional complication.”

The HCF Research Foundation encourages and delivers health services research that benefits all Australians. The foundation has invested over $20 million in Australian health services research since its inception in 2000.

-ENDS-

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HCF Research Foundation 2019 Funded Projects

Professor Luke Bereznicki, University of Tasmania

Preventing Adverse Drug Reactions in the Elderly

• 250,000 hospital admissions annually are a result of medication-related problems1
• Medication-related hospital admissions cost $1.4B annually¹
• Professor Bereznicki hypothesises that risk assessment on admission to hospital, and communication of this risk with targeted medication management recommendations to the clinical team and patients’ GPs will reduce the incidence of adverse drug reactions (ADR) in elderly people in the 12 months following discharge
• The study aims to demonstrate the effectiveness of intervention by reducing ADRs during hospitalisation and following discharge
• This project will also contribute to the expansion of an ADR register to better inform future prevention strategies

¹ Pharmaceutical Society of Australia 2019. Medicine Safety: Take Care. Canberra: PSA.

Associate Professor Tom Briffa, The University of Western Australia

Better use of invasive coronary angiography

• Each year around 57,000 Australians suffer a heart attack and many more present to hospital with chest pain that is ultimately found not to be a heart attack or even heart related.
• This research will investigate practice variation in the use of invasive coronary angiography (ICA) for two groups of patients: those with an acute myocardial infarction (AMI) and those with a low likelihood of AMI. The evidence for ICA in AMI is strong and is therefore considered ‘best practice’ use. Conversely, patients with chest pain but a low likelihood of AMI often may not warrant ICA and its use in this setting could, therefore, be considered as ‘equivocal value’.
• A/Prof Briffa and team will examine:
  • variations within and between institutions in the use of ‘best-practice’ and ‘equivocal value’ use of ICA
  • the characteristics of patients undergoing ‘best-practice’ and ‘equivocal value’ use of ICA, including from where and when they present
  • common characteristics of institutions supplying ‘best-practice’ and ‘equivocal value’ use of ICA
  • differences in hospital care utilisation (costs, length of stay) and outcomes between recipients and non-recipients of ‘best-practice’ and ‘equivocal value’ use of ICA.

Professor Gustavo Duque, University of Melbourne

Prevention of in-hospital hip fractures in frail older persons

• Frail, older patients over the age of 75 are at a high risk of fractures
• Professor Duque aims to investigate the efficacy of external hip protector devices to prevent inhospital hip fractures
• This study will also identify adherence to hip protectors in hospitalised frail older persons which will inform a future multi-centre trial.

Professor Ian Harris, Whitlam Orthopaedic Research Centre

Practice variation and outcomes of inpatient rehabilitation after joint replacement surgery, a data linkage study.

This study aims to address the following hypotheses:

• The use of and threshold for inpatient rehabilitation after hip and knee replacement is dependent on surgeon and hospital preference
• There is regional and institutional (private vs public) variation in the use of and threshold for inpatient rehabilitation after hip and knee replacement
• The use of inpatient rehabilitation after hip and knee replacement is decreasing, specifically since 2017
• Revision surgery can be predicted by pre- and post-rehabilitation functional scores
• Determine reasons for practice variation between hospitals and what distinguishes early adopters of evidence from non-adopters

Associate Professor Mitchell Lawlor, University of Sydney

Minimally invasive glaucoma devices: assessing safety and efficacy with existing real-world registry data

Glaucoma is the major cause of irreversible visual impairment in Australia. A range of new surgical devices have recently become available providing patients with access to “minimally invasive” glaucoma surgery. One of these devices recently had a global product withdrawal because of safety concerns. Professor Lawlor and team will investigate how safe these devices are, and how well they work by:

• Providing real time analysis of registry data to clinicians allowing comparison of their outcomes to registry benchmarks 
• Performing a data analysis on all minimally invasive glaucoma devices within the registry looking at safety and efficacy for each glaucoma subtype 

Professor David Paterson, University of Queensland

RCT of “treat all” versus “test and treat” strategies to prevent surgical site infections

• Surgical site infection is one of the most common complications associated with surgery. In Australia, infection of the surgical site occurs in approximately 3% of surgical procedures 
• Prof Paterson and team will aim to demonstrate that the strategy of universal intra-nasal mupirocin and topical chlorhexidine for five days prior to elective orthopaedic and neurosurgical operations reduces post-operative surgical site infections 
• They will also examine whether this reduces hospital readmissions and total costs compared to usual practice which does not utilise this strategy.

Professor Geoffrey Tofler, Royal North Shore Hospital

Patient Directed Discharge Letter (PADDLE): A novel approach to improve patient knowledge satisfaction and outcome

• Patients generally have a poor understanding of the events that occur during their hospitalisation and their post-discharge care and recommendations. This lack of understanding makes it hard for patients to actively participate in the management of their medical issues, and contributes to adverse events and readmissions.
• This study aims to incorporate into the public and private hospital discharge process a one page patient directed discharge letter, written for the patient, and discussed with their doctor at the bedside.
• Professor Tofler and team will attempt to establish PADDLE in 3 hospitals and evaluate its efficacy for patients and clinicians. The team from Royal North Shore Hospital will also aim to develop a framework for scalability and wider dissemination.