Mater Research -UQ Palliative Care Research University of - PDF document

12/7/18 Mater Research -UQ Palliative Care Research University of Queensland • Prof J Hardy • A/Prof P Good • Janet Hardy • Phillip Good • Russel Richard, Rohan Vora, Korana Kindl, Will Syrmis, • Rebecca Olsen Jess Cross, Petra Vayne-Bossert, Geoff Mitchell, Alison Haywood, • Geoff Mitchell Ross Norris, Patsy Yates, Carol Douglas, Rebecca Olsen…. • Sarah Winch Mater Research -UQ Mater Research -UQ • An open label pilot study of oral water soluble contrast • Genomic variation in symptom expression in Men with (Gastrografin) in addition to conservative medical Castrate Resistant Prostate Cancer (CRPC) management for the resolution of malignant bowel • The prevalence of QTc prolongation in patients with obstruction in adult patients cancer • Quality Use of Medicine: The Use of oral corticosteroids in patients with advanced cancer • Randomised double-blind placebo-controlled phase III • Assessing physical activity as an outcome of pain trial of oral melatonin for the prevention of delirium in management in patients with advanced cancer hospital in people with advanced cancer (PaCCSC) Mater Research -UQ • Oral Medicinal Cannabinoids to Relieve Symptom Burden in the Palliative Care of Patients with Advanced Cancer: a double-blind, placebo controlled, randomised clinical trial of efficacy and safety of 1:1 delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) • MRFF grant 1

12/7/18 Rebecca E. Olson, Senior Lecturer in Sociology, UQ Mater Research -UQ Qualitative sub-study to RCT, using medicinal • An open label pilot study of medicinal cannabis to relieve cannabinoids in palliative care symptom burden in patients with cancer • Examines social and culturally relative • Using pharmacokinetic and pharmacodynamics data to perceptions of medicinal cannabinoids, in optimise cannabinoid dosing in palliative care setting particular stigma, as a possible barrier to effective use for symptom burden • A qualitative study of cancer patients’ perceptions and attitudes toward use of medicinal cannabinoids in palliative care Hardy, J., Good, P., Lintzeris, N., Martin, J., Yates, P., Chye, R., Haywood, A., & Olson, R. NHMRC Medical Research Future Fund, ‘Medicinal cannabinoids to relieve symptom burden in the palliative care of patients with advanced cancer,’ 2018, $1,363,040. Hardy, J., Good, P., & Olson, R. Mater Clinical Research Seeding Grant, ‘A qualitative study of cancer patients’ perceptions and attitudes toward use of medicinal cannabinoids in palliative care,’ 2017-2018, $19,496. Rebecca E. Olson, Senior Lecturer in Sociology, UQ Primary Palliative Care research 2019 ‘ Talking about death’: Qualitative study of how medical professionals balance protocols on open communication about EoL with family/cultural preferences for indirect communication. • In interactions with other clinicians, in multidisciplinary team meetings, synonyms are often used • In interactions with patients and families, doctors perform ‘culturally and emotionally reflexive labour’ to decipher the preferred terminology Good, P., Hardy, J., & Olson, R. Clinical Seeding Grant, Mater Clinical Research Seeding Grant. ‘Talking about death: A mixed methods study into palliative care communication,’ $19,320. CRICOS code 00025B [Entity Name] [Entity Name] Identifying people at risk of dying in primary care Determining GP practice at end of life (HCF RACGP grant) RCT of structured screening for potential deaths within months vs unguided intuition GP end of life minimum dataset - structured screening no better than intuition Development and piloting of an end of life minimum dataset - but doing anything to identify patients is far more effective than doing nothing GP self reporting of practice and challenges for patients reported dead in the 6 Palliat Med 2018 Feb;32(2):384-394. months before death Case controlled study identifying factors predicting death in general practice Data collection through sentinel practices. populations (RACGP funded) Johnson, Mitchell, Deckx, Chua - current - determined independent predictors to facilitate online searching for potential patients at risk of dying Systematic review of GP performance in end of life care (five papers reporting - also generated a nomogram that calculates a percentage risk of dying several months 248 studies 2000-17) out National and international research group – PC4 support - needs formal testing A Woolfield (Hons student) – paper under review [Presentation Title] | [Date] CRICOS code 00025B CRICOS code 00025B 11 [Presentation Title] | [Date] CRICOS code 00025B CRICOS code 00025B 12 2

12/7/18 [Entity Name] [Entity Name] 2. The why and how for GPs initiating EOL conversation How do GPs practice when a patient approaches death? WHY 1. Describing GP practice at the last months before death •It is part of being a GP – you have to do it 1.People also appreciate it more often than not 2.It prevents people from being hurt 3.It saves time down the line Critical points are: 4.It is rewarding HOW - GPs choose whether to participate in PC or not •Normalise the conversation - Do patients articulate awareness that end of life is approaching? 1.embedding it within routine older person care health assessment, document statement of choices 2.bringing it up repeatedly in normal consultations Ÿ If yes – structured planning, PC involvement Ÿ If no – unspoken changing of goals of care to comfort care •Find other entry point to start the conversation 1.clear evidence of declining health 2.unexpected hospitalization Deckx et al (under review) •Spread it over multiple consultations Deckx, Thomas, Sieben, Mitchell – in Preparation [Presentation Title] | [Date] CRICOS code 00025B CRICOS code 00025B 13 [Presentation Title] | [Date] CRICOS code 00025B CRICOS code 00025B 14 3

12/7/18 [Entity Name] Buccal Pilocarpine for dry mouth Follows PhD thesis to determine how to maximise taste acceptance and efficiency of delivery Dr Sarah Winch PhD - Estafanos, Supervisors Steadman, Senior, Mitchell Head of the Medical Ethics, Law and Professionalism discipline at the N-of-1 study of Pilocarpine Oral Dose Tablets in palliative care patients with dry Faculty of Medicine, University of Queensland. mouth CEO of Health Ethics Australia Richards, Hardy, Good, Mitchell, Nikles, Senior, McGree “The best death: how to die well” [Presentation Title] | [Date] CRICOS code 00025B CRICOS code 00025B 19 4