The research team for SWSLHD Palliative Care services spans projects based in acute care, community based care and palliative care inpatient services. Its aim is to undertake research which directly informs the provision of care to those living with advanced life limiting illness and their families.
In the period of 20011-2013, expansion of research activity and funding has occurred across clinical sites and disciplines. The team has received over $32 million in competitive research funding. Importantly, the team has been instrumental in the development and support of ImPaCCT (Improving Palliative Care through Clinical Trials), the NSW collaborative trials group, which was successful in securing a further 3 years of funding from Cancer Institute New South Wales.
Projects conducted within SWSLHD or with contribution from our researchers during this period have included:
Cluster randomised controlled trial of facilitated case conferencing versus usual care for improving end of life outcomes in aged care residents with advanced dementia and their families (IDEAL trial)
Examining Organisational Complexity to Improve Hospital Patients' Safety-Healing Environments
Efficacy of Elastic Compression Stockings in Treatment of chronic oedema in Palliative Care Patients
Strategies to decrease pain through implementing a dual clinical pain pathway
Carers views of home oxygen use
Advance care planning in the emergency department: identification of barriers, facilitators and technological solutions
A randomised controlled trial of structured home-based support and education for carers of people with high grade glioma
Self-reported evaluation of the adverse effects of Dexamethasone - The SEED study
The Measurement of function limited by breathlessness in advanced cancer: Comparison of the 6-minute walk test, 2-minute walk test, isometric arm exercises and reading numbers
Randomised double blind placebo controlled pilot phase II trial of oral melatonin for the prevention of delirium in hospital in people with advanced cancer
The team has continued to be a lead site for the Palliative Care Clinical Trials Collaborative (PaCCSC) recruiting actively to six randomised control clinical trials in the areas of ketamine for cancer pain, octreotide for bowel obstruction, risperidone for delirium, sertraline for dyspnoea, morphine and oxycodone for dyspnoea, and megestrol acetate for appetite. Two of these trials, ketamine for cancer pain and octreotide for bowel obstruction are now complete.
Other investigator led collaborative clinical trials which the unit is recruited during this period include methylphenidate for fatigue, levomepromazine versus ondansetron for refractory nausea in palliative care; a NHMRC funded cluster randomized control trial comparing the severity of constipation symptoms experienced by palliative care patients receiving usual care compared to those diagnosed and managed according to the underlying pathophysiology, randomised control trial of the timing of dosing of dexamethasone and effect on sleep, randomised control trial of oral melatonin controlled release for the prevention of delirium in cancer patients and a NHMRC funded randomized controlled trial of guideline driven treatment for nausea versus single agent haloperidol. Associate Professor Agar is also an investigator for the recently funded NHMRC Partnership Centre dealing with cognitive and associated functional decline in the elderly.
The ongoing priority is continued development of research capacity with the multidisciplinary clinical team, and increasing interest in palliative and supportive care research. The group works with the Psycho-oncology Co-operative Research Group (PoCoG), the Cooperative Trials Group for Neuro-Oncology (COGNO), Palliative Care Clinical Studies Collaborative and the South West Sydney Translational Cancer Research Unit.