Anazodo, AC, Stern, CJ, McLachlan, RI, Gerstl, B, Agresta, F, Cohn, RJ, Jayasinghe, Y, Wakefield, CE, Daly, G, Chan, D, Gilbert, L, Kemertzis, M, Orme, LM, Wand, H, Viney, R, Gillam, L, Deans, R, Jetti, M, Wu, J, Chapman, M, Ledger, W & Sullivan, EA 2016, 'A Study Protocol for the Australasian Oncofertility Registry: Monitoring Referral Patterns and the Uptake, Quality, and Complications of Fertility Preservation Strategies in Australia and New Zealand', Journal of Adolescent and Young Adult Oncology, vol. 5, no. 3, pp. 215-225.
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© 2016, Mary Ann Liebert, Inc. Improvements in cancer diagnosis and treatment in patients of a reproductive age have led to significant improvements in survival rates; however, a patient's fertility can be affected by both cancer and its treatment. As survival rates improve, there is an expectation by clinicians and patients that patient's reproductive potential should be considered and protected as much as possible. However, there is a lack of data about current fertility preservation (FP) uptake as well as accurate data on the acute or permanent reproductive risks of cancer treatment, complications of FP in cancer patients, and the use and success of assisted reproductive technology by cancer survivors. FP remains a major gap in acute cancer management with lifelong implications for cancer survivors. The FUTuRE Fertility research team has established the first binational multisite Australasian Oncofertility Registry, which is collecting a complete oncofertility data set from cancer and fertility centers in Australia and New Zealand. Outcomes from the research study will monitor referral, uptake, and complications of FP, document patient's reproductive potential after treatment, and collect data on the use of assisted reproductive technology following cancer treatment. The data will be linked to other routine health and administrative data sets to allow for other research projects to be carried out. The changes in oncofertility care will be benchmarked against the Australasian Oncofertility Charter. The data will be used to develop evidence-based guidelines and resources, including development of accurate risk projections for patients' risk of infertility, allowing clinicians to make recommendations for FP or assisted reproductive technology.
Arora, S, Goodall, S, Viney, R & Einfeld, S 2016, 'Using A Discrete Choice Experiment To Value Informal Care Provided To Children with Intellectual Disabilities', Value in Health, vol. 19, no. 7, pp. A905-A906.
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Asamani, JA, Naab, F, Ofei, AMA & Addo, R 2016, 'Do leadership styles influence productivity?', British Journal of Healthcare Management, vol. 22, no. 2, pp. 83-91.
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Background: Leadership and productivity in nursing and midwifery have become topical issues for discussion. This is possibly due to nurses constituting the largest group of the healthcare workforce. Nurses and midwives have been held accountable for low productivity and inappropriate leadership in the past. However, there has been limited consensus in the nursing literature about the impact of nurse managers' leadership styles on nurses' and midwives' productivity levels. Method: Two hundred and seventy five nurses and midwives (response rate of 99.2%) were asked to take part in a cross-sectional survey from five hospitals in the eastern region of Ghana, to examine the impact of nurse managers' leadership styles on self-reported productivity levels. Descriptive summaries, Pearson's correlations and linear regressions are presented. Results: Findings show for every hour of lost productive time, four hours of unpaid overtime in the course of the month was accrued due to staff shortages. Nurse managers' most frequently exercised a supportive leadership style, and a directive leadership style the least. Within the last one month of work experience prior to the study, nurses' self-perception of productivity levels were high (8.39 on a 10-point scale), 10% more productive than their peers in the same unit. Nurses believed their own productivity improved by about 1.8% over the preceding six months. Leadership styles explained only 6.9% (95% CI: 4.6–9.3%) of the variance in nurses' perceived level of productivity. Achievement-oriented leadership style most significantly improved productivity by 18.4% (95% CI: 13.0–24.0%). Implications for management and policy: There is a need to strengthen supervision and establish performance benchmarks with...
Atukorale, YN, Church, JL, Hoggan, BL, Lambert, RS, Gurgacz, SL, Goodall, S & Maddern, GJ 2016, 'Self-Expanding Metallic Stents for the Management of Emergency Malignant Large Bowel Obstruction: a Systematic Review', JOURNAL OF GASTROINTESTINAL SURGERY, vol. 20, no. 2, pp. 455-462.
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Barnett, AG, Campbell, MJ, Shield, C, Farrington, A, Hall, L, Page, K, Gardner, A, Mitchell, BG & Graves, N 2016, 'The high costs of getting ethical and site-specific approvals for multi-centre research', Research Integrity and Peer Review, vol. 1, no. 1, p. 16.
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Multi-centre studies generally cost more than single-centre studies because of larger sample sizes and the need for multiple ethical approvals. Multi-centre studies include clinical trials, clinical quality registries, observational studies and implementation studies. We examined the costs of two large Australian multi-centre studies in obtaining ethical and site-specific approvals.We collected data on staff time spent on approvals and expressed the overall cost as a percent of the total budget.The total costs of gaining approval were 38 % of the budget for a study of 50 centres (mean cost AUD $6960 per site) and 2 % for a study of 11 centres (mean cost AUD $2300 per site). Seventy-five and 90 % of time was spent on repeated tasks, respectively, and many time-consuming tasks, such as reformatting documents, did nothing to improve the study design or participant safety.Improvements have been made to the ethical approval application system, but more gains could be made without increasing risks of harm to research participants. We propose that ethical review bodies and individual sites publish statistics on how long they take to process approvals which could then be nationally benchmarked.
Bird, EM & Street, DJ 2016, 'D-optimal asymmetric orthogonal array plus p run designs', Journal of Statistical Planning and Inference, vol. 170, pp. 64-76.
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In a recent paper, Chatzopoulos et al. (2011) identified some sufficient conditions to describe a set of p runs which, when adjoined to a symmetric orthogonal array, would result in a Type 1 optimal orthogonal array plus p run design. In this paper we find conditions for sets of p runs which, when adjoined to an asymmetric orthogonal array, result in a D-optimal orthogonal array plus p run design.
Bloem, LT, De Abreu Lourenço, R, Chin, M, Ly, B & Haas, M 2016, 'Factors Impacting Treatment Choice in the First-Line Treatment of Colorectal Cancer', Oncology and Therapy, vol. 4, no. 1, pp. 103-116.
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Butler, K, Reeve, R, Arora, S, Viney, R, Goodall, S, Van Gool, K & Burns, L 2016, 'The hidden costs of drug and alcohol use in hospital emergency departments', DRUG AND ALCOHOL REVIEW, vol. 35, no. 3, pp. 359-366.
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© 2016 Australasian Professional Society on Alcohol and other Drugs. Introduction and Aims: This study estimates the burden of drug and alcohol morbidity on hospitals in New South Wales (NSW) by observing a multi-site collective sample utilising survey information and data linkage. Specifically we aimed to determine the prevalence of alcohol and other drug (AOD) problems and to estimate patterns of utilisation of hospital services, costs of presentations, and admissions for patients with AOD problems. Design and Methods: Patients were recruited from eight NSW public hospitals presenting to the hospital emergency department over a 10 day period. Participants completed a self-administered survey with demographic characteristics and questions about substance use. More than two-thirds (68%) of participants consented to provide access to their NSW Health medical data for a period spanning 2.5 years. Results: One-third (35%) of the total sample were identified as having problematic AOD use with one in five of these patients requiring a high level of intervention. Those patients requiring a high level of intervention present more often and cost more per presentation. If admitted they were more likely to have longer stays and were also more likely to be admitted to a psychiatric ward and have a longer stay in the ward. Discussion: This study demonstrates a need for AOD interventions in the emergency department setting, both because it represents an opportunity for intervention in a population in which problems with substance use is highly prevalent, and because there is evidence that AOD imposes additional costs on the health system.
Cheng, Q, Church, J, Haas, M, Goodall, S, Sangster, J & Furber, S 2016, 'Cost-effectiveness of a Population-based Lifestyle Intervention to Promote Healthy Weight and Physical Activity in Non-attenders of Cardiac Rehabilitation', HEART LUNG AND CIRCULATION, vol. 25, no. 3, pp. 265-274.
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Cole, AM, Shah, K, Mulhern, B, Feng, Y & Devlin, N 2016, 'A New Approach to Presenting Health States in Stated Preference Valuation Studies', Value in Health, vol. 19, no. 7, pp. A384-A385.
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Gardner, T, Refshauge, K, McAuley, J, Goodall, S, Hübscher, M & Smith, L 2016, 'Patient-led Goal Setting', Spine, vol. 41, no. 18, pp. 1405-1413.
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Graves, N, Page, K, Martin, E, Brain, D, Hall, L, Campbell, M, Fulop, N, Jimmeison, N, White, K, Paterson, D & Barnett, AG 2016, 'Cost-Effectiveness of a National Initiative to Improve Hand Hygiene Compliance Using the Outcome of Healthcare Associated Staphylococcus aureus Bacteraemia', PLOS ONE, vol. 11, no. 2, pp. e0148190-e0148190.
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Hall, JP & Gool, KC 2016, 'Paying hospitals for quality: can we buy better care?', Medical Journal of Australia, vol. 205, no. S10, pp. S27-S29.
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Economic theory predicts that changing financial rewards will change behaviour. This is valid in terms of service use; higher costs reduce health care use. It should follow that paying more for quality should improve quality; however, the research evidence thus far is equivocal, particularly in terms of better health outcomes. One reason is that 'financial incentives' encompass a range of payment types and sizes of reward. The design of financial incentives should take into account the desired change and the context of existing payment structures, as well as other strategies for improving quality; further, financial incentives should be fair in rewarding effort. Financial incentives may have unintended consequences, including rewarding hospitals for selecting patients with lower risks, diverting attention from the overall patient population to specific conditions, gaming, and 'crowding out' or displacing intrinsic motivation. Managers and clinicians can only respond to financial incentives if they have the data, tools and skills to effect changes. Australia should not adopt widespread use of financial incentives for improving quality in health care without careful consideration of their design and context, the potential for unintended effects (particularly beyond their immediate targets), and evaluation of outcomes. The relative cost-effectiveness of financial incentives compared with, or in concert with, other strategies should also be considered.
Havers, S, Hall, L, Page, K & Wilson, A 2016, 'Turning policy into practice – Infection control practitioner perspectives on implementation of Standard 3 criteria 10 aseptic technique of the NSQHS standards', Infection, Disease & Health, vol. 21, no. 3, pp. 143-143.
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Heyeres, M, McCalman, J, Tsey, K & Kinchin, I 2016, 'The Complexity of Health Service Integration: A Review of Reviews', Frontiers in Public Health, vol. 4.
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Hole, AR, Norman, R & Viney, R 2016, 'Response Patterns in Health State Valuation Using Endogenous Attribute Attendance and Latent Class Analysis', HEALTH ECONOMICS, vol. 25, no. 2, pp. 212-224.
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Copyright © 2014 John Wiley & Sons, Ltd. Summary Not accounting for simplifying decision-making heuristics when modelling data from discrete choice experiments has been shown potentially to lead to biased inferences. This study considers two ways of exploring the presence of attribute non-attendance (that is, respondents considering only a subset of the attributes that define the choice options) in a health state valuation discrete choice experiment. The methods used include the latent class (LC) and endogenous attribute attendance (EAA) models, which both required adjustment to reflect the structure of the quality-adjusted life year (QALY) framework for valuing health outcomes. We find that explicit consideration of attendance patterns substantially improves model fit. The impact of allowing for non-attendance on the estimated QALY weights is dependent on the assumed source of non-attendance. If non-attendance is interpreted as a form of preference heterogeneity, then the inferences from the LC and EAA models are similar to those from standard models, while if respondents ignore attributes to simplify the choice task, the QALY weights differ from those using the standard approach. Because the cause of non-attendance is unknown in the absence of additional data, a policymaker may use the range of weights implied by the two approaches to conduct a sensitivity analysis.
Jimmieson, NL, Tucker, MK, White, KM, Liao, J, Campbell, M, Brain, D, Page, K, Barnett, AG & Graves, N 2016, 'The role of time pressure and different psychological safety climate referents in the prediction of nurses’ hand hygiene compliance', Safety Science, vol. 82, pp. 29-43.
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Johnson, S, Clayton, J, Butow, PN, Silvester, W, Detering, K, Hall, J, Kiely, BE, Cebon, J, Clarke, S, Bell, ML, Stockler, M, Beale, P & Tattersall, MHN 2016, 'Advance care planning in patients with incurable cancer: study protocol for a randomised controlled trial', BMJ Open, vol. 6, no. 12, pp. e012387-e012387.
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Introduction: There is limited evidence documenting the effectiveness of Advance Care Planning (ACP) in cancer care. The present randomised trial is designed to evaluate whether the administration of formal ACP improves compliance with patients' end-of-life (EOL) wishes and patient and family satisfaction with care. Methods and analysis: A randomised control trial in eight oncology centres across New South Wales and Victoria, Australia, is designed to assess the efficacy of a formal ACP intervention for patients with cancer. Patients with incurable cancer and an expected survival of 3-12 months, plus a nominated family member or friend will be randomised to receive either standard care or standard care plus a formal ACP intervention. The project sample size is 210 patient-family/friend dyads. The primary outcome measure is family/friendreported: (1) discussion with the patient about their EOL wishes and (2) perception that the patient's EOL wishes were met. Secondary outcome measures include: documentation of and compliance with patient preferences for medical intervention at the EOL; the family/friend's perception of the quality of the patient's EOL care; the impact of death on surviving family; patient-family and patient-healthcare provider communication about EOL care; patient and family/ friend satisfaction with care; quality of life of patient and family/friend subsequent to trial entry, the patient's strength of preferences for quality of life and length of life; the costs of care subsequent to trial entry and place of death. Ethics and dissemination: Ethical approval was received from the Sydney Local Health District (RPA Zone) Human Research Ethical Committee, Australia (Protocol number X13-0064). Study results will be submitted for publication in peer-reviewed journals and presented at national and international conferences. Trial registration number: Pre-results; ACTRN12613001288718.
Kendig, H & Woods, M 2016, 'Corrigendum', Australasian Journal on Ageing, vol. 35, no. 4, pp. 295-295.
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© 2016 AJA Inc. The order of the authors of this article should be corrected to: Mike Woods and Hal Kendig. Their affiliations should be corrected to: Mike Woods: Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, New South Wales, Australia. Hal Kendig: Centre for Research on Ageing, Health and Wellbeing, Australian National University; and ARC Centre of Excellence in Population Ageing Research, Canberra, Australian Capital Territory, Australia. The authors apologize for this error and any confusion it may have caused. Australasian Journal
Kenny, P, De Abreu Lourenco, R, Wong, CY, Haas, M & Goodall, S 2016, 'Community preferences in general practice: important factors for choosing a general practitioner', Health Expectations, vol. 19, no. 1, pp. 26-38.
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AbstractBackgroundUnderstanding the important factors for choosing a general practitioner (GP) can inform the provision of consumer information and contribute to the design of primary care services.ObjectiveTo identify the factors considered important when choosing a GP and to explore subgroup differences.DesignAn online survey asked about the respondent's experience of GP care and included 36 questions on characteristics important to the choice of GP.ParticipantsAn Australian population sample (n = 2481) of adults aged 16 or more.MethodsPrincipal components analysis identified dimensions for the creation of summated scales, and regression analysis was used to identify patient characteristics associated with each scale.ResultsThe 36 questions were combined into five scales (score range 1–5) labelled: care quality, types of services, availability, cost and practice characteristics. Care quality was the most important factor (mean = 4.4, SD = 0.6) which included questions about technical care, interpersonal care and continuity. Cost (including financial and time cost) was also important (mean = 4.1, SD = 0.6). The least importa...
Kenny, P, Reeve, R & Hall, J 2016, 'Satisfaction with nursing education, job satisfaction, and work intentions of new graduate nurses', NURSE EDUCATION TODAY, vol. 36, pp. 230-235.
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Kinchin, I, Jacups, S, Hunter, G & Rogerson, B 2016, 'Economic evaluation of ‘Return to Country’: A remote Australian initiative to address indigenous homelessness', Evaluation and Program Planning, vol. 56, pp. 69-75.
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Kinchin, I, Tsey, K, Heyeres, M & Cadet-James, Y 2016, 'Systematic review of youth mental health service integration research', Australian Journal of Primary Health, vol. 22, no. 4, pp. 304-304.
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Quality mental health care is based on the integration of care across organisations and disciplines. The aims of this study were, first, to assess the extent, characteristics and reported outcomes of publications concerned with youth mental health service integration in Australia and internationally; and second, to investigate the study design quality of evaluative interventions and determine whether the studies report on the cost-effectiveness of the integration in order to inform the reform of youth mental health services by Queensland Health. A systematic search of the peer-reviewed literature and a narrative synthesis were undertaken of English language publications from 21 electronic databases. Inclusion criteria were: published 1998–2014 (inclusive); peer-reviewed research; focused on mental health services integration; reported data for youth aged 12–25 years. The methodological quality of evaluative interventions was assessed using the Quality Assessment Tool for Quantitative Studies developed by the Effective Public Health Practice Project (EPHPP). Twenty-five studies met the inclusion criteria: one (4%) was classified as a measurement research, 13 (52%) as descriptive, and 11 (44%) as interventions including five (45%) evaluative interventions. Four out of the five evaluative interventions reported positive effects of youth mental health service integration. Particular problems included ambiguity of definitions, absence of economic or cost analyses and insufficient consumer involvement. The methodological quality of the interventions was variable with, on average, a moderate level of selection bias and study design. Despite a slight increase in the number of studies in the last couple of years, there are important gaps in the evidence base for youth mental health service integration processes. The relatively small number of evaluative studies and lack of economic evaluations point to the need for additional research in this important area.
King, MT, Costa, DSJ, Aaronson, NK, Brazier, JE, Cella, DF, Fayers, PM, Grimison, P, Janda, M, Kemmler, G, Norman, R, Pickard, AS, Rowen, D, Velikova, G, Young, TA & Viney, R 2016, 'QLU-C10D: a health state classification system for a multi-attribute utility measure based on the EORTC QLQ-C30', Quality of Life Research, vol. 25, no. 3, pp. 625-636.
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King, MT, Norman, R, Viney, R, Costa, D, Brazier, J, Cella, D, Gamper, E, Kemmler, G, McTaggart-Cowan, H, Peacock, S, Pickard, AS, Rowen, D & Young, TA 2016, 'Two New Cancer-Specific Multi-Attribute Utility Instruments: EORTC QLU-C10D and FACT-8D', Value in Health, vol. 19, no. 7, pp. A807-A807.
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Langton, JM, Reeve, R, Srasuebkul, P, Haas, M, Viney, R, Currow, D, Pearson, S-A & Authors, EOL-CCS 2016, 'Health service use and costs in the last 6 months of life in elderly decedents with a history of cancer: a comprehensive analysis from a health payer perspective', BRITISH JOURNAL OF CANCER, vol. 114, no. 11, pp. 1293-1302.
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© 2016 Cancer Research UK. Background: There is growing interest in end-of-life care in cancer patients. We aim to characterise health service use and costs in decedents with cancer history and examine factors associated with resource use and costs at life's end.Methods:We used routinely collected claims data to quantify health service use and associated costs in two cohorts of elderly Australians diagnosed with cancer: one cohort died from cancer (n=4271) and the other from non-cancer causes (n=3072). We used negative binomial regression to examine the factors associated with these outcomes.Results:Those who died from cancer had significantly higher rates of hospitalisations and medicine use but lower rates of emergency department use than those who died from non-cancer causes. Overall health care costs were significantly higher in those who died from cancer than those dying from other causes; and 40% of costs were expended in the last month of life.Conclusions:We analysed health services use and costs from a payer perspective, and highlight important differences in patterns of care by cause of death in patients with a cancer history. In particular, there are growing numbers of highly complex patients approaching the end of life and the heterogeneity of these populations may present challenges for effective health service delivery.
Lee, BB, Toh, S-L, Ryan, S, Simpson, JM, Clezy, K, Bossa, L, Rice, SA, Marial, O, Weber, G, Kaur, J, Boswell-Ruys, C, Goodall, S, Middleton, J, Tudehope, M & Kotsiou, G 2016, 'Probiotics [LGG-BB12 or RC14-GR1] versus placebo as prophylaxis for urinary tract infection in persons with spinal cord injury [ProSCIUTTU]: a study protocol for a randomised controlled trial', BMC UROLOGY, vol. 16, no. 1.
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© 2016 Lee et al. Background: Urinary tract infections [UTIs] are very common in people with Spinal Cord Injury [SCI]. UTIs are increasingly difficult and expensive to treat as the organisms that cause them become more antibiotic resistant. Among the SCI population, there is a high rate of multi-resistant organism [MRO] colonisation. Non-antibiotic prevention strategies are needed to prevent UTI without increasing resistance. Probiotics have been reported to be beneficial in preventing UTIs in post-menopausal women in several in vivo and in vitro studies. The main aim of this study is to determine whether probiotic therapy with combinations of Lactobacillus reuteri RC-14 + Lactobacillus rhamnosus GR-1 [RC14-GR1] and/or Lactobacillus rhamnosus GG + Bifidobacterium BB-12 [LGG-BB12] are effective in preventing UTI in people with SCI compared to placebo. Method: This is a multi-site randomised double-blind double-dummy placebo-controlled factorial design study conducted in New South Wales, Australia. All participants have a neurogenic bladder as a result of spinal injury. Recruitment started in April 2011. Participants are randomised to one of four arms, designed for factorial analysis of LGG-BB12 and/or RC14-GR1 v Placebo. This involves 24 weeks of daily oral treatment with RC14-GR1 + LGG-BB12, RC14-GR1 + placebo, LGG-BB12 + placebo or two placebo capsules. Randomisation is stratified by bladder management type and inpatient status. Participants are assessed at baseline, three months and six months for Short Form Health Survey [SF-36], microbiological swabs of rectum, nose and groin; urine culture and urinary catheters for subjects with indwelling catheters. A bowel questionnaire is administered at baseline and three months to assess effect of probiotics on bowel function. The primary outcome is time from randomisation to occurrence of symptomatic UTI. The secondary outcomes are change of MRO status and bowel function, quality of life and cost-effectivenes...
Li, Y, Wang, JL, Zhang, XC, Liu, D, Shi, WH, Liang, XF & Wu, J 2016, 'Effectiveness of Adherence to Standardized Hypertension Management by Primary Health Care Workers in China: a Cross-sectional Survey 3 Years after the Healthcare Reform.', Biomed Environ Sci, vol. 29, no. 12, pp. 915-921.
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The standardized hypertension management provided by primary health care workers is an important part of China's recent health care reform efforts. Investigating 5,116 hypertensive patients from a cross-sectional survey conducted by the Chinese Center for Disease Control and Prevention in 2012, this study found that adherence to standardized hypertension management is associated with positive effects on hypertension- related knowledge, healthy lifestyle behavior, antihypertensive medical treatments, and blood pressure control. It will be necessary to provide primary health care workers with sufficient training and reasonable incentives to ensure the implementation and effectiveness of hypertension management.
Liu, H, Muhunthan, J, Hayek, A, Hackett, M, Laba, T-L, Peiris, D & Jan, S 2016, 'Examining the use of process evaluations of randomised controlled trials of complex interventions addressing chronic disease in primary health care—a systematic review protocol', Systematic Reviews, vol. 5, no. 1.
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© 2016 The Author(s). Background: Randomised controlled trials (RCTs) of complex interventions in primary health care (PHC) are needed to provide evidence-based programmes to achieve the Declaration of Alma Ata goal of making PHC equitable, accessible and universal and to effectively address the rising burden from chronic disease. Process evaluations of these RCTs can provide insight into the causal mechanisms of complex interventions, the contextual factors, and inform as to whether an intervention is ineffective due to implementation failure or failure of the intervention itself. To build on this emerging body of work, we aim to consolidate the methodology and methods from process evaluations of complex interventions in PHC and their findings of facilitators and barriers to intervention implementation in this important area of health service delivery. Methods: Systematic review of process evaluations of randomised controlled trials of complex interventions which address prevalent major chronic diseases in PHC settings. Published process evaluations of RCTs will be identified through database and clinical trial registry searches and contact with authors. Data from each study will be extracted by two reviewers using standardised forms. Data extracted include descriptive items about (1) the RCT, (2) about the process evaluations (such as methods, theories, risk of bias, analysis of process and outcome data, strengths and limitations) and (3) any stated barriers and facilitators to conducting complex interventions. A narrative synthesis of the findings will be presented. Discussion: Process evaluation findings are valuable in determining whether a complex intervention should be scaled up or modified for other contexts. Publishing this protocol serves to encourage transparency in the reporting of our synthesis of current literature on how process evaluations have been conducted thus far and a deeper understanding of potential challenges and solutions to ai...
Mazza, D, Black, K, Taft, A, Lucke, J, McGeechan, K, Haas, M, McKay, H & Peipert, JF 2016, 'Increasing the uptake of long-acting reversible contraception in general practice: the Australian Contraceptive ChOice pRoject (ACCORd) cluster randomised controlled trial protocol', BMJ Open, vol. 6, no. 10, pp. e012491-e012491.
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McCalman, J, Bainbridge, R, Kinchin, I, Tsey, K, Lawson, K, Lui, FW & Cadet-James, Y 2016, 'Indigenous and tribal peoples' health', The Lancet, vol. 388, no. 10062, pp. 2867-2868.
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McCluskey, A, Ada, L, Kelly, PJ, Middleton, S, Goodall, S, Grimshaw, JM, Logan, P, Longworth, M & Karageorge, A 2016, 'A behavior change program to increase outings delivered during therapy to stroke survivors by community rehabilitation teams: The Out-and-About trial', International Journal of Stroke, vol. 11, no. 4, pp. 425-437.
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Background Australian guidelines recommend that outdoor mobility be addressed to increase participation after stroke. Aim To investigate the efficacy of the Out-and-About program at increasing outings delivered during therapy by community teams, and outings taken by stroke survivors in real life. Method Cluster-randomized trial involving 22 community teams providing stroke rehabilitation. Experimental teams received the Out-and-About program (a behavior change program comprising a training workshop with barrier identification and booster session, printed educational materials, audit, and feedback). Control teams received printed clinical guidelines only. The primary outcome was the percentage of stroke survivors receiving four or more outings during therapy. Secondary outcomes included the number of outings received by stroke survivors during therapy and undertaken in real life. Results At 12 months after implementation of the behavior change program, 9% of audited experimental group stroke survivors received four or more outings during therapy compared with 5% in the control group (adjusted risk difference 4%, 95% CI − 9 to 17, p = 0.54). They received 1.1 (SD 0.9) outings during therapy compared with 0.6 (SD 1.0) in the control group (adjusted mean difference 0.5, 95% CI − 0.4 to 1.4; p = 0.26). After six months of rehabilitation, observed experimental group stroke survivors took 9.0 (SD 3.0) outings per week in real life compared with 7.4 (SD 4.0) in the control group (adjusted mean difference 0.5, 95% CI − 1.8 to 2.8; p = 0.63). Conclusion The Out-and-About program did not change team or stroke survivor behavior.
Moullin, JC, Sabater-Hernandez, D, Garcia-Corpas, JP, Kenny, P & Benrimoj, SI 2016, 'Development and testing of two implementation tools to measure components of professional pharmacy service fidelity', JOURNAL OF EVALUATION IN CLINICAL PRACTICE, vol. 22, no. 3, pp. 369-377.
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© 2015 John Wiley & Sons, Ltd. Rationale, aims and objectives There is a need to evaluate both service process and implementation outcomes as professional services are being implemented into pharmacy practice. Fidelity is an implementation outcome, which may be used for service optimization, by associating service components to patient outcomes, as well as use in process evaluation. The objective of this study was to develop tools to measure components of fidelity, specifically, an adherence index (adherence of the service provider to the elements of the service) and a patient responsiveness scale for the professional pharmacy service, medication review with follow-up. Methods The procedure described by DeVellis was followed to develop the tools. An expert panel was used to create items and establish content validity. Primary data were collected from 190 service provider pharmacists from 128 pharmacies across 11 provinces of Spain using Spanish version tools as part of an ongoing implementation study (English translations appended to the online version of the article as supplementary material). An initial assessment of item functionality was performed using descriptive statistics and item discrimination for both tools. The patient responsiveness scale's internal consistency was confirmed by calculating Cronbach's alpha coefficient and inter-item correlations. In addition, for the patient responsiveness scale, the number of factors to retain was based on Kaiser criterion, parallel analysis and Cattell's scree test and the number of items was optimized as guided by iterative exploratory factor analysis (EFA). Results Acceptability of both tools was high. An adherence index of 39 items was developed. After five EFA iterations, four items were removed, resulting in a reliable, 12-item, two-factor patient responsiveness scale, explaining 53.9% of total variance. Conclusions Two tools for measuring implementation fidelity, an adherence index and a patient res...
Mulhern, B, Norman, R, Viney, R & Stolk, E 2016, 'USING DISCRETE CHOICE EXPERIMENTS TO VALUE GENERIC PREFERENCE-BASED MEASURES: A SYSTEMATIC REVIEW', Value in Health, vol. 19, no. 3, pp. A95-A96.
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Mulhern, B, Norman, R, Viney, R, Lorgelly, P, Lancsar, E, Ratcliffe, J & Brazier, J 2016, 'VALUING EQ-5D-5L USING DISCRETE CHOICE EXPERIMENTS WITH DURATION: INVESTIGATING DIMENSION ORDER', Value in Health, vol. 19, no. 3, pp. A94-A94.
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Mulhern, B, Norman, R, Viney, R, Lorgelly, P, Lancsar, E, Ratcliffe, J & Brazier, J 2016, 'VALUING EQ-5D-5L USING DISCRETE CHOICE EXPERIMENTS WITH DURATION: INVESTIGATING DIMENSION ORDER', Value in Health, vol. 19, no. 3, pp. A94-A94.
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Mulhern, B, Shah, K, Janssen, MFB, Longworth, L & Ibbotson, R 2016, 'Valuing Health Using Time Trade-Off and Discrete Choice Experiment Methods: Does Dimension Order Impact on Health State Values?', Value in Health, vol. 19, no. 2, pp. 210-217.
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Nejad, MN & Young, AT 2016, 'Want freedom, will travel: Emigrant self-selection according to institutional quality', European Journal of Political Economy, vol. 45, pp. 71-84.
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We investigate emigrant self-selection according to institutional quality using up to 3566 observations on bilateral migration flows from 77 countries over the 1990–2000 period. We relate these flows to differences in political and economic institutions. We improve and expand upon previous studies by (i) examining decade-long migration flows that (ii) include flows not only to OECD countries but also to non-OECD countries, also (iii) utilizing an estimation method that takes into account the information in zero value migration flows and (iv) examining not only total migration flows but also college-educated and non-college-educated subsamples separately. We find that economic freedoms are a significant pull factor for potential migrants. Once economic freedoms are controlled for, measures of political institutions do not always enter significantly into our estimations. Results are similar for college- and non-college-educated subsamples. Improvements in legal systems and property rights appear to be the strongest pull factor for potential migrants.
Nerich, V, Saing, S, Gamper, EM, Kemmler, G, Daval, F, Pivot, X & Holzner, B 2016, 'Cost–utility analyses of drug therapies in breast cancer: a systematic review', Breast Cancer Research and Treatment, vol. 159, no. 3, pp. 407-424.
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The economic evaluation (EE) of health care products has become a necessity. Their quality must be high in order to trust the results and make informed decisions. While cost–utility analyses (CUAs) should be preferred to cost–effectiveness analyses in the oncology area, the quality of breast cancer (BC)-related CUA has been given little attention so far. Thus, firstly, a systematic review of published CUA related to drug therapies for BC, gene expression profiling, and HER2 status testing was performed. Secondly, the quality of selected CUA was assessed and the factors associated with a high-quality CUA identified. The systematic literature search was conducted in PubMed, MEDLINE/EMBASE, and Cochrane to identify published CUA between 2000 and 2014. After screening and data extraction, the quality of each selected CUA was assessed by two independent reviewers, using the checklist proposed by Drummond et al. The analysis of factors associated with a high-quality CUA (defined as a Drummond score ≥7) was performed using a two-step approach. Our systematic review was based on 140 CUAs and showed a wide variety of methodological approaches, including differences in the perspective adopted, the time horizon, measurement of cost and effectiveness, and more specially health-state utility values (HSUVs). The median Drummond score was 7 [range 3–10]. Only one in two of the CUA (n = 74) had a Drummond score ≥7, synonymous of “high quality.” The statistically significant predictors of a high-quality CUA were article with “gene expression profiling” topic (p = 0.001), consulting or pharmaceutical company as main location of first author (p = 0.004), and articles with both incremental cost–utility ratio and incremental cost–effectiveness ratio as outcomes of EE (p = 0.02). Our systematic review identified only 140 CUAs published over the past 15 years with one in two of high quality. It showed a wide variety of methodological approaches, especially focused on HSUVs. A critical ...
Norman, R, Kemmler, G, Viney, R, Pickard, AS, Gamper, E, Holzner, B, Nerich, V & King, M 2016, 'Order of Presentation of Dimensions Does Not Systematically Bias Utility Weights from a Discrete Choice Experiment', Value in Health, vol. 19, no. 8, pp. 1033-1038.
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© 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR).Background: Discrete choice experiments (DCEs) are increasingly used to value aspects of health. An issue with their adoption is that results may be sensitive to the order in which dimensions of health are presented in the valuation task. Findings in the literature regarding order effects are discordant at present. Objectives: To quantify the magnitude of order effect of quality-of-life (QOL) dimensions within the context of a DCE designed to produce country-specific value sets for the EORTC Quality of Life Utility Measure-Core 10 dimensions (QLU-C10D), a new utility instrument derived from the widely used cancer-specific QOL questionnaire, the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30. Methods: The DCE comprised 960 choice sets, divided into 60 versions of 16 choice sets, with each respondent assigned to a version. Within each version, the order of QLU-C10D QOL dimensions was randomized, followed by life duration in the last position. The DCE was completed online by 2053 individuals in France and Germany. We analyzed the data with a series of conditional logit models, adjusted for repeated choices within respondent. We used . F tests to assess order effects, correcting for multiple hypothesis testing. Results: Each . F test failed to reject the null hypothesis of no position effect: 1) all QOL order positions considered jointly; 2) last QOL position only; 3) first QOL position only. Furthermore, the order coefficients were small relative to those of the QLU-C10D QOL dimension levels. Conclusions: The order of presentation of QOL dimensions within a DCE designed to provide utility weights for the QLU-C10D had little effect on level coefficients of those QOL dimensions.
Norman, R, Mulhern, B & Viney, R 2016, 'The Impact of Different DCE-Based Approaches When Anchoring Utility Scores', PHARMACOECONOMICS, vol. 34, no. 8, pp. 805-814.
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© 2016, Springer International Publishing Switzerland. Background: Discrete choice experiments (DCEs) have been proposed as a method to estimate utility weights for health states within utility instruments. However, the most appropriate method to anchor the utility values on the full health to dead quality-adjusted life year (QALY) scale remains uncertain. We test four approaches to anchoring in which dead is valued at zero and full health at one. Methods: We use data from two DCEs valuing EQ-5D-3L and EQ-5D-5L health states, which presented pairs of health profiles with an associated duration, and a dead option. The approaches to anchoring the results on the required scale were (1) using only preferences between non-dead health profiles; (2) including the dead data, treating it as a health profile with zero duration; (3) explicitly modelling both duration and dead; and (4) using the preferences regarding the dead health state as an external anchor subsequent to the estimation of approach 1. Results: All approaches lead to differences in the scale of utility decrements, but not the ranking of EQ-5D health states. The models differ in their ability to predict preferences around dead health states, and the characteristics of the value sets in terms of their range and the proportion of states valued as worse than dead. Discussion: Appropriate anchoring of DCEs with or without complementary time trade-off (TTO) data remains unresolved, and the method chosen will impact on health resource allocation decision making employing the value sets.
Norman, R, Mulhern, B, Viney, R, Bansback, N & Pearce, A 2016, 'THE IMPACT OF DURATION ON EQ-5D-5L VALUE SETS DERIVED FROM A DISCRETE CHOICE EXPERIMENT', VALUE IN HEALTH, vol. 19, no. 7, pp. A828-A828.
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Norman, R, Mulhern, B, Viney, R, Bansback, N & Pearce, A 2016, 'The Impact of Duration on EQ‐5D‐5l Value Sets Derived from a Discrete Choice Experiment', Value in Health, vol. 19, no. 7, pp. A828-A828.
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Norman, R, Viney, R, Aaronson, NK, Brazier, JE, Cella, D, Costa, DSJ, Fayers, PM, Kemmler, G, Peacock, S, Pickard, AS, Rowen, D, Street, DJ, Velikova, G, Young, TA & King, MT 2016, 'Using a discrete choice experiment to value the QLU-C10D: feasibility and sensitivity to presentation format', Quality of Life Research, vol. 25, no. 3, pp. 637-649.
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© 2015, Springer International Publishing Switzerland. Purpose: To assess the feasibility of using a discrete choice experiment (DCE) to value health states within the QLU-C10D, a utility instrument derived from the QLQ-C30, and to assess clarity, difficulty, and respondent preference between two presentation formats. Methods: We ran a DCE valuation task in an online panel (N = 430). Respondents answered 16 choice pairs; in half of these, differences between dimensions were highlighted, and in the remainder, common dimensions were described in text and differing attributes were tabulated. To simplify the cognitive task, only four of the QLU-C10D’s ten dimensions differed per choice set. We assessed difficulty and clarity of the valuation task with Likert-type scales, and respondents were asked which format they preferred. We analysed the DCE data by format with a conditional logit model and used Chi-squared tests to compare other responses by format. Semi-structured telephone interviews (N = 8) explored respondents’ cognitive approaches to the valuation task. Results: Four hundred and forty-nine individuals were recruited, 430 completed at least one choice set, and 422/449 (94 %) completed all 16 choice sets. Interviews revealed that respondents found ten domains difficult but manageable, many adopting simplifying heuristics. Results for clarity and difficulty were identical between formats, but the “highlight” format was preferred by 68 % of respondents. Conditional logit parameter estimates were monotonic within domains, suggesting respondents were able to complete the DCE sensibly, yielding valid results. Conclusion: A DCE valuation task in which only four of the QLU-C10D’s ten dimensions differed in any choice set is feasible for deriving utility weights for the QLU-C10D.
Page, K, Lum, E & Healey, L 2016, 'What do consumers do with, and think about, antibiotics?', Infection, Disease & Health, vol. 21, no. 3, pp. 145-146.
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Pantiri, K, Shah, K, Devlin, N, Mulhern, B & van Hout, B 2016, 'Directly Eliciting Personal Utility Functions From A Convenience Sample Of 30 Health Outcomes Professionals: A Pilot Study', Value in Health, vol. 19, no. 7, pp. A473-A473.
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Parkinson, B, Viney, R, Haas, M, Goodall, S, Srasuebkul, P & Pearson, S-A 2016, 'Real-World Evidence: A Comparison of the Australian Herceptin Program and Clinical Trials of Trastuzumab for HER2-Positive Metastatic Breast Cancer', PHARMACOECONOMICS, vol. 34, no. 10, pp. 1039-1050.
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© 2016, Springer International Publishing Switzerland. Introduction: Estimating the real-world cost-effectiveness of a new drug relies on understanding the differences between clinical trial data (pre-reimbursement) and clinical practice (post-reimbursement). This is important for decision makers when reviewing reimbursement decisions, prices, and considering other drugs for the same condition. Differences can arise from differences in patient characteristics, but also from the availability of new evidence and evolving treatment practices. This paper examines these issues using a case study. Methods: In 2001, the Australian Government funded trastuzumab for the treatment of HER2+ metastatic breast cancer through the Herceptin Program. The administrative arrangements of the Program resulted in rich observational data that captured information about patients treated with trastuzumab between 2001 and 2010 (n = 3830). The dataset included patient characteristics, dispensed medicines, medical service use and date of death. Results: Compared to participants in the clinical trials, patients were older, received more prior chemotherapies and a broader range of co-administered chemotherapies. Treatment practices differed from the clinical trials, but also changed over time. For example, in situ hybridization testing, rather than immunohistochemistry testing, and a three weekly administration schedule, rather than one weekly, were increasingly used. Compared to the clinical trials, patients administered trastuzumab with a concomitant chemotherapy generally experienced longer overall survival (151.3 weeks, 95 % CI: 142.6, 163.4), while those who received trastuzumab as a monotherapy experienced shorter overall survival (94.4 weeks, 95%CI: 86.4, 102.9). These findings may be due to a differing relative treatment effect in clinical practice, but may also be due to a range of other factors. Conclusion: This analysis demonstrates the challenges for decision makers tha...
Rechel, B, Džakula, A, Duran, A, Fattore, G, Edwards, N, Grignon, M, Haas, M, Habicht, T, Marchildon, GP, Moreno, A, Ricciardi, W, Vaughan, L & Smith, TA 2016, 'Hospitals in rural or remote areas: An exploratory review of policies in 8 high-income countries', Health Policy, vol. 120, no. 7, pp. 758-769.
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Our study reviewed policies in 8 high-income countries (Australia, Canada, United States, Italy, Spain, United Kingdom, Croatia and Estonia) in Europe, Australasia and North America with regard to hospitals in rural or remote areas. We explored whether any specific policies on hospitals in rural or remote areas are in place, and, if not, how countries made sure that the population in remote or rural areas has access to acute inpatient services. We found that only one of the eight countries (Italy) had drawn up a national policy on hospitals in rural or remote areas. In the United States, although there is no singular comprehensive national plan or vision, federal levers have been used to promote access in rural or remote areas and provide context for state and local policy decisions. In Australia and Canada, intermittent policies have been developed at the sub-national level of states and provinces respectively. In those countries where access to hospital services in rural or remote areas is a concern, common challenges can be identified, including the financial sustainability of services, the importance of medical education and telemedicine and the provision of quick transport to more specialized services.
Rechel, B, McKee, M, Haas, M, Marchildon, GP, Bousquet, F, Blümel, M, Geissler, A, van Ginneken, E, Ashton, T, Saunes, IS, Anell, A, Quentin, W, Saltman, R, Culler, S, Barnes, A, Palm, W & Nolte, E 2016, 'Public reporting on quality, waiting times and patient experience in 11 high-income countries.', Health Policy, vol. 120, no. 4, pp. 377-383.
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This article maps current approaches to public reporting on waiting times, patient experience and aggregate measures of quality and safety in 11 high-income countries (Australia, Canada, England, France, Germany, Netherlands, New Zealand, Norway, Sweden, Switzerland and the United States). Using a questionnaire-based survey of key national informants, we found that the data most commonly made available to the public are on waiting times for hospital treatment, being reported for major hospitals in seven countries. Information on patient experience at hospital level is also made available in many countries, but it is not generally available in respect of primary care services. Only one of the 11 countries (England) publishes composite measures of overall quality and safety of care that allow the ranking of providers of hospital care. Similarly, the publication of information on outcomes of individual physicians remains rare. We conclude that public reporting of aggregate measures of quality and safety, as well as of outcomes of individual physicians, remain relatively uncommon. This is likely to be due to both unresolved methodological and ethical problems and concerns that public reporting may lead to unintended consequences.
Reeve, R, Arora, S, Butler, K, Viney, R, Burns, L, Goodall, S & van Gool, K 2016, 'Evaluating the Impact of Hospital Based Drug and Alcohol Consultation Liaison Services', JOURNAL OF SUBSTANCE ABUSE TREATMENT, vol. 68, pp. 36-45.
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© 2016 Elsevier Inc. Consultation liaison (CL) services provide direct access to specialist services for support, treatment advice and assistance with the management of a given condition. Alcohol and other drugs (AOD) CL services aim to improve identification and treatment of patients with AOD morbidity. Our objective was to evaluate the costs and consequences of AOD CL services in hospitals in New South Wales, Australia. Patients were surveyed at eight hospitals and problematic AOD use was identified using the Alcohol, Smoking and Substance Involvement Screening Test (n = 1615). For consenting participants, medical record data were obtained from 18 months pre- to 12 months post-survey. We used interrupted time series analyses to compare utilization and costs for patients with and without AOD problems and changes over time between those who received AOD CL and similar patients. Approximately 35% of patients surveyed had AOD problems (excluding tobacco) with 7% requiring intensive treatment. Only 24% of patients requiring intensive treatment were treated by AOD CL. Those treated had relative improvements over time in the cost of presentations to emergency departments, emergency admission performance and increased uptake of appropriate pharmaceuticals. The estimated net benefit of AOD CL services was at least AUD$100,000 savings per hospital per year. Expanding AOD CL services to address current unmet need may lead to even greater cost savings for hospitals.
Sabater-Hernandez, D, Moullin, JC, Hossain, LN, Durks, D, Franco-Trigo, L, Fernandez-Llimos, F, Martinez-Martinez, F, Saez-Benito, L, de la Sierra, A & Benrimoj, SI 2016, 'Intervention mapping for developing pharmacy-based services and health programs: A theoretical approach', AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY, vol. 73, no. 3, pp. 156-164.
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Sabater-Hernández, D, Sabater-Galindo, M, Fernandez-Llimos, F, Rotta, I, Hossain, LN, Durks, D, Franco-Trigo, L, Lopes, LA, Correr, CJ & Benrimoj, SI 2016, 'A Systematic Review of Evidence-Based Community Pharmacy Services Aimed at the Prevention of Cardiovascular Disease', Journal of Managed Care & Specialty Pharmacy, vol. 22, no. 6, pp. 699-713.
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© 2016, Academy of Managed Care Pharmacy. BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death worldwide and has a substantial impact on people's health and quality of life. CVD also causes an increased use of health care resources and services, representing a significant proportion of health care expenditure. Integrating evidence-based community pharmacy services is seen as an asset to reduce the burden of CVD on individuals and the health care system. OBJECTIVES: To (a) identify community pharmacy evidence-based services designed to help prevent CVD and (b) provide fundamental information that is needed to assess their potential adaptation to other community pharmacy settings. METHODS: This review used the DEPICT database, which includes 488 randomized controlled trials (RCT) that address the evaluation of pharmacy services. Articles reviewing these RCTs were identified for the DEPICT database through a systematic search of the following databases: MEDLINE, Scopus, SciELO (Scientific Electronic Library Online), and DOAJ (Directory of Open Access Journals). The DEPICT database was reviewed to identify evidence-based services delivered in the community pharmacy setting with the purpose of preventing CVD. An evidence-based service was defined as a service that has been shown to have a positive effect (compared with usual care) in a high-quality RCT. From each evidence-based service, fundamental information was retrieved to facilitate adaptation to other community pharmacy settings. RESULTS: From the DEPICT database, 14 evidence-based community pharmacy services that addressed the prevention of CVD were identified. All services, except 1, targeted populations with a mean age above 60 years. Pharmacy services encompassed a wide range of practical applications or techniques that can be classified into 3 groups: activities directed at patients, activities directed at health care professionals, and assessments to gather patient-related i...
Sangster, J, Church, J, Haas, M, Furber, S & Bauman, A 2016, 'Corrigendum to ‘A Comparison of the Cost-effectiveness of two Pedometer-based Telephone Coaching Programs for People with Cardiac Disease’', Heart, Lung and Circulation, vol. 25, no. 4, pp. 410-411.
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Santo, K, Kirkendall, S, Laba, T-L, Thakkar, J, Webster, R, Chalmers, J, Chow, CK & Redfern, J 2016, 'Interventions to improve medication adherence in coronary disease patients: A systematic review and meta-analysis of randomised controlled trials', European Journal of Preventive Cardiology, vol. 23, no. 10, pp. 1065-1076.
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BACKGROUND: Adherence to multiple cardiovascular (CV) medications is a cornerstone of coronary heart disease (CHD) management and prevention, but it is sub-optimal worldwide. This review aimed to examine whether interventions improve adherence to multiple CV medications in a CHD population. DESIGN: This study was based on a systematic review and meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. METHODS: Randomised controlled trials were identified by searching multiple databases and reference lists. Studies were selected if they evaluated interventions aiming to improve adherence to multiple CV medications targeting a CHD population and if they provided an appropriate measure of adherence. Interventions were classified as complex or simple interventions. Odds ratios (ORs) were calculated and pooled for a meta-analysis. Risk of bias, heterogeneity and publication bias were also assessed. RESULTS: Sixteen studies (10,706 patients) were included. The mean age was 62 years (standard deviation (SD) 3.6) and 72% were male. In a pooled analysis, the interventions significantly improved medication adherence (OR 1.52; 95% confidence interval (CI) 1.25-1.86; p < 0.001) and there were no significant differences based on intervention type (complex vs simple), components categories and adherence method. There was moderate heterogeneity (I(2) ( )= 61%) across the studies. After adjusting for publication bias, the effect size was attenuated but remained significant (OR 1.35; 95% CI 1.09-1.68). CONCLUSION: Interventions to improve adherence to multiple CV medication in a CHD population significantly improved the odds of being adherent. Simple one-component interventions might be a promising way to improve medication adherence in a CHD population, as they would be easier to replicate in different settings and on a large scale.
Scarf, V, Catling, C, Viney, R & Homer, C 2016, 'Costing Alternative Birth Settings for Women at Low Risk of Complications: A Systematic Review', PLOS ONE, vol. 11, no. 2, pp. e0149463-e0149463.
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© 2016 Scarf et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background: There is demand from women for alternatives to giving birth in a standard hospital setting however access to these services is limited. This systematic review examines the literature relating to the economic evaluations of birth setting for women at low risk of complications. Methods: Searches of the literature to identify economic evaluations of different birth settings of the following electronic databases: MEDLINE, CINAHL, Econ Lit, Business Source Complete and Maternity and Infant care. Relevant English language publications were chosen using keywords and MeSH terms between 1995 and 2015. Inclusion criteria included studies focussing on the comparison of birth setting. Data were extracted with respect to study design, perspective, PICO principles, and resource use and cost data. Results: Eleven studies were included from Australia, Canada, the Netherlands, Norway, the USA, and the UK. Four studies compared costs between homebirth and the hospital setting and the remaining seven focussed on the cost of birth centre care and the hospital setting. Six studies used a cost-effectiveness analysis and the remaining five studies used cost analysis and cost comparison methods. Eight of the 11 studies found a cost saving in the alternative settings. Two found no difference in the cost of the alternative settings and one found an increase in birth centre care. Conclusions: There are few studies that compare the cost of birth setting. The variation in the results may be attributable to the cost data collection processes, difference in health systems and differences in which costs were included. A better understanding of the cost of birth setting is needed to inform policy makers and service providers.
Shah, K, Mulhern, B, Longworth, L & Janssen, MFB 2016, 'An Empirical Study of Two Alternative Comparators for Use in Time Trade-Off Studies', Value in Health, vol. 19, no. 1, pp. 53-59.
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Siva, S, Kron, T, Bressel, M, Haas, M, Mai, T, Vinod, S, Sasso, G, Wong, W, Le, H, Eade, T, Hardcastle, N, Chesson, B, Pham, D, Høyer, M, Montgomery, R & Ball, D 2016, 'A randomised phase II trial of Stereotactic Ablative Fractionated radiotherapy versus Radiosurgery for Oligometastatic Neoplasia to the lung (TROG 13.01 SAFRON II)', BMC Cancer, vol. 16, no. 1.
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© 2016 Siva et al. Background: Stereotactic ablative body radiotherapy (SABR) is emerging as a non-invasive method for precision irradiation of lung tumours. However, the ideal dose/fractionation schedule is not yet known. The primary purpose of this study is to assess safety and efficacy profile of single and multi-fraction SABR in the context of pulmonary oligometastases. Methods/Design: The TROG 13.01/ALTG 13.001 clinical trial is a multicentre unblinded randomised phase II study. Eligible patients have up to three metastases to the lung from any non-haematological malignancy, each<5cm in size, non-central targets, and have all primary and extrathoracic disease controlled with local therapies. Patients are randomised 1:1 to a single fraction of 28Gy versus 48Gy in four fractions of SABR. The primary objective is to assess the safety of each treatment arm, with secondary objectives including assessment of quality of life, local efficacy, resource use and costs, overall and disease free survival and time to distant failure. Outcomes will be stratified by number of metastases and origin of the primary disease (colorectal versus non-colorectal primary). Planned substudies include an assessment of the impact of online e-Learning platforms for lung SABR and assessment of the effect of SABR fractionation on the immune responses. A total of 84 patients are required to complete the study. Discussion: Fractionation schedules have not yet been investigated in a randomised fashion in the setting of oligometastatic disease. Assuming the likelihood of similar clinical efficacy in both arms, the present study design allows for exploration of the hypothesis that cost implications of managing potentially increased toxicities from single fraction SABR will be outweighed by costs associated with delivering multiple-fraction SABR. Trials registration:ACTRN12613001157763 , registered 17th October 2013
Skoien, W, Ashover, S, Milburn, T, Page, K, Cullen, L & Parsonage, W 2016, 'Research Translation: Implementation Evaluation of the Queensland Accelerated Chest Pain Risk Evaluation (ACRE) Project', Heart, Lung and Circulation, vol. 25, pp. S62-S62.
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Skoien, W, Page, K, Parsonage, W, Ashover, S, Milburn, T & Cullen, L 2016, 'Use of the Theoretical Domains Framework to evaluate factors driving successful implementation of the Accelerated Chest pain Risk Evaluation (ACRE) project', Implementation Science, vol. 11, no. 1, p. 136.
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BACKGROUND: The translation of healthcare research into practice is typically challenging and limited in effectiveness. The Theoretical Domains Framework (TDF) identifies 12 domains of behaviour determinants which can be used to understand the principles of behavioural change, a key factor influencing implementation. The Accelerated Chest pain Risk Evaluation (ACRE) project has successfully translated research into practice, by implementing an intervention to improve the assessment of low to intermediate risk patients presenting to emergency departments (EDs) with chest pain. The aims of this paper are to describe use of the TDF to determine which factors successfully influenced implementation and to describe use of the TDF as a tool to evaluate implementation efforts and which domains are most relevant to successful implementation. METHODS: A 30-item questionnaire targeting clinicians was developed using the TDF as a guide. Questions encompassed ten of the domains of the TDF: Knowledge; Skills; Social/professional role and identity; Beliefs about capabilities; Optimism; Beliefs about consequences; Intentions; Memory, attention and decision processes; Environmental context and resources; and Social influences. RESULTS: Sixty-three of 176 stakeholders (36 %) responded to the questionnaire. Responses for all scales showed that respondents were highly favourable to all aspects of the implementation. Scales with the highest mean responses were Intentions, Knowledge, and Optimism, suggesting that initial education and awareness strategies around the ACRE project were effective. Scales with the lowest mean responses were Environmental context and resources, and Social influences, perhaps highlighting that implementation planning could have benefitted from further consideration of the factors underlying these scales. CONCLUSIONS: The ACRE project was successful, and therefore, a perfect case study for understanding factors which drive implementation success. T...
Srivastava, R, Downie, J, Hall, J & Reynolds, G 2016, 'Costs of children with medical complexity in Australian public hospitals', Journal of Paediatrics and Child Health, vol. 52, no. 5, pp. 566-571.
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AimTo describe the hospital costs, hospital types and differences across states and territories for children with medical complexity cared for in Australian public hospitals.MethodsRetrospective national administrative database study of 212 Australian public hospitals from six states (excluding Queensland) and two territories that submitted cost data to the National Hospital Costing Data Collection for 2010–2011. Participants included all hospitalised patients with comparisons between adults and children (17 years of age and younger), and adults with chronic diseases and children with medical complexity. Total hospital costs were the main outcome measure.ResultsThe National Hospital Costing Data Collection contained data from 212 public hospitals; total admissions (adults and children) were 3 519 140 at a total hospital cost of $16 187 400 000. Children accounted for 350 499 (9.9%) of the admissions at a total hospital cost of $1 931 585 123 (11.9%). Of all children, those with medical complexity accounted for 48 758 (13.9%), and their total hospital costs were $620 948 769 (32.1%). Six children's hospitals had 145 213 (41%) of the total children admissions at a total hospital cost of $936 041 843 (48%). Across the states and territories, the number of childhood admissions ranged from 9164 to 146 618 with 4.7–14.8% for children with medical complexity. Total hospital costs ranged from $44 to $592 million with 15.4–39.4% for children with medical complexity.ConclusionsThe national burden of hospitalised children is substantial. Children with medical complexity only account for a small percentage of hospitalisations but almost one third of total hospital costs for children, with children's hospitals bearing the major costs.
Taylor, CJ, Wright, M, Jackson, CL & Hobbs, R 2016, 'Grass is greener? General practice in England and Australia', British Journal of General Practice, vol. 66, no. 649, pp. 428-429.
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Thakkar, J, Kurup, R, Laba, T-L, Santo, K, Thiagalingam, A, Rodgers, A, Woodward, M, Redfern, J & Chow, CK 2016, 'Mobile Telephone Text Messaging for Medication Adherence in Chronic Disease', JAMA Internal Medicine, vol. 176, no. 3, pp. 340-340.
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IMPORTANCE: Adherence to long-term therapies in chronic disease is poor. Traditional interventions to improve adherence are complex and not widely effective. Mobile telephone text messaging may be a scalable means to support medication adherence. OBJECTIVES: To conduct a meta-analysis of randomized clinical trials to assess the effect of mobile telephone text messaging on medication adherence in chronic disease. DATA SOURCES: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, PsycINFO, and CINAHL (from database inception to January 15, 2015), as well as reference lists of the articles identified. The data were analyzed in March 2015. STUDY SELECTION: Randomized clinical trials evaluating a mobile telephone text message intervention to promote medication adherence in adults with chronic disease. DATA EXTRACTION: Two authors independently extracted information on study characteristics, text message characteristics, and outcome measures as per the predefined protocol. MAIN OUTCOMES AND MEASURES: Odds ratios and pooled data were calculated using random-effects models. Risk of bias and study quality were assessed as per Cochrane guidelines. Disagreement was resolved by consensus. RESULTS: Sixteen randomized clinical trials were included, with 5 of 16 using personalization, 8 of 16 using 2-way communication, and 8 of 16 using a daily text message frequency. The median intervention duration was 12 weeks, and self-report was the most commonly used method to assess medication adherence. In the pooled analysis of 2742 patients (median age, 39 years and 50.3% [1380 of 2742] female), text messaging significantly improved medication adherence (odds ratio, 2.11; 95% CI, 1.52-2.93; P < .001). The effect was not sensitive to study characteristics (intervention duration or type of disease) or text message characteristics (personalization, 2-way communication, or daily text message frequency). In a sensitivity analysis, our findings remained robust to chang...
Thiboonboon, K, Santatiwongchai, B, Chantarastapornchit, V, Rattanavipapong, W & Teerawattananon, Y 2016, 'A Systematic Review of Economic Evaluation Methodologies Between Resource-Limited and Resource-Rich Countries: A Case of Rotavirus Vaccines', Applied Health Economics and Health Policy, vol. 14, no. 6, pp. 659-672.
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BACKGROUND: For more than three decades, the number and influence of economic evaluations of healthcare interventions have been increasing and gaining attention from a policy level. However, concerns about the credibility of these studies exist, particularly in studies from low- and middle- income countries (LMICs). This analysis was performed to explore economic evaluations conducted in LMICs in terms of methodological variations, quality of reporting and evidence used for the analyses. These results were compared with those studies conducted in high-income countries (HICs). METHODS: Rotavirus vaccine was selected as a case study, as it is one of the interventions that many studies in both settings have explored. The search to identify individual studies on rotavirus vaccines was performed in March 2014 using MEDLINE and the National Health Service Economic Evaluation Database. Only full economic evaluations, comparing cost and outcomes of at least two alternatives, were included for review. Selected criteria were applied to assess methodological variation, quality of reporting and quality of evidence used. RESULTS: Eighty-five studies were included, consisting of 45 studies in HICs and 40 studies in LMICs. Seventy-five percent of the studies in LMICs were published by researchers from HICs. Compared with studies in HICs, the LMIC studies showed less methodological variety. In terms of the quality of reporting, LMICs had a high adherence to technical criteria, but HICs ultimately proved to be better. The same trend applied for the quality of evidence used. CONCLUSION: Although the quality of economic evaluations in LMICs was not as high as those from HICs, it is of an acceptable level given several limitations that exist in these settings. However, the results of this study may not reflect the fact that LMICs have developed a better research capacity in the domain of health economics, given that most of the studies were in theory led by researchers fro...
Tsey, K, Lawson, K, Kinchin, I, Bainbridge, R, McCalman, J, Watkin, F, Cadet-James, Y & Rossetto, A 2016, 'Evaluating Research Impact: The Development of a Research for Impact Tool', Frontiers in Public Health, vol. 4.
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Vargas Parada, C & Lennert Veerman, J 2016, 'Cost-Effectiveness Study of HPV Vaccination as a Primary Prevention Strategy for Anal Cancer in HIV-Positive Men in Chile', Value in Health Regional Issues, vol. 11, pp. 17-23.
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© 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Background: Most anal cancers are caused by the human papilloma virus (HPV) infection. The incidence is increasing, especially in high-risk individuals such as HIV-positive men. Evidence shows that the new quadrivalent HPV vaccine reduces the rates of anal intraepithelial neoplasia among men who have sex with men. Objective: To determine whether vaccinating against HPV-related anal cancer is cost-effective in HIV-positive men in Chile. Methods: A cost-effectiveness analysis was conducted by constructing a cohort multistate life-table-based Markov model in MS Excel in which the prevention of HPV infection was expected to influence the incidence of anal cancer in HIV-positive men. The comparator was the current practice of no systematic HPV prevention. Estimates of the efficacy of the vaccine were obtained from a substudy of a larger randomized controlled trial, incidence rates from the Chilean Population Cancer Registries, mortality rates from the National Institute of Statistics, and disease costs from a cost-effectiveness report. A public health care sector perspective was applied. The outcome was measured in averted disability-adjusted life-years. The incremental cost-effectiveness ratio was calculated considering a lifetime horizon for costs and health outcomes. Results: The estimated incremental cost-effectiveness ratio was US $138,269/ disability-adjusted life-year (95% confidence interval $95,936-$221,862). Assuming a threshold of 3 times the gross domestic product per capita, the intervention was not cost-effective. The outcome was sensitive to the vaccine price and vaccine efficacy. Conclusions: HPV vaccination in HIV-positive men from a Chilean public health care sector perspective is not cost-effective.
Yu, S 2016, 'Retiree Welfare and the 2009 Pension Increase: Impacts from an Australian Experiment', Economic Record, vol. 92, no. 296, pp. 67-80.
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The welfare effects from the 2009 increase in the age pension are evaluated using a quasi‐experimental, difference‐in‐difference regression framework. Using microdata to exploit the exogenous and large increase in the single‐person pension rate, the research finds significant improvements in the material welfare of single age pensioners. In particular, non‐housing and total consumption rose by 7 per cent and 4 per cent, respectively. The effects were amplified among the poorest retirees. The study extends the literature on the welfare benefits of pension programs, and provides evidence that the policy changes were highly effective in lifting the material welfare of the targeted beneficiaries.
Addo, R, Hall, J, Goodall, S & Haas, M 1970, 'The Feasibility of Health Technology Assessment in the Ghanaian health System: The State of Economic Evaluation Studies Conducted in Ghana', UTS Business School PhD Conference, Sydney.
Agar, M, Luckett, T, Luscombe, G, Phillips, J, Beattie, E, Pond, D, Mitchell, G, Cook, J, Davidson, PM, Brooks, D, Houltram, J, Goodall, S & Chenoweth, L 1970, 'Pragmatic cluster randomised controlled trial of facilitated family case conferencing versus usual care for people with advanced dementia living in aged care: effects on end of life care', Palliative Care Nurses Australia Conference, Canberra.
Arora, S, Goodall, S, Viney, R & Einfeld, S 1970, 'USING A DISCRETE CHOICE EXPERIMENT TO VALUE INFORMAL CARE PROVIDED TO CHILDREN WITH INTELLECTUAL DISABILITIES', VALUE IN HEALTH, ISPOR 7th Asia-Pacific Conference, ELSEVIER SCIENCE INC, Singapore, pp. A905-A906.
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Arora, S, Goodall, S, Viney, R & Einfeld, S 1970, 'Using a discrete choice experiment to value informal care provided to children with intellectual disabilities', 38th Annual Australian Health Economics Society Conference, Perth.
Cronin, PA, Reeve, R, Goodall, S, Viney, R & McCabe, T 1970, 'The implications of school quality on the academic achievements of children with language difficulties', 38th Annual Australian Health Economics Society Conference, Australian Health Economics Society Conference, Perth.
De Abreu Lourenco, R 1970, 'Incorporating Patient Values (Session Chair)', Room with a Patient View – Engaging patients in health care decision making, Sydney.
De Abreu Lourenco, R 1970, 'Using health economics in radiotherapy research (Invited during plenary session)', TROG Annual Scientific Meeting.
De Abreu Lourenco, R, Haas, M, Hall, J, Parish, K, Stuart, D & Viney, R 1970, 'Placing a value on avoiding cancer recurrence: women’s preferences for contralateral prophylactic mastectomy', 38th Annual Australian Health Economics Society Conference, Perth.
Franco-Trigo, L, Hossain, L, Durks, D, Benrimoj, SI & Sabater-Hernández, D 1970, 'Shared initiatives proposed by stakeholders from different parts of the system to achieve a leading cardiovascular care integrating community pharmacy services', Simpodader International Conference, Granada, Spain.
Goodall, S, Zhao, F, Street, D & Viney, R 1970, 'Estimating the Impact of Direct-to-Consumer Advertising of Pharmacy Only Medicine Using Discrete Choice Experiments', Value in Health, ISPOR 7th Asia-Pacific Conference, Elsevier BV, Singapore, pp. A855-A855.
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Gravelle, HS, Liu, D, Propper, C & Santos, R 1970, 'Does competition improve quality in general practices?', The Health Economists’ Study Group Meeting, Manchester, UK.
Haas, M & De Abreu Lourenco, R 1970, 'The development and implementation of Health Economics in the SAFRON II trial protocol – an interactive workshop', TROG Annual Scientific Meeting.
Haas, MR 1970, 'Health Economics 101 (Invited during plenary session)', TROG Annual Scientific Meeting.
Havers, S, Hall, L & Page, K 1970, 'From Policy to Practice: Evaluating Health Policy Implementation in Australia', INTERNATIONAL JOURNAL OF QUALITATIVE METHODS, SAGE PUBLICATIONS INC.
Hossain, L, Fernandez-Llimos, F, Luckett, T, Moullin, JC, Franco-Trigo, L, Benrimoj, SI, Durks, D & Sabater-Hernández, D 1970, 'A qualitative meta-synthesis of factors that influence the implementation of community pharmacy services in Australia: the perspectives of patients, general practitioners and nurses', Simpodader International Conference, Granada, Spain.
Liu, D, Li, Y, Wang, JL, Zhang, X, Shi, WH, Liang, XF, Wu, J & Turati, G 1970, 'The effects of incentive mechanisms on hypertension management in China: Results from a cross-sectional survey three years after the 2009 healthcare reform', 27th Chinese Economic Association (CEA) (UK) and 8th CEA (Europe) Annual Conference, Duisburg, Germany.
Longden, T, Wong, CY, Haywood, P, Hall, J & van Gool, K 1970, 'A question of persistence and related health states: an analysis of persistently high healthcare costs in the short term and long term', Australian Health Economics Society Conference, Fremantle, Australia.
Lourenco, RDA, Haas, M, Hall, J, Parish, K, Stuart, D & Viney, R 1970, 'WOMEN'S PREFERENCES FOR AVOIDING CANCER RECURRENCE: A FOCUS ON CONTRALATERAL PROPHYLACTIC MASTECTOMY', ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, pp. 137-137.
Luckett, T, Chenoweth, L, Brooks, D, Cook, J, Mitchell, G, Pond, D, Beattie, E, Davidson, PM, Luscombe, G, Goodall, S, Allsopp, J, Grover, S & Agar, S 1970, 'Implementing facilitated case conferencing for people living in aged care with advanced dementia: benefits, barriers and facilitators', Palliative Care Nurses Australia Conference, Palliative Care Nurses Australia Conference, Canberra.
Meshcheriakova, O, Goodall, S & Viney, R 1970, 'Consumer preferences for food processing technologies: evidence from a discrete choice experiment', 38th Annual Australian Health Economics Society Conference, Perth.
Page, K 1970, 'Incontinence management for the stroke', INTERNATIONAL JOURNAL OF STROKE, SAGE PUBLICATIONS LTD, pp. 29-29.
Prichard, R, Hayward, C, Davidson, P, Goodall, S & Newton, P 1970, 'Impact of Left Ventricular Assist Device Implantation on Hospitalisation, and Readmissions Using a Linked Administrative Dataset', Heart, Lung and Circulation, The Cardiac Society of Australia and New Zealand, Elsevier BV, Adelaide, pp. S114-S114.
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Prichard, RA, Newton, P, Goodall, S, Kershaw, L, Davidson, PM, Homer, T, McNeil, F & Hayward, CS 1970, 'Establishing Institutional Costs in the Year Before and After VAD Implant and Before Heart Transplant', JOURNAL OF HEART AND LUNG TRANSPLANTATION, 36th Annual Meeting and Scientific Sessions of the International-Society-for-Heart-and-Lung-Transplantation (ISHLT), ELSEVIER SCIENCE INC, Washington, DC, pp. S272-S272.
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Saing, S 1970, 'Graded Sensory and Motor Training for Chronic Low-Back Pain: Protocol for the RESOLVE Trial Randomised Controlled Trial', 16th World Congress on Pain, Yokohama, Japan.
Saing, S, Haywood, P & Goodall, S 1970, 'Cost Effectiveness of Contrast-Enhanced Liver MRI in the Characterisation of Suspected Liver Lesions in Patients with Colorectal Cancer', Value in Health, ISPOR Asia-Pacific Conference, Elsevier BV, Singapore, pp. A860-A860.
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Saing, S, Haywood, P & Goodall, S 1970, 'Economic evaluation of contrast-enhanced liver MRI in the characterisation of suspected liver lesions', ISPOR Australia Chapter, Contemporary Economic Modelling: State of the Art, Sydney.
Saing, S, Kemmler, G, Gamper, EM, Daval, F, Holzner, B, Pivot, X, Viney, R & Nerich, V 1970, 'Cost-utility analyses of drug therapies in breast cancer: a systematic review and critical appraisal of health-state utility values', 38th Annual Australian Health Economics Society Conference, Australian Health Economics Society Conference, Perth.
Scuffham, P, Viney, R & Goodall, S 1970, 'Risky Business: Decision making in Health Care with economic modelling', ISPOR 7th Asia-Pacific Conference, Singapore.
Shah, K, Mulhern, B, Longworth, L & Janssen, B 1970, 'IMPORTANT ASPECTS OF (FULL) HEALTH NOT CAPTURED BY EQ-5D', Value in Health, EuroQol Group Plenary 2015, Elsevier BV, Krakow, Poland, pp. A283-A283.
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Viney, RC, Street, D, Norman, R & Mulhern, B 1970, 'Discrete Choice Experiments: An Introduction (Invited Workshop)', EuroQoL Mid Year Plenary Meeting, Nordwijk, Netherlands.
Wright, M 1970, 'From Provider Continuity to Practice Integration. Changing Care in Australian General Practice', International Journal of Integrated Care, 16th International Conference for Integrated Care, Ubiquity Press, Ltd., Barcelona, Spain, pp. 95-95.
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Wright, MC 1970, 'Changing continuity of care in Australian General Practice', 38th Annual Australian Health Economics Society Conference, Perth.
