Meningococcal disease in an adult

A team of WA researchers is set to discover whether weekly community-based exercise sessions for people with moderate to severe lung impairment can significantly enhance participants’ wellbeing and reduce their cost to the health system.

Lung impairment, caused by chronic obstructive pulmonary disease (COPD), is a leading cause of preventable hospitalisations that limits affected individuals’ quality of life. In WA alone COPD was estimated to have added more than $30 million to public health spending in 2014.

Now a study being led by University of Western Australia (UWA) public health researcher Dr Derrick Lopez – and supported by a Department of Health-funded Research Translation Projects grant – will see if a pulmonary rehabilitation program of increased duration can provide a cost-effective means of improving and sustaining patient quality of life and reduce the burden of COPD on WA’s health system.

Pulmonary rehabilitation is provided to patients who have been admitted to hospital for an acute flare up of their lung condition and to non-admitted patients limited by symptoms of breathlessness and fatigue.

The program is made up of group sessions, which are supervised by a physiotherapist and held in outpatient or community settings for an eight-week period. These sessions include exercise and education, and are complemented by a program of exercises that patients are encouraged to undertake at home.

But the benefits of these sessions were found to decline in the months following completion of the eight-week program so an additional phase of rehabilitation was introduced, consisting of 10 community-based “maintenance” sessions, held weekly and supplemented with the home-based exercise program.

Without robust research to demonstrate their cost-effectiveness, funding for the maintenance sessions was regularly under threat.

Dr Lopez said he and his team would pilot a six-month trial of the community-based maintenance sessions to test their hypothesis that participants who completed the additional maintenance sessions would have fewer hospital admissions and sustain an improved quality of life compared to those who undertook only unsupervised home exercises.

Dr Lopez said that if his team’s hypothesis was verified, the case for extending pulmonary rehabilitation beyond the initial program would be on a much stronger footing.

Dr Lopez’ team includes epidemiologists from UWA, physiotherapists from Community Physiotherapy Services and Sir Charles Gairdner Hospital, and Lung Foundation Australia.

Western Australia’s Chief Medical Officer Professor Gary Geelhoed said COPD was a debilitating condition that caused severe breathlessness and fatigue in those affected.

“The research of Dr Lopez and his team has the potential to enhance the care of people with COPD and provide significant improvement to their quality of life,” he said.

“While extending the current pulmonary rehabilitation program seems to be showing sustained benefit to both patient and the health system it is important we have clear evidence to back up this belief.”

Dr Lopez’ research is among 11 projects that will share in more than $2.2 million of funding in the latest round of the Research Translation Projects grants program.

The program, which is now in its eleventh year, encourages research and the translation of research outcomes into effective health care policy and practice.

The full list of list of RTP recipients for 2017 is:

CPI

CPI Inst

Project Title

1

Blyth, Christopher

Telethon Kids Institute

Influenza vaccination in Western Australian children: an economic evaluation to inform future state and national programs

2

Clifford, Rhonda

University of WA

Methotrexate in Seriously Sick Kids (MiSSK): Proof of concept of personalised cancer treatment using pharmacogenomics to improve patient outcomes and reduce healthcare costs

3

Etherton-Beer, Christopher

University of WA

The Australian team Approach to Polypharmacy Evaluation and Reduction (AusTAPER) study for older hospital inpatients

4

Hulse, Gary

University of WA

A randomised (non-blinded) trial comparing the clinical efficacy of implant plus cognitive behavioural therapy versus cognitive behavioural therapy in the management of problem amphetamine use

5

Lopez, Derrick

University of WA

Cost effectiveness of extending the Phase 3 community pulmonary rehabilitation program beyond the recommended 10 weeks

6

Lucas, Michaela

Sir Charles Gairdner Hospital

Facing the challenge of self-reported antibiotic allergies in WA Health

7

Manning, Laurens

Fiona Stanley Hospital

Spray-on skin for diabetic foot ulcers: an open label randomised controlled trial

8

Raby, Edward

Fiona Stanley Hospital

Celecoxib for Acute Burn Inflammation and Fever: The CABIN Fever Trial

9

Rajwani, Adil

Royal Perth Hospital

The incremental utility of a developed cardiac valvular and aortic disease clinic

10

Riley, Tom

Edith Cowan University

Reducing hospital-identified Clostridium difficile infection by reducing environmental sources of C. difficile

11

Schultz, Carl

Royal Perth Hospital

West Australian cardiac outcomes registry: does routine stratification for competing risks at the time of diagnosis of acute coronary syndromes improve outcomes and lower health care costs?