NHMRC announces six new leaders in Australian health care

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The National Health and Medical Research Council (NHMRC) has announced the awarding of six 2009 NICS Fellowships to help improve the use of evidence in key areas including cardiovascular disease, gynaecological cancer, multiple sclerosis, bowel disease and smoking cessation.

“The NHMRC offers these unique Fellowships through our National Institute of Clinical Studies (NICS), to help build Australia’s own cohort of leaders in evidence implementation,” said Professor Warwick Anderson, NHMRC’s Chief Executive Officer.

The two year program provides NICS Fellows with funding, new skills, networks and knowledge to help bridge an important gap in the delivery of health care by undertaking an evidence implementation project in their workplace. 34 fellowships have been awarded since the program was launched in 2003.

“By partnering with key health organisations we can provide NICS Fellowships that target real problems in health care and provide solutions that work. These Fellowships are highly sought so I congratulate our 2009 NICS Fellows.” said Professor Anderson.

The 2009 NICS Fellowships have been awarded to:

NICS-Cancer Australia National Centre for Gynaecological Cancers Fellow: Dr Mary Ryan Implementation Project: Improving nutritional status and physical conditioning in women affected by gynaecological cancer.

Evidence-Practice Gap: Weight loss and loss of physical condition are known consequences of gynaecological cancers which can delay treatment delivery and recovery. Early intervention and the motivation to self manage aspects of care can have a significant impact on quality of life.

Improved health outcomes including decreased length of hospital stay following surgery and less wound infections can result when women with cancer and their health care providers proactively manage nutrition and physical condition. However, assessment of these conditions is not routinely undertaken at the time of diagnosis or during the course of the disease. Dr Ryan will develop and implement an assessment tool at the Royal Hospital for Women, working with staff and patients to make assessment and management a routine component of patient care.

NICS-HCF (Hospitals Contribution Fund) Health and Medical Research Foundation Fellow: Ms Paula Wye

Implementation Project: Decreasing risk factors for coronary heart disease: reducing smoking in patients in mental health inpatient settings.

Evidence-Practice Gap: Smoking is a leading cause of coronary heart disease. Up to 90% of people with a mental health illness smoke and as a consequence, are more likely to die from smoking related diseases, such as coronary heart disease, compared to people in the community. Helping people with mental health illness stop smoking provides an important opportunity to improve their cardiovascular and general health but is not routinely provided. Ms Wye will increase awareness of the need to provide smoking cessation assistance and develop processes to support staff to implement such programs.

NICS-Gastroenterological Society of Australia Fellow: Dr Alissa Walsh

Implementation Project: Reducing opportunistic infections in people with inflammatory bowel disease.

Evidence-Practice Gap: Inflammatory bowel disease (IBD) describes two diseases, ulcerative colitis and Crohn’s disease. It is primarily a disease of young adults and causes debilitating inflammation of the bowel. New medications are effective in managing symptoms and improving quality of life. However they suppress immunity and can result in a greatly increased risk of opportunistic infections which can be life threatening.

Despite the effectiveness of immunisation in preventing these infections, patients are not routinely screened or protected. Dr Walsh will implement a program at five Sydney hospitals to help identify patients at risk and ensure clinicians recommend suitable preventive measures. Dr Walsh plans to offer this program to other sites in Australia in the future.

NICS-Melbourne Health Fellow: Michael Frank

Implementation Project: Improving the management of nicotine withdrawal in Melbourne Health’s inpatients

Evidence-Practice Gap:
One in five Australians smoke despite the fact that it is the single greatest cause of preventable death and illness in Australia. Although evidence suggests that people are receptive to accept help to quit smoking when admitted to hospital for a smoking related illness, this help is not routinely offered in all hospitals.

In order to support inpatients wishing to cease smoking while in the smoke free environment of The Royal Melbourne Hospital, Mr Frank will develop and implement a customised guide to prescribing nicotine replacement therapies (NRT). A range of these drug therapies exist and can improve the chance of successful quitting by reducing the impact of nicotine withdrawal. Frank will deliver education and tools to staff to support correct and consistent prescribing of NRT across the hospital.

NICS-Multiple Sclerosis Research Australia Betty Cuthbert Fellow: Dr Celia Chen

Implementation Project: Optimising the management of acute optic neuritis in people with Multiple Sclerosis

Evidence-Practice Gap: 80% of people with Multiple Sclerosis (MS) will have at least one episode of optic neuritis, an inflammation of the optic nerve, which results in painful loss of vision. Prompt treatment can result in faster recovery and as MS is a chronic disease, patient knowledge and motivation is vital to ensuring optimal management however, suitable information is not always readily available.

Dr Chen will develop and implement information tools about the symptoms and treatment options for optic neuritis, to help ensure people with MS make informed decisions about their care.

NICS Fellow: Dr Nigel Toussaint

Implementation Project: Reducing the risk of cardiovascular disease in people with chronic kidney disease by improving management of bone and mineral disorders

Evidence-Practice Gap:
Chronic kidney disease (CKD) affects approximately 15% of the Australian population. A major consequence of CKD is vascular calcification (calcium deposited in blood vessels) which in turn can lead to cardiovascular disease (CVD), a leading cause of mortality faced by people with CKD.

Disorders of bone and mineral metabolism in people with CKD can lead to this build up of calcium, therefore improved management of mineral disorders is an important step to reducing the burden of CVD.

Guidelines to manage optimal levels of these mineral markers exist but these levels are not routinely achieved. Dr Toussaint will work with health care staff and people with CKD in kidney clinics and dialysis units, to identify barriers to optimal control of mineral metabolism disorders. He will promote improved detection and management of these disorders through an awareness-raising and education program.
   
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