Palliative Care

A selection of current palliative and supportive care research projects, including a number of active clinical trials. Scroll down further to see completed projects. Several projects that integrate palliative care with end-of-life dementia care appear in the Dementia and Aged Care research listings. 

Current Projects

Randomised control trial of oral risperidone, oral haloperidol, and oral placebo with rescue subcutaneous midazolam in the management of delirium in palliative care inpatients

This project is a phase III clinical trial which seeks to compare the effectiveness and toxicity of oral risperidone and oral haloperidol in the management of palliative care patients with delirium. This is a national collaborative project , currently being undertaken at HammondCare’s Braeside Hospital, and is funded by the Palliative Care Clinical Studies Collaborative.

Randomised, double blind control trial of megestrol acetate, dexamethasone and placebo in the management of anorexia in people with cancer

This clinical trial aims to compare the ability of megestrol acetate and dexamethasone to produce short-term appetite stimulation and quality of life enhancement in people with advanced cancer receiving palliative care. This is a national collaborative project, currently being conducted at HammondCare’s Greenwich and Braeside Hospitals, and is funded by the Palliative Care Clinical Studies Collaborative.

A randomised double-blind multi-site fixed dose controlled cross-over trial comparing morphine, oxycodone and placebo for the relief of refractory breathlessness

This clinical trial aims to evaluate the efficacy of opioids in the treatment of dyspnoea (shortness of breath) in people with a life limiting illness. This is a national collaborative project, currently being undertaken at HammondCare’s Braeside Hospital, and is funded by the Palliative Care Clinical Studies Collaborative.

A two-stage trial of anti-emetic therapy in patients with cancer and nausea not related to anticancer therapy

This clinical trial is aimed at evaluating the efficacy of an aetiology-based antiemetic guideline for the management of nausea. Anti-emetic drugs are typically administered to control and manage symptoms such as nausea and vomiting. The first stage of the trial will compare the outcomes of patients who are managed using a single agent therapy (haloperidol). Participants with resistant nausea may enter the second stage of the trial which trials the use of two novel antiemetics. This is a national collaborative project, currently being undertaken at HammondCare’s Braeside Hospital, and is funded by the Palliative Care Clinical Studies Collaborative.

A randomised double-blinded multi-site parallel arm controlled trial to assess relief of refractory breathlessness comparing oral sertraline and placebo

This clinical trial tests the efficacy of sertraline compared with placebo in relieving the sensation of intractable breathlessness. The study also aims to determine if sertraline improves quality of life, reduces dyspnoea-related anxiety and depression, adverse effects and improves breathing function. This is a national collaborative project, currently being undertaken at HammondCare’s Braeside Hospital, and is funded by the Palliative Care Clinical Studies Collaborative.

Rapid report pharmacovigilance program

This study is investigating the adverse side effects associated with the use of common medications used by palliative care patients. HammondCare'a Braeside and Greenwich Hospitals are currently participating in this national project, coordinated by the Palliative Care Clinical Studies Collaborative.

Exploring attitudes, behaviours, perceptions and personal challenges faced by allied health students in palliative care clinical placements

Palliative care is an especially difficult area for students to undertake a placement due to the high level of grief and loss encountered. This HammondCare project aims to identify the attitudes, behaviours, perceptions and personal challenges faced by allied health students understand clinical placements in the palliative care setting and to provide suggestions to prepare students for a palliative care clinical placement.

Management of Constipation in Palliative Care

This project examines the diagnosis and management of the constipation symptom among palliative care patients. Key objectives of this project include developing an approach to constipation that enables the underlying problems to be quantified in palliative care patients using well-tolerated and validated diagnostic methods and comparing whether patient outcomes are affected if a mechanistic approach to assessment and treatment is used. This is a national collaborative project, currently being conducted at HammondCare’s Greenwich and Braeside Hospitals, and is funded by the Palliative Care Clinical Studies Collaborative.

STOP PAIN

Evidence suggests that the implementation of evidence-based guidelines for pain can improve outcomes for people with cancer-related pain. However, the 2010 National Pain Summit’s Cancer Pain and Palliative Care Working Group found that no guidelines have been widely adopted for cancer pain in Australia. Clinical pathways that give precise instructions on how to implement guidelines along with a framework for evaluation have proven useful in international studies. Using environmental scanning and clinical process mapping, this project assesses barriers and facilitators to pain assessment and management and will test the feasibility of a dual clinical pathway that involves physicians and nurses as well as patients and their families in managing pain. This is a collaborative project between the University of Technology Sydney and HammondCare and is being funded by a UTS Partnership Grant

Self- reported evaluation of the adverse effects of Dexamethasone (SEED)

This multisite study aims to assess the feasibility of patient reported outcomes in the evaluation of dexamethasone use in patients with brain tumours, brain metastases or advanced cancer. The primary aim of the study is to assess feasibility and face validity of the revised version of the Dexamethasone Symptom Questionnaire Chronic, both as a self reported measure and as a caregiver proxy report, and to generate pilot data and information on the incidence and severity of symptoms and side effects that may be due to dexamethasone. The study will also assess the incidence of clinician-rated side effects that may be attributable to dexamethasone. HammondCare’s Braeside and Greenwich Hospitals are currently participating in this collaborative national project, coordinated by the Palliative Care Clinical Studies Collaborative.

A double-blind, placebo-controlled cross-over study of the effect of corticosteroids on sleep quality – a pilot study in patients with advanced cancer

Corticosteriods, such as dexamethasone, are widely used in oncology and palliative care to manage symptoms such as pain, fatigue, dyspnoea, nausea and anorexia. However, a well documented side-effect of corticosteroids is restlessness and agitation, often resulting in sleep disturbance. In this collaborative national study, researchers examine whether the effect of the timing of the administration of dexamethasone affects sleep quality. This project is currently being conducted at HammondCare’s Greenwich and Braeside Hospitals.

Efficacy of elastic compression stockings in treatment of chronic oedema in palliative care patients

Chronic oedema (fluid retention, swelling) is prevalent among palliative care patients and is associated with significant and distressing symptomatology and reduced patient mobility. This HammondCare study investigates whether the use of a compression garments is of benefit for patients with chronic oedema. This study is currently being undertaken at HammondCare’s Braeside Hospital.

Spiritual needs of patients and the role of doctors in identifying them

This study examines the nature of spirituality for Australian patients and their preferences with regards to discussing spirituality with healthcare providers. Data will be collected using qualitative techniques and analysed using interpretative phenomenological analysis. Both HammondCare’s Greenwich and Braeside Hospitals are participating in this multi-site research.

The measurement of function limited by breathlessness in advanced cancer

The measurement of function limited by breathlessness in advanced cancer In this project functional assessments are undertaken to determine the extent patients with advanced cancer are affected by symptomatic breathlessness. HammondCare’s Braeside Hospital is currently participating in this multi-site project, coordinated by Prince of Wales Hospitals, Randwick.

The impact of constipation on health related quality of life for advanced cancer patients

Constipation is a common and distressing problem for many people receiving specialist palliative care however there is little data that objectively reports on constipation negatively affecting quality of life for these patients. This study aims to establish this evidence base and determine whether constipation has any impact on quality of life. This is a multi-site study being led by the Calvary Mater Hospital, Newcastle and is currently being undertaken at HammondCare’s Braeside Hospital.

Phase and palliative care problem severity score reliability and acceptability

HammondCare’s Greenwich and Neringah Hospitals are currently involved in this national project, coordinated by the Palliative Care Outcomes Collaborative. This research examines the inter-rata biases and user acceptability of current palliative care assessment tools.

Pilot evaluation of a new clinical pathway for the assessment and management of pain in people with cancer

This pilot study will evaluate the feasibility, utility and acceptability of a clinician-mediated and a patient/family-mediated pain management pathway for people with cancer pain. This multi-site research also aims to illuminate the prevalence of and relationships pain, breathlessness and distress in patients with cancer of different types and stages. This project is coordinated by HammondCare and is funded by an investigated-initiated grant obtained from Pfizer Australia.

Completed Projects

A pilot study of Australian Palliative Care patients using a tool to address spiritual and existential distress

This study involved piloting a previously developed end-of-life intervention that has been designed to help address spiritual and existential distress experienced by people with advanced life-limiting illness. In this current project, the feasibility and acceptability of the tool in an Australian palliative care population was evaluated. To read more about this HammondCare project, click here.

Experiences of a palliative care day hospital: A qualitative study of patients’ perspectives

This project aimed to explore the experiences of patients attending an Australian palliative care day hospital and their views on the outcomes of the care provided. The study took place at HammondCare's Northern Beaches Palliative and Supportive Care Service. It used a symbolic interactionist approach to enhance interpretation of the subjective meaning of the data.

A palliative approach for people with declining health living in hostel accommodation: the state of play

Residential aged care facilities are increasingly the place of care and of death for people with complex chronic illnesses, making a palliative approach to care relevant. This study sought to identify the extent to which a palliative approach is being incorporated into the care of high-level care residents in hostel settings in NSW including any knowledge gaps, barriers and unmet needs. The study also explored the experiences of residents and their families, including their perceptions of how appropriately their needs were being met. The knowledge gained will benefit planning for future strategies, enhance the quality of care for an ageing population and the experiences of staff providing their care.

Safe Healing Environments

This research explored how healthcare spaces can enhance safety and healing for dying patients, their families and healthcare staff. This study is part of a larger Australian Research Council Discovery funded project ‘Examining organisational complexity and clinical risk to improve patient safety’ undertaken by the University of Technology, Sydney and involved Braeside Hospital.

HammondCare Collaborations

Improving Palliative Care through Clinical Trials (ImPACCT)
ImPaCCT’s mission is to improve NSW palliative care services for people with advanced cancer and other life limiting illness through ethical, scientifically rigorous, collaborative research. HammondCare is an active participant in this collaborative, with our researchers involved in its ongoing work.

Links: For more information about ImPACCT please click here.