Braeside Hospital part of pain drug research with international impact

HammondCare’s Braeside Hospital was one of eight research sites to participate in a landmark national study that found the drug ketamine - widely used to treat pain related to cancer - has no clinical benefit.

The national study involved 185 patients with advanced cancer, 93 of whom received the drug ketamine while the other 92 received a placebo. The results, published in the prestigious international Journal of Clinical Oncology, not only showed identical benefit between the two groups but revealed significantly higher rates of toxicity and other side-effects for those receiving ketamine.

A/Prof Meera Agar, Director of Palliative Care at Braeside, was part of the study investigator team led by Prof Janet Hardy and was involved in initial design of the study and interpretation of findings. Researchers including A/Prof Agar are part of the Palliative Care Clinical Studies Collaborative (PaCCSC) based at Flinders University. She is also Chair of its trials management committee.

Chief Investigator and Professor of Palliative and Supportive Services, David Currow, said the results of the study have highlighted the potential harm that can be caused by prescribing “off label” – that is, using drugs in ways other than originally intended – without adequate trials.

“The role of ketamine in routine clinical care for chronic, complex cancer pain is not in any way supported by this study. The result is resoundingly negative,” Professor Currow said.

Professor Currow said that “robust data” were needed to inform the care of people with advanced life limiting illnesses.

“These people deserve exactly the same quality of care that anyone else gets in the health system. In fact, they’re more at risk than anyone else of adverse outcomes,” he said.

Excellent research can be done in palliative care setting

A/Prof Agar agreed, saying publication of the study demonstrates that excellent research which directly impacts on clinical care can be done in the palliative care setting.

“It’s a testament to the organisational support we receive to participate in such endeavours,” A/Prof Agar said. “The results will be of international significance and the challenge now will be to put this new evidence into practice.

“When research is conducted within clinical services the ability to respond with practice change in a timely fashion is enhanced and we are working with the palliative care services across HammondCare to ensure these results are widely known and inform our practice.

“I also would like to acknowledge our three clinical trials nurses who supported and provided care for every individual participant we put on trial.

“And also our wonderful pharmacy team who in conjunction with Liverpool Pharmacy ensured we had correct procedures in place for a S8 clinical trial and access to study medication when the patients needed it,” A/Prof Agar said.

This study is the first to be published by PaCCSC, which is funded under the national Palliative Care Program and supported by the Australian Government Department of Health and Ageing, to test the effectiveness of various medications in order to improve symptom management and quality of care in patients living with a terminal illness.

Other research currently underway includes the world’s largest study on the use of anti-psychotic medications to treat acute confusion, or delirium. Braeside Hospital also has significant involvement in this study.

In 2011 A/Prof Meera Agar received Palliative Care NSW's Significance in Research Award and the Premier’s $20,000 Innovation in Cancer Clinical Trials.