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Trial registered on ANZCTR
Registration number
ACTRN12612001149853
Ethics application status
Approved
Date submitted
29/10/2012
Date registered
31/10/2012
Date last updated
7/03/2016
Type of registration
Prospectively registered
Titles & IDs
Public title
A randomised controlled trial of MAXCOG (MAXimising COGnition in Preclinical and Early Dementia): an individualised early intervention program for people with Mild Cognitive Impairment or early dementia and their family supporters
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Scientific title
A randomised controlled trial of MAXCOG (MAXimising COGnition in Preclinical and Early Dementia: an individualised early intervention program for people with Mild Cognitive Impairment or early dementia and their family supporters) versus Usual Care to assess the efficacy of MAXCOG to improve occupational performance problems relating to self-care, productivity, and leisure (measured by the Canadian Occupational Performance Measure (COPM)
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Secondary ID [1]
281458
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Nil
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Universal Trial Number (UTN)
Nil
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Trial acronym
MAXCOG RCT
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Mild Cognitive Impairment
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Early Dementia
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Condition category
Condition code
Neurological
288057
288057
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0
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Dementias
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Mental Health
288070
288070
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0
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Studies of normal psychology, cognitive function and behaviour
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This semi-tailored intervention is designed to deliver psycho-education and counselling to clients with MCI or early dementia and their primary caregivers in the weeks following diagnosis. The objective of the intervention is to teach a range of new strategies to help manage cognitive impairment in daily life.
The content will be based on a set of information handouts recently developed by our project team at La Trobe University and Kingston Centre (www.latrobe.edu.au/aipca/projects/mci). An adapted problem solving approach will be adopted in which clients and caregivers will be encouraged to participate in the process of developing the goals for the therapy, and finding the most appropriate strategies to manage cognitive impairment in their day-to-day lives.
Session will be face-to-face with the client and their primary caregiver, administered by an Alzheimer's Australia counsellor;
Duration/frequency of the intervention: 1 hour session administered weekly for 4 weeks.
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Intervention code [1]
285961
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Treatment: Other
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Intervention code [2]
285974
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Behaviour
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Comparator / control treatment
Usual care consists of careful assessment and provision of a diagnosis. At the Cognitive, Dementia and Memory Service (CDAMS) final feedback session efforts are made to provide recommendations and written materials to support clients and their family supporters to manage cognitive difficulties and to link them into community-based services.
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Control group
Active
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Outcomes
Primary outcome [1]
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Canadian Occupational Performance Measure (COPM)[Detection of occupational performance problems relating to self-care, productivity, and leisure]. CLIENT & CAREGIVER.
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Assessment method [1]
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Timepoint [1]
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6 weeks post-baseline (=2 weeks post-intervention)
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Secondary outcome [1]
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Illness Cognition Questionnaire [Adjustment to the experience of chronic illness]. CLIENT.
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Assessment method [1]
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Timepoint [1]
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6 weeks post-baseline (=2 weeks post-intervention)
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Secondary outcome [2]
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Knowledge of cognitive strategies adaptation of Troyer (2001) [Knowledge of strategies]. CLIENT & CAREGIVER.
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Assessment method [2]
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Timepoint [2]
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6 weeks post-baseline (=2 weeks post-intervention)
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Secondary outcome [3]
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Multifactorial Metacognition Questionnaire an adaptation of Troyer and Rich (2002) [Use of cognitive strategies described on the handouts given to clients]. CLIENT & CAREGIVER.
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Assessment method [3]
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Timepoint [3]
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6 weeks post-baseline (=2 weeks post-intervention)
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Secondary outcome [4]
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Health-related quality of life for people with dementia: DEMQoL [HRQoL in dementia (emotion, memory and quality of life)]. CLIENT.
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Assessment method [4]
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Timepoint [4]
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6 weeks post-baseline (=2 weeks post-intervention)
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Secondary outcome [5]
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Zarit Carer Burden Scale Short Version [Carer-reported burden]. CAREGIVER.
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Assessment method [5]
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Timepoint [5]
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6 weeks post-baseline (=2 weeks post-intervention)
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Secondary outcome [6]
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DEMQoL-Proxy [HRQoL in dementia (emotion, memory and quality of life) - proxy-rated]. CAREGIVER.
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Assessment method [6]
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Timepoint [6]
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6 weeks post-baseline (=2 weeks post-intervention)
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Secondary outcome [7]
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Revised Memory and Behaviour Checklist [Caregivers' ratings of the clients' cognitive and behavioural difficulties and the impact]. CAREGIVER.
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Assessment method [7]
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Timepoint [7]
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6 weeks post-baseline (=2 weeks post-intervention)
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Secondary outcome [8]
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Depression Anxiety Stress Scales (DASS) [Depression, anxiety and stress (caregiver)]. CAREGIVER.
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Assessment method [8]
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Timepoint [8]
299726
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6 weeks post-baseline (=2 weeks post-intervention)
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Secondary outcome [9]
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Geriatric Depression Scale [Depression]. CLIENT.
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Assessment method [9]
299727
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Timepoint [9]
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6 weeks post-baseline (=2 weeks post-intervention)
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Secondary outcome [10]
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Open questions and ratings about their experience of the counselling and knowledge of the strategies and use of community services during the counselling period. CLIENT & CAREGIVER.
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Assessment method [10]
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Timepoint [10]
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6 weeks post-baseline (=2 weeks post-intervention)
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Eligibility
Key inclusion criteria
Community-dwelling clients with a recent (i.e., less than or equal to 6 months) clinical diagnosis of MCI or early dementia (any type); fluent in English; age greater than or equal to 50 years; Mini–mental state examination (MMSE) score greater than or equal to 20; and a primary caregiver with close contact to the client willing to participate in the study and the intervention.
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Minimum age
50
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Clients with severe somatic or psychiatric comorbidity, or impaired hearing or vision (which would impair their ability to complete the intervention). Clients already involved in other counselling or cognitive rehabilitation programs.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Consecutive clients and primary caregivers eligible for the study will be approached at their CDAMS feedback session (i.e., the final session provided by the clinic in which a diagnosis is provided as well as assistance with ongoing management and links to community-based services). If interested, CDAMS key workers will provide information about the study and obtain written informed consent from the client and primary caregiver. One to two weeks after the feedback session, baseline data will be collected (in person) by a MONARC researcher. Following baseline data collection, participants will be randomly allocated to the MAXCOG intervention or usual care by a person not involved in data collection (the MONARC researcher responsible for data collection will be blind to group allocation). The MONARC researcher will collect follow up data two weeks post-intervention (via telephone). (Ideally we would also undertake longer-term follow up; we will seek additional funding for further follow up data collection). Losses to follow up will be minimised and data quality maximised by collecting follow up data via telephone (rather than mail). Attrition will be monitored and reasons for withdrawal will be recorded.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
We will use a central allocation process to randomize participants, using a computer programme and a random block size algorithm to prevent imbalance between the allocation groups - stratified by MMSE score (20–23; 24–30), diagnosis (MCI; early dementia), and use/non-use of anti-dementia drugs.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
Nil
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
15/04/2013
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Actual
16/10/2013
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Date of last participant enrolment
Anticipated
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Actual
24/09/2014
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
56
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Accrual to date
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Final
40
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment postcode(s) [1]
5903
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3192
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Recruitment postcode(s) [2]
5904
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3930
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Recruitment postcode(s) [3]
5905
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3162
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Funding & Sponsors
Funding source category [1]
286228
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Charities/Societies/Foundations
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Name [1]
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Alzheimer's Australia - Victoria (Alzheimer's Australia Dementia Research Foundation)
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Address [1]
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1 Frewin Place
Scullin
ACT, 2614
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Country [1]
286228
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Australia
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Primary sponsor type
University
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Name
Monash University
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Address
Monash University
Victoria 3800
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
285037
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Address [1]
285037
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Country [1]
285037
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Southern Health HREC A
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Ethics committee address [1]
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Research Directorate Level 4, Main Block, Monash Medical Centre 246 Clayton Road CLAYTON VIC 3168
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Ethics committee country [1]
288296
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Australia
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Date submitted for ethics approval [1]
288296
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21/11/2012
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Approval date [1]
288296
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13/02/2013
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Ethics approval number [1]
288296
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Summary
Brief summary
Currently few services aim to support people in the community who are experiencing mild cognitive difficulties or who have early dementia. However, the experience of cognitive difficulties and worry about the future can be very stressful for the person and their close family members; and may make everyday tasks, such as interacting in a group or managing finances, much more difficult. In this project we will develop and evaluate a new face-to-face psycho-educational and counselling program for people with cognitive difficulties and their close family members. The aim of the intervention is to help people implement practical strategies to manage cognitive difficulties in their day-to-day life. By increasing strategy use, we also hope to reduce the anxiety and depression that people with mild cognitive difficulties and their family members can experience. We will evaluate our counselling program by comparing the outcomes for people who undergo the program with those of a comparison group who receive service as usual (a randomised controlled trial).
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Trial website
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Trial related presentations / publications
Ryburn B, Varanelli L, Wells Y. How Helpful are our handouts? An evaluation of information handouts for clients with MCI and their family members. International Neuropsychological Society Mid Year Meeting / ASSBI 4th Pacific Rim Conference. J Int Neuropsych Soc 2011;17(S2):46 [Abstract].
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Public notes
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Contacts
Principal investigator
Name
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Dr Bridget Regan
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Address
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c/o Medical Admin, Kingston Centre, Warrigal Road, Cheltenham, Vic 3192
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Country
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Australia
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Phone
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+61 3 9265 1268
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Dr Bridget Regan
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Address
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c/- Medical Admin
Kingston Centre
Warrigal Rd
Cheltenham Vic 3192
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Country
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Australia
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Phone
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+61 3 9265 1268
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr Bridget Regan
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Address
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c/- Medical Admin
Kingston Centre
Warrigal Rd
Cheltenham Vic 3192
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Country
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Australia
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Phone
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+61 3 9265 1268
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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