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Trial registered on ANZCTR
Registration number
ACTRN12609000227291
Ethics application status
Approved
Date submitted
18/02/2009
Date registered
5/05/2009
Date last updated
5/07/2012
Type of registration
Retrospectively registered
Titles & IDs
Public title
Caring Safely at Home: Are there differences in confidence and safety for lay cares who need to administer subcutaneous injections to their loved one, depending upon whether the lay carer or someone else prepares the injection.
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Scientific title
Are there differences in confidence and safety for lay carers administering subcutaneous medications to palliative patients dependent upon whether the lay carer, registered nurse or pharmacist prepares the injection.
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Secondary ID [1]
797
0
Nil
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Universal Trial Number (UTN)
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Trial acronym
CS@H
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Symptom control in home based palliative patients
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Condition category
Condition code
Public Health
4474
4474
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0
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Health service research
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Provision of standardised education; Group 1 – Lay carer prepares, labels and stores injections for subsequent administration; Group 2 - Registered nurse prepares, labels and stores injections for subsequent administration by the lay carer.
The visiting registered nurse will deliver the standardised education component face to face, as a one on one session to all lay caregivers participating in the study, occurring once when the need to administer subcutaneous injections becomes apparent. The session is expected to last between 30 – 60 minutes. During this time caregivers will be given the opportunity to prepare and practice giving the injections under the supervision of the registered nurse. The topics covered include: a) how to manage symptoms; b) commonly used medications for symptom control; c) access to medications in the community; and d) Safe storage and disposal of medications. At the completion of the session registered nurses will work through a competency checklist with caregivers.
The standardised education package includes the following resources: a) a DVD “How to prepare and administer a subcutaneous injection”. This DVD demonstrates aspects of subcutaneous injecting and trouble shooting; b) a booklet “Palliative subcutaneous medication administration: a guide for carers”. This booklet covers topics such as frequently asked questions, importance of symptom control, management of common palliative symptoms, commonly used subcutaneous medications and processes of injecting; c) charts – illustrated step by step guides concerning how to prepare and administer subcutaneous injections; d) colour coded medication labels; e) a daily diary to document aspects of care; and f) a practice demonstration kit that includes a cannula and other equipment involved with subcutaneous injections.
Types of injections will depend upon the symptoms displayed by the patient as well as the medications and doses contained within subcutaneous injections.
The trial period is determined by the amount of time the lay carer is required to administer subcutaneous medications up to a maximum of 14 days.
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Intervention code [1]
3974
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Treatment: Other
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Comparator / control treatment
Group 3- Pharmacist control group. Pharmacist prepares, labels and delivers injections to lay carer for subsequent administration as required for symptom management.
The visiting registered nurse will deliver the standardised education component face to face, as a one on one session to all lay caregivers participating in the study, occurring once when the need to administer subcutaneous injections becomes apparent. The session is expected to last between 30 – 60 minutes. During this time caregivers will be given the opportunity to prepare and practice giving the injections under the supervision of the registered nurse. The topics covered include: a) how to manage symptoms; b) commonly used medications for symptom control; c) access to medications in the community; and d) safe storage and disposal of medications. At the completion of the session registered nurses will work through a competency checklist with caregivers.
The standardised education package includes the following resources: a) a DVD “How to prepare and administer a subcutaneous injection”. This DVD demonstrates aspects of subcutaneous injecting and trouble shooting; b) a booklet “Palliative subcutaneous medication administration: a guide for carers”. This booklet covers topics such as frequently asked questions, importance of symptom control, management of common palliative symptoms, commonly used subcutaneous medications and processes of injecting; c) charts – illustrated step by step guides concerning how to prepare and administer subcutaneous injections; d) colour coded medication labels; e) a daily diary to document aspects of care; and f) a practice demonstration kit that includes a cannula and other equipment involved with subcutaneous injections.
Types of injections will depend upon the symptoms displayed by the patient as well as the medications and doses contained within subcutaneous injections.
The trial period is determined by the amount of time the lay carer is required to administer subcutaneous medications up to a maximum of 14 days.
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Control group
Active
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Outcomes
Primary outcome [1]
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Lay carer confidence that injections were well prepared as rated on a 7 point Likert Scale
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Assessment method [1]
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Timepoint [1]
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The trial period is determined by the amount of time the lay carer is required to administer subcutaneous medications up to a maximium of 14 days.
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Secondary outcome [1]
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Lay carer satisfaction with educational process. This will be measure using two lay carer questionnaires. The first will be completed immediately following the delivery of the standardised package. The second will be repeated four weeks after their completion on the trial. The questionnaires will rate the usefulness of the education delivered and resources provided.
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Assessment method [1]
9001
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Timepoint [1]
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Timepoint 1 - at completion of standardised education
Timepoint 2 - Maximium of 6 weeks after commencement of subcutaneous injections.
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Eligibility
Key inclusion criteria
Unpaid lay carers of palliative patients in the home setting who require subcutaneous medications via a subcutaneous cannula.
Able to speak, read, write and understand english language.
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Minimum age
18
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?
Yes
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Key exclusion criteria
Lay carers deemed not competent by the registered nurses to prepare and administer subcutaneous injections.
Paid carers or lay carers with previous experience in administering subcutaneous medications.
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Study design
Purpose of the study
Educational / counselling / training
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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)
Central randomisation by phone, stratified according to proximity to study pharmacist.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation using a randomisation table created by a software system and stratified according to proximity of study pharmacist.
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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
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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
Not yet recruiting
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Date of first participant enrolment
Anticipated
18/02/2009
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
70
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment postcode(s) [1]
1420
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4113
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Recruitment postcode(s) [2]
1421
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4355
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Recruitment postcode(s) [3]
1422
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4350
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Recruitment postcode(s) [4]
1423
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4114
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Recruitment postcode(s) [5]
1424
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4129
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Recruitment postcode(s) [6]
1425
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4131
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Recruitment postcode(s) [7]
1426
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4178
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Recruitment postcode(s) [8]
1427
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4165
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Recruitment postcode(s) [9]
1428
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4064
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Recruitment postcode(s) [10]
1429
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4102
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Recruitment postcode(s) [11]
1430
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4179
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Recruitment postcode(s) [12]
1431
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4108
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Recruitment postcode(s) [13]
1432
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4555
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Recruitment postcode(s) [14]
1433
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4030
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Recruitment postcode(s) [15]
1434
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4169
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Recruitment postcode(s) [16]
1435
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4073
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Recruitment postcode(s) [17]
1436
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4567
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Recruitment postcode(s) [18]
1437
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4551
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Recruitment postcode(s) [19]
1438
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4558
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Recruitment postcode(s) [20]
1439
0
4573
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Funding & Sponsors
Funding source category [1]
4431
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Government body
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Name [1]
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Department of Health & Ageing
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Address [1]
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GPO BOx 9848, Canberra, ACT 2601
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Country [1]
4431
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Australia
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Primary sponsor type
Other Collaborative groups
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Name
Brisbane South Palliative Care Collaborative
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Address
PO Box 4069
Eight Mile Plains Brisbane Queensland 4113
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Country
Australia
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Secondary sponsor category [1]
3992
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None
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Name [1]
3992
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Address [1]
3992
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Country [1]
3992
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Other collaborator category [1]
544
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Government body
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Name [1]
544
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Centre for Palliative Care Research & Education
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Address [1]
544
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Royal Brisbane & Women's Hospital
Block 7, Level 7
Herston Rd
Herston Brisbane Queensland 4006
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Country [1]
544
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
6479
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Princess Alexandra Hospital HumanResearch Ethics Committee
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Ethics committee address [1]
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Level 2 Building 35 Princess Alexandra Hospital Ipswich Rd Woolloongabba Brisbane QLD 4102
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Ethics committee country [1]
6479
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Australia
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Date submitted for ethics approval [1]
6479
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Approval date [1]
6479
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08/08/2008
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Ethics approval number [1]
6479
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2008/155
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Ethics committee name [2]
6480
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St Vincents & Holy Spirit Health Human Research Ethics Committee
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Ethics committee address [2]
6480
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Level 14 IBM Building 348 Edwards St, Brisbane, QLD 4004
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Ethics committee country [2]
6480
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Date submitted for ethics approval [2]
6480
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Approval date [2]
6480
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12/11/2008
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Ethics approval number [2]
6480
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HREC#08/04
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Ethics committee name [3]
6481
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Blue Care Health Human Research Ethics Committee
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Ethics committee address [3]
6481
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PO Box 1539 Milton BC, QLD 4064
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Ethics committee country [3]
6481
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Australia
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Date submitted for ethics approval [3]
6481
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Approval date [3]
6481
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07/10/2008
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Ethics approval number [3]
6481
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Reymond 3808
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Ethics committee name [4]
6482
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Karuna Hospice Service Board
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Ethics committee address [4]
6482
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PO Box 2020 Windsor QLD 4030
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Ethics committee country [4]
6482
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Australia
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Date submitted for ethics approval [4]
6482
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Approval date [4]
6482
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18/09/2008
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Ethics approval number [4]
6482
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N/A
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Ethics committee name [5]
6483
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Cittamani Hospice Service Board
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Ethics committee address [5]
6483
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PO Box 324 Palmwoods QLD 4555
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Ethics committee country [5]
6483
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Australia
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Date submitted for ethics approval [5]
6483
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Approval date [5]
6483
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10/09/2008
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Ethics approval number [5]
6483
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N/A
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Summary
Brief summary
Palliative care services strive to support patients to die within the setting of their choice, usually home, with optimal symptom control and a pattern of care that is supportive of caregivers. Palliative care professionals appreciate that, due to resource constraints, the likelihood of patients remaining symptomatically well managed at home depends upon input from lay carers, usually family members. This study has been designed to evaluate an intervention that supports and educates caregivers to safely and appropriately administer subcutaneous medications for the purpose of symptom control. The study has two components: 1. To implement a standardised education and support package for lay carers living in urban, regional and rural settings within Queensland and to evaluate that package across the domains of content, efficacy, safety and satisfaction. The package will be evaluated using two lay carer questionnaires. The first will be completed immediately following the delivery of the standardised package. The second will be repeated four weeks after their completion on the trial. The questionnaires will rate the usefulness of the education delivered and resources provided. 2. To identify possible differences in outcomes for lay carers, in terms of confidence, safety, satisfaction, and stress measures with the preparation and injection of subcutaneous medications across three different conditions. I. The lay carer prepares, labels and stores daily breakthrough medications for subsequent injection II. A registered nurse prepares and labels daily breakthrough medications for subsequent storage and injection by lay carers III. A clinical trial pharmacist prepares and labels daily breakthrough medications for subsequent storage and injection by lay carers. Differences in outcomes will be measured using surveys and Likert scales and statistically analysed. In addition, caregivers will be invited to record their experience in a daily diary.
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Trial website
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Trial related presentations / publications
Israel, F., Reymond, L., Charles, M., Healy, S. Caring Safely at Home: Development of a Palliative Medications Education Program for Lay Caregivers 7th Palliative Care Congress, April 29th - May 1st 2008, Glasgow Healy, S., Reymond, L., Israel, F. Development of Guidelines for the Handling of Medications in Community Based Palliative Care Services in Queensland Advancing Key Initiatives in Cancer Care Forum, 14th & 15th May 2008, Brisbane
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Public notes
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Contacts
Principal investigator
Name
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Address
29232
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Country
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Phone
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Fax
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Email
29232
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Contact person for public queries
Name
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Sue Healy
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Address
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Brisbane South Palliative Care Collaborative
PO Box 4069
Eight Mile Plains Brisbane Queensland 4069
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Country
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Australia
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Phone
12479
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+ 61 7 3169 9876
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Fax
12479
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+ 61 7 3169 9885
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Email
12479
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[email protected]
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Contact person for scientific queries
Name
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A/Prof Liz Reymond
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Address
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Brisbane South Palliative Care Collaborative
PO Box 4069
Eight Mile Plains Brisbane Queensland 4069
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Country
3407
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Australia
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Phone
3407
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+61 7 3169 9867
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Fax
3407
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+61 7 3169 9885
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Email
3407
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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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