Clinic Helps Aussies Catch Their Breath

Breathlessness – that frightening feeling when you can’t get enough air into your lungs – is one of the most common reasons Australians call an ambulance.

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While the problem lands thousands in hospital emergency departments every year, too few people are able to get their breathlessness problem resolved quickly, respiratory specialists warn.

Woolcock Institute of Medical Research in Sydney has launched a Breathlessness Clinic to fast track diagnosis and treatment for the many people suffering from this worrying, anxiety-inducing complaint. “The problem is breathlessness can be a very challenging clinical problem,” explains Woolcock respiratory physician Dr Tracy Smith. “The heart, lungs, muscles and the brain can all be involved, making the cause a tricky puzzle to solve.”

Breathless patients are often referred to a respiratory physician or a cardiologist first, only to be sent to the other specialist later, she says. “This process can be time-consuming and frustrating for all involved,” Dr Smith says. On top of this, treatment recommendations for conditions which can lead to breathlessness are constantly changing, and there are few clinical guidelines to help specialists manage problems which affect more than one organ system, for instance patients with both heart AND lung disease.

The Woolcock Breathlessness Clinic seeks to solve this problem with a new and innovative model of care. The multispecialty approach will see patients see a cardiologist and a respiratory physician at the same time to allow rapid, comprehensive assessment.

“We’re creating the state’s first one-stop-shop for breathlessness, promising to investigate, diagnose and treat all patients under one roof and in a timely fashion,” Dr Smith says. “We’ll collaborate closely with GPs to ensure they are kept informed about the patient’s assessment and treatment recommendations.”

Getting breathless when walking up a steep hill or running is normal, however when you get more out-of-breath than expected for the amount of exercise you have done, it can suggest a medical problem.

“Getting out of breath when you don’t expect to be puffed out can be a frightening experience,” Dr Smith says. “It can also be embarrassing and stops many people from doing exercise, which can actually make the problem worse. There’s also a perception among many people that breathlessness is part of getting older and not something a doctor can help with.”

The problem, known in clinical circles as dyspnoea, has many potential causes. “For people with irregular bouts of breathlessness it could be a flare-up of a long-standing lung disease, like asthma,” explains the clinic’s chief cardiologist Professor Len Kritharides.

“There’s also the chance it’s linked to a heart condition such as coronary disease or an abnormal heart rhythm, which is why I get involved,” Professor Kritharides says. For those with daily, long-term breathlessness, it may be caused by a range of lung, heart or muscle conditions, obesity, poor fitness or a combination of things.

“Understanding the problem is the essential first step to treatment,” Professor Kritharides says. “We hope that we can help patients identify their treatment options as quickly as possible and help them live a better, healthier, more active life.”

The Woolcock Breathlessness Clinic is for patients who have been breathless for more than four weeks despite treatment by their GP. Patients must be referred by their doctor.

Nicotine Addiction & Smoking Cessation Update Day

 

We have secured a number of notable speakers to present at our Nicotine Addiction and Smoking Cessation Update Day on 21 November 2017, 9am - 5pm.

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One of the highlights of the day will feature a group of medical experts from a range of clinical specialties presenting both their views and the evidence around the pros and cons of vaping. This will conclude with a panel discussion and the opportunity to ask questions. Full program to follow.

Date: 21 November 2017

Registration fee: $120 ($100 for AASCP members)

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Location:
Woolcock Institute of Medical Research
431 Glebe Point Road, Glebe NSW 2037

Wake-Up Drug May Get Insomniacs Snoozing

AS SEEN ON CHANNEL 9 NEWS: 

A drug used to keep narcoleptics awake may also help insomniacs sleep better, Sydney researchers hope.

Scientists at the Woolcock Institute of Medical Research are investigating whether a popular wakefulness drug could be used to make an important insomnia treatment, sleep restriction therapy, more effective. The trial, a world-first, could hand Australia’s 1.5 million insomniacs a better, more appealing treatment plan to get them snoozing through the night.

“Sleep restriction therapy is one of the best treatments we have for people with insomnia but sadly the side effects – extreme daytime sleepiness – make it difficult for patients to stick to,” explains Study Doctor and Sleep Specialist Daniel Judge. “If we can show that using a wakefulness-promoting drug in the day improves side effects of sleep restriction therapy then the treatment will become far easier for patients to use.”

Studies estimate 13 to 33 per cent of the adult population have insomnia, defined as difficulty falling asleep, staying asleep, or both.[1] Sedatives are the most common treatment but they should only be used short term and may not treat the underlying cause of the condition.

Delivered by a sleep psychologist, sleep restriction therapy (SRT) is a non-drug option in which time in bed is restricted each night. The partial sleep deprivation makes you more tired the next night, setting you up for a deeper sleep which is gradually lengthened as the therapy progresses.

“The concept of reducing sleep in order to increase it might seem absurd but studies show it’s actually just as effective as sleeping tablets at getting you sleeping better,” Dr Judge says. “The trouble is you feel so groggy and sleepy during the day that so many people drop out of treatment before they see the benefits.”

The Woolcock team is enlisting 30 people with insomnia to trial the therapy alongside the drug armodafinil, marketed as Nuvigil, which is approved in Australia to treat patients with excessive sleepiness associated with narcolepsy, obstructive sleep apnea or shift work disorder.

“If it works to keep these patients awake during the day then we’re hoping it will have the same alerting effect on people with insomnia, ultimately making it easier for them to recover from their condition,” Dr Judge says.

Volunteers will take the drug daily over four weeks alongside sleep restriction therapy. Sleep diaries and actiwatches will be used to monitor sleep and track progress.

It is not a placebo-controlled trial so all participants will receive the active drug. If results are positive, the Woolcock will run a much larger study before specialists could consider widespread use of armodafinil for insomnia, Dr Yee says.

If you are an insomnia patient seeking treatment, contact the study coordinator Parisa Hassan on (02) 9114 0469, email woolcock.moderate@sydney.edu.au, or visit https://woolcock.org.au/new-2/do-you-have-insomnia-2 to register your interest.

Woolcock Wins $2.2M Grant to Support Asthma Battlers

Australians living with poorly controlled asthma will get a boost from their local pharmacist thanks to a $2.2million grant that backs an innovative Woolcock initiative. 

The Federal Government has announced it will fund a new Pharmacy Asthma Service trial that targets patients most at risk of dangerous asthma flair-ups.

The Woolcock Institute of Medical Research will establish the service in partnership with University of Sydney, Curtin University, University of Tasmania, National Asthma Council,  Asthma Australia, Pharmacy Guild of Australia, Pharmaceutical Society of Australia and The George Institute.

Woolcock Executive Director Professor Carol Armour says the service offers a unique opportunity to get asthma under control in the community. “We’ll be focused squarely on that at-risk group of patients that carry the highest burden of disease and are most likely to wind up in emergency departments with out-of control asthma symptoms,” Professor Armour says. “Under this new model, community pharmacists working at the coal face will be skilled up to identify these patients, find out why their asthma is poorly controlled and help them manage their condition.”

The pharmacists will support these at-risk patients with three private consultations over 12 months to make sure they don’t keep falling through the cracks. “Central to this support is ensuring they’re taking their medication regularly, using their inhaler correctly, and checking their hay fever to see if it could be exacerbating their asthma,” Professor Armour says. Those patients with complex issues or unknown causes will be referred to their GP.

If the trial proves successful the consortium hope to roll out the trial to more communities across Australia.

The grant, entitled Getting Asthma Under Control Using the Skills of the Community Pharmacist, will be funded to the tune of $2,199,100 over two years. It was announced by the Federal Minister for Health Greg Hunt at the Pharmaceutical Society of Australia Conference in Sydney on July 28.