Palliative Care
The Barwon Health Palliative Care Research Group aims to improve quality of life for patients by conducting research into commonly experienced palliative care symptoms such as pain, cancer cachexia, nausea, loss of appetite, breathlessness and delirium. Research is embedded into every aspect of our service delivery, and our team is committed to undertaking and facilitating quality research.
As a member of the national Palliative Care Clinical Studies Collaborative (PaCCSC) and Cancer Symptoms Trials (CST) Group Barwon Health has been a research site for pivotal multi-centre studies that have triggered the re-evaluation of commonly used symptom management approaches for people with life-limiting diseases. Additionally the unit has worked hard to build and foster a research culture within the multi-disciplinary palliative care department and has supported the planning and implementation of a wide range of investigator-led projects through the Palliative Care Research Group.
We have also been involved in international pharmaceutical industry trials for cancer cachexia and have ongoing research into this debilitating condition through our Cachexia clinic.
Research Areas
COPD and Interstitial lung disease
Protocol title: BETTER-B (AUS) - BETter TreatmEnts for ChRonic Breathlessness (Australia) An International, Multicentre, Randomised Controlled Pragmatic Trial of Mirtazapine to alleviate Breathlessness in Palliative and End of Life Care (Australian Arm)
Study population: People diagnosed with Chronic Obstructive Pulmonary Disease (COPD) and/or Interstitial lung disease (ILD) AND breathlessness Grade 3 or 4 on the Modified MRC breathlessness scale.
Oral Mirtazapine/Placebo.
Cachexia research
An ongoing research initiative of the Cachexia and Nutrition Support Service data.
Cancer cachexia is a debilitating condition of tissue wasting affecting 50% of cancer patients. It results in loss of weight and muscle and therefore loss of functional ability.
Barwon Health runs a unique cancer cachexia clinic and data from this clinic is routinely collected and used for ongoing research. There are currently multiple research projects in progress and/or recently published.
Palliative care service delivery
- Life stories: Evaluating the Life Stories program for Community Palliative Care from a patient and carer perspective.
- GBM PCU: Outcomes in palliative glioblastoma.
- Life stories-volunteer experience: Telling it like it is: The volunteer experience of the Life Story process from the perspective of interviewer and transcriber.
A retrospective comparison of outcomes for patients with glioblastoma compared to non small cell lung cancer admitted to the palliative care unit
GBM (glioblastoma mulitforme) in an uncommon and incurable disease with a mortality similar to other incurable malignancies (Tran 2010) such as advanced lung cancer. There are no previous studies comparing patients with glioblastoma (GBM) and those with metastatic non-small cell lung cancer (NSCLC) admitted to the palliative care unit.
A comparison of these groups will help to identify similarities and differences between patients with GBM and those with a more common palliative care disease presentation. This may help clinicians when making decisions regarding type and venue of care for patients with GBM and how they may fit within the current care model.
Timing of palliative care referral for patients with advanced lung cancer in the immunotherapy era
This project seeks to explore the utilisation of palliative care services during the era of immunotherapy for patients with advanced non-small cell lung cancer. This project will also consider the palliative care phase and symptom burden of referred patients at the time of first specialist palliative care assessment, and the duration and type of ongoing specialist palliative care involvement.
The goals are to establish an increased understanding of current practice, compared to previous reported trials in the cytotoxic chemotherapy era; and to facilitate care delivery and workforce planning into the future.
Collaborating Organisations
PaCCSC | The Australasian Lung Cancer Trials Group | Deakin University | |
Regional Trials Network Victoria | CST |
Research Team
Research Staff
- Peter Eastman, Palliative Care Consultant, Co-head of Department
- Anna Dowd, Clinical Trial Coordinator and Chair of The Palliative Care Research Group
- Meg Harrison, Nurse Practitioner, MPhil Candidate, Deakin School Of Medicine
Featured Publications
Dowd A, Davies M, Short S, Morrison R, Spiller C, Carter J, Eastman P. Dying at home: enablers and barriers. Internal Journal of Palliative Nursing. 2023: Published Online:21 Jul 2023. https://doi.org/10.12968/ijpn.2023.29.7.326 |
Wong AK, Hawke J, Eastman P, Buizen L, Le B. Does cancer type and adjuvant analgesic prescribing influence opioid dose?-a retrospective cross-sectional study. Annals of Palliative Medicine. 2023 Apr 10:apm-22. |
Eastman P, Dowd A, White J, Carter J, Ely M. Telehealth: rapid adoption in community palliative care due to COVID-19: patient and professional evaluation. BMJ Supportive & Palliative Care. 2021 Jun 22. |
Bland K, Harrison M, Zopf E, Sousa M, Currow D, Ely M et al. Quality of Life and Symptom Burden Improve in Patients Attending a Multidisciplinary Clinical Service for Cancer Cachexia: A Retrospective Observational Review. Journal of Pain and Symptom Management 2021. DOI: 10.1016/J.JPAINSYNMAN.2021.02.034 |
Vaughan VC, Harrison M, Dowd A, Eastman P, Martin P. Evaluation of a Multidisciplinary Cachexia and Nutrition Support Service—The Patient and Carers Perspective. Journal of Patient Experience 2021 Jan 13;8:2374373520981476. |
Currow DC, Glare P, Louw S, Martin P, Clark K, Fazekas B, Agar MR. A randomised, double blind, placebo-controlled trial of megestrol acetate or dexamethasone in treating symptomatic anorexia in people with advanced cancer. Scientific Reports. 2021 11:2421. |
Politis J, Eastman P, Le B, Furler J, Irving L, Smallwood N. Managing Severe Chronic Breathlessness in Chronic Obstructive Pulmonary Disease Is Challenging for General Practitioners. Am J Hosp Pall Med 2020. Published online Sept 17. |
Eastman P, Le B, Ko D. Challenges in advance care planning: the interface between explicit instructional directives and palliative care. Med J Aust 2020;213(2):67-8 |
Rajadorai S, Eastman P. Subcutaneous antiepileptic agents for the prevention and management of seizures in the deteriorating and dying patient: Identifying palliative care clinicians’ experiences and current practice. ANZSPM Newsletter 2020;32(1):6 |
Bland A, Zopf E , Harrison M, Ely M, Dowd A, Cormie P, Martin P. Clinically-Measured Muscular Strength Predicts Quality of Life And Symptom Burden In Patients with Cancer Cachexia. Medicine & Science in Sports & Exercise. 2020. WOSUID: WOS:00590026303281. |
Bland KA, Zopf EM, Harrison M, Ely M, Cormie P, Liu E, Dowd A & Martin P. Prognostic markers of overall survival in cancer patients attending a cachexia support service: an evaluation of clinically assessed physical function, malnutrition and inflammatory status. Nutrition and Cancer: An International Journal. 2020 Aug 6;1-11. |
Phillips J, Wiseman R, Eastman P, Li C, Smallwood N. Mapping non-malignant, respiratory palliative care services in Australia & New Zealand. Aust. Health Review 2020;44(5):778-781 |
Dawson J, Le B, Eastman P. Australian palliative physicians’ perceptions of clinician performed ultrasound scanning. J Palliat Med 2020;23(1):4 |
Pitson G, Matheson L, Garrard B, Eastman P, Rogers M. Population-Based Analysis of Radiotherapy and Chemotherapy Treatment in the Last Month of Life within regional Australia. Intern Med J 2020;50(5):596-602 |
Pitson G, Matheson L, Eastman P, Rogers M. Population Based Analysis of End of Life Treatment Patterns in Thoracic Malignancies. Journal of Thoracic Oncology 2019;14(10):S329-330 |
Vaughan VC, Farrell H, Lewandowski PA, McCoombe SG, Martin P. Defining a new model of interdisciplinary cancer cachexia care in regional Victoria, Australia. Supportive Care in Cancer. 2019;28: 3041-3049. |
Diabetes and Palliative Care: A Framework to Help Clinicians Proactively Plan for Personalized care Dunning T, Martin P. In: Palliative Care; 2019 [Book Chapter]. |
Kerr D, Milnes S, Ammentorp J, McKie C, Dunning T, Ostaszkiewicz J, Wolderslund M, Martin P. Challenges for nurses when communicating with people who have life‐limiting illness and their families: A focus group study. Clin Nurs. 2019;29:416-28. |
Kim ML, Matheson L, Garrard B, Francis M, Broad A, Malone J, Eastman P, Rogers M, Yap C-H. Use of clinical quality indicators to improve lung cancer care in a regional/rural network of health services. Aust. J. Rural Health. 2019;27(2):183-187 |
Eastman P, Le B. The deteriorating patient representative on a palliative care quality committee: Ethical and practical considerations. Palliative and Supportive Care 2019;17(6):735-737 |
See D, Le B, Gorelik A, Eastman P. Symptom burden in malignant and non-malignant disease on admission to a palliative care unit. BMJ Support Palliat Care 2019; published online February 4, 2019 |
Eastman P, Currow D, Fazekas B, Brown L, Le B. Oral dexamethasone in the management of cancer-related pain: A feasibility study. Palliat Med 2019;33(4):477-478 |
Smallwood N, Moran T, Thompson M, Eastman P, Le B, Philip J. Integrated respiratory and palliative care leads to high levels of satisfaction: a survey of patients and carers. BMC Palliative Care 2019;18:7 |
Le BH, Marston C, Kerley C, Eastman P. Facilitating the choice of dying at home or in residential care with the implementation of a palliative care rapid response team in a cancer centre and general hospital. Palliat Med 2019;33(4):475-476 |
Mounsey L, Ferres M, Eastman P. Palliative care for the patient without cancer. AJGP 2018;47(11):765-769 |
Kuruvilla L, Weeks G, Eastman P, Johnson G. Medication management for community palliative care patients and the role of a specialist palliative care pharmacist: A qualitative exploration of consumer and health care professional perspectives. Palliat Med 2018;32(8):1369-1377 |
Smallwood N, Thompson M, Warrender-Sparkes M, Eastman P, Le B, Irving L, Philip J. Integrated respiratory and palliative care may improve outcomes in advanced lung disease. ERJ Open Research 2018 4: 00102-2017; DOI: 10.1183/23120541.00102-2017 |
Eastman P., Le B. (2018) Palliative Care and Stroke. In: MacLeod R., van den Block L. (eds) Textbook of Palliative Care. Springer, Cham |
Research Grants
- Western Alliance - The rapid adoption of telehealth by a regional community-based palliative care service due to COVID-19: Patient and Health Care Professional perspectives and opportunities for service enhancement: 2020.
Support our Research
Participate in a Clinical Trial
To find out about clinical trials currently underway at Barwon Health, click here.
Donate
Clinical trials require ongoing investment and there are several ways to support this amazing work.
You can make a donation today and contribute to an item on our research wish list, consider a bequest in your will, or establish a lasting legacy fund in your name. No matter what size, your philanthropic support with deliver an immediate impact.
To donate now or for more information and further discuss your support, please contact the Barwon Health Foundation.
Wish List
- Funding to support development of new researchers within our team, including allowing us to provide some dedicated research hours without taking people away from day to day duties.
- Funding to allow us to research our foray into virtual reality technology for palliative care patients and families. This was recently introduced to the Palliative Care Unit.
- Funding to support research into the new and unique Palliative Care at Home model (Pall@Home).
- Funding to support more research into volunteer programs within the palliative care service.
Last Modified: Thursday, 21 September 2023
Research Leads
Dr Peter Eastman, Co-head, Palliative Care
Anna Dowd, Chair, Palliative Care Research Group & Clinical Trial Coordinator
Unit C, Deforest House
McKellar Centre, Barwon Health
45-95 Ballarat Road, North Geelong
Phone (03) 4215 5700