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Trial registered on ANZCTR
Registration number
ACTRN12612000558820
Ethics application status
Approved
Date submitted
11/05/2012
Date registered
25/05/2012
Date last updated
25/05/2012
Type of registration
Retrospectively registered
Titles & IDs
Public title
Evaluation of an assessment tool to guide heart failure support
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Scientific title
Implementation of a self-care assessment tool to enhance health outcomes among heart failure patients: a modified Solomon 4-group design
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Secondary ID [1]
280479
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Chronic Heart Failure and patient self-care
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Condition category
Condition code
Cardiovascular
286715
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0
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Other cardiovascular diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The study intervention is the application of the screening tool by a CHF nurse clinician. The screening tool assesses physical, cognitive and emotional functioning as key determinants of CHF self-care. For each of the three domains the patient’s level of functioning is quantified as low, medium or high. In this manner, low functioning indicates the individual is at greater risk of inadequate self-care ability and will require more intensive strategies than an individual with high functioning. The screening tool is administered to each participant once only and is administered by the CHF nurse at their first home visit following recruitment to the study. The screening tool takes approximately10 minutes to administer. The screening tool provides the nurse clinician with recommendations on the frequency of contact, symptom monitoring and most appropriate educational and counselling approaches to adopt in promoting and supporting patient self-care. For example, if a patient is screened as ‘low’ self-care ability on the cognitive domain it is recommended that the CHF nurse has weekly contact with the patient via home visits or telephone support. The overall duration of the intervention is 3 months.
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Intervention code [1]
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Early detection / Screening
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Intervention code [2]
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Rehabilitation
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Comparator / control treatment
The control group will receive the standard CHF nursing care in accordance with the Eastern HARP guidelines.
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Control group
Active
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Outcomes
Primary outcome [1]
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Patients in the intervention groups will have significantly higher self-care maintenance, management and confidence scores from the Self-Care Heart Failure Index.
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Assessment method [1]
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Timepoint [1]
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At 3 and 6 months
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Primary outcome [2]
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Patients in the intervention groups will have significantly higher medication adherance scores
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Assessment method [2]
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Timepoint [2]
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At 3 and 6 months
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Secondary outcome [1]
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Health related quality of life (SF-12)
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Assessment method [1]
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Timepoint [1]
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At baseline and at 3 and 6 months post intervention commencement
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Secondary outcome [2]
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All-cause hospitalisation and death
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Assessment method [2]
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Timepoint [2]
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At 3 and 6 months post intervention commencement
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Eligibility
Key inclusion criteria
Participants will be 18 years of age or older and have a confirmed diagnosis of CHF. Confirmation of the diagnosis will be from: 1) symptoms and clinical features of congestion that occur at rest or on minimal effort (dyspnoea, orthopnea, paroxysmal nocturnal dyspnoea, fatigue, palpitations, elevated jugular venous pressure, cardiomegaly, lung crepitations, hepatomegaly, oedema); 2) either objective evidence of underlying structural cardiac dysfunction that impairs the ability of the ventricle to fill with or eject blood or an elevated plasma level of B-type natriuretic Peptide (BNP), >200 pg/mL. Participants will have been referred and enrolled into the CHFMP which is conducted across Eastern health.
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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?
No
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Key exclusion criteria
Patient participants will be excluded if they reside in a residential aged high care facility (nursing home), have a documented history of moderate-to-severe cognitive impairment or dementia, or have a terminal diagnosis. Participants who do not have sufficient comprehension to read English without the need of a translator will be excluded.
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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)
All patients who meet the study criteria and are enrolled into a CHF management program (CHFMP) across Eastern Health will be approached and recruited over a 16 month time period. A research associate (RA) working closely with the CHF nurses will screen and recruit participants. Once participants have consented to the study a detailed history will be collected by the RA and pre-test assessments conducted. Each CHFMP program (Box Hill, Maroondah and Angliss) has been randomly assigned to a group and sequence of testing as outlined below (other design features). Participants are allocated to the respective study group according to the location of the CHFMP (Box Hill, Maroondah or Angliss hospitals). The RA will notify the respective CHF nurses of participants recruited. The CHF nurses at the Angliss and BoxHill hospitals will administer the screening tool during their first home visit and use the recommendations to develop an individualised nursing care plan. Participants who are recruited into the Maroondah CHFMP will have the self-care screening tool administered by the RA. In this manner, the Maroondah nurse clinicians are concealed of their patients screening and level of functioning.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
The allocation of the hospitals to the respective intervention or control groups was determined by the name of each hospital being drawn randomly and then the study group allocation was drawn randomly
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Other
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Other design features
This study is a modified Solomon 4-group design. Each CHFMP program has been randomly assigned to a group and sequence of testing as outlined below:
Angliss: Pre-testing - Intervention - 3 and 6 month post-testing
BoxHill: No pre-testing - Intervention - 3 and 6 month post-testing
Maroondah: Pre-testing - No intervention - 3 and 6 month post-testing
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
12/02/2012
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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
240
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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]
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3128
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Recruitment postcode(s) [2]
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3125
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Recruitment postcode(s) [3]
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3134
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Recruitment postcode(s) [4]
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3133
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Recruitment postcode(s) [5]
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3130
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Recruitment postcode(s) [6]
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3129
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Recruitment postcode(s) [7]
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3180
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Recruitment postcode(s) [8]
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3754
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Recruitment postcode(s) [9]
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3149
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Recruitment postcode(s) [10]
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3796
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Recruitment postcode(s) [11]
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3140
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Recruitment postcode(s) [12]
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3155
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Nurses Board Legacy LTD
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Address [1]
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Royal College of Nursing, Australia (RCNA)
1 Napier Close, Deakin, ACT 2600
PO BOX 219, Deakin West, ACT 2600
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Country [1]
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Australia
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Funding source category [2]
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University
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Name [2]
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Australian Catholic University
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Address [2]
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PO 4115, Fitzroy, MDC, Vic 3065
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Country [2]
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Australia
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Primary sponsor type
University
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Name
Cardiovascular Research Centre/ Australian Catholic University
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Address
Level 4, 486 Albert Street, East Melbourne, Vic 3002
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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]
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Address [1]
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Country [1]
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Other collaborator category [1]
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Hospital
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Name [1]
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Eastern Health
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Address [1]
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Nelson Street, Box Hill, Vic 3128
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Country [1]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Eastern Health
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Ethics committee address [1]
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5, Arnold Street, Box Hill Vic, 3128
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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25/01/2012
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Approval date [1]
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07/02/2012
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Ethics approval number [1]
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LR39-1112
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Ethics committee name [2]
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Australian Catholic University
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Ethics committee address [2]
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Victoria Parade, Fitzroy Vic, 3065
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Ethics committee country [2]
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Australia
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Date submitted for ethics approval [2]
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07/02/2012
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Approval date [2]
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09/02/2012
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Ethics approval number [2]
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2012 04V
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Summary
Brief summary
The provision of education, counselling and support directed at enhancing patient self-care skills is an important aspect in the longterm management of chronic heart failure (CHF). This study builds upon CIA Cameron's PhD program of research that identified factors that predicted CHF self-care [1-3]. The proposed study will evaluate a unique screening tool that complements the existing nursing assessment, helping to identify an individual’s level of CHF self-care ability according to three domains: physical, emotional and cognitive functioning, and patient clinical characteristics. The implementation of this screening tool will guide health care professionals in determining if the patient is at low, medium or high risk of inadequate CHF self-care, thereby permitting sophisticated monitoring and serving as a basis for developing individualised plans of care, including educational and behavioural strategies directed at promoting self-care. In this manner, tailoring education and follow-up strategies to individual need and ability may further enhance the clinical status of patients, ensuring that these vulnerable patients remain in their community for longer periods. The aim of this study is to evaluate the clinical application of the CHF self-care assessment tool. The research will be conducted at the Eastern Health sites that conduct a CHF management program (Box Hill, Maroondah and Angliss hospitals). Recruitment to the study will be conducted over a 16 month period. A research associate from Eastern Health’s Cardiology Research Department will recruit approximately 240 patients from the three CHF management programs within Eastern Health.
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Trial website
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Trial related presentations / publications
1. Cameron J, Worrall-Carter L, Riegel B, Lo SK, Stewart S. Testing a model of patient characteristics, psychological status and cognitive function as predictors of self-care in persons with heart failure Heart & Lung 2009;38:410-8. 2. Cameron J, Worrall-Carter L, Page K, Riegel B, Lo SK, Stewart S. Does cognitive impairment predict poor self-care in patients with chronic heart failure? Eur J Heart Fail 2010;12:508-15; 3. Cameron J, Worrall-Carter L, Page K, Stewart S. Self-care behaviours and heart failure: Does experience with symptoms really make a difference? European Journal of Cardiovascular Nursing 2010;9:92-100
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Dr Jan Cameron
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Address
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Level 4, 486 Albert Street,
East Melbourne
Vic 3002
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Country
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Australia
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Phone
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+61 3 99533698
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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 Jan Cameron
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Address
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Level 4, 486 Albert Street,
East Melbourne
Vic 3002
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Country
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Australia
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Phone
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+ 61 3 99533698
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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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