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Content ArticleThe General Practice Data Trust (GPDT) Pilot Study: Report on Patient Focus Groups reports on patients’ attitudes about sharing their health data for research and planning purposes. It is the result of research by academics at the Centre for Social Ethics and Policy (CSEP) at the University of Manchester, supported by the Patients Association, and is part of the GP Data Trusts pilot project. Funded by the Data Trusts Initiative, the project wanted to understand why so many people opted out from NHS Digital’s GP Data for Research and Planning (GPDPR) programme when it was launched in 2021. The research found that patients mostly supported the use of patient data in health research, but they often didn’t like the idea that companies might make money from the use of their health data. Many felt they had not been given enough information about the GPDPR programme; some would have been happy to share their data if they had known more about the programme. The researchers also asked focus group participants if holding patient data in a trust would reassure them about how their data are used. This was welcomed and the report goes into more detail about what patients thought of this idea.
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Content ArticleChronic pain is common and debilitating, affecting about one in five people globally. However, chronic pain can be difficult to treat, and management is often suboptimal. The 2021 National Institute for Health and Care Excellence guideline for chronic primary pain explicitly recommends against the use of pain medicines, with the exception of antidepressants. To provide patients and clinicians with an updated and comprehensive resource on the efficacy, safety, and tolerability of antidepressants to treat pain, Ferreira et al. conducted an overview of relevant systematic reviews. The study found no review could provide high certainty evidence on the effectiveness of antidepressants for pain for any condition. Nine reviews did provide evidence that some antidepressants were effective, such as moderate evidence suggesting serotonin-norepinephrine reuptake inhibitors (SNRIs), such as duloxetine, were effective for back pain, post-operative pain, fibromyalgia and nerve pain. However, the study only found low certainty evidence that selective serotonin reuptake inhibitors (SSRIs) were effective for people with depression and pain related to other conditions, and that tricyclic antidepressants (TCAs) were effective for irritable bowel syndrome, nerve pain and chronic tension-type headaches. The findings suggest that a more nuanced approach is needed when prescribing antidepressants for pain conditions.
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Content ArticleLast year, the independent NHS Race and Health Observatory commissioned consultancy, Public Digital, to undertake a ‘digital discovery’ project to explore the lived experience of people undergoing acute emergency hospital admissions for sickle cell and managing crisis episodes at home. The NHS Race and Health Observatory’s January 2023 publication – ‘Sickle cell digital discovery report – Designing better acute painful sickle cell care’ – sets out to understand the broad availability of digital products and services that currently exist. The report explores the range of technology that is in place for Accident and Emergency clinicians, red-cell specialists, and ambulance care, to aid timely support to sufferers on their emergency hospital arrival. A number of focus groups and interviews were carried out with those that have lived experience of the disease, including patients who have suffered acute, painful sickle cell episodes during NHS A&E admissions. Research found a lack of individual care plans in place and, more broadly, no clear definition of what constitutes an actual care plan. A number of recommendations are set out in the report for the NHS and the wider healthcare system.
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Content ArticleCardiovascular disease (CVD) causes 1 in 4 deaths in England, and is a leading cause of morbidity, disability and health inequalities. The Covid-19 pandemic has added to the urgency of tackling CVD because CVD significantly increases the risk of severe disease and death from Covid-19. This report by The King's Fund looks at published data, literature, policy and evidence on CVD. The writers also carried out interviews and a workshop with key stakeholders working in health and care to inform their research.
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Content ArticleElectroconvulsive therapy (ECT) is a technique that has been used since 1938 to treat several psychiatric disorders as a replacement for chemically induced seizures. Despite its history of stigma, controversy and low accessibility, ECT is found to be beneficial and efficient in severe cases of depression where medication fails to bring results. This article in Experimental and Therapeutic Medicine aimed to summarise the research conducted on the efficacy of ECT on major depressive disorder and variables studied such as technique, comorbidities and medication as well as the effects and outcomes of this procedure.
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Content ArticleThis recording is of the launch of the Health Equity Network (HEN) on 24 January 2023. The HEN aims to roll out practical solutions to reduce health inequalities, and will help organisations and individuals across the public, private and third sectors to connect and collaborate with those working towards similar health equity goals. It will offer opportunities to share work and knowledge and for members to engage with others across the country. Speakers at the event included: Dr. Jessica Allen, Deputy Director of The Institute for Health Equity Dr. Henry Kippin, Managing Director of the North of Tyne Combined Authority Pete Gladwell, Group Social Impact and Investment Director, Legal & General Capital Alan Higgins, Health Equity Network Lead Professor Sir Michael Marmot, Director of the Institute of Health Equity Sign up to join the Health Equity Network online community
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Content ArticleIn this article for the Byline Times, Consultant David Oliver analyses claims by media and political commentators about spending, waste and inefficiency in healthcare and proposes a ten point plan to restore services to their 2010 level.
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Content ArticleMany people see their GP with symptoms that could either get better without treatment, or be a sign of serious illness; their diagnosis is uncertain. Research has explored how GPs and patients can work together to develop follow-up plans (a process known as safety-netting). New recommendations could help GPs manage uncertain diagnoses. To avoid unnecessary referrals, GPs may adopt a ‘watch and wait’ strategy when someone has an uncertain diagnosis. This strategy should come with a clear follow-up plan so that people understand the possible causes of their symptoms, how to look after themselves and what to do if symptoms persist. This is good safety-netting. Without good safety-netting, watch and wait carries risks. For example, late cancer diagnoses have been linked to poor safety-netting. However, professional guidance on safety-netting is lacking. This is a knowledge and practice gap. A study from Friedemann Smith explored the best ways to deliver safety-netting advice. It suggests that people are more likely to follow advice if they are involved in developing the follow-up plan. They need to understand: why they are receiving this advice what actions are required, and by whom. The lack of time within primary care consultations is well known. This may need to be addressed for clinicians to have long enough to develop a safety-netting plan. Professionals may also need training to develop the appropriate communication skills.
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Content ArticleTo date, research on adverse drug reactions (ADRs) has focused on secondary care, and there is limited studies that have prospectively examined ADRs affecting older adults in general practice. This study from Doherty et al. examined the cumulative incidence and severity of ADRs and associated patient characteristics in a sample of community-dwelling older adults. They found that over one-quarter of older adults experienced an ADR over a 6-year period. Polypharmacy is independently associated with ADR risk in general practice and older adults on ≥10 drug classes should be prioritised for regular medication review.
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Content ArticleIn this blog, Paul E Sax, Contributing Editor at NEJM Journal Watch looks at a recent study into the effectiveness of medical masks compared to N95 respirators for preventing Covid-19 infection among healthcare workers. The author aims to help readers understand how to appraise research studies and decide how and whether to apply their findings. He defines some of the complex terminology used in the study and looks at its methods and findings from both a critical and supportive viewpoint.
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Content ArticleThis research by the Nuffield Trust looked at how smaller hospitals have fared over the pandemic. Smaller hospitals are sometimes overlooked when system planning gets done, so this report focuses on the operational responses and management approaches taken by staff from 10 smaller hospitals over the course of the first and second waves of the pandemic. It aims to tell the stories of those working in small hospitals in order to understand what happened to acute and emergency care in these institutions during the pandemic. The authors interviewed staff in smaller hospitals around the country during 2021 to understand their key concerns. The report makes a set of recommendations for future crisis planning and response.
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Content ArticleThis article in iNews looks at a major new study in The BMJ by researchers in Israel which suggests that symptoms of Long Covid end within a year in most people with the condition. The study looked at information on a number of symptoms linked to Long Covid, including loss of taste and smell, breathing problems, concentration and memory issues, weakness, palpitations and dizziness. The research also demonstrated the role of Covid vaccines in improving outcomes for people with Long Covid. However, the article also highlights cautions from experts who note that people who got Long Covid after a more serious case of the virus were not included in the study, and their symptoms typically last longer than for those who got the condition after a mild infection. The authors also highlight that these results do not match up with the latest data from the Office for National Statistics (ONS). According to the ONS, 57% people reporting symptoms in December 2022 said that they had had long Covid symptoms for at least one year, with 30 per cent reporting that symptoms had lasted for at least two years.
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Content ArticleThis study examined the risks and patterns of childhood deaths before and during the COVID-19 pandemic. In this cohort study, there were 3409 childhood deaths from April 2019 to March 2020, 3035 deaths from April 2020 to March 2021, and 3428 deaths from April 2021 to March 2022. Overall risk of death was significantly lower from 2020 to 2021, but not from 2021 to 2022 when compared with the reference year of 2019 to 2020. These findings suggest that there was a significant reduction in all-cause child mortality during the first year of the COVID-19 pandemic (2020-2021), which returned to near prepandemic levels the following year (2021-2022).
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Content ArticleIt is estimated that at least 65 million people worldwide have Long Covid. This research paper, published by Nature Reviews Microbiology, explores the current knowledge base of Long COVID as well as misconceptions surrounding long COVID and areas where additional research is needed.
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Content ArticleThis study, published in The New England Journal of Medicine, looks at the frequency, preventability and severity of patient harm in a random sample of admissions from 11 Massachusetts hospitals during 2018. From this sample, it identified adverse events in nearly one in four admissions, approximately a quarter of which were deemed as preventable.
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Content ArticleThis paper in the journal RSC Advances aimed to track changes in chemical bonding taking place in PP meshes on the nanoscale via mechano–chemical processes. The authors used the novel and advanced spectroscopic characterisation technique secondary electron hyperspectral imaging (SEHI) to build high resolution chemical maps. Polypropylene (PP) surgical mesh is associated with serious clinical complications when used in the pelvic floor for repair of stress urinary incontinence or support of pelvic organ prolapse. While manufacturers claim that the material is inert and non-degradable, there is a growing body of evidence that asserts PP fibres are subject to oxidative damage. Material surgically removed from patients suffering with clinical complications has shown some evidence of fibre cracking and oxidation. It has been proposed that a pathological cellular response to the surgical mesh contributes to medical complications, but the mechanisms that trigger the specific host response against the material are not well understood. The study presented key insights into the mechano–chemistry reaction of PP which can cause polymer oxidation, changes in molecular structure, crack/craze formation and the release of etched oxidised insoluble particles. SEHI, provided a new route to link the effect of localised stresses to reactions of mechano–chemistry within PP. The method of mechanical distension testing during hydrogen peroxide exposure followed SEHI image analysis could form the basis of an “early warning” system which has the ability to identify materials which are not appropriate for use as medical implants.
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Content Article
Molnupiravir plus usual care versus usual care alone as early treatment for adults with COVID-19 at increased risk of adverse outcomes (PANORAMIC): an open-label, platform-adaptive randomised controlled trial (22 December 2022)
Patient Safety Learning posted an article in Data, research and statistics
The safety, effectiveness, and cost-effectiveness of molnupiravir, an oral antiviral medication for SARS-CoV-2, has not been established in vaccinated patients in the community at increased risk of morbidity and mortality from COVID-19. In this study, Butler et al. aimed to establish whether the addition of molnupiravir to usual care reduced hospital admissions and deaths associated with COVID-19 in this population. The authors conclude that molnupiravir did not reduce the frequency of COVID-19-associated hospitalisations or death among high-risk vaccinated adults in the community. -
Content ArticlePatient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) are used to assess the quality of healthcare experiences, focusing on patients. These measures help healthcare providers, commissioners and other stakeholders to make informed changes to their services. Showing the benefits of your intervention to the patient and healthcare delivery is important if you aim to have your digital product or service embedded within the healthcare system. The Office for Health Improvement and Disparities has collated guidance on how to use a patient-reported outcomes and experiences study to evaluate your digital health product.
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Content ArticleThis study in the journal Dove Press aimed to explore the experience of patient safety culture among South Korean advanced practice nurses in hospital-based home healthcare. 20 nurses involved in home healthcare were recruited from twelve hospitals located in three different cities throughout South Korea. The authors concluded that there were significant aspects of patient safety culture in hospital-based home healthcare, allowing for good continuity of care for patients. These aspects include communicating with caregivers, building community partnerships, understanding unexpected home environments and enhancing the safety of nurses.
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Content ArticleThis article in Science News looks at the impact of the growing global burden of Long Covid during 2022. It describes "a tidal wave of people with lingering symptoms—some mild, some profoundly disabling" which has commanded the attention of researchers and doctors, who are still looking for answers on how to diagnose and treat Long Covid. The article also highlights risk factors, symptoms and the need to focus on people whose lives are most severely restricted by the condition.
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Content ArticleThis article for ABC News looks at a study conducted by researchers from the Bond University and other Australian universities about the impact of the 'hero' and 'angel' narratives applied to nurses during the Covid-19 pandemic. They interviewed critical care nurses in the UK, Australia and North America about their perceptions of these terms. The study found that nurses felt the labels devalued their professionalism, created unreasonable expectations, contributed to gender stereotypes and increased burn-out by putting emphasis on showing up for work even when nurses are unwell. The study also highlighted that nurses responded more positively to the terms 'hero' and 'angel' when used by patients, as opposed to governments and the media.
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Content ArticleIn this video, Yvonne Silove from the Healthcare Quality Improvement Partnership (HQIP), presents on HQIP datasets and offers top tips for data access. Yvonne's presentation was originally given at the Using Health and Social Care Datasets in Research event 'Lifting the lid on data—meet the data custodians'.
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Content ArticleUp to 30% of healthcare spending is considered unnecessary and represents systematic waste. While much attention has been given to low-value clinical tests and treatments, much less has focused on identifying low-value safety practices in healthcare settings. This study in the Journal of Patient Safety surveyed healthcare staff in the UK and Australia to identify safety practices perceived to be of low value. Staff who took part in a survey as part of the study frequently identified the following categories of practices as being low-value: paperwork, duplication and intentional rounding. Five cross-cutting themes (for example, 'covering ourselves') offered an underpinning rationale for why staff perceived these practices to be of low value. The authors conclude that in healthcare systems under strain, removing existing low-value practices should be a priority.
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Content ArticleThis blog focuses on a poster presented at the World Congress on Pain that recently took place in Toronto and discusses the connection between Long Covid and fibromyalgia.
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Content ArticleThis article by the Betsy Lehman Center in Massachusetts draws attention to research by ECRI, a US non-profit research and risk management firm, which shows that efforts to address racial inequalities in medical care need to include an examination of the way in which patient safety events are reported. Research by ECRI shows that existing patient safety reporting systems may be undercounting events experienced by patients who are Black , Latino or from other ethnic groups. It also highlights that racial, ethnic and other demographic data about patients is missing in adverse event reports from most US healthcare organisations.
