600 results found
Achana F, Petrou S, Khan K, et al., 2018, A methodological framework for assessing agreement between cost-effectiveness outcomes estimated using alternative sources of data on treatment costs and effects for trial-based economic evaluations, EUROPEAN JOURNAL OF HEALTH ECONOMICS, Vol: 19, Pages: 75-86, ISSN: 1618-7598
Barbaric J, Abbott R, Posadzki P, et al., 2018, Light therapies for acne: abridged Cochrane systematic review including GRADE assessments, BRITISH JOURNAL OF DERMATOLOGY, Vol: 178, Pages: 61-75, ISSN: 0007-0963
Cowling TE, Majeed A, Harris MJ, 2018, Patient experience of general practice and use of emergency hospital services in England: regression analysis of national cross-sectional time series data., BMJ Qual Saf
BACKGROUND: The UK Government has introduced several national policies to improve access to primary care. We examined associations between patient experience of general practice and rates of visits to accident and emergency (A&E) departments and emergency hospital admissions in England. METHODS: The study included 8124 general practices between 2011-2012 and 2013-2014. Outcome measures were annual rates of A&E visits and emergency admissions by general practice population, according to administrative hospital records. Explanatory variables included three patient experience measures from the General Practice Patient Survey: practice-level means of experience of making an appointment, satisfaction with opening hours and overall experience (on 0-100 scales). The main analysis used random-effects Poisson regression for cross-sectional time series. Five sensitivity analyses examined changes in model specification. RESULTS: Mean practice-level rates of A&E visits and emergency admissions increased from 2011-2012 to 2013-2014 (310.3-324.4 and 98.8-102.9 per 1000 patients). Each patient experience measure decreased; for example, mean satisfaction with opening hours was 79.4 in 2011-2012 and 76.6 in 2013-2014. In the adjusted regression analysis, an SD increase in experience of making appointments (equal to 9 points) predicted decreases of 1.8% (95% CI -2.4% to -1.2%) in A&E visit rates and 1.4% (95% CI -1.9% to -0.9%) in admission rates. This equalled 301 174 fewer A&E visits and 74 610 fewer admissions nationally per year. Satisfaction with opening hours and overall experience were not consistently associated with either outcome measure across the main and sensitivity analyses. CONCLUSIONS: Associations between patient experience of general practice and use of emergency hospital services were small or inconsistent. In England, realistic short-term improvements in patient experience of general practice may only have modest effects on A&
Komwong D, Greenfield G, Zaman H, et al., 2018, Clinical pharmacists in primary care: a safe solution to the workforce crisis?, J R Soc Med
Majeed A, Morgan P, 2018, We need a review of all sepsis deaths, not the conviction of health professionals, BMJ-British Medical Journal, Vol: 360, Pages: k629-k629, ISSN: 1756-1833
Peters L, Greenfield G, Majeed A, et al., 2018, The impact of private online video consulting in primary care., J R Soc Med
Rosenberg-Wohl S, Greenfield G, Majeed A, et al., 2018, Seven-day access to NHS primary care: how does England compare with Europe?, J R Soc Med
Political pressure to increase access to primary care is growing. In the face of ever increasing demand for healthcare, this increase in primary care aims to reduce the burden on urgent and secondary care services. Also part of a broader driver towards establishing a seven-day NHS service, this would require general practice surgeries to extend their opening hours beyond their current obligatory 52.5 h per week. However, benchmarking with other European systems demonstrates that normal in-hours general practice provision in England already exceeds that of most other European countries. Furthermore, patients in England express greater satisfaction with primary care access relative to many other European countries. The reality of demand for extension of general practice opening hours in England remains unclear and evidence about whether additional primary care access decreases accident and emergency department use limited and inconclusive. Before significant investment in further extension of general practice opening hours, more research is required to understand the effects of changes to in- and out-of-hours primary care provision on access and emergency use.
Afshin A, Forouzanfar MH, Reitsma MB, et al., 2017, Health Effects of Overweight and Obesity in 195 Countries over 25 Years, NEW ENGLAND JOURNAL OF MEDICINE, Vol: 377, Pages: 13-27, ISSN: 0028-4793
Ahmed F, Ahmed N, Stubbens A, et al., 2017, Is there a role for smaller hospitals in the future NHS?, British Journal of Hospital Medicine, Vol: 78, Pages: 424-425, ISSN: 1750-8460
Aljuaid M, Elmontsri M, Edvardsson D, et al., 2017, Psychometric evaluation of the Arabic language person-centred climate questionnaire-staff version., J Nurs Manag
AIM: To evaluate the psychometric properties of the Arabic language person-centred climate questionnaire-staff version. BACKGROUND: There have been increasing calls for a person-centred rather than a disease-centred approach to health care. A limited number of tools measure the extent to which care is delivered in a person-centred manner, and none of these tools have been validated for us in Arab settings. METHOD: The validated form of the person-centred climate questionnaire-staff version was translated into Arabic and distributed to 152 health care staff in teaching and non-teaching hospitals in Saudi Arabia. Statistical estimates of validity and reliability were used for psychometric evaluation. RESULTS: Items on the Arabic form of the person-centred climate questionnaire-staff version had high reliability (Cronbach's alpha .98). Cronbach's alpha values for the three sub-scales (safety, everydayness and community), were .96, .97 and .95 respectively. Internal consistency was also high and measures of validity were very good. CONCLUSION: Arabic form of the person-centred climate questionnaire-staff version provides a valid and reliable way to measure the degree of perceived person-centredness. IMPLICATIONS FOR NURSING MANAGEMENT: The tool can be used for comparing levels of person-centredness between wards, units, and public and private hospitals. The tool can also be used to measure the extent of person-centredness in health care settings in other Arab countries.
Alshaikh MK, Filippidis FT, Al-Omar HA, et al., 2017, The ticking time bomb in lifestyle-related diseases among women in the Gulf Cooperation Council countries; review of systematic reviews, BMC PUBLIC HEALTH, Vol: 17, ISSN: 1471-2458
Alshamsan R, Leslie H, Majeed A, et al., 2017, Financial hardship on the path to Universal Health Coverage in the Gulf States, HEALTH POLICY, Vol: 121, Pages: 315-320, ISSN: 0168-8510
Alsharif U, El Bcheraoui C, Khalil I, et al., 2017, Burden of cancer in the Eastern Mediterranean Region, 2005–2015: findings from the Global Burden of Disease 2015 Study, International Journal of Public Health, Pages: 1-14, ISSN: 1661-8556
© 2017 The Author(s) Objectives: To estimate incidence, mortality, and disability-adjusted life years (DALYs) caused by cancer in the Eastern Mediterranean Region (EMR) between 2005 and 2015. Methods: Vital registration system and cancer registry data from the EMR region were analyzed for 29 cancer groups in 22 EMR countries using the Global Burden of Disease Study 2015 methodology. Results: In 2015, cancer was responsible for 9.4% of all deaths and 5.1% of all DALYs. It accounted for 722,646 new cases, 379,093 deaths, and 11.7 million DALYs. Between 2005 and 2015, incident cases increased by 46%, deaths by 33%, and DALYs by 31%. The increase in cancer incidence was largely driven by population growth and population aging. Breast cancer, lung cancer, and leukemia were the most common cancers, while lung, breast, and stomach cancers caused most cancer deaths. Conclusions: Cancer is responsible for a substantial disease burden in the EMR, which is increasing. There is an urgent need to expand cancer prevention, screening, and awareness programs in EMR countries as well as to improve diagnosis, treatment, and palliative care services.
Asaria P, Elliott P, Douglass M, et al., 2017, Acute myocardial infarction hospital admissions and deaths in England: a national follow-back and follow-forward record-linkage study, LANCET PUBLIC HEALTH, Vol: 2, Pages: E191-E201, ISSN: 2468-2667
Azzopardi P, Cini K, Kennedy E, et al., 2017, Adolescent health in the Eastern Mediterranean Region: findings from the global burden of disease 2015 study, International Journal of Public Health, Pages: 1-18, ISSN: 1661-8556
© 2017 The Author(s) Objectives: The 22 countries of the East Mediterranean Region (EMR) have large populations of adolescents aged 10–24 years. These adolescents are central to assuring the health, development, and peace of this region. We described their health needs. Methods: Using data from the Global Burden of Disease Study 2015 (GBD 2015), we report the leading causes of mortality and morbidity for adolescents in the EMR from 1990 to 2015. We also report the prevalence of key health risk behaviors and determinants. Results: Communicable diseases and the health consequences of natural disasters reduced substantially between 1990 and 2015. However, these gains have largely been offset by the health impacts of war and the emergence of non-communicable diseases (including mental health disorders), unintentional injury, and self-harm. Tobacco smoking and high body mass were common health risks amongst adolescents. Additionally, many EMR countries had high rates of adolescent pregnancy and unmet need for contraception. Conclusions: Even with the return of peace and security, adolescents will have a persisting poor health profile that will pose a barrier to socioeconomic growth and development of the EMR.
Balinskaite V, Bottle A, Shaw LJ, et al., 2017, Reorganisation of stroke care and impact on mortality in patients admitted during weekends: a national descriptive study based on administrative data., BMJ Qual Saf
OBJECTIVE: To evaluate mortality differences between weekend and weekday emergency stroke admissions in England over time, and in particular, whether a reconfiguration of stroke services in Greater London was associated with a change in this mortality difference. DESIGN, SETTING AND PARTICIPANTS: Risk-adjusted difference-in-difference time trend analysis using hospital administrative data. All emergency patients with stroke admitted to English hospitals from 1 January 2008 to 31 December 2014 were included. MAIN OUTCOMES: Mortality difference between weekend and weekday emergency stroke admissions. RESULTS: We identified 507 169 emergency stroke admissions: 26% of these occurred during the weekend. The 7-day in-hospital mortality difference between weekend and weekday admissions declined across England throughout the study period. In Greater London, where the reorganisation of stroke services took place, an adjusted 28% (relative risk (RR)=1.28, 95% CI 1.09 to 1.47) higher weekend/weekday 7-day mortality ratio in 2008 declined to a non-significant 9% higher risk (RR=1.09, 95% CI 0.91 to 1.32) in 2014. For the rest of England, a 15% (RR=1.15, 95% CI 1.09 to 1.22) higher weekend/weekday 7-day mortality ratio in 2008 declined to a non-significant 3% higher risk (RR=1.03, 95% CI 0.97 to 1.10) in 2014. During the same period, in Greater London an adjusted 12% (RR=1.12, 95% CI 1.00 to 1.26) weekend/weekday 30-day mortality ratio in 2008 slightly increased to 14% (RR=1.14, 95% CI 1.00 to 1.30); however, it was not significant. In the rest of England, an 11% (RR=1.11, 95% CI 1.07 to 1.15) higher weekend/weekday 30-day mortality ratio declined to a non-significant 4% higher risk (RR=1.04, 95% CI 0.99 to 1.09) in 2014. We found no statistically significant association between decreases in the weekend/weekday admissions difference in mortality and the centralisation of stroke services in Greater London. CONCLUSIONS: There was a steady reduction in weekend/weekday differences i
Barber RM, Fullman N, Sorensen RJD, et al., 2017, Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990-2015: a novel analysis from the Global Burden of Disease Study 2015, LANCET, Vol: 390, Pages: 231-266, ISSN: 0140-6736
Belisario JSM, Doherty K, O'Donoghue J, et al., 2017, A bespoke mobile application for the longitudinal assessment of depression and mood during pregnancy: protocol of a feasibility study, BMJ OPEN, Vol: 7, ISSN: 2044-6055
Bottle A, Kim D, Aylin P, et al., 2017, Routes to diagnosis of heart failure: observational study using linked data in England., Heart
OBJECTIVE: Timely diagnosis and management of heart failure (HF) is critical, but identification of patients with suspected HF can be challenging, especially in primary care. We describe the journey of people with HF in primary care from presentation through to diagnosis and initial management. METHODS: We used the Clinical Practice Research Datalink (primary care consultations linked to hospital admissions data and national death registrations for patients registered with participating primary care practices in England) to describe investigation and referral pathways followed by patients from first presentation with relevant symptoms to HF diagnosis, particularly alignment with recommendations of the National Institute for Health and Care Excellence guideline for HF diagnosis. RESULTS: 36 748 patients had a diagnosis of HF recorded that met the inclusion criteria between 1 January 2010 and 31 March 2013. For 29 113 (79.2%) patients, this was first recorded in hospital. In the 5 years prior to diagnosis, 15 057 patients (41.0%) had a primary care consultation with one of three key HF symptoms recorded, 17 724 (48.2%) attended for another reason and 3967 (10.8%) did not see their general practitioner. Only 24% of those with recorded HF symptoms followed a pathway aligned with guidelines (echocardiogram and/or serum natriuretic peptide test and specialist referral), while 44% had no echocardiogram, natriuretic peptide test or referral. CONCLUSIONS: Patients follow various pathways to the diagnosis of HF. However, few appear to follow a pathway supported by guidelines for investigation and referral. There are likely to be missed opportunities for earlier HF diagnosis in primary care.
Car LT, Papachristou N, Urch C, et al., 2017, Prioritizing medication safety in care of people with cancer: clinicians' views on main problems and solutions, JOURNAL OF GLOBAL HEALTH, Vol: 7, ISSN: 2047-2978
Carruthers J, Holmes A, Majeed A, 2017, A suspected viral rash in pregnancy, BMJ-BRITISH MEDICAL JOURNAL, Vol: 356, ISSN: 1756-1833
Carruthers J, Holmes A, Majeed A, 2017, Authors' reply to Mannion., BMJ, Vol: 357
Carruthers J, Holmes A, Majeed A, 2017, Incorrect information on immunoglobulin as preventive treatment for varicella Reply, BMJ-BRITISH MEDICAL JOURNAL, Vol: 357, ISSN: 1756-1833
Chang K, Lee JT, Vamos E, et al., 2017, SOCIO-DEMOGRAPHIC INEQUALITIES IN CARDIOVASCULAR RISK MANAGEMENT AND EARLY DETECTION OF VASCULAR CONDITIONS BY THE NHS HEALTH CHECK: A DIFFERENCE-IN-DIFFERENCES MATCHING ANALYSIS, JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, Vol: 71, Pages: A4-A4, ISSN: 0143-005X
Chang K, Lee JT, Vamos E, et al., 2017, Socio-demographic inequalities in the effectiveness of England's NHS Health Check, 10th European Public Health Conference Sustaining resilient and healthy communities, Publisher: Oxford University Press (OUP), ISSN: 1101-1262
Chang KC-M, Majeed A, Vamos EP, et al., 2017, The authors respond to "NHS Health Check: national evaluation findings and implications", CANADIAN MEDICAL ASSOCIATION JOURNAL, Vol: 189, Pages: E173-E173, ISSN: 0820-3946
Chaudhry Z, Mannan F, Gibson-White A, et al., 2017, Outputs and Growth of Primary Care Databases in the United Kingdom: Bibliometric Analysis., J Innov Health Inform, Vol: 24
BACKGROUND: Electronic health database (EHD) data is increasingly used by researchers. The major United Kingdom EHDs are the 'Clinical Practice Research Datalink' (CPRD), 'The Health Improvement Network' (THIN) and 'QResearch'. Over time, outputs from these databases have increased, but have not been evaluated. OBJECTIVE: This study compares research outputs from CPRD, THIN and QResearch assessing growth and publication outputs over a 10-year period (2004-2013). CPRD was also reviewed separately over 20 years as a case study. METHODS: Publications from CPRD and QResearch were extracted using the Science Citation Index (SCI) of the Thomson Scientific Institute for Scientific Information (Web of Science). THIN data was obtained from University College London and validated in Web of Science. All databases were analysed for growth in publications, the speciality areas and the journals in which their data have been published. RESULTS: These databases collectively produced 1,296 publications over a ten-year period, with CPRD representing 63.6% (n=825 papers), THIN 30.4% (n=394) and QResearch 5.9% (n=77). Pharmacoepidemiology and General Medicine were the most common specialities featured. Over the 9-year period (2004-2013), publications for THIN and QResearch have slowly increased over time, whereas CPRD publications have increased substantially in last 4 years with almost 75% of CPRD publications published in the past 9 years. CONCLUSION: These databases are enhancing scientific research and are growing yearly, however display variability in their growth. They could become more powerful research tools if the National Health Service and general practitioners can provide accurate and comprehensive data for inclusion in these databases.
Chaudhry Z, Mannan F, Gibson-White A, et al., 2017, Research Outputs of England's Hospital Episode Statistics (HES) Database: Bibliometric Analysis., J Innov Health Inform, Vol: 24
BACKGROUND: Hospital administrative data, such as those provided by the Hospital Episode Statistics (HES) database in England, are increasingly being used for research and quality improvement. To date, no study has tried to quantify and examine trends in the use of HES for research purposes. OBJECTIVE: To examine trends in the use of HES data for research. METHODS: Publications generated from the use of HES data were extracted from PubMed and analysed. Publications from 1996 to 2014 were then examined further in the Science Citation Index (SCI) of the Thompson Scientific Institute for Science Information (Web of Science) for details of research specialty area. RESULTS: 520 studies, categorised into 44 specialty areas, were extracted from PubMed. The review showed an increase in publications over the 18-year period with an average of 27 publications per year, however with the majority of output observed in the latter part of the study period. The highest number of publications was in the Health Statistics specialty area. CONCLUSION: The use of HES data for research is becoming more common. Increase in publications over time shows that researchers are beginning to take advantage of the potential of HES data. Although HES is a valuable database, concerns exist over the accuracy and completeness of the data entered. Clinicians need to be more engaged with HES for the full potential of this database to be harnessed.
Cliffe C, Hillyard M, Joseph A, et al., 2017, The transgender patient in primary care: practical advice for a 10-minute consultation, BJGP Open, Pages: BJGP-2017-0103-BJGP-2017-0103
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