Publications
116 results found
D'Amico F, Rehill A, Knapp M, et al., 2016, Cost-effectiveness of exercise as a therapy for behavioural and psychological symptoms of dementia within the EVIDEM-E randomised controlled trial, INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Vol: 31, Pages: 656-665, ISSN: 0885-6230
- Author Web Link
- Cite
- Citations: 19
Nilforooshan R, Benson L, Gage H, et al., 2016, Comparison of service utilisation and costs of working age adults and older adults receiving treatment for psychosis and severe non-psychotic conditions in England: implications for commissioning., International Journal of Geriatric Psychiatry, ISSN: 1099-1166
OBJECTIVE: Current plans in the English National Health Service are to replace block contracts for mental health providers with a single tariff for each 'cluster' of conditions. A single tariff will not take into account the potential additional complexity and costs inherent in caring for older people. To examine the basis for a uniform tariff, differences in service utilisation and costs between working age adults and older adults in two populous clusters (non-psychotic, psychotic) were investigated across five mental health healthcare providers in and around London. METHODS: Retrospective review of records over 3 months assessing service utilisation and costs using the Client Services Receipt Inventory. RESULTS: Records of 362 patients were reviewed, 179 older adults (90 non-psychotic, 89 psychotic) and 183 adults of working age (83 non-psychotic, 100 psychotic). Older adults in both clusters had more tests, assessments and home visits. Overall costs of care of older adults were significantly higher in the non-psychotic cluster (£5634, vs £4405 psychotic, p = 0.044). CONCLUSIONS: An appropriate age-related tariff is required for each cluster. Copyright © 2016 John Wiley & Sons, Ltd.
Maclaren T, Warner J, 2016, Will the journal club survive?: Commentary on… are journal clubs useful in teaching psychiatry?, BJ Psych Advances, Vol: 22, Pages: 211-212, ISSN: 2056-4678
We outline benefits and problems of introducing internet-based approaches (e.g. e-learning, social networking) into journal clubs. We also look at potential risks to the continuing existence of clubs posed by the changing health economy and the move in psychiatry from clinical medicine to community care. Overall, we are optimistic for the journal club’s survival.
Warner JP, 2015, Old age psychiatry in the modern age, BRITISH JOURNAL OF PSYCHIATRY, Vol: 207, Pages: 375-376, ISSN: 0007-1250
- Author Web Link
- Cite
- Citations: 9
Lowery D, Cerga-Pashoja A, Iliffe S, et al., 2014, The effect of exercise on behavioural and psychological symptoms of dementia: the EVIDEM-E randomised controlled clinical trial, INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Vol: 29, Pages: 819-827, ISSN: 0885-6230
- Author Web Link
- Cite
- Citations: 70
Warner J, 2014, Wither old age psychiatry?, INTERNATIONAL PSYCHOGERIATRICS, Vol: 26, Pages: 1055-1058, ISSN: 1041-6102
- Author Web Link
- Cite
- Citations: 11
Manthorpe J, Iliffe S, Goodman C, et al., 2013, Working together in dementia research: Reflections on the EVIDEM programme, Working with Older People, Vol: 17, Pages: 138-145, ISSN: 1366-3666
– The purpose of this case study is to report and reflect on a recently completed five-year programme of research on dementia care and practice in England. This EVIDEM programme of research was specifically designed to influence services for people with dementia and their carers; several additional lessons emerged along the way that might shape broader research on ageing that includes older people and those who work with them. – This case study of the EVIDEM programme presents and discusses four lessons learned by the core research team – covering the implications of newly basing research inside the NHS, multi-disciplinary working across academic disciplines, communicating with diverse practitioners, and the impact of patient and public involvement on the research process. The paper reflects on communication between the NHS and academic communities, and the creation of new research capacity in dementia. – Collaborative working between academic disciplines is possible, given willing researchers and commitment to participating in frequent opportunities for dialogue and learning. In research in dementia these foundations are probably essential, given the growing scale of the problem and the small size of the research community, if we are to have a beneficial impact on people's lives. Lay expertise is a necessary ingredient of research programmes, not just for its co-design power, but for its ability to redesign projects when major problems arise. – This case study reports the subjective views of the research collaborators. While this raises the potential for bias, it offers an “insider” perspective of the research process and engagement in research leadership. – There are few reflections on research processes and management and this case study may be useful to academic researchers, to those working in the NHS with responsibility for research in different forms, and to older people's organisations who wish to hear of the v
Lowery D, Cerga-Pashoja A, Warner JP, 2013, EVIDEM-EXERCISE: EXERCISE AS A THERAPY FOR PSYCHOLOGICAL SYMPTOMS OF DEMENTIA, GERONTOLOGIST, Vol: 53, Pages: 447-447, ISSN: 0016-9013
Holzer S, Warner JP, Iliffe S, 2013, Diagnosis and Management of the Patient with Suspected Dementia in Primary Care, DRUGS & AGING, Vol: 30, Pages: 667-676, ISSN: 1170-229X
- Author Web Link
- Cite
- Citations: 8
Rajenthran S, Holzer S, Warner J, 2013, Redefining old age psychiatry--pragmatic approach., Int J Geriatr Psychiatry, Vol: 28
Warner J, Jenkinson J, 2013, Psychiatry for the elderly in the UK., Lancet, Vol: 381
Manthorpe J, Samsi K, Campbell S, et al., 2013, From forgetfulness to dementia: clinical and commissioning implications of diagnostic experiences., Br J Gen Pract, Vol: 63, Pages: e69-e75
BACKGROUND: The National Dementia Strategy in England stressed the importance of earlier diagnosis of dementia. In-depth knowledge of the experiences of patients using such services remains an evidence gap. AIM: To increase understanding of the experiences of people developing dementia and of their carers, to inform practice and decision making. DESIGN AND SETTING: A retrospective and prospective qualitative interview study of participants recruited from four memory clinics in London, the north-west and the north-east of England. METHOD: Purposive sampling was used to recruit 27 individuals with memory problems and 26 supporters and carers. Interviews explored referral pathways, assessment processes, disclosure of the diagnosis, experiences of being prescribed medication to help with symptoms, and issues of risk and decision making. RESULTS: Few participants experienced the process of memory assessment as patient centred. Where assessment processes were lengthy and drawn out, participants experienced considerable uncertainty. Many experienced tests and assessments as distressing, sometimes in settings that were perceived as alarming or potentially stigmatising by association. Information provision and communication were variable and practitioners were not always thought to help people to make sense of their experiences. CONCLUSION: The transition from the early stages of cognitive impairment is not straightforward. There is potentially much uncertainty and waiting. Primary care practitioners may be better able to provide tailored support to individuals and their carers during this time if they are aware of what patients are anticipating and are informed about the diagnostic 'journey' by the insights of those who have experienced it.
Thune-Boyle ICV, Iliffe S, Cerga-Pashoja A, et al., 2012, The effect of exercise on behavioral and psychological symptoms of dementia: towards a research agenda, INTERNATIONAL PSYCHOGERIATRICS, Vol: 24, Pages: 1046-1057, ISSN: 1041-6102
- Author Web Link
- Cite
- Citations: 72
Gupta S, Fiertag O, Thanulingam T, et al., 2012, Further Rare and unusual dementias, Advances in Psychiatric Treatment, Vol: 18
Lowery DP, Warner J, Cerga-Pashoja A, et al., 2011, Clinicians as recruiters to dementia trials: lessons from the EVIDEM-E project, INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Vol: 26, Pages: 767-769, ISSN: 0885-6230
- Author Web Link
- Cite
- Citations: 8
Carney S, Warner J, Ahmad S, et al., 2011, Teaching, learning and assessing evidence-based psychiatry, Psychiatrist, Vol: 35, Pages: 192-195, ISSN: 1758-3209
This paper sets out the rationale, process for development and the content of the new evidence-based practice syllabus, which is examined as part of the Membership of the Royal College of Psychiatrists' Paper 3. The syllabus was developed by the Critical Review Paper Panel of the Royal College of Psychiatrists. Suggestions for learning and teaching evidence-based practice are also put forward. © 2011 The Royal College of Psychiatrists.
Bailey A, Warner JP, 2011, Service line management and medical education - Uncomfortable bed fellows?, Psychiatrist, Vol: 35, Pages: 121-123, ISSN: 1758-3209
The current method of delivery of psychiatric training and education in the UK is still almost solely based on the 'firm' or consultant-led system. Traditionally, these units have had fairly wide-ranging loci of clinical responsibility, ensuring a broad exposure to mental health conditions for both undergraduate students and psychiatric trainees. However, changes over the past decade, particularly in terms of functional splits within psychiatric services, have led to some limitation of this exposure. Various strategies have been employed by those responsible for educational provision within services, such as assigning trainees and students to in-patient and community 'pairs' of teams. Although this has had some success, the introduction of more fundamental restructuring of mental health services and the advent of service lines will have even greater and more wide-ranging implications on education. This editorial examines some of these implications and looks at potential solutions to ensure that training is not forgotten in the wave of far-reaching and strategically driven reorganisations occurring within the National Health Service and more globally. © 2011 The Royal College of Psychiatrists.
Katona C, Chiu E, Adelman S, et al., 2010, World psychiatric association section of old age psychiatry consensus statement on ethics and capacity in older people with mental disorders, Revista de Psiquiatria Clinica, Vol: 37, Pages: 157-161, ISSN: 0101-6083
Background: The World Psychiatric Association (WPA) Section of Old Age Psychiatry, since 1997, has developed Consensus Statements relevant to the practice of Old Age Psychiatry. Since 2006 the Section has worked to develop a Consensus Statement on Ethics and Capacity in older people with mental disorders. Method: A Consensus Conference was realized in Prague, September 2008. The meeting was organized by the WPA Section of Old Age Psychiatry, with the participation of International Council of Nurses, Alzheimer Europe and Alzheimer Disease International. Participants who are recognised for their expertise in this area came from 11 countries and include psychiatrists, a neurologist, a nurse and family caregiving representatives. Results: After two days of debate a draft was prepared and submitted to the organizations/ associations represented at the meeting. When their respective comments were collected, a final text was prepared and published originally in English. This Portuguese version was prepared by two members of the meeting who came from Portuguese spoken countries. Discussion: This Consensus Statement offers to mental health clinicians caring for older people with mental disorders, caregivers, other health professionals and the general public the setting out of and discourse in ethical principles which can often be complex and challenging, supported by practical guidance in meeting such ethical needs and standards, and to encouraged good clinical practice.
Manthorpe J, Iliffe S, Samsi K, et al., 2010, Dementia, dignity and quality of life: nursing practice and its dilemmas., Int J Older People Nurs, Vol: 5, Pages: 235-244
AIMS: The need for healthcare practitioners to respect the dignity of older people is widely recognised in England, where it has been given attention by politicians, professionals and health service regulators. This article aims to provide examples of how such ambitions may be used in practice development. METHODS: This article reports the use of five vignettes discussed by dementia care practitioners that explored the areas of dementia diagnosis, lying, incontinence, behavioural and psychological distress, and end of life care. FINDINGS: Each vignette promoted discussion of differences of perspectives about the ways to enhance the dignity of people with dementia in hospital, care home and community settings. The discussion confirmed that while dignity may be one quality indicator of good care potentially enhancing quality of life, it is not always straightforward. It may be more easily conceptualised when talking of physical care and treatment than other areas. CONCLUSION: The opportunity to debate the subject and to discuss practice examples revealed differences of opinion and moral perspectives between practitioners about the use and relevance of the term dignity. These need to be acknowledged in any debates about objective and subjective definitions of quality of life.
Cerga-Pashoja A, Lowery D, Bhattacharya R, et al., 2010, Evaluation of exercise on individuals with dementia and their carers: a randomised controlled trial, TRIALS, Vol: 11
- Author Web Link
- Cite
- Citations: 25
Bhattacharya R, Maier M, Bhugra D, et al., 2010, Curriculum for workplace-based assessments: A Delphi study, Psychiatrist, Vol: 34, Pages: 204-207, ISSN: 1758-3209
Aims and method: To generate a list of topics for 'core curriculum' that can be used as a guide for trainees and trainers carrying out workplace-based assessments (WPBAs). A three-stage Delphi consultation was carried out. Results: Generation of a list of topics for WPBA appropriate for each year of core training with a mean rating of importance in curriculum. Clinical implications: In the absence of formal guidance, the list generated can serve as an informal guide.
Warner JP, Butler R, Gupta S, 2010, Dementia., BMJ Clin Evid, Vol: 2010
INTRODUCTION: Dementia is characterised by chronic, global, non-reversible deterioration in memory, executive function, and personality. Speech and motor function may also be impaired. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments on cognitive symptoms of dementia (Alzheimer's, Lewy body, or vascular)? What are the effects of treatments on behavioural and psychological symptoms of dementia (Alzheimer's, Lewy body, or vascular)? We searched: Medline, Embase, The Cochrane Library, and other important databases up to April 2008 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 33 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review, we present information relating to the effectiveness and safety of the following interventions: acetylcholinesterase inhibitors (donepezil, galantamine, rivastigmine), antidepressants (clomipramine, fluoxetine, imipramine, sertraline), antipsychotics (haloperidol, olanzapine, quetiapine, risperidone), aromatherapy, benzodiazepines (diazepam, lorazepam), cognitive behavioural therapy (CBT), cognitive stimulation, exercise, ginkgo biloba, memantine, mood stabilisers (carbamazepine, sodium valproate/valproic acid), music therapy, non-steroidal anti-inflammatory drugs (NSAIDs), omega 3 (fish oil), reminiscence therapy, and statins.
Lopez JE, Orrell M, Morgan L, et al., 2010, Empowerment in Older Psychiatric Inpatients: Development of the Empowerment Questionnaire for Inpatients (EQuIP), AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY, Vol: 18, Pages: 21-32, ISSN: 1064-7481
- Author Web Link
- Cite
- Citations: 14
Katona C, Chiu E, Adelman S, et al., 2010, World Psychiatric Association Section of Old Age Psychiatry Consensus Statement on Ethics and Capacity in older people with mental disorders, REVISTA DE PSIQUIATRIA CLINICA, Vol: 37, Pages: 157-161, ISSN: 0101-6083
- Author Web Link
- Cite
- Citations: 1
Katona C, Chiu E, Adelman S, et al., 2009, World psychiatric association section of old age psychiatry consensus statement on ethics and capacity in older people with mental disorders, INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Vol: 24, Pages: 1319-1324, ISSN: 0885-6230
- Author Web Link
- Cite
- Citations: 18
Nilforooshan R, Amin R, Warner J, 2009, Ethnicity and outcome of appeal after detention under the Mental Health Act 1983, Psychiatric Bulletin, Vol: 33, Pages: 288-290, ISSN: 0955-6036
AIMS AND METHOD: There is insufficient research into the relationship between ethnicity and appeals against detention under mental health legislation. We sought to identify rates and success of appeals in different ethnic groups through a retrospective analysis of all detentions under the Mental Health Act 1983 over 1 year. RESULTS: We found high rates of appeals overall, with substantial differences between ethnic groups (36 (39%) White British compared with 71 (63%) Black Caribbean (P = 0.0001) and 21 (68%) White Irish (P = 0.01) individuals (Yates corrected chi-squared)). Success rates on appeal were very low in all groups. CLINICAL IMPLICATIONS: There are significant ethnic differences in appeals against detention under the Mental Health Act.
Warner J, Gupta S, 2009, Alcohol-related brain damage: not a silent epidemic Reply, BRITISH JOURNAL OF PSYCHIATRY, Vol: 194, Pages: 288-288, ISSN: 0007-1250
McCarney R, Fisher P, Iliffe S, et al., 2009, Ginkgo Biloba trial: response by McCarney <i>et al</i>., INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Vol: 24, Pages: 213-213, ISSN: 0885-6230
Lowery D, Warner J, 2009, Behavioural and psychological symptoms of dementia (BPSD): The personal and practical costs of dementia, Journal of Integrated Care, Vol: 17, Pages: 13-19, ISSN: 1476-9018
Behavioural and psychological symptoms of dementia (BPSD) are a far too common and disturbing occurrence for people with dementia, their families and those who care for them. The consequences can be not only devastating personally and challenging professionally, but also costly for service providers. In this, the fourth of this series on older people's mental health services, we describe what BPSD are, what we know about current service provision for this group and the gaps, and how commissioners might approach these issues when developing services for older people with dementia. © Pavilion Journals (Brighton) Ltd.
This data is extracted from the Web of Science and reproduced under a licence from Thomson Reuters. You may not copy or re-distribute this data in whole or in part without the written consent of the Science business of Thomson Reuters.