Publications
20 results found
Jayasooriya N, Pollok RC, Blackwell J, et al., 2023, Adherence to 5-aminosalicylic acid maintenance treatment in young people with ulcerative colitis: a retrospective cohort study in primary care, British Journal of General Practice, Vol: 73, Pages: e850-e857, ISSN: 0960-1643
Background: Maintenance treatment with 5-aminosalicylic acid (5-ASA) is recommended in ulcerative colitis (UC), but accurate estimates of discontinuation and adherence in adolescents transitioning to young adulthood are lacking.Aim: To determine rates and risk factors for discontinuation and adherence to oral 5-ASA in adolescents and young adults 1 year following diagnosis of UC.Design and setting: Observational cohort study using the UK Clinical Practice Research Datalink among adolescents and young adults (aged 10–24 years) diagnosed with UC between 1 January 1998 and 1 May 2016.Method: Time to oral 5-ASA discontinuation (days) and adherence rates (proportion of days covered) were calculated during the first year of treatment using Kaplan–Meier survival analysis. Cox regression models were built to estimate the impact of sociodemographic and health-related risk factors.Results: Among 607 adolescents and young adults starting oral 5-ASA maintenance treatment, one-quarter (n = 152) discontinued within 1 month and two- thirds (n = 419) within 1 year. Discontinuation was higher among those aged 18–24 years (74%) than younger age groups (61% and 56% in those aged 10–14 and 15–17 years, respectively). Adherence was lower among young adults than adolescents (69% in those aged 18–24 years versus 80% in those aged 10–14 years). Residents in deprived versus affluent postcodes were more likely to discontinue treatment (adjusted hazard ratio [aHR] 1.46, 95% confidence interval [CI] = 1.10 to 1.92). Early corticosteroid use for an acute flare lowered the likelihood of oral 5-ASA discontinuation (aHR 0.68, 95% CI = 0.51 to 0.90).Conclusion: The first year of starting long-term therapies in adolescents and young adults diagnosed with UC is a critical window for active follow-up of maintenance treatment, particularly in those aged 18–24 years and those living in deprived postcodes.
Creese H, Saxena S, Nicholls D, et al., 2023, The role of dieting, happiness with appearance, self-esteem, and bullying in the relationship between mental health and body-mass index among UK adolescents: a longitudinal analysis of the Millennium Cohort Study., EClinicalMedicine, Vol: 60, Pages: 1-13, ISSN: 2589-5370
BACKGROUND: Mental illness and obesity are among the biggest challenges to population health, they are linked, and may be modifiable during adolescence. We aimed to determine intervening pathways between mental health and BMI z-score symptoms across adolescence. METHODS: In this longitudinal cohort study, we used path models to examine self-reported dieting, happiness with appearance, self-esteem and bullying at 14 years as potential mediators of the cross-lagged relationship between mental health (via the Strengths and Difficulties Questionnaire) and Body Mass Index (BMI) z-score at 11 and 17 years by sex in the UK Millennium Cohort Study, a prospective cohort study of 18,818 children born in the UK between September 1st, 2000, and January 31st, 2002. Full, incomplete data on all singleton children still participating in the study by age 11 years were analysed in GSEM via maximum likelihood estimation (N = 12,450). FINDINGS: We found happiness with appearance and self-esteem, but not dieting or bullying, mediated the relationship between BMI age 11 and mental health age 17. Each increase in BMI z-score at 11 years was associated with 0.12 increase for boys and a 0.19 increase for girls in scores of unhappiness with appearance (boys: b 0.12, 95% C.I.; girls b 0.19, C.I. 0.14 to 0.23) and a 16% increase for boys and a 22% increase for girls in odds of low self-esteem (boys OR 1.16, 95% C.I. 1.07 to 1.26; girls: OR 1.22, 95% C.I. 1.15 to 1.30) at 14 years. In turn, for both boys and girls, being unhappy with appearance and low self-esteem at 14 years were associated with a greater likelihood of emotional and externalizing symptoms at 17 years. INTERPRETATION: Early prevention strategies to encourage healthy physical and mental development of children need to focus on the promotion of positive body-mage and self-esteem. FUNDING: The National Institute for Health and Care Research (NIHR) School for Public Health Research (SPHR).
Creese H-M, Creese H-M, 2023, Risk factors of persistent adolescent thinness: findings from the UK millennium cohort study, BMC Public Health, Vol: 23, Pages: 1-12, ISSN: 1471-2458
BackgroundThinness during adolescence can increase the risk of adverse health outcomes across the life-course and impede development. There is limited research examining the prevalence and determinants of persistent adolescent thinness in the United Kingdom (UK). We used longitudinal cohort data to investigate determinants of persistent adolescent thinness.MethodsWe analyzed data from 7,740 participants in the UK Millennium Cohort Study at ages 9 months, 7, 11, 14 and 17 years. Persistent thinness was defined as thinness at ages 11, 14 and 17; thinness was defined as an age- and sex-adjusted Body Mass Index (BMI) of less than 18.5 kg/m2. In total, 4,036 participants, classified either as persistently thin or at a persistent healthy weight, were included in the analyses. Logistic regression analyses were conducted to examine associations between 16 risk factors and persistent adolescent thinness by sex.ResultsThe prevalence of persistent thinness among adolescents was 3.1% (n = 231). Among males (n = 115), persistent adolescent thinness was significantly associated with non-white ethnicity, low parental BMI, low birthweight, low breastfeeding duration, unintended pregnancy, and low maternal education. Among females (n = 116), persistent adolescent thinness was significantly associated with non-white ethnicity, low birthweight, low self-esteem, and low physical activity. However, after adjusting for all risk factors, only low maternal BMI (OR: 3.44; 95% CI:1.13, 10.5), low paternal BMI (OR: 22.2; 95% CI: 2.35, 209.6), unintended pregnancy (OR: 2.49; 95% CI: 1.11, 5.57) and low self-esteem (OR: 6.57; 95% CI: 1.46,29.7) remained significantly associated with persistent adolescent thinness among males. After adjustment for all risk factors, not reaching the recommended physical activity levels (OR: 4.22; 95% CI: 1.82, 9.75) remained significantly associated with persistent adolescent thinness among females. No appreciable associa
Jayasooriya N, Baillie S, Blackwell J, et al., 2023, Systematic review with meta-analysis: Time to diagnosis and the impact of delayed diagnosis on clinical outcomes in inflammatory bowel disease, ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Vol: 57, Pages: 635-652, ISSN: 0269-2813
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- Citations: 11
Creese H, Lai E, Mason K, et al., 2022, Disadvantage in early-life and persistent asthma in adolescents: a UK cohort study, THORAX, Vol: 77, Pages: 854-864, ISSN: 0040-6376
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- Citations: 3
Jayasooriya N, Baillie S, Blackwell J, et al., 2022, IMPACT OF TIME TO DIAGNOSIS ON INFLAMMATORY BOWEL DISEASE OUTCOMES: A SYSTEMATIC REVIEW AND META-ANALYSIS, Annual Meeting of the British-Society-of-Gastroenterology (BSG), Publisher: BMJ PUBLISHING GROUP, Pages: A52-A53, ISSN: 0017-5749
Jayasooriya N, Blackwell J, Saxena S, et al., 2022, Antidepressant medication use in Inflammatory Bowel Disease: a nationally representative population-based study, ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Vol: 55, Pages: 1330-1341, ISSN: 0269-2813
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- Citations: 4
Blackwell J, Saxena S, Jayasooriya N, et al., 2022, Stoma Formation in Crohn's Disease and the Likelihood of Antidepressant Use: A Population-Based Cohort Study, CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, Vol: 20, Pages: E703-E710, ISSN: 1542-3565
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- Citations: 3
Jayasooriya N, Ballie S, Blackwell J, et al., 2022, Systematic review and meta-analysis: Diagnostic delay and the subsequent impact on the disease course of adult Inflammatory Bowel Disease, Publisher: OXFORD UNIV PRESS, Pages: I552-I552, ISSN: 1873-9946
Jayasooriya N, Ballie S, Blackwell J, et al., 2022, Systematic review and meta-analysis: Diagnostic delay and the subsequent impact on the disease course of adult Inflammatory Bowel Disease, Publisher: OXFORD UNIV PRESS, Pages: I552-I552, ISSN: 1873-9946
Reyes BD, Hargreaves DS, Creese H, 2021, Early-life maternal attachment and risky health behaviours in adolescence: Findings from the United Kingdom Millennium Cohort Study, BMC Public Health, Vol: 21, Pages: 1-11, ISSN: 1471-2458
BackgroundEarly uptake of multiple risky behaviours during adolescence, such as substance use, antisocial and sexual behaviours, can lead to poor health outcomes without timely interventions. This study investigated how early-life maternal attachment, or emotional bonds between mothers and infants, influenced later risky behaviours in adolescence alongside other potential explanatory pathways using the United Kingdom Millennium Cohort Study.MethodsTotal maternal attachment scores measured at 9 months using the Condon (1998) Maternal Postnatal Attachment Scale compared higher and lower attachment, where mothers in the lowest 10th percentile represented lower attachment. Multiple risky behaviours, defined as two or more risky behaviours (including smoking cigarettes, vaping, alcohol consumption, illegal drug use, antisocial behaviour, criminal engagement, unsafe sex, and gambling), were scored from 0 to 8 at age 17. Five multivariate logistic regression models examined associations between maternal attachment and multiple risky behaviours among Millennium Cohort Study members (n = 7796). Mediation analysis sequentially adjusted for blocks of explanatory mechanisms, including low attachment mechanisms (multiple births, infant prematurity, sex, breastfeeding, unplanned pregnancy and maternal age at birth), maternal depression, and social inequalities (single-parent status, socioeconomic circumstance by maternal education and household income) at 9 months and poor adolescent mental health at 14 years.ResultsChildren of mothers with lower maternal attachment at 9 months had 23% increased odds of multiple risky behaviours at 17 years (OR: 1.23, 95% CI: 1.00–1.50) in the unadjusted baseline model. All five explanatory blocks attenuated baseline odds. Low attachment mechanisms attenuated 13%, social inequalities 17%, and poor mental health 17%. Maternal depression attenuated the highest proportion (26%) after fully adjusting fo
Jayasooriya N, Saxena S, Blackwell J, et al., 2021, IMPACT OF CONSULTATION FREQUENCY AND TIME TO DIAGNOSIS ON SUBSEQUENT INFLAMMATORY BOWEL DISEASE OUTCOMES, Annual Meeting of the British-Society-of-Gastroenterology (BSG), Publisher: BMJ PUBLISHING GROUP, Pages: A78-A78, ISSN: 0017-5749
Jayasooriya N, Pollok R, Blackwell J, et al., 2021, ADHERENCE AND DISCONTINUATION OF ORAL 5-AMINOSALICYLIC ACID AMONGST ADOLESCENTS AND YOUNG ADULTS WITH ULCERATIVE COLITIS, Publisher: BMJ PUBLISHING GROUP, Pages: A30-A31, ISSN: 0017-5749
Creese H, Saxena S, Nicholls D, et al., 2021, Internalized weight bias in the relationship between mental health and obesity in UK adolescents, Publisher: OXFORD UNIV PRESS, Pages: 562-562, ISSN: 1101-1262
Creese H-M, Hope S, Christie D, et al., 2021, Is earlier obesity associated with poorer executive functioning later in childhood? Findings from the Millennium Cohort Study, PEDIATRIC OBESITY, Vol: 16, ISSN: 2047-6310
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- Citations: 3
Blackwell J, Saxena S, Petersen I, et al., 2021, Depression in individuals who subsequently develop inflammatory bowel disease: a population-based nested case-control study, GUT, Vol: 70, Pages: 1642-1648, ISSN: 0017-5749
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- Citations: 26
Blackwell J, Alexakis C, Saxena S, et al., 2021, The association between antidepressant medication use and steroid dependency in patients with ulcerative colitis: a population-based study, BMJ Open Gastroenterology, Vol: 8, ISSN: 2054-4774
Background: Animal studies indicate a potential protective role of antidepressant medication (ADM) in models of colitis but the effect of their use in humans with ulcerative colitis (UC) remains unclear. Objective: To study the relationship between ADM use and corticosteroid dependency in UC. Design: Using the Clinical Practice Research Datalink we identified patients diagnosed with UC between 2005-2016. We grouped patients according to serotonin selective reuptake inhibitor (SSRI) and tricyclic antidepressant (TCA) exposure in the 3 years following diagnosis: 'continuous users', 'intermittent users' and 'non users'. We used logistic regression to estimate the adjusted risk of corticosteroid dependency between ADM exposure groups. Results: We identified 6373 patients with UC. 5,230 (82%) use no ADMs, 627 (10%) were intermittent SSRI users and 282 (4%) were continuous SSRI users, 246 (4%) were intermittent TCA users and 63 (1%) were continuous TCA users. Corticosteroid dependency was more frequent in continuous SSRI and TCA users compared with non-users (19% vs. 24% vs. 14%, respectively, χ2 p=0.002). Intermittent SSRI and TCA users had similar risks of developing corticosteroid dependency to non-users (SSRI: OR 1.19, 95%CI 0.95-1.50, TCA: OR 1.14, CI 0.78-1.66). Continuous users of both SSRIs and TCAs had significantly higher risks of corticosteroid dependency compared to non-users (SSRI: OR 1.62, CI 1.15-2.27, TCA: OR 2.02, CI 1.07-3.81). Conclusions: Continuous ADM exposure has no protective effect in routine clinical practice in UC and identifies a population of patients requiring more intensive medical therapy. ADM use is a flag for potentially worse clinical outcomes in UC.
Jayasooriya N, Saxena S, Blackwell J, et al., 2021, Impact of consultation frequency and time to diagnosis on subsequent Inflammatory Bowel Disease outcomes, Publisher: OXFORD UNIV PRESS, Pages: S242-S243, ISSN: 1873-9946
Creese H-M, Taylor-Robinson D, Saglani S, et al., 2020, Primary care of children and young people with asthma during the Covid-19 era, British Journal of General Practice, Vol: 70, Pages: 528-529, ISSN: 0960-1643
Around 1.1 million children and young people (CYP)currently receive treatment for asthma in the United Kingdom (UK)(1). The UK performs poorly compared with other European countries in children's outcomes of asthma management and has had amongst the highest number of reported asthma deaths in Europesince 1998 (2). We evaluate evidenceofthe impact of Covid-19 on CYP with asthma and consider what actionsgeneral practitioners can take to protect these children from serious harm.
Creese H, Mason K, Schluter DK, et al., 2020, Early years pathways to inequalities in childhood asthma? A causal mediation analysis, EUPHA, Publisher: OXFORD UNIV PRESS, Pages: V434-V434, ISSN: 1101-1262
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