Professor Niro Siriwardena was a keynote speaker at Lincolnshire Partnership NHS Foundation Trust’s (LPFT) Research and Innovation Conference which took place at Branston Hall on 8 March 2018. The conference was chaired by Dr Sue Elcock, medical director at LPFT. The event, which was attended by over 100 delegates, included keynote talks from Chris Roberts, Alzheimer’s Society Ambassador, Professor Belinda Lennox of the University of Oxford and Dr Joanna Moncrieff of University College London.
Chris Roberts, who himself has dementia and his wife, Jayne Goodrick spoke on ‘Join dementia research ‘handing out hope’ and the importance of those with the condition and their families engaging with studies into the condition as a means of providing possibilities for future treatment and care. Professor Cox spoke on her ground-breaking work on psychosis and immunity on ‘Could psychosis be a treatable immune disorder?’ This was followed by workshops on ‘How to make a first step into a clinical academic career’, ‘Taking a stab at research’, ‘How research improved practice’ and ‘Falls prevention in care homes’.
After lunch there followed LPFT’s innovation bid winners and how they had developed their ideas. Another example of ‘How to develop your ideas into research’ and the importance of collaboration between the NHS and the University of Lincoln was presented by Dr Amulya Nadkarni (consultant in child and adolescent mental health), Sophie Keogh (undertaking a research secondment at the Lincoln Institute for Health), Prof Siriwardena of CaHRU. They discussed how the collaboration began, how the ideas for research emerged, progress on current work on a systematic review of ‘Effects of non-pharmacological interventions for insomnia in children with Autistic Spectrum Condition, and how this was planned to lead to future work.
The final talk was from Dr Moncrieff on ‘Get involved – research into reducing or stopping antipsychotic medication’, how drugs could we withdrawn in some patients on these drugs and the programme of research which included a randomised controlled trial of antipsychotic withdrawal.
The latest in the CaHRU and Lincoln Institute for Health Improvement Science and Research Methods seminar series was given by Professor Siriwardena on ‘Quality Improvement Collaboratives (QICs): theory design and effects on 28 February 2018. The CaHRU team have led three large scale collaboratives over the past 12 years, including Resources for Effective Sleep Treatment (REST), the Ambulance Services Cardiovascular Quality Initiative (ASCQI) and most recently Scaling up PINCER (a pharmacist and information technology intervention to reduce potential clinically important prescribing errors in general practice.
QICs are an organised, multifaceted approach to quality improvement involving five essential features: a specified topic; clinical experts and experts in quality improvement provide ideas and support for improvement; multi-professional teams from multiple sites participate; using a model for improvement (measurement, change, feedback); and a collaborative process involves series of structured activities. The talk described how QICs have been used to implement healthcare interventions at scale and referred to a recent systematic review suggesting that over 4 out of 5 reported improvement in one or more outcomes although the quality of studies was variably poor.
QICs were described in terms of their common features: a logic model and theory of change; the complex (pragmatic) contexts of the intervention, setting and participants; and the variation in effects and changes that the intervention can or will undergo during the process of the collaborative. It was proposed that there were different types of collaborative based on their purpose which could be for intervention development, increasing reliability of evidence based processes, or scaling up evidence based complex interventions. It was argued that reviews of QICs should consider these different purposes when describing the outcomes and effects of QICs.
By Professor Niro Siriwardena[su_document url=”https://communityandhealth.dev.lincoln.ac.uk/files/2018/03/QICs_Siriwardena.pdf” width=”660″ responsive=”no”]Multi-morbidity, goal-oriented care, the community and equity[/su_document]
Dr Julie Pattinson presented at the Ottawa-International Conference on Medical Education (ICME), Abu Dhabi, United Arab Emirates; March 10th – 14th 2018. The conference is held biennially and provides a forum for medical and other health care profession educationalists to network and share ideas on all aspects of the assessment of competence in both clinical and non-clinical domains, throughout the continuum of education. There were near 1500 attendees, and hosted plenary sessions, symposia, oral presentations, workshops and poster sessions. Overall it was an educative programme covering all aspects of Health Professions with special emphasis on assessment.
Julie Pattinson of CaHRU gave a presentation in parallel session 13, titled Postgraduate Assessment on Understanding Reasons for Variations by Ethnicity in Attainment in the Performance of General Practitioners in Speciality Training completing the Membership of the Royal College of General Practitioners (MRCGP) Applied Knowledge Test; cognitive interview study. The study was conducted in collaboration with Professor Niro Siriwardena, University of Lincoln, Dr Bijoy Sinha, GP Speciality Training Director, Lincolnshire, and Dr Carol Blow, MRCGP clinical lead. Dr Pattinson talked about the differences that exists in candidate performance in high stakes medical licensing examinations, specifically the MRCGP AKT, between black and minority ethnic doctors (BME) compared to white British doctors. Grounded theory analysis generated discussions into why differences exist in candidates of different ethnicity highlighted that overseas trained doctors do face additional difficulties answering AKT questions.
The study has provided a basis for developing interventions to reduce differential attainment in UK speciality training for general practice. Overall the conference was interactive and five minute questions were addressed after each presentation.
The latest edition of the CaHRU Newsletter (Winter 2017/18) was published in March 2018. The newsletter presents the work of the research centre over the previous three months and includes articles from the CaHRU blog covering publications, conferences and funding. The newsletter is written by members of the CaHRU team and produced by Sue Bowler, CaHRU administrator.
[su_document url=”https://communityandhealth.dev.lincoln.ac.uk/files/2018/03/CaHRU-Newsletter-Winter-2017-18.pdf” width=”640″ responsive=”no”]Multi-morbidity, goal-oriented care, the community and equity[/su_document]
A qualitative study exploring the experiences and perceptions of informal carers of people with dementia when interacting with health care services was published this month in the journal Dementia. The study entitled ‘Caregivers’ interactions with health care services – Mediator of stress or added strain? Experiences and perceptions of informal caregivers of people with dementia – A qualitative study’ was undertaken by Despina Laparidou (lead author), Dr Jo Middlemass, Professor Terence Karran and Prof Niro Siriwardena.
The study explored carers’ unmet needs for both information/knowledge about dementia and support from healthcare services. The researchers found that carers would greatly benefit from detailed information on disease progression, guidelines and tips on dealing with challenging behaviours, as well as information on financial and legal advice. Carers also felt that health and social care services are often fragmented, making it harder for them to receive the support they need and want.
At the same time, healthcare professionals stated that while they have a theoretical knowledge of the disease, they felt they often lack knowledge of how it is to live with dementia, which can make it difficult to know how best to support carers. Another interesting finding of the study was that having carers keep a daily diary of symptoms and behaviour could help to empower carers and facilitate communications with healthcare professionals.
The research team hopes to expand this study and develop an educational intervention for informal carers of people with dementia.