Tag Archives: impact

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CaHRU presents research on sleep at college summer showcase

BrayfordThe annual research showcase, featuring speakers from the College of Social Science took place on 6 June 2018. Professor Niro Siriwardena presented on CaHRU’s work on sleep. Sleep is fundamental to our wellbeing, from birth to old age. Poor sleep affects health, sickness, life, death, productivity, and the wider economy. Sleep is as important to health as other lifestyle factors such as diet and exercise but, compared to these, is under-researched and under-invested in. There are effective psychological treatments for insomnia but these are not widely available, whereas less effective and potentially harmful drug treatments are commonly used.

CSSsummershowcase2He described the work of members of CaHRU together with partners at the University of Lincoln and other academic institutions (Oxford, Manchester, Glasgow, Ghent), in partnership with service users, staff and healthcare organisations, locally, nationally and internationally. Over the past 15 years, using systematic reviews, observational and qualitative studies, quasi-experiments and trials, staff in CaHRU have explored the problem of primary care for sleep, how this might be improved, and what effect this is having on sleep, prescribing, and health outcomes.

INB2The work has led to a major multicentre trial, funded by the National Institute for Health Research (£1.8M), investigating the effectiveness and cost-effectiveness of sleep restriction therapy, a behavioural treatment for insomnia, delivered in primary care. These studies and the wider impacts of this work were presented to those present.

 

[su_document url=”https://communityandhealth.dev.lincoln.ac.uk/files/2018/07/Sleep_Siriwardena.pdf” width=”660″]Multi-morbidity, goal-oriented care, the community and equity[/su_document]

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CaHRU contributes to international EMS quality & safety programme

Professor Niro Siriwardena recently contributed to ‘Safer, Better and Stronger: Quality Improvement for EMS Leaders’ a one-day preconference course at the North American Emergency Medical Services Physicians (NAEMSP) Annual Conference in San Diego, on January 10, 2018.

SD1Around 60 EMS physicians attended the day to learn about quality improvement methods from experts based in the US and UK led by Dr Michael Redlener, EMS and Emergency Department physician based in New York city and chair of the NAEMSP Quality and Safety Committee together with Dr Scott Bourn, president of the National Association of EMS Educators, supported by Mike Taignan, Associate Professor in the Emergency Health Services Management graduate program at the University of Maryland Baltimore County, Dr David Williams, Executive Director at the US Institute for Health Improvement, and Prof Siriwardena from CaHRU.

SD4The preconference course began with an overview of the day by Dr Scott Bourn. This was followed by Dave Williams leading a session on the science of improvement including the ‘red bead experiment’ and an outline of Deming’s theory of profound knowledge. Niro Siriwardena led a session on understanding the model for improvement and Mike Taigman helped delegates get to grips with the plan-do-study-act cycle using the coin-spinning game. The later sessions were focussed on application of these ideas to selecting a good project, identifying measures, developing a measurement strategy, managing change and understanding what changes will result in an improvement faciltated by other faculty members including  Joseph Grover MD, Jeffrey L. Jarvis, MD, MS, EMT-P, Kevin Mackey, MD, FACEP, Kim D McKenna, PhD, RN, EMT-P, and James “Tripp” Winslow, MD, MPH.

SD3The day will be followed by a year-long course for around 25 delegates from the US and Canada who will take part in monthly moderated online educational sessions on key aspects of quality improvement, read relevant articles and conduct a ‘capstone project to implement quality improvement methods to a problem in their agency or system, supported by a mentor from the course faculty to help guide their progress. Participants will present their work to colleagues and members of the NAEMSP community to share the impact of quality improvement.

The preconference has been summarised by Dr Catherine Counts, one of the delegates in a blog entitled: ‘Quick take: Quality and safety gain prominence at NAEMSP‘.

[su_document url=”https://communityandhealth.dev.lincoln.ac.uk/files/2018/01/FLYER-QI-2018.pdf” width=”640″ responsive=”no”]Multi-morbidity, goal-oriented care, the community and equity[/su_document]

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‘Tribulations and trials in primary care insomnia’ at BSS 2017

brighton_metropole This year’s British Sleep Society (BSS) conference, held in Brighton at the Hilton Metropole, featured an invited presentation from Prof Niro Siriwardena, director of CaHRU, entitled ‘Tribulations and trials in primary care insomnia’.

After a welcome to the conference by Professor Mary Morell, President of the BSS, the opening keynote was given by Professor Franco Cappuccio, from the University of Warwick on the topic of ‘Healthy sleep’. This was followed by the opening session of the conference on ‘Sleep and health’ chaired by Professor Graham Law, secretary of the BSS and a member of CaHRU. This session included three presentations. The first was on ‘Sleep and chronic pain: moving from association to causation?’ give by Dr John brighton_peopleMcBeth, Reader at the University of Manchester. He described the bidirectional relationship between chronic pain and sleep, with pain giving rise to insomnia and sleep disturbance exacerbating or even causing pain. Studies had shown that treating insomnia in people with chronic pain, for example due to fibromyalgia led to improvements in wellbeing and quality of life but no improvement in pain.

Prof Siriwardena next talked about how he had initially developed an interest in the problem of insomnia through initial research into use of sleeping tablets by general practitioners. ‘Tribulations and trials in primary care insomnia’ went on to describe the studies that showed that hypnotic drugs like benzodiazepines and z-drugs though often prescribed for insomnia did more harm than good, and that primary care trials of cognitive behavioural therapy for insomnia (CBT-I) showed positive effects. He went on to describe the work on the Resources for Effective Sleep Treatment (REST) project, a quality improvement project which successfully implemented CBT-I in general practice which led to reduced hypnotic prescribing in those practices. Because of the low uptake of CBT-I in primary care, there was increasing evidence that online or self-help CBT-I was effective with similar effect sizes to face-to-face individual or group therapy. Finally he presented the evidence on short behavioural therapies such as sleep restriction therapy including a forthcoming HTA funded trial led by Oxford University’s Simon Kyle and involving the Universities of Manchester (Peter Bower) and Lincoln (Niro Siriwardena).

brighton_sea

The final talk in the session was Dr Eleanor Scott, Senior Lecturer at Leeds University and Consultant Diabetologist at Leeds Teaching Hospitals, who spoke on Sleep and metabolic health, describing the relationship between insomnia and diabetes, obesity and cardiovascular disease. This was followed by Dr Jason Rihel,of University College London discussing his work on sleep in zebrafish and Dr Claire Sexton of Oxford University on her work on sleep related to dementia. Brighton was an excellent setting for a well-attended BSS conference.

By Niro Siriwardena

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Despina Laparidou presents Scaling up PINCER at ISQua 2017

IMG_0923Despina Laparidou, Research Assistant at CaHRU, together with Antony Chuter, a patient representative for Scaling Up PINCER (pharmacist-led information technology intervention for reducing clinically important errors) recently attended the International Society for Quality in Health Care (ISQua) Conference at the Queen Elizabeth II Conference Centre in London (1st – 4th October 2017) and presented the preliminary findings of the Scaling Up PINCER project, funded by the Health Foundation.

IMG_1639The Main Conference offered a combination of exciting plenaries, short oral presentations and longer themed sessions, while poster and e-poster presentations were also presented throughout the duration of the conference. One of the most interesting sessions was the “A Mile in My Shoes”. A Mile in My Shoes is an interactive shoe shop that invited delegates to “(literally) step into someone else’s shoes and embark on a mile-long physical, emotional and imaginative journey to see the world through their eyes”. The session involved listening to, while wearing their shoes at the same time, unique audio stories from people working within health and social care, sharing their experiences and showing the remarkable contribution and challenges faced by those working in, and using, our health and social care system.

IMG_1634Despina and Antony gave their presentation on the morning of Tuesday 3rd October during a session on “Health Foundation Improving Quality in Community Health Services” and was very well received by the audience. PINCER is a pharmacist-led information technology intervention for reducing clinically important errors in medication management in general practices and the study’s preliminary results show early indications of improvement in most of the study’s safety indicators for gastrointestinal bleed, stroke, heart failure and acute kidney injury, but not for the two asthma indicators. The session, chaired by Will Warburton from The Health Foundation, also showcased studies, such as the “Ophelia Project” on improving health literacy for vulnerable people in the community, and “Making Waves” on Promoting a positive experience for people with COPD.

The Conference came to an end with Wednesday’s plenary and the promise to meet again in 2018 for an even more exciting ISQua Conference in Malaysia!

By Despina Laparidou