Tag Archives: multimorbidity

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Comparing national multimorbidity policies and guidelines

CaHRU_logotypePeople living with a long-term condition often have more than one condition to contend with. This is known as ‘multimorbidity’, commonly defined as the co-occurrence of two or more chronic conditions within one person. In this situation it is important that the person, not the disease, is the focus. Policies referring to multimorbidity are considered a crucial element in safe health systems.

NadeekaChandraratneThe CaHRU team of Dr Nadeeka Chandraratne and Dr Ravindra Pathirathna, international visiting fellows attached to CaHRU from the Postgraduate Institute of Medicine at the University of Colombo, Sri Lanka, together with Prof Niro Siriwardena and Dr Christopher Harrison from the University of Sydney conducted a content analysis of policy documents and guidelines on multimorbidity from the UK, Australia and Sri Lanka. Despite considerable differences in healthcare structure and financing, all three countries face the challenge of multimorbidity. An understanding of how each country is addressing this challenge was considered important for identifying policy initiatives, gaps and opportunities for further improvement.

RavindraPathirathneThe article describing the study and its findings, ‘A comparison of policies and guidelines related to multimorbidity in the UK, Australia and Sri Lanka‘, was published this month in the first issue of the Australian Journal of General Practice 2018 with an accompanying editorial on Multimorbidity written by Niro Siriwardena and Christopher Harrison.

The team found overall a lack of health policy and guidance for multimorbidity: the guideline ‘Multimorbidity: Clinical assessment and management’ from The National Institute for Health and Care Excellence (NICE), UK was the only specific guideline on multimorbidity. Australia and Sri Lanka lack specific national documents addressing multimorbidity. The promising features observed in Australia were policies that are directly concerned with the health of socially disadvantaged groups, which are at higher risk of multimorbidity. Policies in Sri Lanka were more concerned with preventing chronic conditions, and on community mobilisation and empowerment.

lilyThe paper highlights that Sri Lanka needs to focus on policies that emphasise integration and patient-centred healthcare delivery for people with multimorbidity, whereas in the UK and Australia, policies on community-based approaches to address determinants of multimorbidity are needed.

By Dr. Nadeeka Chandraratne

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CaHRU at SAPC Annual Scientific Meeting in Dublin 2016

Despina A team from CaHRU, Dr Coral Sirdifield, Dr Jo Middlemass, Despina Laparidou and Professor Niro Siriwardena, attended the 45th Annual Scientific Meeting of the National Society of Academic Primary Care (SAPC) held at Dublin Castle from 6th-8th July where they gave oral, elevator and poster presentations. The conference opening plenary was given by Prof Margaret Cupples from Belfast who spoke on non-pharmacological interventions for cardiovascular prevention. After parallel session and posters Prof Chris Dowrick delivered the 3rd Helen Lester memorial lecture on his work on depression and mental illness, and this was followed by a drinks reception at the Royal College of Surgeons of Ireland.

JoDespina Laparidou (above right) gave an oral presentation on challenges for carers of people with dementia and their support needs from health and social care providers. Jo Middlemass (left) gave an elevator presentation on perceptions and experiences of telemonitoring in older patients with multimorbidity. Niro Siriwardena presented on behalf of Jolien Vos on personal care networks of older people with multimorbidity. Coral Sirdifield presented her poster entitled ‘What does qualitative research on patients’ experiences tell us about how to support safer prescribing of benzodiazepines and and z-drugs?’ Dr Zahid Ashgar’s Dublinposter entitled ‘Suspected cross-sectional study of factors associated with transport to hospital after a suspected convulsion or seizure’ was also presented at the conference.

While they were there, the team also had a little time to sample the cultural delights of Dublin including open air music, Irish dancing and the lively Temple Bar, culminating in an enjoyable conference dinner on Thursday evening.

By Jo Middlemass

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CaHRU presents at College Research Showcase

Members of the CaHRU team recently attended the College of Social Science Research Showcase at the University of Lincoln on 4 July 2016. The event aimed to present the work being undertaken across the College of Social Science. The day started with registration and a poster-viewing session. Posters portrayed research from a variety of areas, ranging from animal and comparative psychology, “Dogs and humans respond to emotionally competent stimuli by producing different facial actions” (Catia Correia Caeiro, Dr Kun Guo, Prof Daniel Mills) to other topics from the Schools of Psychology, Health & Social Care and Sport & Exercise Science.

WP_20160704_09_36_33_RichThe rest of the day included presentations from across the College of Social Science, with Dr Jo Middlemass (pictured right) giving the first presentation of the day on her innovative work on the EU funded CHROMED project (Clinical Trials for Elderly Patients with Multiple Diseases), entitled “Perceptions and experiences of tele-monitoring in older patients with multi-morbidity- a qualitative study”. Other CaHRU members also gave excellent presentations including Mohammed Iqbal (“A non-randomised control study to investigate the effectiveness of a novel pain assessment tool for use by ambulance clinicians: improving prehospital pain management”), Dr Zahid Asghar (“Exploratory Cross-Sectional Study of Factors Associated with Transport to Hospital in Patients with Suspected Convulsions presenting to Ambulance Services”), WP_20160704_12_33_22_RichJoseph Akanuwe ( pictured left “Exploring service user and practitioner perspectives of QCancer use in primary care consultations”), Viet-Hai Phung (“Delivering ambulance service care that meets the needs of EU Accession migrants in Lincolnshire”), Fiona Togher (“The use of cognitive interviews to enhance the quality of a Patient Reported Experience Measure (PREM) for use in NHS ambulance services”), Dr Stephanie Armstrong (“Network exploring the Ethics of Ambulance based clinical Trials (NEAT)”), and Despina Laparidou (“Challenges for carers of people with dementia and their support needs from health and social care providers: a qualitative study”). Overall, the event was an excellent opportunity for all researchers to present their work and ‘showcase’ the wonderful projects taking place within CaHRU.

A quick break for a final session of poster viewing was followed by the keynote speaker, Prof Martin Tovee from the School of Psychology, giving an excellent talk on “Body Image, Eating Disorders and the Media”. The day was brought to its close with a reception, where delegates had the opportunity to further discuss the presentations given earlier and share thought-provoking ideas.

By Despina Laparidou

 

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Patients and health professionals join research team to hear about early CHROMED study findings

chromedevent1Research participants along with their spouse or carer, and health professionals who took part in the CHROMED trial were invited to a feedback session on Wednesday 23rd March at the Petwood Hotel in Woodhall Spa to mark the end of the study and to hear about initial results from the trial.

 

chromedteamCHROMED (Clinical Trials for Elderly Patients with Multiple Diseases) is a European Commission (Framework 7) funded randomised control trial (RCT) which was conducted over three years in seven European countries. The study looked at the impact of telemonitoring equipment in the homes of older people (aged 60 years or over) with a chronic condition commonly known as COPD (Chronic Obstructive Pulmonary Disease) and an associated heart condition. The University of Lincoln and Lincolnshire Community Health Services NHS Trust (LCHS) collaborated closely on this study with partners in Liverpool, Italy, Spain, Sweden, Norway, Estonia, and Slovenia.

chromedevent2Dr Jo Middlemass, study research nurse, gave a presentation detailing the early results. In the feasibility (testing) phase a new breathing device (Resmon Pro) was shown to have identified a chest infection five days before it was treated. It was too early to present the results from the main study but Jo described the findings from interviews carried out with those participants who had the equipment in their homes. David Madeley (technician from Electronic Assistive Technology Service at LCHS) set up the equipment at the event to give everyone who wished to do so, and particularly those who were in the observation arm, an opportunity to try the equipment.

The event was positively received and culminated in a delicious afternoon tea!

By Dr Jo Middlemass

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CaHRU team attends CHROMED European trial meeting in Uppsala, Sweden

Dr Jo Middlemass, trial nurse, and Prof Niro Siriwardena who are members of the Clinical Trials for Elderly Patients with Multiple Diseases (CHROMED) (Funding by the European Commission’s 7th Framework Programme) attended the final investigator team meeting in Uppsala earlier this month (March 2016).

IMG_4175The study includes a consortium of seven European countries led by TESAN (Italy), Restech and including Del Politcnico Di Milano (Italy), University of Liverpool (UK), Tallina Tehnikaulikool (Estonia), Universitat De Barcelona (Spain), Uppsala Universitet (Sweden), Universitetssykehuset Nord-Norge (Norway), Bolnisnica Sezana Zavod (Slovenia), University of Lincoln, Lincolnshire Community Health Services NHS Trust.

The CHROMED study has been investigating the effectiveness and cost-effectiveness of a telemonitoring system for people with multiple chronic disease, specifically Chronic Obstructive Pulmonary Disease (COPD) and heart disease. The trial in Lincoln involved a feasibility study of five patients and a randomisation cohort of 32 patients aged 65 years and above in Lincolnshire. The monitoring equipment included a novel device for measuring lung function (using a technique called forced oscillation) and a wrist clinic measuring pulse, blood pressure, oxygen saturation, and temperature.

chromedThe study has already shown evidence that monitoring can detect patients’ worsening condition, even before symptoms are apparent. The study data have now been collected and are being analysed to see whether the monitoring system has improved patients’ outcomes, quality of life and healthcare costs.