Tag Archives: primary care

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CaHRU sleep research cited in UK parliamentary briefings on Sleep and Health

Sleep and healthResearch from CaHRU was cited in the recently published parliamentary briefing on Sleep and Health and Sleep and Long-term Health. The briefing was issued as a POSTnote from the Parliamentary Office of Science and Technology and cited CAHRU’s work on primary care for insomnia including the Resources for Effective Sleep Treatment (REST) website. Professor Graham Law and Niro Siriwardena met with one of the co-authors Lev Tankelevitch earlier this year to discuss their work.

Sleep and longterm healthThe briefing on Sleep and Health also cites two systematic reviews led by CaHRU’s Dr Coral Sirdifield on patient and general practitioner (GP) perceptions of the problems of benzodiazepine sleeping pills, an article by Prof Siriwardena providing guidance for GPs, and the OASIS trial (led by Prof Dan Freeman of Oxford University) showing the effects of treatment using digital Cognitive Behavioural Therapy for Insomnia (dCBTi) on psychiatric symptoms. The briefing on Sleep and Long-term Health  research papers on sleep assessment and the DIALS trial showing the effect of dCBTI on quality of life which is due for publication this autumn.

rest-logoThe REST project is also explicitly mentioned: ‘One strategy to improve training for healthcare professionals is through online training developed by the Resources for Effective Sleep Treatment project’ and the REST e-learning programme for GPs and healthcare staff has been accessed over 16,000 times by users in over 160 countries.

POSTnotes are distributed in paper copies to Parliamentarians, placed in the reference libraries of both Houses of Parliament and also promoted via social media using Twitter @POST_UK. CaHRU are currently collaborating in a major trial of sleep restriction therapy in primary care, the HABIT trial. You can find out more about our work on sleep from our infographic on ‘Sleep and Insomnia‘.

By Prof Niro Siriwardena

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Joseph Akanuwe receives PhD for work on communicating cancer risk

Joseph Akanuwe, doctoral student at CaHRU was recently confirmed by the College of Social Science Research Degrees Board that he be awarded his PhD for his thesis ‘Exploring service user and practitioner perspectives of using cancer risk assessment tools in primary care consultations. Cancer risk prediction tools are novel tools that combine risk factors and symptoms to predict an individual’s risk of developing cancer.

WP_20160208_16_16_01_RichThe work included a systematic scoping review followed by interviews of 19 service users and 17 primary care practitioners, the latter before and after they had used the tools in patient consultations. Participants suggested ways to best communicate cancer risk to patients in primary care consultations, emphasising the importance of: tailoring visual representation of risk; being open and honest; informing and involving patients in use of cancer risk prediction tools and providing time for listening, explaining and reassuring in the context of a professional approach.

He also found barriers to the uptake of cancer risk prediction tools including: the additional time required; worry and anxiety generated by referral for investigations; potential for over-referral; practitioner scepticism about using the new tool; and the need for evidence of effectiveness before introducing cancer risk prediction tools in general practice consultations. These barriers were perceived before the use of the tools. The findings add to the knowledge and understanding of how best to communicate cancer risk information to patients when using cancer risk prediction tools. Joseph was supervised by Profs Niro Siriwardena and Sara Owen, together with Dr Sharon Black.

By Prof Niro Siriwardena

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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/LIH seminar: Quality Improvement Collaboratives – theory design and effects

CaHRU_logotypeThe 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.

niro2QICs 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]

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Dr Pradeep Ratnasekare joins CaHRU as an international visiting fellow

sigiriya2Dr Pradeep Ratnasekare joined CaHRU this January 2018 as our third international visiting fellow from the University of Colombo’s Postgraduate Institute of Medicine. Pradeep graduated as a bachelor of Medicine and bachelor of Surgery in 1996 from the faculty of Medicine, University of Ruhuna and then completed postgraduate studies at the University of Colombo, Sri Lanka, in the fields of respiratory medicine and then in medical administration where he gained his master’s in 2011 and MD in 2016.

davHe has worked for over four years as a primary care medical officer, and six years as a medical officer in respiratory medicine, health system manager and health care researcher. As a health system manager he developed experience in various fields of hospital and public health programme management. He has worked as a hospital director in many secondary and tertiary care hospitals in Sri Lanka and worked as deputy director of the Medical Research Institute, the premier national level reference and referral medical laboratory and medical research centre for public and private sectors in Sri Lanka for last 18 months. His main interests are in health technology assessment and management, modern hospital planning and architecture, health system research and quality improvement in health care. Pradeep has several publications into his credit in the Journal of Medical Administrators Sri Lanka and Sri-Lanka journal of Health Policy and Management mainly on interventions carried out to improve health systems. He is a member of several academic associations in Sri Lanka including the College of Medical Administrators of Sri Lanka and Sri Lanka Medical Association. He is a member of research evaluation committee of the Medical Research Institute.

lilypondWhile at CaHRU he plans to: study the prehospital care system in the UK with a view to adapting it to develop a suitable model for Sri Lanka; to study the primary health care system in the UK National Health Service (NHS) of United Kingdom with respect to quality improvement and clinical governance; to study the systems and methods in place for Health Technology Assessment (HTA) and Health Technology planning in the United Kingdom; to learn about hospital design and planning; and to actively contribute to CaHRU’s research programme in primary and prehospital care. Listening to classical music, singing and playing cricket are his favourite hobbies.