A5024928084- Chronic Disease Management Strategies
- Primary Care and Health Outcomes
- Health Systems, Economic Evaluations, Quality of Life
- Diabetes Management and Education
- Geriatric Care and Nursing Homes
- Emergency and Acute Care Studies
- Acute Kidney Injury Research
- Heart Failure Treatment and Management
- Healthcare cost, quality, practices
- Healthcare Policy and Management
- Pharmaceutical Practices and Patient Outcomes
- Frailty in Older Adults
- Dialysis and Renal Disease Management
- Chronic Kidney Disease and Diabetes
- Interprofessional Education and Collaboration
- Blood Pressure and Hypertension Studies
- Cardiac Arrest and Resuscitation
- Healthcare Decision-Making and Restraints
- Patient Safety and Medication Errors
- Mental Health and Patient Involvement
- Cardiovascular Function and Risk Factors
- Health Policy Implementation Science
- Telemedicine and Telehealth Implementation
- Healthcare Systems and Technology
- Homelessness and Social Issues
University of Manchester
2016-2025
Manchester Academic Health Science Centre
2014-2025
National Institute for Health Research
2014-2024
Primary Health Care
2011-2024
NIHR Manchester Biomedical Research Centre
2015-2023
University of Exeter
2023
NIHR School for Primary Care Research
2023
NIHR Greater Manchester Patient Safety Translational Research Centre
2020-2023
Royal College of General Practitioners
2020
Salford Royal NHS Foundation Trust
2017-2020
<b>Objective</b> To determine the effectiveness of an intervention to enhance self management support for patients with chronic conditions in UK primary care. <b>Design</b> Pragmatic, two arm, cluster randomised controlled trial. <b>Setting</b> General practices, serving a population northwest England high levels deprivation. <b>Participants</b> 5599 diagnosis diabetes (n=2546), obstructive pulmonary disease (n=1634), and irritable bowel syndrome (n=1419) from 43 practices (19 22 control...
Background. Primary care professionals often manage patients with multiple long-term health conditions, but managing multimorbidity is challenging given time and resource constraints interactions between conditions. Objective. To explore GP nurse perceptions of the influence on service organization clinical decision making. Methods. A qualitative interview study primary in practices Greater Manchester, UK. Interviews were conducted 15 GPs 10 practice nurses. Results. identified tensions...
Demographic and policy changes appear to be increasing the complexity of consultations in general practice.To describe number types problems discussed practice consultations, differences between raised by patients or doctors, recorded medical records.Cross-sectional study based on video recordings 22 practices Bristol North Somerset.Consultations were examined 30 representative GPs adults making a pre-booked day-time appointment. The main outcome measures issues discussed; who each...
To examine if there is an increased participation in physical or sporting activities following Olympic Paralympic games.Overview of systematic reviews.We searched the Medline, Embase, Cochrane, DARE, SportDISCUS and Web Knowledge databases. In addition, we for 'grey literature' Google, Google scholar on International Committee websites. We restricted our search to those reviews published English. used AMSTAR tool assess methodological quality included.The primary outcome was evidence...
The challenge of ageing populations and frail people: can primary care adapt? StandfirstHealth systems worldwide are having to adapt increasing numbers older people with frailty complex health social needs, in the UK is at frontline policy attempts meet this challenge, but achieving goal making an integral part practice not without considerable challenges.
Abstract Title. Practice nurses and the facilitation of self‐management in primary care. Aim. This paper is a report study to explore practice nurse involvement for long‐term conditions. Background. In United Kingdom chronic disease services have shifted from secondary care general practitioners nurses. A new General contract requires adherence management protocols, facilitating recognized as an important component. However, improving relatively focus little known about ways which engage...
Implementation of long-term condition management interventions rests on the notion whole systems re-design, where incorporating wider elements health care are integral to embedding effective and integrated solutions. However, most self-management support (SMS) evaluations still focus particular or outcomes a sub-system. A randomised controlled trial SMS intervention (WISE-Whole System Informing Self-management Engagement) implemented in primary showed no effect patient-level outcomes. This...
<h3>Background</h3> Primary care is recognised to have an important role in the delivery of for people with chronic kidney disease (CKD). However, there evidence that CKD management currently suboptimal, a range practitioner concerns about its management. <h3>Aim</h3> To explore processes underpinning implementation primary care. <h3>Design and setting</h3> Qualitative study general practices participating collaborative undertaken as part National Institute Health Research (NIHR)...
An implementation gap exists between policy aspirations for provision and the delivery of self-management support in primary care. evidence based training package using a whole systems approach implemented as part randomised controlled trial was delivered to general practice staff. The found no effect intervention on patient outcomes. This paper explores why failed become normal practice. We focussed tools which capture two key aspects – education (guidebooks patients) forming collaborative...
A growing proportion of people are living with long term conditions. The majority have more than one. Dealing multi-morbidity is a complex problem for health systems: those designing and implementing healthcare as well providing the evidence informing practice. Yet concept (the presence >2 diseases) product design care systems which define need on basis disease status. So does solution lie in an alternative model healthcare?Strengthening generalist practice has been proposed part to tackling...
Abstract Background The prevalence and impact of long term conditions continues to rise. Care planning for people with has been a policy priority in England chronic disease management. However, it is not clear how care currently understood, translated implemented primary care. This study explores experience patients three areas England. Methods We conducted semi-structured interviews 23 predominantly elderly multiple conditions. were designed explore variations emergent experiences planning....
Background Implementation of self-management support in traditional primary care settings has proved difficult, encouraging the development alternative models which actively link to community resources. Chronic kidney disease (CKD) is a common condition usually diagnosed presence other co-morbidities. This trial aimed determine effectiveness an intervention provide information and telephone-guided access versus usual for patients with stage 3 CKD. Methods Findings In pragmatic, two-arm,...
Patients with long-term conditions are increasingly the focus of quality improvement activities in health services to reduce impact these on life and burden care utilisation. There is significant interest potential for self-management support improve utilisation patient populations, but little consensus concerning optimal model that would best provide such support. We describe implementation evaluation through an evidence-based 'whole systems' involving support, training primary teams,...
Abstract Objective To combine insights from service users with long‐term conditions ( LTC s) to assist the development of a community referral intervention designed promote engagement and improve access health‐relevant resources. Background Social deprivation reduced resources have been causally linked social isolation ability manage s. Participation in meaningful activity has associated positive health benefits, strategies activities shown some potential outcomes for people This suggests...
Background The COVID-19 pandemic has caused unprecedented disruption and change to the organisation of primary care, including for people experiencing homelessness who may not have access a phone. Little is known about whether recent changes required deliver services will help address or compound inequality in accessing care. Aim To explore experience impact organisational technology response on health care homelessness. Design setting An action-led participatory research methodology was...
Three leading disease causes of age-related visual loss are cataract, macular degeneration (AMD), and glaucoma. Although all 3 eye diseases have been implicated with falls fracture risk, evidence is mixed, the contribution different being uncertain.
Objectives: To understand social processes underpinning support for self-management of long-term conditions in primary care. Methods: Comparative analysis observational and interview data concerning the management UK primary-care consultations. Analysis recordings care consultations (n = 86) was conducted conjunction with semi-structured interviews health professionals 17) patients 12) living a condition. Results: A key finding infrequency which topics became legitimate objects discussion...