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Hughes SE, Aiyegbusi OL, McMullan C, Turner GM, Anderson N, Cruz Rivera S, Collis P, Glasby J, Lasserson D, Calvert M. Patient-reported outcomes in integrated health and social care: A scoping review. JRSM Open 2024; 15:20542704241232866. [PMID: 38529208 PMCID: PMC10962043 DOI: 10.1177/20542704241232866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024] Open
Abstract
Background Patient-reported outcomes (PROs) have potential to support integrated health and social care research and practice; however, evidence of their utilisation has not been synthesised. Objective To identify PRO measures utilised in integrated care and adult social care research and practice and to chart the evidence of implementation factors influencing their uptake. Design Scoping review of peer-reviewed literature. Data sources Six databases (01 January 2010 to 19 May 2023). Study selection Articles reporting PRO use with adults (18+ years) in integrated care or social care settings. Review methods We screened articles against pre-specified eligibility criteria; 36 studies (23%) were extracted in duplicate for verification. We summarised the data using thematic analysis and descriptive statistics. Results We identified 159 articles reporting on 216 PRO measures deployed in a social care or integrated care setting. Most articles used PRO measures as research tools. Eight (5.0%) articles used PRO measures as an intervention. Articles focused on community-dwelling participants (35.8%) or long-term care home residents (23.9%), with three articles (1.9%) focussing on integrated care settings. Stakeholders viewed PROs as feasible and acceptable, with benefits for care planning, health and wellbeing monitoring as well as quality assurance. Patient-reported outcome measure selection, administration and PRO data management were perceived implementation barriers. Conclusion This scoping review showed increasing utilisation of PROs in adult social care and integrated care. Further research is needed to optimise PROs for care planning, design effective training resources and develop policies and service delivery models that prioritise secure, ethical management of PRO data.
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Affiliation(s)
- Sarah E Hughes
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration West Midlands, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Blood and Transplant Research Unit in Precision Cellular Therapeutics, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Olalekan L Aiyegbusi
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration West Midlands, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Blood and Transplant Research Unit in Precision Cellular Therapeutics, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Christel McMullan
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Blood and Transplant Research Unit in Precision Cellular Therapeutics, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Surgical Reconstruction and Microbiology Centre, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Grace M Turner
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Nicola Anderson
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration West Midlands, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Samantha Cruz Rivera
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- DEMAND Hub, University of Birmingham, Birmingham, UK
| | | | - Jon Glasby
- School of Social Policy, University of Birmingham, Birmingham, UK
- IMPACT (Improving Adult Social Care Together), University of Birmingham, Birmingham, UK
| | - Daniel Lasserson
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration West Midlands, Birmingham, UK
- Warwick Medical School, University of Warwick, Coventry, UK
- Department of Geriatric Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Melanie Calvert
- Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration West Midlands, Birmingham, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Blood and Transplant Research Unit in Precision Cellular Therapeutics, University of Birmingham, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- National Institute for Health and Care Research (NIHR) Surgical Reconstruction and Microbiology Centre, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- DEMAND Hub, University of Birmingham, Birmingham, UK
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Urquhart A, Yardley S, Thomas E, Donaldson L, Carson-Stevens A. Learning from patient safety incidents involving acutely sick adults in hospital assessment units in England and Wales: a mixed methods analysis for quality improvement. J R Soc Med 2021; 114:563-574. [PMID: 34348052 DOI: 10.1177/01410768211032589] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Six per cent of hospital patients experience a patient safety incident, of which 12% result in severe/fatal outcomes. Acutely sick patients are at heightened risk. Our aim was to identify the most frequently reported incidents in acute medical units and their characteristics. DESIGN Retrospective mixed methods methodology: (1) an a priori coding process, applying a multi-axial coding framework to incident reports; and, (2) a thematic interpretative analysis of reports. SETTING Patient safety incident reports (10 years, 2005-2015) collected from the National Reporting and Learning System, which receives reports from hospitals and other care settings across England and Wales. PARTICIPANTS Reports describing severe harm/death in acute medical unit were identified. MAIN OUTCOME MEASURES Incident type, contributory factors, outcomes and level of harm were identified in the included reports. During thematic analysis, themes and metathemes were synthesised to inform priorities for quality improvement. RESULTS A total of 377 reports of severe harm or death were confirmed. The most common incident types were diagnostic errors (n = 79), medication-related errors (n = 61), and failures monitoring patients (n = 57). Incidents commonly stemmed from lack of active decision-making during patient admissions and communication failures between teams. Patients were at heightened risk of unsafe care during handovers and transfers of care. Metathemes included the necessity of patient self-advocacy and a lack of care coordination. CONCLUSION This 10-year national analysis of incident reports provides recommendations to improve patient safety including: introduction of electronic prescribing and monitoring systems; forcing checklists to reduce diagnostic errors; and increased senior presence overnight and at weekends.
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Affiliation(s)
- Alexandra Urquhart
- Division of Population Medicine, Cardiff University, Cardiff CF14 4YU, UK
| | - Sarah Yardley
- Central and North West London NHS Foundation Trust, London NW1 3AX, UK.,Marie Curie Palliative Care Research Department, University College London, London WC1E 6BT, UK
| | - Elin Thomas
- Division of Population Medicine, Cardiff University, Cardiff CF14 4YU, UK
| | - Liam Donaldson
- Division of Population Medicine, Cardiff University, Cardiff CF14 4YU, UK.,London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
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Zipitis CS, Mughal ZM, Clayton PE. Assessing the population impact of low rates of vitamin D supplementation on type 1 diabetes using a new statistical method. JRSM Open 2016; 7:2054270416653522. [PMID: 27895928 PMCID: PMC5117162 DOI: 10.1177/2054270416653522] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Vitamin D supplementation for all children <5 is recommended by the UK Department of
Health for its skeletal effects. Vitamin D is also linked with a number of extra-skeletal
effects; one of them being protection against type 1 diabetes. With a rapid increase in
the incidence of type 1 diabetes and the associated costs, measures of curtailing the
rapid increase of type 1 diabetes are needed. In this review, we look at type 1 diabetes
using a statistical method (PIN-ER-t) and published data in an attempt to quantify the
impact on the population of babies born in 2012 of increasing vitamin D supplementation
rates. Calculations show that for the population of 729,674 babies born in England and
Wales in 2012, 374 cases of type 1 diabetes (out of 1357 total predicted) could be
prevented over 18 years if all were supplemented with vitamin D. This could lead to
savings in excess of £62 million for the cohort. This piece of work adds to the argument
for studying the potential link between vitamin D supplementation and type 1 diabetes
further.
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Affiliation(s)
- Christos S Zipitis
- The University of Manchester, Manchester Academic Health Science Centre, Department of Paediatrics, Wrightington Wigan & Leigh NHS Foundation Trust, Wigan Lane, Wigan WN1 2NN, UK
| | - Zulf M Mughal
- The University of Manchester, Manchester Academic Health Science Centre, Department of Paediatric Endocrinology, Central Manchester University Hospitals NHS Trust, Oxford Road, Manchester M13 9WL, UK
| | - Peter E Clayton
- The University of Manchester, Manchester Academic Health Science Centre, Department of Paediatric Endocrinology, Central Manchester University Hospitals NHS Trust, Oxford Road, Manchester M13 9WL, UK
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