The English GP Patient Survey is the single biggest and most reliable source of information for practices about how patients view their experience. But practices vary in how, and how much, they use the survey data to address patient perceptions.
The IMPROVE team carried out detailed analysis on 2009 GP Patient Survey data to examine the variations between patients in different ethnic groups. This showed that certain patient groups reported more negative experiences of care than all respondents.
While the GP Patient Survey data for any given practice is used a part of its CQC inspection record there is no other standard requirement for practices to review that data or act upon them. As a result there are wide variations in the use of the data and the value that can be derived from them.
This Highlight draws on four journal publications derived from the findings of the following NIHR research study: IMPROVE - Improving patient experience in Primary Care: a multi-method programme of research on the measurement and improvement of patient experience.
Collaborative care is a way of managing care and treatment for patients with chronic conditions. It has the potential to offer a more co-ordinated form of care, as well as the opportunity for case managers to provide simple psychological support.
At the moment, NICE recommend collaborative care only for people who have both depression and a chronic physical condition. But evidence suggests that collaborative care could be effective for people with depression alone.
Every few years a strain of flu emerges to which people have little immunity. It can spread quickly and cause a serious pandemic. This highlight discusses two influential projects funded by the NIHR during the last pandemic in 2009.
Before the 2009 pandemic, it was already known that pregnant women are more susceptible to the complications of flu, such as pneumonia. NIHR research also showed that if women caught flu during the pandemic, their babies were at greater risk of being born prematurely or even stillborn.
As with any condition, research is needed to identify the best treatment and management of flu. The results can be used with routine surveillance data to improve the outcomes for individuals and the population as a whole.
In the UK over ten million people are living with musculoskeletal conditions, such as arthritis and injuries. Evidence is now increasing on promising alternatives to open surgery, such as less invasive surgery, using slings or special types of plaster cast, and physiotherapy.
Three recent large NIHR trials have findings that can apply to many patients. These findings have helped healthcare professionals and patients to make decisions when discussing the most suitable treatment options.
Around 90% of people with dementia exhibit some form of challenging behaviour, including states of agitation and aggression. This is one of the most challenging aspects of care. As well as causing distress to carers, it can lead to inappropriate medication or hospital admission.
It is known that people with dementia often have other health issues, such as diabetes. Dementia is also associated with cardiovascular risk factors, like hypertension. These different conditions can interact in complex ways and the presence of dementia will affect the ability of individual to manage other diseases.
Problems with continence are often cited as one of the worst aspects of caring and can lead to people with dementia being admitted to care home or hospital. However, we do not know very much about how common it is or how carers cope.
An NIHR study started with a literature review to assess the evidence on exercise. It found limited, but promising, evidence to support the use of exercise to address the behavioral and psychological symptoms of dementia.
An NIHR programme reviewed published evidence on case management approaches. The review showed some evidence that case management led to better outcomes for people with dementia and their carers - but the picture was mixed.
Computerised or online CBT is offered by a number of providers, and involves completing a series of modules usually from a home computer with varying degrees of support but usually minimal or no direct contact with a therapist.
An NIHR study has found that individual, face to face cognitive behavioural therapy (CBT) used alongside anti-depressant medication, was effective for people with depression who had not responded to treatment with antidepressants alone.
More than half of people who experience depression once will go on to have at least one more episode. For people who have experienced several periods of depression, recurrence rates can be as high as 80%, even if an individual episode was treated successfully.
This Highlight is based on findings from the following four NIHR-funded studies. We selected these studies because they are relatively recent, high quality and fall within the specific area of cognitive therapies for depression.
A review of two large NHS weight-loss programmes found that only around 10% of referrals were men. But when men do engage with a weight-loss programme, they do well, with lower drop-out rates than women, and some evidence they may lose more weight than women.
Although men are more likely than women to be overweight or obese, they are less likely to seek help or join a weight-loss programme. If men do join a weight-loss programme, the evidence suggests there are certain factors which are more likely to make the programme successful.
There is limited evidence from the UK on the most effective weight-loss approaches for men. Those that exist mainly reflect the experience of white, middle class, middle aged men, and there is a lack of longer term data.
Stroke services have been transformed in the last twenty years and NIHR research has played an important part in this. Roads to Recovery should help those making decisions about stroke systems and services to deliver better care.
A healthy pregnancy helps a child to get the best possible start in life. Better Beginnings – Health for Pregnancy covers NIHR research into health and wellbeing before, during and soon after pregnancy.
Type 2 diabetes is a serious condition and big public health challenge. This themed review features over 50 studies that follow the patient pathway, from prevention through to management of the disease.