Polypharmacy and the complexity of deprescribing medications – Dr Kinda Ibrahim

Dr KInda Ibrahim, is a Senior Research Fellow based in the Faculty of Medicine at University Hospital Southampton

The concurrent use of 5 or more medications by one individual – is becoming increasingly a challenging phenomenon that demands attention at clinical policy and practice level. In the past decade, the average number of items prescribed for each person per year in England has increased by 53.8% from 11.9 to 18.3. It is 35-50% of community older people aged 65 years and above take 5 or more medications. The King’s fund ¹ published in November 2018 a report “Polypharmacy and medicines optimisation: Making it safe and sound” where they distinguished between the terms ‘appropriate’ and ‘problematic’ polypharmacy.

Appropriate polypharmacy: means prescribing for an individual for complex conditions or for multiple conditions in circumstances where medicines use has been optimised and the medicines are prescribed according to best evidence.

Problematic polypharmacy where multiple medications are prescribed inappropriately, or where the intended benefit of the medication is not realised.

What does it mean to be a nurse? International Nurses Day

To mark International Nurses Day we asked the many researchers who are qualified nurses to answer these three questions:

1. What nursing means to you? And is there a different view of it if you’re originally from another country?
2. How you would encourage other nurses to progress and conduct research?
3. What are the challenges facing the future of nursing that you can see?

Here’s what they said.

Professor of Health Services Research and the lead for CLAHRC research into Fundamental Care in Hospital

Professor Peter Griffiths

I remember being asked in my interview for nursing why I wasn’t applying to be a doctor. There’s no simple answer to ‘what nursing is’ or ‘what it means to me’ but the answer I gave then is probably as close as I’ll ever get.

I’m not that interested in disease but I am interested in people. Nursing is about supporting and helping people, often through their most difficult times. While it’s hard to distinguish this from many other caring professions the key (to me) is that the focus is on the person comes first and the rest follows.

The movement behind saving our antibiotics

This week has been World Antibiotic Awareness Week to be followed tomorrow (Friday 18 November) by European Antibiotic Awareness Day. So what all the urgent action?

Well it’s well documented that resistance by bacteria to the existing supply of antibiotics is growing. The World Health Organisation has estimated that by 2050 deaths caused by antibiotic resistant bacteria could number 10 million people a year.

 

This week NIHR CLAHRC Wessex hosted the Southampton Premiere of the award winning short film Catch, which tells the story of a family broken apart and facing difficult choices in a post antibiotic world.

Give me more: Why Insulin pumps aren’t just about what the doctor tells you – Claire Reidy

More and more of us are looking online for information to support our health (see Chris Allen’s work on support in Online Communities). In my research, I have found that the ability to get hold of that information and support, which is personal to you, can make a huge difference to how well you are.

I’m focusing on insulin pumps, which are an alternative means to deliver insulin to people with diabetes – compared to the more traditional multiple daily injections.

Insulin pumps have been developed to help people with Type 1 diabetes manage the condition better; both in terms of their quality of life and by more closely resembling a fully-functioning pancreas.

However, introducing a new health technology to an already difficult to manage condition is not necessarily simple, or easy.

Should Wessex implement ReSPECT process? – The NIHR CLAHRC Wessex hosted event May 11, 2017

The event in Southampton attracted organisations* from across the Wessex region and beyond and a wide range of people including the public, paramedics, nursing staff, clinicians, managers and researchers.

Many stakeholders were represented bringing together 44 delegates, all there to examine and reflect on whether the ReSPECT approach to decision making for emergency care should be adopted.

OPINION: Tonight’s movie is a set in a dystopian future and stars your local A&E department. Dr Tom Monks

If you surf to a news website right now or flick on the TV news this evening, you might for a moment think that you watching a bad science fiction movie of a dystopian future starring your local A&E department. Sadly, it is real. The news has gone mad about A&E and the waiting time crisis that it faces. This morning the BBC reported that only 82% of patients are meeting the four-hour waiting time target. It doesn’t make pleasant reading.

Location, location, location – The social factors making a difference to kidney health.

Many of us don’t fully understand what our kidneys are for or how they work, but they are important to all of us. A team of us a CLAHRC Wessex have been conducting a big research project to find out more about something called ‘Acute kidney injury’, which is when the kidney suddenly stops working properly. This can make people very ill by causing a build-up of waste products in the blood and upsetting the balance of fluids in the body. As a result, people with acute kidney injury can have longer hospital stays and can experience serious consequences, such as needing dialysis or even dying.

Breathe in the knowledge -by Lindsay Welch

Lindsay Welch is the Integrated COPD Team Lead; Solent NHS Trust and UHS NHS Foundation Trust

COPD or Chronic Obstructive Pulmonary Disease is a preventable disease and is one of the world’s biggest killers – it causes a narrowing of the breathing tubes and air sacs in our chest and lungs, reducing the amount of oxygen we can get into our bodies. There are several causes, air pollution and exposure to dust, but the main culprit is smoking. It is estimated that over three million people with COPD in the UK but only a quarter of those are diagnosed

What’s at stake with Kidneys – Dr Simon Fraser

Doctor Simon Fraser is part of a team conducting the Hampshire Acute Kidney Injury study which is part of the Public Health and Primary Care theme of NIHR CLAHRC Wessex. He writes:

Kidneys are incredibly important to the human body. Among other things, they deal with fluids that we drink and help to regulate important functions like blood pressure.

Where the NHS stops and online takes over – Chris Allen

Chris Allen is a Research Fellow and a nurse in Southampton

There comes a point in everyone’s life when they get news that changes their life…of course it’s not always bad. Think “you’ve got the all clear” or “you’re going to have a baby”.

But what if that’s not so good. “You have diabetes” or “you have developed COPD”. In those cases firstly you might ask the doctor or nurse- “what can you do?” and “how is it going to affect me?”