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.
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.
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.
Previously I have written about using a detailed computer model to ask ‘what-if’ an emergency department could be run differently. Hidden away in complex models like these are important rules of thumb that tell us how to efficiently manage patient flow.
Managing our mental health is something we all do and for many of us it is a fairly straightforward process, but a significant number of us are likely to find it rather more complex, sometimes needing support from our GP or mental health services. As part of our research in CLAHRC Wessex we’re looking at how people use their social networks to improve and manage their mental health.
Many patients whose condition becomes worse during their stay in hospital face uncertainty about the likelihood of recovery. For patients, families and healthcare professionals deciding on the best thing to do can be hard.
By Claire Ballinger and Mark Stafford-Watson – Chairs, Wessex Inclusion in Service Design and Delivery (WISeRD) group
It’s the end of our first year in CLAHRC Wessex, we have been thinking about our progress in involving patients and the public in our work (or PPI as it’s called), and reviewing where our focus should be for the coming year. We have settled on five strategic aims:
Develop our capacity for patient and public involvement (PPI) in research and implementation programmes
Promote our CLAHRC Wessex activities to the wider public (public engagement)
Evolve and measure ways to include patients and the public to identify research priorities
Develop a group of patient and public researchers
Measure the impact of patient and public involvement within CLAHRC Wessex
In the many discussions I’ve had people about our newly established and growing CLAHRC programme of research and implementation, it often centres on the question of what is Applied Health Research? Is it different from more conventional bio-medical research? It made me think that we need to be a bit more explicit about this thing called Applied Research. So here goes.
I’m Nuno Tavares, a staff nurse at Queen Alexandra Hospital and I’m also a PhD student carrying out research for NIHR CLAHRC Wessex and Portsmouth Hospitals NHS Trust. My research is about improving end of life care for patients with COPD.
Living with a serious long-term condition is often hard and complex work. My team and I are interested in finding ways to reduce complexity and lift the burden for people with these conditions, and their families, at end of life.
To help us think about the kind of research questions we should be asking we held a research forum at Freemantle Community Centre in Southampton. We invited people with a range of conditions to join us and to inform our work.
This site promotes independent research by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Funding Scheme. The views expressed in this blog are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health