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.

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.

Maths without equations: Dr Tom Monks insights into patient flow from queuing theory

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.

It’s the taking part that counts – How using social networks might support mental health recovery. Sandra Walker writes about how her research took an unexpected turn.

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.

Where do people want to draw the line? Making shared decisions about treatment. Professor Alison Richardson

Professor Alison Richardson is Clinical Professor of Cancer Nursing and End of Life Care at the University of Southampton and University Hospital Southampton NHS Foundation Trust

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.

Involving patients and the public in research: Reflecting back and looking ahead

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

APPLIED HEALTH RESEARCH – GET A GRiP – Professor Anne Rogers Research Director of the NIHR 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.

Can we discuss end of life care with patients with COPD?

Nuno Caixinha Tavares – Staff Nurse at Queen Alexandra Hospital
Clinical Academic Fellow in the University of Southampton
NIHR CLAHRC Wessex – Theme 1 – Integrated Respiratory Care

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.

Why staying well is hard work. Professor Carl May – Healthcare Innovation

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.