Impact of a national quality improvement programme for hospital wards is unclear
The Productive Ward quality improvement programme has shown some procedural changes on hospital wards in England in the 10 years since it was introduced. But evidence to show any sustained changes to the experiences of staff or patients is hard to find.
This NIHR-funded study used quantitative and qualitative methods to evaluate the programme in six acute hospitals in England. It found some evidence of a lasting impact, such as wards continuing to display metrics and using equipment storage sys...
Computerised speech and language therapy can help people with aphasia find words following a stroke
People with aphasia caused by a stroke showimprovements in retrieving words when they useself-managed computerised speech and language therapy in addition to usual care from a speech and language therapist. No improvements are seen in patients’ conversational abilities or their quality of life.
Aphasia is a complex language and communication disorder. It can affect people’s abilities to read, listen, speak, and write or type. Symptoms vary: some people may mix up a few words, while ...
Online patient feedback is mostly positive — but is not being used effectively
People are increasingly reading online feedback from other patients to gauge service qualitybut fewer people go online to write feedback themselves. Health organisations and professionals are not currently effective at using this feedback to improve services.
These findings come from an NIHR-funded study which used five research streams to provide an overview of online patient feedback in the NHS.
Healthcare professionals rarely encourage online patient feedback and may be sceptical about it. ...
Working in groups with ongoing support is valued by people with severe obesity trying to lose weight
People with severe obesity, a BMI of 35kg/m² or more, value the support and motivation they get from weight management programmes that include group-based interventions. However, commissioners and service managers should consider how to maintain adequate support and motivation once programmes end.
Although previous studies have assessed the impact of non-surgical weight management programmes for obese adults, this is the first qualitative review to focus on the opinions of providers and ad...
Holistic services in advanced lung disease can help people cope better with breathlessness
Services providing holistic health care can improve the psychological well-being of people who are living with breathlessness associated with chronic or advanced lung disease, such as lung cancer or chronic obstructive pulmonary disease. Breathlessness is a distressing symptom in which feelings of fear and helplessness, social isolation, high levels of anxiety and significant carer burden are common experiences.
Drugs can have limited effectiveness in advanced disease and do not address the und...
Losing weight following type 2 diabetes diagnosis boosts chance of remission
People who lose at least 10% of their body weight in the first year after being diagnosed with type 2 diabetes increase their chances of being in remission after five years, compared with those whose weight remains stable. Losing this achievable amount of weight over the next four years also makes remission more likely.
In this study of 867 people, 257 (30%) achieved remission at five-year follow-up. The participants had been taking part in a trial but had not received intensive lifestyle inter...
Telephone-delivered CBT can provide lasting benefits for people with IBS
People with irritable bowel syndrome (IBS) who receive cognitive behavioural therapy (CBT) continue to have lower levels of symptoms over the following two years. Telephone-delivered CBT is particularly effective, with 71% of study participants experiencing a clinically significant improvement in their IBS symptoms.
This NIHR-funded study is the 24-month follow-up to an earlier publication of 12-month outcomes for 558 people with IBS receiving usual care alone or additional telephone or web-bas...
Partial knee replacement ‘could be first choice’ for suitable patients with osteoarthritis
Partial knee replacement surgery improves pain and function similarly tototal knee replacement in people with osteoarthritis that affects only a single compartment of the knee. Partial knee replacement surgery is also cheaper.
In this NIHR-funded trial of 528 people with osteoarthritis affecting only one compartment of the knee, those who had partial knee replacement saw at least as much improvement as those who had a total joint replacement. Their care also cost about £900 less over five...
Better strategies are needed to reduce preventable patient harm in healthcare
About 6% of patients in healthcare settings internationally experience harm that could have been prevented. Around one in eight of these cases result in severe harm, causing permanent disability or death.
Drug errors, therapeutic management incidents and incidents involving invasive clinical procedures are the most common causes of preventable patient harm. Higher rates of harm were seen in intensive care and surgical departments than in general hospital settings.
This NIHR-funded review poole...
‘Last resort’ antipsychotic remains the gold standard for treatment-resistant schizophrenia
Among patients with schizophrenia that has not responded to other drugs, the antipsychotic drug clozapine cuts the chances of hospital admissions and drugdiscontinuation.
Recent trials have questioned the superior efficacy of clozapine compared with other standard antipsychotic drugs. However, a review of real-world data from observational studies confirms its place as a drug that may work when others fail. Patients prescribed clozapine had better outcomes, despite having more severe illness.