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NIHR Signal Clinicians prescribe antibiotics for childhood respiratory tract infection based on assessment, rather than parental expectation
Implied parental expectation of antibiotic prescription does not appear to affect clinician prescribing for childhood respiratory tract infection in primary care. Parents typically accept clinicians’ treatment recommendations based on symptoms and signs, with a minority seeking further home care advice. This NIHR-funded analysis of 56 videoed primary care consultations is the first such study to be carried out in the UK, covering diverse populations from both deprived and affluent neighbo...
NIHR Signal 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...
NIHR Signal Enhanced communication and staff training could improve the experience of maternity services for asylum-seeking women
Pregnant asylum seekers experience significant barriers to accessing maternity services in the UK. A review found that these barriers often relate to language differences and practical challenges associated with their status. Provision of interpreter services and training for health care professionals could improve maternity support for these women. Pregnant women seeking asylum have often experienced significant trauma. Many arrive in the country having received no maternity care and experienc...
NIHR Signal Packages of care interventions ‘not effective’ to reduce repeat admissions for COPD
Care bundles for COPD are difficult to implement, and their introduction in NHS hospitals does not reduce repeat admissions, deaths or use of resources when used on or after admission. Care bundles are packages of interventions which, in other situations, can improve care. COPD care bundles include: checking inhaler technique and medication use providing a written plan for COPD management and supply of emergency medicines assessing willingness to stop smoking assessing suitability for pul...
NIHR Signal Routine engagement in end of life planning can improve health outcomes for people with heart failure
Interventions that encourage healthcare professionals to engage in advance care planning with heart failure patients can work more effectively than stand-alone training activities in improving health outcomes. Approaches that involve patients to change clinicians’ professional practice behaviours, the use of reminder systems and educational meetings may offer the best potential. There is no cure for heart failure, and palliative care is known to help this patient group. Advance care plann...
NIHR Signal New insights into how fatigue affects the lives of people on dialysis
Feelings of profound and relentless exhaustion while undergoing haemodialysis impact on patients’ ability to lead a normal life. This overwhelming fatigue is different from the immediate symptoms of post-dialysis fatigue observable in a clinical setting and can pervade all aspects of a patient’s life. This review of 65 international studies, including 1,713 participants, found that patients can feel unable to maintain fulfilling relationships and are vulnerable to misunderstandings ...
NIHR Signal Smartphones may help people with diabetes manage their condition better
People with type 2 diabetes using smartphone apps or message services feel more confident about their ability to manage their condition, are more likely to engage in self-care activities and have a better quality of life. Smartphone self-management technologies can be split into two main types: applications where users can record data and view information, and SMS text messages which can act as prompts or reminders. A review of 22 international studies found that smartphones could aid diabetes ...
NIHR Signal Partial knee replacements have some short-term advantages compared to total knee replacements
Replacing one side of the knee, unicompartmental knee replacement, may result in shorter hospital stays, fewer short-term complications, faster recovery and better knee function than total knee replacements. However, about 8% need revision by five years - about two to three times the rate with total knee replacements. People with pain and immobility from osteoarthritis that cannot be controlled by other treatments may be referred for knee surgery. If the damage is only to one side of the knee, ...
NIHR Signal Goal-setting can help people with early-stage dementia improve function
Goal-setting as part of cognitive rehabilitation delivered by occupational therapists helped people with early dementia progress towards independence in daily tasks, with benefits lasting for nine months. This approach focuses on the everyday tasks needing concentration and memory and prioritising those that matter most to individuals, from using the cooker or answering the phone. The intervention was well-received, but the cost-effectiveness is not clear, because quality of life continued to de...
NIHR Signal New insights into how ethnicity and culture affect maternal mental health
Ethnicity and culture can affect how and when women seek help for mental health problems before or after having a baby. Many women avoid seeking help because they feel services are not sensitive to their beliefs. Services should ensure all women, regardless of background, can access the support they need during and after pregnancy. This mixed methods systematic review of UK evidence found that many women are not aware of the help available to them, and those that are aware often view it negativ...
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