Ways of integrating care that better coordinate services may benefit patients
New integrated care models can increase patient satisfaction, perceived quality of care and improve access to services. It is less clear whether there may be effects on hospital admissions, appointments or healthcare costs. Strong leadership and patient engagement are among factors influencing successful implementation.
The NHS is undergoing reconfiguration to better coordinate services around patients. This NIHR-funded review looked at the international literature to understand how new care mo...
New insights into living with inflammatory bowel disease
Living with inflammatory bowel disease as a `hidden’ condition can lead to feelings of isolation and exclusion. These experiences are characterised by exhaustion, feelings of damaged body image, loss of control and living with the fear of complications.
The condition can be unpredictable and have a profound impact on quality of life, disrupting social relationships and interactions with the outside world. The ongoing emotional and psychological difficulties caused by this chronic, long te...
Peer support may reduce readmissions following mental health crises
People discharged from mental health crisis teams are less likely to re-enter acute services within a year if they receive self-management support. The support in this study was provided by a peer worker, someone with experience of mental illness. The peer worker used a workbook to provide information and talk through recovery goals. The study compared this with those who had received the workbook by post.
Participating adults had a range of mental illnesses and had been managed by six crisis r...
Supporting families of those in intensive care improved family satisfaction but didn’t reduce family distress
A multicomponent support intervention for family members of patients in intensive care didn’t reduce their anxiety, depression or distress around the overall experience. However, it increased satisfaction with the quality of staff communication and delivery of care.
Family members of critically unwell patients on intensive care often need to be involved in care decisions. Yet they may feel unsupported and bewildered in the process. This intervention, delivered in five US intensive care un...
Self-monitoring of blood glucose provides no important benefit for most people with type 2 diabetes
Patients with type 2 diabetes who monitor their blood glucose themselves may see small, short-term improvements in blood sugar control. This is not enough to be clinically important or outweigh the costs and personal inconvenience of long-term self-testing.
Self-monitoring is a well-established strategy for type 1 diabetes and for people with type 2 who need insulin. The benefit for all people with type 2 is debatable. This review pooled 24 randomised controlled trials comparing self-monitoring...
A football programme for overweight men achieves sustained weight loss
A 12-week weight management programme for men, centred on football, achieved 4.9kg weight loss at 12 months. Modest weight loss of 2.9kg was maintained at 3.5 years.
Rates of overweight and obesity are higher for men than women in the UK, and there is little evidence that interventions are effective in the longer term. This NIHR-funded study followed 488 of 747 men (65%), average age 47 years, originally allocated to a programme of behavioural advice and football training with a professional co...
Patient-centred care for multimorbidity improves patient experience, but quality of life is unchanged
A patient-centred intervention in general practice for people with multiple chronic conditions, based on recommended best practice, had no effect on patient quality of life or burden of illness and treatment. Patients were, however, more likely to report being satisfied with their care.
An increasing number of people in the UK are living with multimorbidity, defined as two or more long-term health conditions. NICE recommends a comprehensive approach to care, tailored to the patient’s need...
Women rate quality and safety of birth experience as important
Most healthy women would like a natural birth if possible, but acknowledge the unpredictability and risks of childbirth. They also appreciate the supportive care environment where healthcare providers are competent, kind and respectful to them, their partners and their baby.
In a large review of studies with over 1,800 women’s views on what matters in childbirth, having a healthy baby was important. Avoiding unnecessary medical intervention and retaining a sense of control over their birt...
People take prescribed statins more reliably after discussing their advantages and disadvantages
Patients want to know more about how statins work, the reasons for prescribing them and their possible side effects.
Statins lower cholesterol and reduce the risk of recurrent stroke or heart attack. They also help prevent cardiovascular disease developing in people at high risk. At a population, level statins reduce the overall incidence of cardiovascular disease for people at moderate risk, but the benefits for an individual are less clear-cut.
This review found that people are happy to take...
Text messages improve diabetes self-management and blood sugar control
In adults with poorly controlled diabetes, text messages offering advice and support can improve self-management and blood sugar control.
This trial included 366 adults with type 1 or type 2 diabetes in New Zealand. An automated system delivered individually tailored text messages to participants over a nine-month period to support self-management of blood sugar. The control group received usual care, comparable to that in the UK.
The text message group had a small reduction in blood sugar lev...