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NIHR Signal Using a ‘telephone first’ approach may increase the total time GPs spend consulting
A system where all patients have a telephone call with their GP before an appointment decreased the number of face-to-face consultations but increased telephone consultations. There was an overall 8% increase in the time GPs spent consulting, though there was large variation across practices. This NIHR-funded study compared 147 practices in England before and after the implementation of the telephone management system and also with a sample of surgeries using a standard appointment system. Tel...
NIHR Signal Young people often have negative views of sex and relationship education
Sex and relationship education in schools is intended to safeguard children from harmful relationships and promote sexual health. This review of 55 qualitative studies, mainly from the UK, suggests the classes do neither and may be failing to prepare, protect or engage young people. Most studies covered secondary school sex and relationship education for pupils aged 12 to 18. Many pupils felt that classes were wrongly taught like other subjects and by their usual teachers, making them feel emba...
NIHR Signal Vomiting is the most common adverse effect among children and young people sedated for emergency procedures
Vomiting is the most common adverse event when sedating a child or young person undergoing a procedure in the emergency department, occurring in 55.5 out of 1,000 cases. Agitation occurred in 17.9/1,000 cases, and hypoxia – lack of oxygen – in 14.8 out of 1,000 cases. Serious breathing problems needing intervention to provide ventilation were rare, but highlight the need for experienced staff when giving sedation to children. This systematic review included 41 studies, six of which ...
NIHR Signal “Case management” can prevent people with heart failure being admitted again
Case management that is initiated in hospital and led by specialist nurses may reduce unplanned hospital readmissions and length of hospital stay for adults with heart failure. Case management is specific, intensive one-to-one care that involves many components to do with planning, coordinating and reviewing the care of people with long-term conditions. This NIHR review of organisational type research found quite a lot of studies: 17 trials and five other studies, including three from the UK. ...
NIHR Signal Optometrists are cautious, but may be as good as ophthalmologists at monitoring a common cause of blindness
Optometrists seem to be as good as ophthalmologists at correctly classifying wet age-related macular degeneration (AMD). Wet AMD is a condition where new blood vessels develop at the back of the eye to supply the damaged macula, responsible for central vision. It can cause permanent vision loss if not treated quickly. Monthly follow-up in specialist clinics is then required to check the condition hasn’t reactivated, which places a high demand on resources. This virtual trial using comput...
NIHR Signal Community pharmacies may be a useful place to deliver stop smoking services
This NIHR review provides evidence that ‘stop smoking’ interventions delivered at a community pharmacy, are effective and probably cost-effective for stopping smoking among adults, especially when compared to usual care without nicotine replacement. These interventions often include such things as behavioural support and nicotine replacement therapy and were most effective when both were delivered together. The review also looked at other community pharmacy-delivered interventions, ...
NIHR Signal Two simple questions help GPs rule out depression
The Whooley questions are useful for ruling out depression in that few people who answer no to both questions are depressed according to a ‘gold standard’ diagnostic interview. A positive screen is indicated by the person answering “yes” to one or both of the Whooley questions and for these people the diagnostic interview will still be necessary to diagnose the condition. The two simple questions are; 1) have you felt down or depressed or hopeless? and 2) have you been b...
NIHR Signal Participation in health research may be linked to better care and performance
This NIHR review found positive evidence that engaging clinicians and healthcare organisations in research is linked to improvements in the delivery of healthcare. In the central part of this three-stage review, most (28/33) papers found a positive impact of research on quality or outcomes. Seven of these studies were able to show a relationship between research activity and patient outcomes. Other studies related research activity to the quality of care. In these, patients were more likely to ...
NIHR Signal Continuity in primary care may be linked to reduced unscheduled hospital care
One positive finding from this review of a broad range of observational studies was that being able to see the same doctor in primary care was associated with fewer emergency department visits and emergency hospital admissions. Other factors associated with less unscheduled secondary care were younger age, higher socioeconomic status, not having a chronic disease or multiple health conditions, shorter distance to primary care compared with secondary care, and easier access to primary care. Becau...
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