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Nefyn Williams_LTC Consensus Meeting 10-Nov-2015

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PRIME Centre Wales
Long Term Conditions Consensus Meeting
Tuesday 10th November 2015, St Mary's Priory, Abergavenny, NP7 5ND
http://www.primecentre.wales/ltc-consensus-meeting.php

Published in: Healthcare
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Nefyn Williams_LTC Consensus Meeting 10-Nov-2015

  1. 1. PRIME Centre Wales Methodologies for Research in Primary Care Dr Nefyn H Williams North Wales Centre for Primary Care Research Bangor University
  2. 2. Work Packages 1. Long term conditions & co-morbidity 2.Patient centred & prudent health care 3.Infections & antimicrobial resistance 4.Screening, prevention, & diagnosis in primary care 5.Unscheduled and
  3. 3. Primary and Emergency Care • First contact • Person-centred • Comprehensive • Co-ordinated • Family centred • Community orientated • Complex • Multi-morbidity • Ageing • Health and social care provision • Multi-disciplinary • Primary care • Community care • Social care • Emergency care
  4. 4. Challenges • Health needs and inequalities in Wales • Prudent health care delivery • Reconfiguring health services • 90% of care outside of hospital • <8% of resources • Re-thinking • More prevention • Increased care in the community • Reducing burden of frailty & chronic disease • Switch focus from disease to functional impairment? • Rehabilitation for all? • More evidence…
  5. 5. Systematic Review methods • Treatment sequencing PhD • Reviews of treatment sequencing • Identify methodological challenge • Identify data needed to parameterise decision analytic models • MRC skills development fellowship • Compare discrete Markov cohort versus discrete event simulation for modelling treatment sequences for advanced prostate cancer • Assess impact of using simplifying assumptions for developing sequence effects on structural uncertainty • Network meta-analysis sciatica treatments • Results used to justify RCT of a biological agent to treat sciatica • Realist review to develop complex intervention • Development of a community based rehabilitation intervention following proximal femoral fracture
  6. 6. Co-production • Research priority setting in residential care homes • Wide range of topics requiring further investigation • Involve stakeholders in decisions regarding prioritisation of topics for future research • Obtain consensus using participatory research techniques (Delphi) • Early cancer diagnosis • Utilise social and community networks to co-produce, evaluate and implement interventions to facilitate early cancer diagnosis
  7. 7. Routinely collected data • Patient safety and healthcare improvement • Collection of routine healthcare data such as safety incident reports and combining with existing research and improvement activity, expert consensus and empirical data • Screening for colorectal cancer • NIHR themed call on multi-morbidity • Data linkage via SAIL to link screening and primary care data • Concurrent economic evaluations • Fracture in the Elderly Multidisciplinary Rehabilitation (FEMuR) feasibility study • Collection of routinely collected health service activity data compared with that obtained from patient completed questionnaires
  8. 8. Randomised Controlled Trials • Adaptive trial design • Adaptive trial design of anti-virals for seasonal influenza • Routinely collected data • Concurrent economic evaluation • e-trials • Outcome measures • FEMuR feasibility study comparing 3 different types of self-efficacy questionnaire, comparison of ICECAP with EQ-5D • Evaluate new quality of life tool for children with eczema • Palliative care settings • NoBLE comparing hyoscine versus placebo for death rattle • Cariad comparing different types of carer administered opioid analgesia
  9. 9. Development of Complex Interventions • Wearable technology • Wearable devices (iWatch, fitbits etc.) linked by blue-tooth technology to mobile phone apps • Multiple methods for intervention development • Fracture in the Elderly Multidisciplinary Rehabilitation (FEMuR) • Intervention developed using: • Realist review • Survey of current practice • Focus groups of participants, carers and rehabilitation professionals
  10. 10. Development of Complex Interventions • Wearable technology • Wearable devices (iWatch, fitbits etc.) linked by blue-tooth technology to mobile phone apps • Multiple methods for intervention development • Fracture in the Elderly Multidisciplinary Rehabilitation (FEMuR) • Intervention developed using: • Realist review • Survey of current practice • Focus groups of participants, carers and rehabilitation professionals

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