'Self-management support is when health professionals, teams and services (both within and beyond the NHS) work in ways that ensure that people with long-term conditions have the knowledge, skills, confidence and support they need to manage their condition(s) effectively in the context of their everyday life. A system of effective self-management support requires changes at every level from how and what services are commissioned, to how health professionals and people with long term conditions work together in a consultation, to how people are supported in between appointments.'
This paper explores how the House of Care, a coordinated approach to personalised care and support planning, can transform the health and care of people with long-term conditions (LTCs).
It contains case studies of evolving practice in Leeds and Somerset and seeks to understand how two whole health economies – individuals, communities, health and social care services and others – are working to manage the rise in the number of people with multiple LTCs and enhance their care experiences.
Objectives This study aimed to understand the influences and decisions of households with children with asthma regarding keeping warm and well at home in winter.
Conclusions The findings illustrate how and why a child with asthma may be at risk of a cold home. A ‘trade-off model’ has been developed as an output of the research to explain the competing demands on families. Messages emerge about the importance of tailored advice and information to families vulnerable to cold-related harm. Open Access Article
Conclusions The relative effect of DPP-4 inhibitors on the risk of heart failure in patients with type 2 diabetes is uncertain, given the relatively short follow-up and low quality of evidence. Both randomised controlled trials and observational studies, however, suggest that these drugs may increase the risk of hospital admission for heart failure in those patients with existing cardiovascular diseases or multiple risk factors for vascular diseases, compared with no use.
More than a quarter of patients have no drug treatment prescribed for chronic obstructive pulmonary disease (COPD) in the first year of diagnosis despite having symptoms and poor lung function, an analysis of UK general practice data has shown. To read in full, use your NHS ATHENS login
As the New Care Models Programme marks its first anniversary, the Commissioning Redesign Manager for Long Term Conditions at the NHS Solihull CCG, outlines the vital work its vanguard is doing:
The Solihull Together for Better Lives vanguard is committed to supporting people to stay independent and out of hospital.
As part of this commitment, local health and social care partners have implemented the integrated care and support in Solihull (ICASS) programme to improve care for frail, older people.
The article presents a case study of a 49-year-old woman who had breast cancer and was counseled by the author. Topics discussed include the mastectomy, chemotherapy and radiotherapy that the patient had undergone; the feeling anxiety that she suffered from after her successful treatment; and the author's effort to form a collaborative relationship with the patient. Also mentioned is the behaviour adopted by the patient to cope with her experience with cancer.. To read the full article, log in using your SSSFT NHS OpenAthens details. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
NHS England is funding a pioneering procedure, called balloon pulmonary angioplasty, for patients who suffer from Chronic Thromboembolic Pulmonary Hypertension (CTEPH) – a form of lung disease where chronic blood clots block blood flow in the arteries, raising pressure in the lung which can cause heart failure and premature death.
Ever since inhaled corticosteroids (ICS) were first introduced as an effective prophylactic agent, there has been a debate over whether asthma exacerbations can be treated by increasing the dose. In theory, as we know systemic steroids are highly effective, they should work. A popular strategy is doubling the dose at the first sign of an exacerbation (sometimes termed the ‘yellow zone’), but trials have not shown this to be effective. Could increasing the dose by a factor of four or five work better?
The NEJM recently published two trials side-by-side addressing this question, which came to opposing conclusions......... To read the full article, log in using your NHS OpenAthens details.
Open access. To investigate the association between physical activity (PA) and amyotrophic lateral sclerosis (ALS) in population-based case–control studies in three European countries using a validated and harmonised questionnaire.
New research, funded by the MRC, found that older people with very low heart disease risks also have very little frailty, raising the possibility that frailty could be prevented.
Hypertension is a common condition in older people, but is often one of many conditions, particularly in frail older people, and so is rarely managed in isolation in the real world—which belies the bulk of the evidence upon which is treatment decisions are often based. In this article, we discuss the issues of ageing, including frailty and dementia, and their impact upon blood pressure management. We examine the evidence base for managing hypertension in older people, and explore some therapeutic ideas that might influence treatment decisions and strategies, including shared decision making.. To read the full article, log in using your MPFT NHS OpenAthens details. SSOTP (legacy account) - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
The management of people with multiple chronic conditions challenges health-care systems designed around single conditions. There is international consensus that care for multimorbidity should be patient-centred, focus on quality of life, and promote self-management towards agreed goals. However, there is little evidence about the effectiveness of this approach. Our hypothesis was that the patient-centred, so-called 3D approach (based on dimensions of health, depression, and drugs) for patients with multimorbidity would improve their health-related quality of life, which is the ultimate aim of the 3D intervention.. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Comment. Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood neurodevelopmental disorders and asthma the most common chronic disease in children; diagnosis of both disorders has increased in the past few decades.1,2 Given their high prevalence and associated morbidity and mortality, insights that improve diagnosis and lead to better understanding of the mechanisms underlying these disorders are crucial.. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Upper limb (UL) deficits in children with unilateral cerebral palsy (uCP) have traditionally been targeted with motor execution treatment models, such as modified Constraint-Induced Movement Therapy (mCIMT). However, new approaches based on a neurophysiological model such as Action-Observation Training (AOT) may provide new opportunities for enhanced motor learning. The aim of this study is to describe a randomised controlled trial (RCT) protocol investigating the effects of an intensive treatment model, combining mCIMT and AOT compared to mCIMT alone on UL function in children with uCP. Additionally, the role of neurological factors as potential biomarkers of treatment response will be analysed.
A pioneering way to bring a programme that helps improve the well-being of people who have chronic or ongoing breathing problems has been trialled in a south Cumbrian GP Practice and is now being rolled out further.
The use of virtual reality to help with the exercise programme for patients has been introduced as part of the Better Care Together programme and has already been well-received amongst the patients who have used it.