Image credit: Doctor and patient – Government of Alberta. Creative Commons License 2.0 (Non-commercial No Derivatives). Source: Flickr: https://www.flickr.com/photos/governmentofalberta/21221196734
In a systematic review published this month, we identified 153 communication skills training interventions for generalists in end of life care. In randomised controlled trials, training improved showing empathy and discussing emotions in simulated interactions (i.e. with actor patients) but evidence of effect on clinician behaviours during real patient interactions, and on patient-reported outcomes, was inconclusive.
The global increase in the proportion of older people and length of life means providing end of life care is now increasingly the responsibility of generalist as well as specialist palliative care providers. But many clinicians find communicating about end of life issues challenging: how do you best discuss imminent mortality, limited treatment options, what to … Read more
When I first became a health researcher, I felt that people would see taking part in research as a bother, a pain, or a waste of their time and that, by association, they would see me as akin to a nuisance caller, intent on coercing them into some unwanted activity. Thankfully, after 10 years doing research, it’s become apparent to me that this is far from the truth.
For a start, the tentativeness with which most of the researchers I know proceed as they recruit participants is anything but a hard-sell. In fact, due to necessarily stringent ethics and governance processes and practices, strict eligibility criteria, and a healthy dose of ‘only wanting to do what’s best for people’, we are possibly more in danger of being talked out of … Read more
A partnership and panel event to support NIHR School for Primary Care Research (SPCR) FR15/16 applications
Pre-grant public involvement is vital to relevant and successful research. It is considered the gold-standard approach. In practice, the issue is that before the grant is awarded, there are often no resources available to conduct high quality public and patient involvement (PPI).
With SPCR funding for pre-grant PPI supporting FR15/16 applications, we developed an event to carry out and promote early PPI at the Centre for Academic Primary Care. This served to achieve PPI for these rounds of SPCR applications, foster links between members of the public and researchers and establish early PPI as achievable and accepted culture.
The event comprised a public panel and parallel sessions of Partneropoly – an interactive game … Read more
Two individuals are supported by the NIHR School for Primary Care Research (NIHR SPCR) to attend the Oxford Leadership Programme every year. This year researchers Drs Alyson Huntley from the Centre for Academic Primary Care, University of Bristol and Sarah Tonkin-Crine, from the Nuffield Department of Primary Care Health Sciences, University of Oxford attended the first week of events at St Hughs’ College, Oxford.
As cohort#12 of the International Primary Care Research Leadership Programme we were lucky to stay at St Hugh’s College, Oxford during a very hot and sunny week in July. After arriving at the college on Sunday afternoon we were given our timetable and a list of our cohort members spanning the UK, Catalonia and … Read more
For 25 years, I have been a frustrated researcher. Like many, I came into the field of research to make a difference. But as the years passed, I realised that research had little influence on healthcare policy making or practice. I wanted to do something, so in 2009 I applied for a NIHR post-doctoral fellowship to skill up research teams to make a bigger impact. The feedback on my (unsuccessful) application was that researchers just had to publish in the BMJ and things would change (if only!).
Imagine my delight when a few short years later, the NIHR Knowledge Mobilisation Research Fellowship scheme was launched. Its aim was to create a “cadre of knowledge mobilisers”, proficient both in the practice and research of knowledge mobilisation (or ways of sharing knowledge). In 2014, I became one of them.
Most clinical trials are pragmatic in nature and aim to assess the effectiveness of a new treatment against ‘treatment as usual’. When interpreting trial results, researchers tend to focus primarily on what treatment participants in different trial arms received. This may be difficult in the usual care arm, as this arm is often poorly defined, whereas the intervention arm is often clearly defined prior to the trial starting. In addition, this focus is very narrow. Treatment is a process and patients’ experiences of accessing and receiving care could also influence their treatment outcomes, and thus the trial’s results.
A paper recently published in Trials highlights that differences do exist between the experiences of participants randomised to usual care and intervention arms. These differences relate not only to what treatment participants receive, but also how they access and engage with … Read more
I know this from working in both general practice and as a hospital doctor in A&E.
During the early stages of an illness it can be difficult for even the most experienced healthcare professionals to determine whether a patient has a minor self-limiting illness or is harbouring a more serious condition. In addition, growing problems such as antibiotic resistance and multimorbidity mean that sometimes even when a doctor makes a correct diagnosis, patients do not always get better with the first round of treatment and may require further medical help.
We cannot, and it is not clinically appropriate, to admit everyone to hospital to observe them until they feel 100% better.
That is why it is important that healthcare professionals provide patients with safety-netting advice. Safety-netting … Read more
With ninety percent of patient interaction with health services going through primary care, it’s not surprising that primary care clinicians and researchers try to figure out ways to improve primary care services. Interventions are many and varied, and result in important questions about their effectiveness. Do electronic consultations offer a good service to patients? If GPs introduce advice on healthy lifestyles into the consultation, does it make patients healthier? What about increasing the duration of GP appointments to ten minutes – does this improve outcomes for patients? Or ensuring that patients always see the same named doctor? Or painting the waiting room green?
Questions like these are normally answered by administration of a generic patient-reported questionnaire. By comparing the responses of groups of patients (say those with eight minute consultations and those with ten minute consultations), researchers can … Read more
I was recently invited to address the annual general meeting of PROSPECT, a local prostate cancer support group. The brief I was given was to discuss the GP’s role in diagnosing prostate cancer and the latest research in this area; a daunting task to tackle in a room full of men with prostate cancer at various stages on their cancer journey.
I spoke of the GP’s role across the continuum of cancer, from prevention and early diagnosis through to survivorship support and palliative care. I tried to discuss some of the latest studies in the field, such as the PROMIS study and the CAP trial, in a digestible form for these men. I also mused with them about the potential role new genetic technologies will have in the future in guiding GPs in determining cancer risk … Read more