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Displaying Results 1 - 25 of 26 on page 1 of 2
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Clinical prediction rules in practice: review of clinical guidelines and survey of GPs
(2014)
Plüddemann, Annette; Wallace, Emma; Bankhead, Claire; Keogh, Claire; Van der Windt, Dan...
Clinical prediction rules in practice: review of clinical guidelines and survey of GPs
(2014)
Plüddemann, Annette; Wallace, Emma; Bankhead, Claire; Keogh, Claire; Van der Windt, Danielle; Lasserson, Daniel; Galvin, Rose; Moschetti, Ivan; Kearley, Karen; O'Brien, Kirsty K.; Sanders, Sharon; Mallett, Susan; Malanda, Uriell; Thompson, Matthew; Fahey, Tom; Stevens, Richard
Abstract:
Background The publication of clinical prediction rules (CPRs) studies has risen significantly. It is unclear if this reflects increasing usage of these tools in clinical practice or how this may vary across clinical areas. Aim To review clinical guidelines in selected areas and survey GPs in order to explore CPR usefulness in the opinion of experts and use at the point of care. Design and setting A review of clinical guidelines and survey of UK GPs. Method Clinical guidelines in eight clinical domains with published CPRs were reviewed for recommendations to use CPRs including primary prevention of cardiovascular disease, transient ischaemic attack (TIA) and stroke, diabetes mellitus, fracture risk assessment in osteoporosis, lower limb fractures, breast cancer, depression, and acute infections in childhood. An online survey of 401 UK GPs was also conducted. Results Guideline review: Of 7637 records screened by title and/or abstract, 243 clinical guidelines met inclusion criteria. C...
http://hdl.handle.net/10344/4762
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Comparison of count-based multimorbidity measures in predicting emergency admission and functional decline in older community-dwelling adults: a prospective cohort study.
(2016)
Wallace, Emma; McDowell, Ronald; Bennett, Kathleen; Fahey, Tom; Smith, Susan M
Comparison of count-based multimorbidity measures in predicting emergency admission and functional decline in older community-dwelling adults: a prospective cohort study.
(2016)
Wallace, Emma; McDowell, Ronald; Bennett, Kathleen; Fahey, Tom; Smith, Susan M
Abstract:
<p>This article is also available at <a href="http://bmjopen.bmj.com/content/bmjopen/6/9/e013089.full.pdf">http://bmjopen.bmj.com/content/bmjopen/6/9/e013089.full.pdf</a></p>
<p><strong>OBJECTIVES</strong>: Multimorbidity, defined as the presence of 2 or more chronic medical conditions in an individual, is associated with poorer health outcomes. Several multimorbidity measures exist, and the challenge is to decide which to use preferentially in predicting health outcomes. The study objective was to compare the performance of 5 count-based multimorbidity measures in predicting emergency hospital admission and functional decline in older community-dwelling adults attending primary care.</p> <p><strong>SETTING</strong>: 15 general practices (GPs) in Ireland.</p> <p><strong>PARTICIPANTS</strong>: n=862, ≥70 years, community-dwellers followed-up for 2 years (2010-2012). Exposure at bas...
https://epubs.rcsi.ie/gpart/107
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External validation of the Probability of repeated admission (Pra) risk prediction tool in older community-dwelling people attending general practice: a prospective cohort study.
(2016)
Wallace, Emma; McDowell, Ronald; Bennett, Kathleen; Fahey, Tom; Smith, Susan M
External validation of the Probability of repeated admission (Pra) risk prediction tool in older community-dwelling people attending general practice: a prospective cohort study.
(2016)
Wallace, Emma; McDowell, Ronald; Bennett, Kathleen; Fahey, Tom; Smith, Susan M
Abstract:
<p>The original article is available at <a href="https://bmjopen.bmj.com/content/6/11/e012336">bmjopen.bmj.com</a></p>
<p><strong>OBJECTIVES:</strong> Emergency admission is associated with the potential for adverse events in older people and risk prediction models are available to identify those at highest risk of admission. The aim of this study was to externally validate and compare the performance of the Probability of repeated admission (Pra) risk model and a modified version (incorporating a multimorbidity measure) in predicting emergency admission in older community-dwelling people.</p> <p><strong>SETTING:</strong> 15 general practices (GPs) in the Republic of Ireland.</p> <p><strong>PARTICIPANTS:</strong> n=862, ≥70 years, community-dwelling people prospectively followed up for 2 years (2010-2012).</p> <p><strong>EXPOSURE:</strong> Pra risk model (o...
https://epubs.rcsi.ie/gpart/131
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External validation of the Vulnerable Elder's Survey for predicting mortality and emergency admission in older community-dwelling people: a prospective cohort study.
(2017)
Wallace, Emma; McDowell, Ronald; Bennett, Kathleen; Fahey, Tom; Smith, Susan M
External validation of the Vulnerable Elder's Survey for predicting mortality and emergency admission in older community-dwelling people: a prospective cohort study.
(2017)
Wallace, Emma; McDowell, Ronald; Bennett, Kathleen; Fahey, Tom; Smith, Susan M
Abstract:
<p>The original article is available at www.biomedcentral.com</p>
<p>BACKGROUND: Prospective external validation of the Vulnerable Elder's Survey (VES-13) in primary care remains limited. The aim of this study is to externally validate the VES-13 in predicting mortality and emergency admission in older community-dwelling adults.</p> <p>METHODS: Design: Prospective cohort study with 2 years follow-up (2010-2012).</p> <p>SETTING: 15 General Practices (GPs) in the Republic of Ireland.</p> <p>PARTICIPANTS: n = 862, aged ≥70 years, community-dwellers Exposure: VES-13 calculated at baseline, where a score of ≥3 denoted high risk.</p> <p>OUTCOMES: i) Mortality; ii) ≥1 Emergency admission and ≥1 ambulatory care sensitive (ACS) admission over 2 years.</p> <p>STATISTICAL ANALYSIS: Descriptive statistics, model discrimination (c-statistic) and sensitivity/specificity.</p> <p>RESULTS: Of 862 study...
https://epubs.rcsi.ie/gpart/110
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Framework for the impact analysis and implementation of Clinical Prediction Rules (CPRs).
(2011)
Wallace, Emma; Smith, Susan M; Perera-Salazar, Rafael; Vaucher, Paul; McCowan, Colin; C...
Framework for the impact analysis and implementation of Clinical Prediction Rules (CPRs).
(2011)
Wallace, Emma; Smith, Susan M; Perera-Salazar, Rafael; Vaucher, Paul; McCowan, Colin; Collins, Gary; Verbakel, Jan; Lakhanpaul, Monica; Fahey, Tom; Idapp Group, International Diagnostic And Prognosis Prediction Group
Abstract:
<p>This article is also available from <a href="http://www.biomedcentral.com">www.biomedcentral.com</a></p>
<p>ABSTRACT: Clinical Prediction Rules (CPRs) are tools that quantify the contribution of symptoms, clinical signs and available diagnostic tests, and in doing so stratify patients according to the probability of having a target outcome or need for a specified treatment. Most focus on the derivation stage with only a minority progressing to validation and very few undergoing impact analysis. Impact analysis studies remain the most efficient way of assessing whether incorporating CPRs into a decision making process improves patient care. However there is a lack of clear methodology for the design of high quality impact analysis studies. We have developed a sequential four-phased framework based on the literature and the collective experience of our international working group to help researchers identify and overcome the specific chal...
https://epubs.rcsi.ie/gpart/12
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Impact analysis studies of clinical prediction rules relevant to primary care: a systematic review
(2016)
Wallace, Emma; Uijen, Maike J M; Clyne, Barbara; Zarabzadeh, Atieh; Keogh, Claire; Galv...
Impact analysis studies of clinical prediction rules relevant to primary care: a systematic review
(2016)
Wallace, Emma; Uijen, Maike J M; Clyne, Barbara; Zarabzadeh, Atieh; Keogh, Claire; Galvin, Rose; Smith, Susan M.; Fahey, Tom
Abstract:
OBJECTIVES: Following appropriate validation, clinical prediction rules (CPRs) should undergo impact analysis to evaluate their effect on patient care. The aim of this systematic review is to narratively review and critically appraise CPR impact analysis studies relevant to primary care. SETTING: Primary care. PARTICIPANTS: Adults and children. INTERVENTION: Studies that implemented the CPR compared to usual care were included. STUDY DESIGN: Randomised controlled trial (RCT), controlled before-after, and interrupted time series. PRIMARY OUTCOME: Physician behaviour and/or patient outcomes. RESULTS: A total of 18 studies, incorporating 14 unique CPRs, were included. The main study design was RCT (n=13). Overall, 10 studies reported an improvement in primary outcome with CPR implementation. Of 6 musculoskeletal studies, 5 were effective in altering targeted physician behaviour in ordering imaging for patients presenting with ankle, knee and neck musculoskeletal injuries. Of 6 cardiova...
http://hdl.handle.net/10344/4998
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Impact analysis studies of clinical prediction rules relevant to primary care: a systematic review.
(2016)
Wallace, Emma; Uijen, Maike JM; Clyne, Barbara; Zarabzadeh, Atieh; Keogh, Claire; Galvi...
Impact analysis studies of clinical prediction rules relevant to primary care: a systematic review.
(2016)
Wallace, Emma; Uijen, Maike JM; Clyne, Barbara; Zarabzadeh, Atieh; Keogh, Claire; Galvin, Rose; Smith, Susan M; Fahey, Tom
Abstract:
<p>This article is also available at <a href="http://bmjopen.bmj.com/content/6/3/e009957.full.pdf+html">http://bmjopen.bmj.com/content/6/3/e009957.full.pdf+html</a></p>
<p>OBJECTIVES: Following appropriate validation, clinical prediction rules (CPRs) should undergo impact analysis to evaluate their effect on patient care. The aim of this systematic review is to narratively review and critically appraise CPR impact analysis studies relevant to primary care.</p> <p>SETTING: Primary care.</p> <p>PARTICIPANTS: Adults and children.</p> <p>INTERVENTION: Studies that implemented the CPR compared to usual care were included.</p> <p>STUDY DESIGN: Randomised controlled trial (RCT), controlled before-after, and interrupted time series.</p> <p>PRIMARY OUTCOME: Physician behaviour and/or patient outcomes.</p> <p>RESULTS: A total of 18 studies, incorporating 14 unique CPRs, were inc...
https://epubs.rcsi.ie/gpart/93
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Impact of Potentially Inappropriate Prescribing on Adverse Drug Events, Health Related Quality of Life and Emergency Hospital Attendance in Older People Attending General Practice: A Prospective Cohort Study.
(2017)
Wallace, Emma; McDowell, Ronald; Bennett, Kathleen; Fahey, Tom; Smith, Susan M
Impact of Potentially Inappropriate Prescribing on Adverse Drug Events, Health Related Quality of Life and Emergency Hospital Attendance in Older People Attending General Practice: A Prospective Cohort Study.
(2017)
Wallace, Emma; McDowell, Ronald; Bennett, Kathleen; Fahey, Tom; Smith, Susan M
Abstract:
<p>The original article is available at https://academic.oup.com</p>
<p>BACKGROUND: Potentially inappropriate prescribing (PIP) describes medications where risk generally outweighs benefit for older people. Cross-sectional studies suggest an association between PIP and poorer health outcomes but there is a paucity of prospective cohort studies. This study investigates the longitudinal association of PIP with adverse drug events (ADEs), health related quality of life, and accident & emergency visits.</p> <p>METHODS: Study design: Two-year (2010-2012) prospective cohort study (n = 904, ≥70 years, community-dwelling) with linked pharmacy dispensing data.</p> <p>EXPOSURE: Baseline PIP: Screening Tool for Older Persons potentially Inappropriate Prescriptions (STOPP) and Beers 2012 applied 12 months prior.</p> <p>STUDY OUTCOMES: ADEs (patient interview), health related quality of life (EQ-5D-3L: patient questionnaire), and acci...
https://epubs.rcsi.ie/gpart/113
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Impact of Potentially Inappropriate Prescribing on Adverse Drug Events, Health Related Quality of Life and Emergency Hospital Attendance in Older People Attending General Practice: A Prospective Cohort Study.
(2016)
Wallace, Emma; McDowell, Ronald; Bennett, Kathleen; Fahey, Tom; Smith, Susan M
Impact of Potentially Inappropriate Prescribing on Adverse Drug Events, Health Related Quality of Life and Emergency Hospital Attendance in Older People Attending General Practice: A Prospective Cohort Study.
(2016)
Wallace, Emma; McDowell, Ronald; Bennett, Kathleen; Fahey, Tom; Smith, Susan M
Abstract:
<p>This article is also available at <a href="https://academic.oup.com/biomedgerontology/article-lookup/doi/10.1093/gerona/glw140">https://academic.oup.com/biomedgerontology/article-lookup/doi/10.1093/gerona/glw140</a></p>
<p>BACKGROUND: Potentially inappropriate prescribing (PIP) describes medications where risk generally outweighs benefit for older people. Cross-sectional studies suggest an association between PIP and poorer health outcomes but there is a paucity of prospective cohort studies. This study investigates the longitudinal association of PIP with adverse drug events (ADEs), health related quality of life, and accident & emergency visits.</p> <p>METHODS: Study design: Two-year (2010-2012) prospective cohort study (n = 904, ≥70 years, community-dwelling) with linked pharmacy dispensing data.</p> <p>EXPOSURE: Baseline PIP: Screening Tool for Older Persons potentially Inappropriate Prescriptions (STOPP)...
https://epubs.rcsi.ie/gpart/108
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Managing patients with multimorbidity in primary care.
(2015)
Wallace, Emma; Salisbury, Chris; Guthrie, Bruce; Lewis, Cliona; Fahey, Tom; Smith, Susan M
Managing patients with multimorbidity in primary care.
(2015)
Wallace, Emma; Salisbury, Chris; Guthrie, Bruce; Lewis, Cliona; Fahey, Tom; Smith, Susan M
Abstract:
<p>This article is also available at</p> <p><a href="http://www.bmj.com/content/350/bmj.h176.full.pdf+html">http://www.bmj.com/content/350/bmj.h176.full.pdf+html</a></p>
<p>Multimorbidity, commonly defined as the presence of two or more chronic medical conditionsin an individual,¹ is associated with decreased quality of life, functional decline, and increased healthcare utilisation, including emergency admissions, particularly with higher numbers of coexisting conditions.²̄⁶ The management of multimorbidity with drugsis often complex, resulting in polypharmacy with its attendant risks.⁷̄⁹ Patients with multimorbidity have a high treatment burden in terms of understanding and self managing the conditions, attending multiple appointments, and managing complex drug regimens.¹⁰ Qualitative research highlights the “endless struggle” patients experience in trying to manage their conditions well.¹¹ Psychological distress is common: in...
https://epubs.rcsi.ie/gpart/70
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Multimorbidity and functional decline in community-dwelling adults: a systematic review.
(2015)
Ryan, Aine; Wallace, Emma; O'Hara, Paul; Smith, Susan M
Multimorbidity and functional decline in community-dwelling adults: a systematic review.
(2015)
Ryan, Aine; Wallace, Emma; O'Hara, Paul; Smith, Susan M
Abstract:
<p>The original article is available at www.biomedcentral.com</p>
<p>BACKGROUND: Multimorbidity affects up to one quarter of primary care populations. It is associated with reduced quality of life, an increased risk of mental health difficulties and increased healthcare utilisation. Functional decline is defined as developing difficulties with activities of daily living and is independently associated with poorer health outcomes. The aim of this systematic review was to examine the association between multimorbidity and functional decline and to what extent multimorbidity predicts future functional decline.</p> <p>METHODS: A systematic literature search (1990-2014) and narrative analysis was conducted.</p> <p>INCLUSION CRITERIA: Population; Community-dwelling adults (≥18 years), Risk; Multimorbidity defined as the presence of ≥2 chronic medical conditions in an individual, Primary outcome; Physical functional decline measured using a val...
https://epubs.rcsi.ie/gpart/90
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Optimized retrieval of primary care clinical prediction rules from MEDLINE to establish a Web-based register.
(2011)
Keogh, Claire; Wallace, Emma; O'Brien, Kirsty K; Murphy, Paul J; Teljeur, Conor; M...
Optimized retrieval of primary care clinical prediction rules from MEDLINE to establish a Web-based register.
(2011)
Keogh, Claire; Wallace, Emma; O'Brien, Kirsty K; Murphy, Paul J; Teljeur, Conor; McGrath, Brid; Smith, Susan M; Doherty, Niall; Dimitrov, Borislav D; Fahey, Tom
Abstract:
<p>This article is also available at <a href="http://www.sciencedirect.com/science/article/pii/S0895435610004233">http://www.sciencedirect.com/science/article/pii/S0895435610004233</a></p>
<p>OBJECTIVES: Identifying clinical prediction rules (CPRs) for primary care from electronic databases is difficult. This study aims to identify a search filter to optimize retrieval of these to establish a register of CPRs for the Cochrane Primary Health Care field.</p> <p>STUDY DESIGN AND SETTING: Thirty primary care journals were manually searched for CPRs. This was compared with electronic search filters using alternative methodologies: (1) textword searching; (2) proximity searching; (3) inclusion terms using specific phrases and truncation; (4) exclusion terms; and (5) combinations of methodologies.</p> <p>RESULTS: We manually searched 6,344 articles, revealing 41 CPRs. Across the 45 search filters, sensitivities ranged from...
https://epubs.rcsi.ie/gpart/26
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Potentially inappropriate prescribing in two populations with differing socio-economic profiles: a cross-sectional database study using the PROMPT criteria.
(2016)
Cooper, Janine A; Moriarty, Frank; Ryan, Cristín; Smith, Susan M; Bennett, Kathleen; Fa...
Potentially inappropriate prescribing in two populations with differing socio-economic profiles: a cross-sectional database study using the PROMPT criteria.
(2016)
Cooper, Janine A; Moriarty, Frank; Ryan, Cristín; Smith, Susan M; Bennett, Kathleen; Fahey, Tom; Wallace, Emma; Cahir, Caitriona; Williams, David; Teeling, Mary; Hughes, Carmel M
Abstract:
<p>This article is available from <a href="http://link.springer.com/article/10.1007%2Fs00228-015-2003-z">http://link.springer.com/article/10.1007%2Fs00228-015-2003-z</a></p>
<p>PURPOSE: The purpose of this study is to establish the prevalence of potentially inappropriate prescribing (PIP) in middle-aged adults (45-64 years) in two populations with differing socio-economic profiles, and to investigate factors associated with PIP, using the PROMPT (PRescribing Optimally in Middle-aged People's Treatments) criteria.</p> <p>METHODS: A retrospective cross-sectional study was conducted using 2012 data from the Enhanced Prescribing Database (EPD), covering the full population in Northern Ireland and the Health Services Executive Primary Care Reimbursement Service (HSE-PCRS) database, covering the most socio-economically deprived third of the population in this age group in the Republic of Ireland. The prevalence for each PROMPT ...
https://epubs.rcsi.ie/gpart/91
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Potentially inappropriate prescribing in two populations with differing socio-economic profiles: a cross-sectional database study using the PROMPT criteria.
(2016)
Cooper, Janine A; Moriarty, Frank; Ryan, Cristín; Smith, Susan M; Bennett, Kathleen; Fa...
Potentially inappropriate prescribing in two populations with differing socio-economic profiles: a cross-sectional database study using the PROMPT criteria.
(2016)
Cooper, Janine A; Moriarty, Frank; Ryan, Cristín; Smith, Susan M; Bennett, Kathleen; Fahey, Tom; Wallace, Emma; Cahir, Caitriona; Williams, David; Teeling, Mary; Hughes, Carmel M
Abstract:
Purpose The purpose of this study is to establish the prevalence of potentially inappropriate prescribing (PIP) in middle-aged adults (45–64 years) in two populations with differing socio-economic profiles, and to investigate factors associated with PIP, using the PROMPT (PRescribing Optimally in Middle-aged People’s Treatments) criteria. Methods A retrospective cross-sectional study was conducted using 2012 data from the Enhanced Prescribing Database (EPD), covering the full population in Northern Ireland and the Health Services Executive Primary Care Reimbursement
The purpose of this study is to establish the prevalence of potentially inappropriate prescribing (PIP) in middle-aged adults (45-64 years) in two populations with differing socio-economic profiles, and to investigate factors associated with PIP, using the PROMPT (PRescribing Optimally in Middle-aged People's Treatments) criteria.
A retrospective cross-sectional study was conducted using 2012 data from the E...
http://hdl.handle.net/10147/620778
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Predicting adverse health outcomes in older community-dwelling adults: a prospective cohort study
(2016)
Wallace, Emma
Predicting adverse health outcomes in older community-dwelling adults: a prospective cohort study
(2016)
Wallace, Emma
Abstract:
<p><strong>Background</strong></p> <p>This thesis aimed to investigate if adverse health outcomes in older community-dwelling people can be predicted, through the application of measures of prescribing, multimorbidity and emergency admission risk models. There were five objectives: 1) to determine if there is a longitudinal association between potentially inappropriate prescribing (PIP) and future adverse drug events (ADEs), reduced health related quality of life (HRQOL) and increased use of Accident & Emergency (A&E) and emergency admissions; 2) to assess the performance of different measures of multimorbidity and vulnerability in predicting emergency hospital attendance and functional decline; 3) to conduct a systematic review of emergency admission risk prediction models developed for use in community-dwelling adults; 4) to systematically review and meta-analyse the validation studies of the Probability of repeated admissions (Pra) risk model...
https://epubs.rcsi.ie/phdtheses/175
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Predicting poorer health outcomes in older community-dwelling patients with multimorbidity: prospective cohort study assessing the accuracy of different multimorbidity definitions.
(2019)
Sasseville, Maxime; Smith, Susan M; Freyne, Lisa; McDowell, Ronald; Boland, Fiona; Fort...
Predicting poorer health outcomes in older community-dwelling patients with multimorbidity: prospective cohort study assessing the accuracy of different multimorbidity definitions.
(2019)
Sasseville, Maxime; Smith, Susan M; Freyne, Lisa; McDowell, Ronald; Boland, Fiona; Fortin, Martin; Wallace, Emma
Abstract:
<p>The original article is available at <a href="https://bmjopen.bmj.com/content/9/1/e023919.long">bmjopen.bmj.com</a></p>
<p><strong>PURPOSE:</strong> Multimorbidity is commonly defined and measured using condition counts. The UK National Institute for Health Care Excellence Guidelines for Multimorbidity suggest that a medication-orientated approach could be used to identify those in need of a multimorbidity approach to management.</p> <p><strong>OBJECTIVES:</strong> To compare the accuracy of medication-based and diagnosis-based multimorbidity measures at higher cut-points to identify older community-dwelling patients who are at risk of poorer health outcomes.</p> <p><strong>DESIGN:</strong> A secondary analysis of a prospective cohort study with a 2-year follow-up (2010-2012).</p> <p><strong>SETTING:</strong> 15 general practices in Ireland.</p> &l...
https://epubs.rcsi.ie/gpart/134
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Prevalence of potentially inappropriate prescribing in older people in primary care and its association with hospital admission: longitudinal study
(2018)
Perez, Teresa; Moriarty, Frank; Wallace, Emma; McDowell, Ronald; Redmond, Patrick
Prevalence of potentially inappropriate prescribing in older people in primary care and its association with hospital admission: longitudinal study
(2018)
Perez, Teresa; Moriarty, Frank; Wallace, Emma; McDowell, Ronald; Redmond, Patrick
Abstract:
<p>The original article is available at <a href="https://www.bmj.com">www.bmj.com</a></p>
<p id="x-x-x-x-p-2"><strong>Objective</strong> To determine whether hospital admission is associated with potentially inappropriate prescribing among older primary care patients (aged ≥65 years) and whether such prescribing was more likely after hospital admission than before.</p> <p id="x-x-x-x-p-3"><strong>Design</strong> Longitudinal study of retrospectively extracted data from general practice records.</p> <p id="x-x-x-x-p-4"><strong>Setting</strong> 44 general practices in Ireland in 2012-15.</p> <p id="x-x-x-x-p-5"><strong>Participants</strong> Adults aged 65 years or over attending participating practices.</p> <p id="x-x-x-x-p-6"><strong>Exposure</strong> Admission to hospital (any hospita...
https://epubs.rcsi.ie/gpart/127
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Risk prediction models to predict emergency hospital admission in community-dwelling adults: a systematic review.
(2014)
Wallace, Emma; Stuart, Ellen; Vaughan, Niall; Bennett, Kathleen; Fahey, Tom; Smith, Sus...
Risk prediction models to predict emergency hospital admission in community-dwelling adults: a systematic review.
(2014)
Wallace, Emma; Stuart, Ellen; Vaughan, Niall; Bennett, Kathleen; Fahey, Tom; Smith, Susan M
Abstract:
<p>This article is also available at <a href="http://journals.lww.com/lww-medicalcare/Fulltext/2014/08000/Risk_Prediction_Models_to_Predict_Emergency.12.aspx">http://journals.lww.com/lww-medicalcare/Fulltext/2014/08000/Risk_Prediction_Models_to_Predict_Emergency.12.aspx</a></p>
<p>BACKGROUND: Risk prediction models have been developed to identify those at increased risk for emergency admissions, which could facilitate targeted interventions in primary care to prevent these events.</p> <p>OBJECTIVE: Systematic review of validated risk prediction models for predicting emergency hospital admissions in community-dwelling adults.</p> <p>METHODS: A systematic literature review and narrative analysis was conducted. Inclusion criteria were as follows;</p> <p>POPULATION: community-dwelling adults (aged 18 years and above); Risk: risk prediction models, not contingent on an index hospital admission, with a deriva...
https://epubs.rcsi.ie/gpart/71
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Supporting prescribing in Irish primary care: protocol for a non-randomised pilot study of a general practice pharmacist (GPP) intervention to optimise prescribing in primary care.
(2018)
Cardwell, Karen; Clyne, Barbara; Moriarty, Frank; Wallace, Emma; Fahey, Tom; Boland, Fi...
Supporting prescribing in Irish primary care: protocol for a non-randomised pilot study of a general practice pharmacist (GPP) intervention to optimise prescribing in primary care.
(2018)
Cardwell, Karen; Clyne, Barbara; Moriarty, Frank; Wallace, Emma; Fahey, Tom; Boland, Fiona; McCullagh, L; Clarke, S; Finnigan, K; Daly, M; Barry, M; Smith, S M; General Practice Pharmacist (GPP) Study Group
Abstract:
<p>The original article is available at <a href="https://www.biomedcentral.com">www.biomedcentral.com</a></p>
<p><strong>Background:</strong> Prescribing for patients taking multiple medicines (i.e. polypharmacy) is challenging for general practitioners (GPs). Limited evidence suggests that the integration of pharmacists into the general practice team could improve the management of these patients. The aim of this study is to develop and test an intervention involving pharmacists, working within GP practices, to optimise prescribing in Ireland, which has a mixed public and private primary healthcare system.</p> <p><strong>Methods:</strong> This non-randomised pilot study will use a mixed-methods approach. Four general practices will be purposively sampled and recruited. A pharmacist will join the practice team for 6 months. They will participate in the management of repeat prescribing and undertake medic...
https://epubs.rcsi.ie/gpart/124
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Supporting prescribing in older people with multimorbidity and significant polypharmacy in primary care (sppire): a cluster randomised controlled trial protocol and pilot
(2018)
McCarthy, Caroline; Clyne, Barbara; Corrigan, Derek; Boland, Fiona; Wallace, Emma; Mori...
Supporting prescribing in older people with multimorbidity and significant polypharmacy in primary care (sppire): a cluster randomised controlled trial protocol and pilot
(2018)
McCarthy, Caroline; Clyne, Barbara; Corrigan, Derek; Boland, Fiona; Wallace, Emma; Moriarty, Frank; Fahey, Tom; Hughes, Carmel; Gillespie, Paddy; Smith, Susan M.
Abstract:
Background: Multimorbidity, defined as the presence of at least two chronic conditions, becomes increasingly common in older people and is associated with poorer health outcomes and significant polypharmacy. The National Institute for Clinical Excellence (NICE) recently published a multimorbidity guideline that advises providing an individualised medication review for all people prescribed 15 or more repeat medicines. This study incorporates this guideline and aims to assess the effectiveness of a complex intervention designed to support general practitioners (GPs) to reduce potentially inappropriate prescribing and consider deprescribing in older people with multimorbidity and significant polypharmacy in Irish primary care. Methods: This study is a cluster randomised controlled trial, involving 30 general practices and 450 patients throughout Ireland. Practices will be eligible to participate if they have at least 300 patients aged 65 years and over on their patient panel and if th...
http://hdl.handle.net/10379/12718
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Supporting prescribing in older people with multimorbidity and significant polypharmacy in primary care (SPPiRE): a cluster randomised controlled trial protocol and pilot.
(2017)
McCarthy, Caroline; Clyne, Barbara; Corrigan, Derek; Boland, Fiona; Wallace, Emma; Mori...
Supporting prescribing in older people with multimorbidity and significant polypharmacy in primary care (SPPiRE): a cluster randomised controlled trial protocol and pilot.
(2017)
McCarthy, Caroline; Clyne, Barbara; Corrigan, Derek; Boland, Fiona; Wallace, Emma; Moriarty, Frank; Fahey, Tom; Hughes, Carmel; Gillespie, Paddy; Smith, Susan M
Abstract:
<p>The original article is available at www.biomedcentral.com</p>
<p><strong>Background:</strong> Multimorbidity, defined as the presence of at least two chronic conditions, becomes increasingly common in older people and is associated with poorer health outcomes and significant polypharmacy. The National Institute for Clinical Excellence (NICE) recently published a multimorbidity guideline that advises providing an individualised medication review for all people prescribed 15 or more repeat medicines. This study incorporates this guideline and aims to assess the effectiveness of a complex intervention designed to support general practitioners (GPs) to reduce potentially inappropriate prescribing and consider deprescribing in older people with multimorbidity and significant polypharmacy in Irish primary care.</p> <p><strong>Methods:</strong> This study is a cluster randomised controlled trial, involving 30 general practices a...
https://epubs.rcsi.ie/gpart/114
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The development of the PROMPT (PRescribing Optimally in Middle-aged People's Treatments) criteria
(2014)
Cooper, Janine A; Ryan, Cristín; Smith, Susan M; Wallace, Emma; Bennett, Kathleen; Cahi...
The development of the PROMPT (PRescribing Optimally in Middle-aged People's Treatments) criteria
(2014)
Cooper, Janine A; Ryan, Cristín; Smith, Susan M; Wallace, Emma; Bennett, Kathleen; Cahir, Caitriona; Williams, David; Teeling, Mary; Fahey, Tom; Hughes, Carmel M; (The PROMPT Steering Group)
Abstract:
Abstract Background Whilst multimorbidity is more prevalent with increasing age, approximately 30% of middle-aged adults (45–64 years) are also affected. Several prescribing criteria have been developed to optimise medication use in older people (≥65 years) with little focus on potentially inappropriate prescribing (PIP) in middle-aged adults. We have developed a set of explicit prescribing criteria called PROMPT (PRescribing Optimally in Middle-aged People’s Treatments) which may be applied to prescribing datasets to determine the prevalence of PIP in this age-group. Methods A literature search was conducted to identify published prescribing criteria for all age groups, with the Project Steering Group (convened for this study) adding further criteria fo...
http://dx.doi.org/10.1186/s12913-014-0484-6
Marked
Mark
The development of the PROMPT (PRescribing Optimally in Middle-aged People's Treatments) criteria.
(2014)
Cooper, Janine A; Ryan, Cristín; Smith, Susan M; Wallace, Emma; Bennett, Kathleen; Cahi...
The development of the PROMPT (PRescribing Optimally in Middle-aged People's Treatments) criteria.
(2014)
Cooper, Janine A; Ryan, Cristín; Smith, Susan M; Wallace, Emma; Bennett, Kathleen; Cahir, Caitriona; Williams, David; Teeling, Mary; Fahey, Tom; Hughes, Carmel M; The PROMPT Steering Group
Abstract:
<p>The original article is available at <a href="http://www.biomedcentral.com">www.biomedcentral.com</a></p>
<p>BACKGROUND: Whilst multimorbidity is more prevalent with increasing age, approximately 30% of middle-aged adults (45-64 years) are also affected. Several prescribing criteria have been developed to optimise medication use in older people (≥65 years) with little focus on potentially inappropriate prescribing (PIP) in middle-aged adults. We have developed a set of explicit prescribing criteria called PROMPT (PRescribing Optimally in Middle-aged People's Treatments) which may be applied to prescribing datasets to determine the prevalence of PIP in this age-group.</p> <p>METHODS: A literature search was conducted to identify published prescribing criteria for all age groups, with the Project Steering Group (convened for this study) adding further criteria for consideration, all of which were reviewed for relevance to...
https://epubs.rcsi.ie/gpart/59
Marked
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The epidemiology of malpractice claims in primary care: a systematic review.
(2013)
Wallace, Emma; Lowry, J; Smith, Susan M; Fahey, Tom
The epidemiology of malpractice claims in primary care: a systematic review.
(2013)
Wallace, Emma; Lowry, J; Smith, Susan M; Fahey, Tom
Abstract:
<p>This article is also available at <a href="http://bmjopen.bmj.com/lookup/pmid?view=long&pmid=23869100">http://bmjopen.bmj.com</a></p>
<p>OBJECTIVES: The aim of this systematic review was to examine the epidemiology of malpractice claims in primary care.</p> <p>DESIGN: A computerised systematic literature search was conducted. Studies were included if they reported original data (≥10 cases) pertinent to malpractice claims, were based in primary care and were published in the English language. Data were synthesised using a narrative approach.</p> <p>SETTING: Primary care.</p> <p>PARTICIPANTS: Malpractice claimants.</p> <p>PRIMARY OUTCOME: Malpractice claim (defined as a written demand for compensation for medical injury). We recorded: medical misadventure cited in claims, missed/delayed diagnoses cited in claims, outcome of claims, prevalence of claims and compensation awarded to claiman...
https://epubs.rcsi.ie/gpart/37
Marked
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Training doctors to manage patients with multimorbidity: a systematic review
(2016)
Lewis, Cliona; Wallace, Emma; Kyne, Lorraine; Cullen, Walter; Smith, Susan M
Training doctors to manage patients with multimorbidity: a systematic review
(2016)
Lewis, Cliona; Wallace, Emma; Kyne, Lorraine; Cullen, Walter; Smith, Susan M
Abstract:
<p>This article is also available at <a href="https://jcomorbidity.com/index.php/test/article/view/87">https://jcomorbidity.com/index.php/test/article/view/87</a></p>
<p>Background: Patients with multimorbidity (two or more chronic conditions) are now the norm in clinical practice, and place an increasing burden on the healthcare system. Management of these patients is challenging, and requires doctors who are skilled in the complexity of multiple chronic diseases.</p> <p>Objective: To perform a systematic review of the literature to ascertain whether there are education and training formats which have been used to train postgraduate medical doctors in the management of patients with multimorbidity in primary and/or secondary care, and which have been shown to improve knowledge, skills, attitudes, and/or patient out- comes.</p> <p>Methods: Overall, 75,110 citations were screened, of which 65 full-text articles were ...
https://epubs.rcsi.ie/gpart/117
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