CBT could be beneficial for adults with ADHD

NIHR | August 2018 | Cognitive behavioural therapy could benefit adults with attention deficit hyperactivity disorder (ADHD)

NIHR have published a new signal which looks at Cognitive behavioural therapy (CBT) and its impact to improve the core symptoms of attention deficit hyperactivity disorder (ADHD) in adults, compared with a range of other treatments. 

The review included trials that compared cognitive behavioural therapy to other specific interventions or to a range of control conditions, including waiting list and no treatment. It also looked at cognitive behavioural therapy plus drug treatment, versus drug treatment alone.

The included trials were rated very low to moderate quality. They also used a variety of outcome measures, which made it difficult to compare the interventions.

Despite these limitations, the review provides evidence that reinforces current guidance and practice (Source: NIHR).
Read the full signal at NIHR 

Prescribing of over the counter medicines is changing

NHS England | August 2018 | Prescribing of over the counter medicines is changing

NHS England have produced a series of documents to support CCGs to implement recommendations and support discussions between patients and their healthcare professionals.

Quick Reference Guide for Healthcare Professionals: Items which should not routinely be prescribed in primary care

The Quick Reference Guide for Healthcare Professionals is a quick reference tools summarising the CCG guidance on Items which should not routinely be prescribed in primary care.

Interactive Quick Reference Guide for Healthcare Professionals: Items which should not routinely be prescribed in primary care

This an interactive, quick reference tool summarising the CCG guidance on Items which should not routinely be prescribed in primary care.

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There are also a series of patient information leaflets, including easy read leaflets

Patient information leaflet ‘Prescribing of over the counter medicines is changing’

A patient information leaflet to support discussions between patients and healthcare professionals

See NHS England for full details 

Reducing emergency admissions

The Health Foundation | August 2018 | Reducing emergency admissions: unlocking the potential of people to better manage their long-term conditions

The Health Foundation has produced a briefing which looks at Patient Activation Measures scores, which assess four levels of knowledge, skill and confidence in self-management, for over 9,000 adults with long-term conditions.

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  • This briefing summarises research that explores the link between how well patients feel able to manage their long-term conditions such as asthma, diabetes and depression and their use of health care.
  • The findings show the NHS could reduce avoidable health care use and improve people’s quality of life, if they were better supported to manage their long-term conditions.
  • The briefing points to solutions and calls for national policy makers and the local NHS to take action now, including by prioritising support for self-management in the NHS long-term plan.

Read the full press release from The Health Foundation here 

The full article has been published in BMJ Quality and Safety 

Abstract

Objective To quantify the association between patient self-management capability measured using the Patient Activation Measure (PAM) and healthcare utilisation across a whole health economy.

Results 12 270 PAM questionnaires were returned from 9348 patients. In the adjusted analyses, compared with the least activated group, highly activated patients (level 4) had the lowest rate of contact with a general practitioner, emergency department attendances, emergency hospital admissions  and outpatient attendances. These patients also had the lowest relative rate (compared with the least activated) of ‘did not attends’ at the general practitioner, ‘did not attends’ at hospital outpatient appointments and self-referred attendance at emergency departments for conditions classified as minor severity, a significantly shorter average length of stay for overnight elective admissions, and a lower likelihood of 30- day emergency readmission, though this did not reach ignificance.

Conclusions Self-management capability is associated with lower healthcare utilisation and less wasteful use across primary and secondary care.

Full reference:

Barker ISteventon AWilliamson R, et al| 2018| Self-management capability in patients with long-term conditions is associated with reduced healthcare utilisation across a whole health economy: cross-sectional analysis of electronic health records |

The full article is available to read from BMJ Quality & Safety 

Towards a longevity dividend: Life expectancy and productivity across developed countries

International Longevity Centre | August 2018 | Towards a longevity dividend: Life expectancy and productivity across developed countries

A new international report from the International Longevity Centre explores the relationship between life expectancy and productivity in developed countries.

This paper explores the effects of life expectancy on productivity across developed countries since the 1970s. For this, the International Longevity Centre utilised the demographic and macroeconomic data collected by the OECD for 35 countries.

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1 minute summary

  • Based on their analysis of OECD data they find life expectancy is positively associated with productivity. As life expectancy rises, this leads to increased output per hour worked, per worker and per capita
  • Using an instrumental variables approach, they find the relationship to be robust to different productivity measures, the inclusion of a range of explanatory and control variables and different instruments
  • In our analysis, life expectancy is a more powerful determinant of productivity than either the young or old age dependency ratios
  • When investigating the channels through which life expectancy boosts productivity, we find education to be more important than employment. In this context, rising life expectancy raises the returns to education
  • Overall, their analysis suggests that there may well be a longevity dividend, whereby improvements to health result in wider economic and productivity gains in developed countries
  • Improving health and raising life expectancy must therefore remain a key goal not only for a nation’s health and wellbeing but also for the wider economy
  • Public policy and economic forecasters should consider how best to take into account the potential fiscal benefit of better health and not neglect it in discussions of our long run sustainability (Source: International Longevity Centre )

    Full details from International Longevity Centre 

Healthcare sustainability project

Royal College of Physicians | August 2018 | Healthcare sustainability project launches new NHS impact animation

The RCP has launched a new animated video outlining the impact the NHS has on the environment, and how health professionals can incorporate sustainability in their work

The video has been  produced by the RCP’s healthcare sustainability project, highlights how NHS activity can impact environmental issues such as climate change, reduce air quality, and lead to long term conditions for patients including respiratory diseases and cancers.

Full details from RCP 

Related: Healthcare sustainability

Learning by doing: integrating health and care in Scotland

The King’s Fund | August 2018| The King’s Fund | Learning by doing: integrating health and care in Scotland

A new blog post on The King’s Fund summarises the experiences of integration authorities who are leading the integrated agenda in the 32 local authority areas of Scotland. The blog makes comparisons between Scotland and England, offering some reflections between the health and care systems. 

The full post is at The King’s Fund 

 

The Hospital Frailty Score

Nuffield Trust | August 2018 | The Hospital Frailty Score

A new tool from the Nuffield Trust has been developed to help providers and commissioners of care in England assess the needs of frail older people being cared for in hospital.

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The Hospital Frailty Score is available to download from Nuffield Trust 

A guest blog at the Nuffield Trust website  from Professor Simon Conroy discusses the advantages of being able to identify older people at risk in hospitals, and how it could make a real difference.

Comprehensive geriatric assessment: needs assessment tool