CaHRU studies presented at Society for Academic Primary Care Annual Scientific Meeting July 2021

Despina Laparidou, Dr Vanessa Botan and Prof Niro Siriwardena attended the 49th Annual Scientific Meeting of SAPC on 30th June and 1st July 2021, Living and Dying Well, which took place online hosted by the University of Leeds, to present research led by the Community and Health Research Unit.

Despina Laparidou, research assistant at CaHRU, presented her study, ‘Perceptions and experiences of residents and relatives of emergencies in care homes: systematic review and meta-synthesis‘, exploring the perceptions and experiences of care home residents and their family members who had experienced a medical emergency in a care home. The review team identified 10 studies from 4 countries (Australia, Canada, UK, and US) from five electronic databases, MEDLINE, CINAHL, PubMed, Cochrane Library and PsycINFO, supplemented with internet searches and citation tracking. Six areas were identified using thematic analysis: infrastructure and process requirements in care homes to prevent and address emergencies; the complexity of hospital transfer decisions; challenges of transfer and hospitalisation for older patients; good communication was needed for desirable outcomes; legal, regulatory and ethical concerns; and the importance of trusting relationships enabling residents to feel safe. The study found that emergency care experiences for care home residents can be improved by providing resources, staff capacity and processes for high quality care, and maintaining trusting relationships between staff and patients or other staff, with good communication and attention to ethical practice. The study is due to be published in Age and Ageing.

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Dr Vanessa Botan, research associate in statistics at CaHRU, presented her study, on ‘The effects of a leaflet-based intervention, ‘Hypos can strike twice’, on recurrent hypoglycaemic attendances by ambulance services (Ambu-HS2)’ which aimed to investigate the effect of advice supported by the ‘Hypos can strike twice’ booklet, following a hypoglycaemic event to prevent future attendances using a non-randomised stepped wedge-controlled design. The intervention was introduced at different times in different areas and included 4825 patients experiencing hypoglycaemic events attended by ambulance. Analysis using a generalised linear mixed model showed a reduction in the number of unsuccessful attendances (i.e. attendance followed by a repeat attendance) in the final step of the intervention when compared to the first (OR: 0.50, 95%CI: 0.33-0.76, p=0.001) and this was supported by an interrupted time series analysis showing a significant decrease in repeat ambulance attendances for hypoglycaemia relative to the pre-intervention trend (p=0.008). The quality of care, as measured by a hypoglycaemia care bundle, also improved significantly during the intervention period. The study although funded by NIHR Applied Research Collaboration was carried out independently of the funder who had no role in the conduct or analysis of the research or preparation of the manuscript. The study was recently published in Diabetic Medicine.

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Finally, Professor Siriwardena co-chaired a session on ‘Teaching, remote consulting, and GP training with Dr Caroline Mitchell (Sheffield) and also presented on ‘Candidates’ perceptions and experiences of the UK Recorded Consultation Assessment implemented during COVID-19: cross-sectional data linkage study’.  The Recorded Consultation Assessment (RCA) was developed to replace the Clinical Skills Assessment (CSA) for UK general practice licensing during COVID-19 in 2020. The cross-sectional survey of RCA candidates found responders were positive about the digital platform and support resources; a small overall majority perceived the RCA to be a fair assessment but a larger majority reported difficulty collecting, selecting, and submitting cases or felt rushed during recording. Logistic regression showed that ethnicity, place of initial medical training and English as first language were associated with exam success but exam experience, type of consultation type (audio vs video) and extent of trainer review were not. A related study, ‘Examiner perceptions of the UK Recorded Consultation Assessment introduced during the COVID-19 pandemic: cross-sectional study’ was presented as a poster.

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