Dementia Analytics Research User Group (DARUG) - A Model for meaningful stakeholder engagement in dementia research

BACKGROUND: The importance of involving stakeholders in research is widely recognised but few studies provide details to implementation in practice. The use of real-time technology involving patients, carers and professionals in project design, monitoring, delivery and reporting could maximise contribution. Stakeholder engagement was included as part of a Dementia Analytics Research User Group project which applied machine learning to the Trinity-Ulster-Department of Agriculture (TUDA) data set, identifying clinical and lifestyle factors associated with cognitive health in 5000 community-dwelling older Irish adults.

Postpartum Readmission Rates for Hypertensive Disorders of Pregnancy During the COVID-19 Pandemic

INTRODUCTION: To compare the postpartum (PP) readmission rates of patients with hypertensive disorders of pregnancy (HDP) before and after implementation of an early discharge policy due to the COVID-19 pandemic. METHODS: This is a retrospective, quality improvement study of patients with HDP who delivered and were readmitted at NYU Langone Health from March 1, 2019, to February 29, 2020 (Pre) and from April 1, 2020, to March 31, 2021 (Post). The primary outcome was comparison of PP readmission rates between groups. Data were analyzed using ANOVA, Fisher's exact test, and chi-square test, with significance defined as P<.05. RESULTS: There was no statistical difference in readmission rates for PP HDP after implementation of an early discharge policy (19 readmissions of 1,851 deliveries with HDP [1.03%] versus 23 readmissions of 1,847 deliveries with HDP [1.25%];P=.53). Demographics in each group were similar, as were mean times to readmission (6.4±5.4 days versus 6.4±5.4 days;P=.88) and mean readmission lengths of stay (3.0±1.04 days versus 3.3±1.2 days;P=.45). There was one ICU readmission in the post-group versus none in the pregroup (P=.45). There were no maternal deaths. CONCLUSION: These findings support reducing postpartum lengths of stay without increasing readmissions for HDP. The reduction of postpartum length of stay was accompanied by the continuation of a home blood pressure monitoring and introduction of outpatient HDP management guidelines. Further investigation into best practices to support early discharge is warranted.

THE ESSENTIAL NETWORK (TEN): A BLENDED MENTAL HEALTH SERVICE FOR AUSTRALIAN HEALTHCARE WORKERS DURING THE COVID-19 PANDEMIC

Background: Healthcare workers (HCWs) are at significant risk of poor mental health (MH) because of the COVID-19 pandemic. MH services are available, but many are not sensitive to the needs and workplace culture of HCWs. 'Blended care', which integrates digital and person-to-person care, may leverage the scalability and anonymity of digital health while offering a choice of care options. Objectives: To outline the design and evaluation of The Essential Network (TEN), a blended mental health service created for Australian HCWs during the COVID-19 pandemic. Methods: We outline the development of TEN and service design methodologies, including stakeholder and user consultation, and strategies for adaptive service delivery. TEN was evaluated through an audit of service analytics (website analytics and clinical service analytics). A total of 105 HCWs also participated in an observational study to use TEN for 1 month. Participants completed MH and service acceptability measures at baseline and followup. Findings: TEN has serviced more than 57,000 HCWs. More than 7000 HCWs completed a digital MH assessment and received personalised referral to services. Engagement was highest for self-assessments and self-help resources. Preliminary results from the observational study indicate high service acceptability. Conclusion: TEN united peak professional bodies and service providers to create a digital hub offering HCWs a range of MH resources and help-seeking options. With more than 800,000 HCWs in Australia, uptake of the service has been relatively low. To leverage the potential of blended care, such services must be implemented in a way that ensures that HCWs feel safe to use them.

COVID-19 and lockdown: The highs and lows of general practitioner prescribing

As a result of the global COVID-19 pandemic and subsequent national lockdown, general practices tried to limit unnecessary footfall into surgeries during this period. This paper aims to investigate how General Practice (GP) prescribing changed following the first COVID-19 lockdown by analysing open-source General Practice prescribing data in England and Northern Ireland. Prescribing data was obtained for the calendar years 2019 and 2020 at British National Formulary (BNF) chapter and section levels, aggregated and compared year on year and with each other. Particular attention was given to the change in prescribing between February and March of both years to examine the change in prescribing immediately following the start of the lockdown. Prescribing markedly increased across BNF categories in March 2020 followed by a dip and return to pre-COVID-19 levels in late summer. The rise in the number of items prescribed in England between February and March 2020 was nearly twice that seen in the same period the previous year (14.5% vs 7.6%). Northern Ireland saw a much greater relative increase of 20.7. The “peak, trough and recovery” pattern observed across BNF chapters reflected patients obtaining bigger stocks of prescriptions pre-lockdown. The higher Northern Ireland peak may be part-explained by lack of electronic transfer to pharmacies which exists in England. Increased antimicrobial prescribing, which spiked in March 2020, may relate to issuing “rescue packs” at the outset of the pandemic, with the sustained decline in the following months a possible effect of Covid measures and reduced consulting. © 2021 IEEE

A review of telephone consultations for head and neck cancer follow up: a patient satisfaction survey.

OBJECTIVE: To review patient satisfaction with the change in practice towards telephone consultations during and after the coronavirus disease 2019 pandemic for head and neck cancer follow up. METHOD: A retrospective analysis was conducted of head and neck cancer telephone appointments during a six-month period in a tertiary referral centre. RESULTS: Patients found the telephone consultations beneficial (98 per cent), with 30 per cent stating they were relieved to not have to attend hospital. Patients who travelled further, those with lower stage disease and patients with a greater interval from initial treatment were most satisfied with the telephone consultations. Sixty-eight per cent of patients stated they would be happy to have telephone consultations as part of their regular follow up after the pandemic. CONCLUSION: Patients found the telephone consultations beneficial and 30 per cent considered them preferable to face-to-face appointments. This study demonstrates that telephone consultations can be used as an adjunct to face-to-face appointments in an effort to reduce hospital attendances whilst maintaining close follow up.

A scoping review of the experience of implementing population testing for SARS-CoV-2.

OBJECTIVES: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) - also known as the coronavirus disease (COVID-19) - pandemic has led to the swift introduction of population testing programmes in many countries across the world, using testing modalities such as drive-through, walk-through, mobile and home visiting programmes. Here, we provide an overview of the literature describing the experience of implementing population testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). STUDY DESIGN: Scoping review. METHODS: We conducted a scoping review using Embase, Medline and the Cochrane library in addition to a grey literature search. We identified indicators relevant to process, quality and resource outcomes related to each testing modality. RESULTS: In total, 2999 titles were identified from the academic literature and the grey literature search, of which 22 were relevant. Most studies were from the USA and the Republic of Korea. Drive-through testing centres were the most common testing modality evaluated and these provided a rapid method of testing whilst minimising resource use. CONCLUSIONS: The evidence base for population testing lacks high quality studies, however, the literature provides evaluations of the advantages and limitations of different testing modalities. There is a need for robust evidence in this area to ensure that testing is deployed in a safe and effective manner in response to the COVID-19 pandemic.