AIMS
Research is needed to improve how hospitals work to meet the needs of patients with multiple long-term conditions (MLTCs).
BACKGROUND
Hospital care is designed to deal with single conditions and yet it’s common that people admitted to hospital are living with MLTCs. People with MLTCs tell us that their hospital care is unsatisfactory and we know that they often stay in hospital longer, their recovery takes longer or they are more likely to experience side effects from medicines.
RESEARCH
Five universities are working together to understand how patients with MLTCs move through the hospital system.
- How do they get admitted to hospital?
- How long do they stay?
- Who looks after them?
- Where in the hospital are they cared for?
- What happens to them after discharge?
This is a complex problem to tackle. The researchers plan to look at it in several different ways including through in-depth interviews with patients and hospital staff. There are lots of different combinations of MLTCs that patients live with, and trying to understand all of these at once would be very difficult.
This specific study will look at how patients with Chronic Obstructive Pulmonary Disease (COPD – a chronic lung disease) with and without other conditions are admitted to hospital, move through the hospital system, and are discharged from hospital. It will also study whether age, sex, ethnicity and how well-off people are makes a difference to these measures, to understand how inequalities might affect hospital care.
It is hoped that the researchers will develop methods that can be used to study other groups of patients with long-term conditions who are admitted to hospital. The findings will help the NHS to redesign hospital services to provide better quality care, tailored to the individual needs of different patients with COPD, to reduce both length of hospital stay and the chance of readmission. This work is part of an overall research programme which was designed with a panel of patients who live with MLTCs. The programme has a wider group of patient contributors that helps to interpret the findings, suggests new directions for the research to take, and acts as a sounding board for the design of projects and analyses.
PATIENT INVOLVEMENT
This work is part of an overall research programme which was designed with a panel of patients who live with MLTCs. The programme has a wider group of patient contributors that helps to interpret the findings, suggests new directions for the research to take, and acts as a sounding board for the design of projects and analyses.
APPROVAL
This project was supported unanimously by the PIONEER Data Trust Committee.
The study is being run by Professor Miles Witham, The University of Newcastle.
I live with MLTCs including COPD. I am a Patient Partner with a number of organisations involved in health and social care research.
I would like to ask if pre-hospital admission ‘lung function testing’ data is included as part of this project? The reason that I ask this question is that if ‘lung function testing’ were to be included in and as part of Primary Care ‘Health Checks’ could this improve diagnostics, treatments and respiratory ‘rehabilitation’ – could this type of screening process improve not only patient outcomes but also reduce hospital admissions etc. I would also like to ask if data is collected and if patients are informed about any respiratory support they may have needed at any stage of their clinical history,i.e. ‘at birth’ and if there is any evidence that this informed knowledge could influence healthy lifestyle decision making, support better self-management etc. particularly for ‘at risk’ groups. I am not a scientist or clinician but it does seem to me that ‘historical clinical data’ could play an important role in patient care and management and that some form of ‘lung function’ screening process could improve prevention and management of respiratory conditions complicated by MLTCs?
Dear Phil
Thank you for your comment on the ADMISSION COPD project being undertaken by Professor Miles Witham via PIONEER. The data for this project is focussed on acute secondary care data to expand knowledge on the trajectories of care through hospital for people with COPD. The addition of pre-hospital lung function data is not included if it is carried out by a GP, in the community or at another hospital out of the area, as this data is not currently available via our research database. However, we have plans to include this in the near-future as we also see the benefits of this joined up clinical data as you correctly summarise in your comment. If the test was carried out in one of our four hospitals prior to an acute medical event then we will be including that data.
The ADMISSION team and our team in PIONEER work hard to ensure we engage and involve our patients and public in all our projects and ensure findings are shared in both the professional contexts but also via public webinars, posters and events. So the learning from this COPD project will be shared widely to hopefully assist patients living with this condition to understand more about care pathways and outcomes. In terms of the broader patient education and testing, we would not be able to comment on this but please be assured we aim to share our findings widely so that the research can have an impact to benefit current and future patients.
We hope this has helped answer your question and we are also grateful for your feedback and input as someone living with COPD and MLTCs.
Thanks
PIONEER Team