Abstract:
OBJECTIVE:Outpatient parenteral antimicrobial therapy (OPAT) provides opportunities for improved cost savings, but in the UK, implementation is patchy and a variety of service models are in use. The slow uptake in the UK and Europe is due to a number of clinical, financial and logistical issues, including concern about patient safety. The measurement of patient experience data is commonly used to inform commissioning decisions, but these focus on functional aspects of services and fail to examine the relational aspects of care. This qualitative study examines patients' experiences of OPAT. DESIGN:In-depth, semistructured interviews. SETTING:Purposive sample of OPAT patients recruited from four acute National Health Service (NHS) Trusts in Northern England. These NHS Trusts between them represented both well-established and recently set-up services running nurse at home, hospital outpatient and/or self-administration models. PARTICIPANTS:We undertook 28 semistructured interviews and one focus group (n=4). RESULTS:Despite good patient outcomes, experiences were coloured by patients' personal situation and material circumstances. Many found looking after themselves at home more difficult than they expected, while others continued to work despite their infection. Expensive car parking, late running services and the inconvenience of waiting in for the nurse to arrive frustrated patients, while efficient services, staffed by nurses with the specialist skills needed to manage intravenous treatment had the opposite effect. Many patients felt a local, general practitioner or community health centre based service would resolve many of the practical difficulties that made OPAT inconvenient. Patients could find OPAT anxiety provoking but this could be ameliorated by staff taking the time to reassure patients and provide tailored information. CONCLUSION:Services configurations must accommodate the diversity of the local population. Poor communication can leave patients lacking the confidence needed to be a competent collaborator in their own care and affect their perceptions of the service.
journal_name
BMJ Openjournal_title
BMJ openauthors
Twiddy M,Czoski Murray CJ,Mason SJ,Meads D,Wright JM,Mitchell ED,Minton J,CIVAS study team.doi
10.1136/bmjopen-2017-019099subject
Has Abstractpub_date
2018-01-10 00:00:00pages
e019099issue
1issn
2044-6055pii
bmjopen-2017-019099journal_volume
8pub_type
杂志文章相关文献
BMJ Open文献大全abstract:OBJECTIVE:China has achieved over 96% health insurance coverage. However, universal health coverage (UHC) entails population coverage and the range of services covered and the extent to which health service costs are covered. This study aimed to determine the performance of the health insurance system in China in terms...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-014425
更新日期:2017-06-02 00:00:00
abstract:INTRODUCTION:Anticoagulant therapy in patients with cancer with venous thromboembolism (VTE) increases the risk of both VTE recurrence and haemorrhagic complication. Direct oral anticoagulants (DOACs) have been shown to be effective in preventing VTE recurrence, and comparable to conventional therapy in preventing VTE ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-031698
更新日期:2019-11-05 00:00:00
abstract:OBJECTIVES:To evaluate glycaemic durability with dipeptidyl peptidase-4 (DPP-4) inhibitors in type 2 diabetes. DESIGN:A systematic review and meta-analysis of long-term randomised trials of DPP-4 inhibitors on haemoglobin A1c (HbA1c) was conducted. Electronic searches were carried out on the following databases: MEDLI...
journal_title:BMJ open
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmjopen-2014-005442
更新日期:2014-06-10 00:00:00
abstract:OBJECTIVE:To examine the role of dietary intake and physical activity in muscle strength among adolescents. DESIGN:Cross-sectional analysis. SETTING:The Malaysian Health and Adolescents Longitudinal Research Team (MyHeART) study. PARTICIPANTS:Fifteen-year-old secondary school children who have given consent and who ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-026275
更新日期:2019-06-27 00:00:00
abstract:INTRODUCTION:Patients with difficult venous access experience undesirable effects during healthcare, such as delayed diagnosis and initiation of treatment, stress and pain related to the technique and reduced satisfaction. This study aims to identify risk factors with which to model the appearance of difficulty in achi...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2017-020420
更新日期:2018-02-08 00:00:00
abstract:INTRODUCTION:General Practitioners (GPs) and allied healthcare professionals working in primary care are regularly required to make decisions with, for and on behalf of patients who lack capacity. In England and Wales, these decisions are made for incapacitated adult patients under the Mental Capacity Act 2005, which p...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-038032
更新日期:2020-10-20 00:00:00
abstract:PURPOSE:The ChicagO Multiethnic Prevention and Surveillance Study or 'COMPASS' is a population-based cohort study with a goal to examine the risk and determinants of cancer and chronic disease. COMPASS aims to address factors causing and/or exacerbating health disparities using a precision health approach by recruiting...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-038481
更新日期:2020-09-16 00:00:00
abstract:OBJECTIVES:Mortality has declined in people with HIV infection, subsequent to the improved access to antiretroviral therapy (ART). We assessed the incidence and determinants of mortality among patients with HIV-1 infection who were started on ART in a referral treatment centre for HIV infection in Yaounde, Cameroon. D...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-003210
更新日期:2013-07-13 00:00:00
abstract:OBJECTIVE:We report on: (1) the proportion of patients with known atrial fibrillation (AF); and (2) demographic, clinical or radiological differences between patients with known AF (and not treated) and patients with newly diagnosed AF, in a cohort of patients who presented with ischaemic stroke or transient ischaemic ...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2018-028387
更新日期:2019-07-24 00:00:00
abstract:INTRODUCTION:High-grade gliomas (HGGs) are the most malignant type of brain tumours. The 5-year survival is 10% and a significant part of the ongoing research aims to increase survival through surgical and oncological treatments. Accordingly, there is an increasing need for investigating the HGG trajectory in order to ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-003183
更新日期:2013-07-11 00:00:00
abstract:OBJECTIVE:To investigate how accurately doctors estimated their performance on the General Medical Council's Tests of Competence pilot examinations. DESIGN:A cross-sectional survey design using a questionnaire method. SETTING:University College London Medical School. PARTICIPANTS:524 medical doctors working in a ran...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-004131
更新日期:2014-02-06 00:00:00
abstract:BACKGROUND:Clinical trials on Traditional Chinese Medicine (TCM) should be registered in a publicly accessible international trial register and report on all outcomes. We systematically assessed and evaluated TCM trials in registries with their subsequent publications. OBJECTIVE:To describe the characteristics of TCM ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-002968
更新日期:2013-07-16 00:00:00
abstract:AIM:Providing an overview of the neuropsychological tests used in Italian memory clinics (defined as Centers for Cognitive Disorders and Dementias-CCDD in Italy) for the diagnosis of cognitive disorders and dementias. METHODS:A total of 501 CCDD, out of all 536 active CCDD, were surveyed between February 2014 and Augu...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-017847
更新日期:2018-03-28 00:00:00
abstract:INTRODUCTION:Residential fires remain a significant global public health problem. It is recognised that the reported number of residential fires, fire-related injuries and deaths significantly underestimate the true number. Australian surveys show that around two-thirds of respondents who experience a residential fire ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-037709
更新日期:2020-09-23 00:00:00
abstract:OBJECTIVES:To identify the diagnostic accuracy of common imaging modalities, chest X-ray (CXR) and CT, for diagnosis of COVID-19 in the general emergency population in the UK and to find the association between imaging features and outcomes in these patients. DESIGN:Retrospective analysis of electronic patient records...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-042946
更新日期:2020-11-06 00:00:00
abstract:INTRODUCTION:Idiopathic subglottic stenosis (iSGS) is an unexplained progressive obstruction of the upper airway that occurs almost exclusively in adult, Caucasian women. The disease is characterised by mucosal inflammation and localised fibrosis resulting in life-threatening blockage of the upper airway. Because of hi...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-022243
更新日期:2018-04-10 00:00:00
abstract:OBJECTIVES:Patient experience is being widely considered in the evaluation of healthcare service quality, which is a key target for public hospitals under China's New Healthcare Reform. This study aimed to illustrate patients' experiences in county-level public hospitals, and identify aspects that need to be improved. ...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2019-034225
更新日期:2019-11-14 00:00:00
abstract:INTRODUCTION:Health literacy research has focused predominantly on the adult population, and much less is understood about this concept from an adolescent perspective. The tools currently available to measure adolescent health literacy have been adapted from adult versions. This limits their applicability to young peop...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-039920
更新日期:2020-11-11 00:00:00
abstract:OBJECTIVE:Podoconiosis is a neglected tropical disease characterised by a slowly progressive swelling of the foot and lower leg. It is prevalent among subsistence barefoot farmers who live and work in highland areas of the tropics. This study was conducted in Wayu Tuka 'woreda' (district), western Ethiopia to determine...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-012308
更新日期:2016-09-26 00:00:00
abstract:OBJECTIVES:The rate of total knee arthroplasty surgery (TKA) is rising in Australia despite varying impacts of TKA on physical function (PF) in population-based studies. There are potentially modifiable risk factors that could enhance PF after TKA, so we evaluated (1) the levels of PF in persons with TKA and the rest o...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-002291
更新日期:2013-07-08 00:00:00
abstract:OBJECTIVE:The aim of this study was to assess the knowledge and practice of health workers about multidrug-resistant tuberculosis (MDR-TB) prevention and control. STUDY DESIGN AND SETTINGS:A cross-sectional study was conducted at Gondar University Referral Hospital and Felege Hiwot Referral Hospital. PARTICIPANTS:Ran...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2018-022948
更新日期:2019-02-19 00:00:00
abstract:OBJECTIVE:Despite the recognition that educating healthcare students in patient safety is essential, changing already full curricula can be challenging. Furthermore, institutions may lack the capacity and capability to deliver patient safety education, particularly from the start of professional practice studies. Using...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-010045
更新日期:2015-12-08 00:00:00
abstract:OBJECTIVE:To identify the advantages and disadvantages that group practices have on patients, physicians and healthcare systems. STUDY DESIGN:A scoping review was performed based on the methodology proposed by Arksey and O'Malley, and refined by Levac et al. Titles and abstracts were screened by two reviewers. A quant...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-041579
更新日期:2021-01-08 00:00:00
abstract:OBJECTIVE:To develop and externally validate a risk algorithm (QAdmissions) to estimate the risk of emergency hospital admission for patients aged 18-100 years in primary care. DESIGN:Prospective open cohort study using routinely collected data from general practice linked to hospital episode data during the 2-year st...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-003482
更新日期:2013-08-19 00:00:00
abstract:OBJECTIVES:To characterise the pattern of colonisation and serotypes of Streptococcus pneumoniae among patients with chronic obstructive pulmonary disease (COPD) who currently receive the 23-valent pneumococcal polysaccharide vaccine (PPV-23) according to vaccination status, use of antibiotics and steroids. To investig...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-013944
更新日期:2017-07-09 00:00:00
abstract:OBJECTIVES:People interact with their work environment through being, to a greater or lesser extent, compatible with aspects of their setting. This interaction between person and environment is particularly relevant in healthcare settings where compatibility affects not only the healthcare professionals, but also poten...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-026266
更新日期:2019-05-09 00:00:00
abstract:OBJECTIVES:We aimed to examine longitudinally whether workplace bullying was associated with subsequent psychotropic medication among women and men. DESIGN:A cohort study. SETTING:Helsinki, Finland. PARTICIPANTS:Employees of the City of Helsinki, Finland (n=6606, 80% women), 40-60 years at baseline in 2000-2002, and...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-001660
更新日期:2012-12-12 00:00:00
abstract:INTRODUCTION:The acceptability and efficacy of existing ready-to-use supplementary and therapeutic foods has been low in Cambodia, thus limiting success in preventing and treating malnutrition among Cambodian children. In that context, UNICEF and IRD have developed a locally produced, multiple micronutrient fortified l...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2017-015958
更新日期:2017-09-06 00:00:00
abstract:INTRODUCTION:Dextro-transposition of the great arteries (d-TGA) is a life-threatening congenital health defect that requires rapid surgery. The most widely used approach is the arterial switch operation (ASO) developed by Jatene in the 1970s. The first set of children who received this intervention are now adults. The ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2014-005123
更新日期:2014-06-11 00:00:00
abstract:INTRODUCTION:Alzheimer's disease and related dementias can be considered the epidemic of the 21st century. Particularly, the predicted growth in the size of elderly populations in low-income and middle-income countries is expected to produce a dramatic surge in dementia prevalence and incidence. Although a rising burde...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-030300
更新日期:2019-07-31 00:00:00