The HOME study - Michael Sharpe s CBT for the elderly

Sly Saint said:
no balloons, just cloudy skies in this one

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I clicked on the home study hashtag. I have a feeling that Sharpe ignored step 2 in this link (my emphasis) :

https://www.adweek.com/digital/create-hashtag/

Next, check to see that your ideal hashtag isn’t already in use. Since you’re looking to create a community around your hashtag, you want to start fresh – you don’t want to encroach on another community’s space. Use Twitter’s search to see if and when your hashtag has ever been used, and go down the list you created in the brainstorm until you find a suitable, quiet hashtag.
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1st December
New Psychological Medicine Centre at John Radcliffe Hospital

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Prof Michael Sharpe and Dame Fiona Caldicott

A NEW mental health facility in Oxford will help improve care for patients who have co-existing psychiatric and medical conditions.

The Oxford Psychological Medicine Centre at the John Radcliffe Hospital will provide a dedicated space for clinical psychiatrists and psychologists at Oxford University Hospitals NHS Foundation Trust (OUH) as well as researchers from Oxford University.

The centre, based in the hospital’s west wing, will house the trust’s clinical psychology team for adults, the clinical psychology team for children, and the clinical psychiatry team together with a university research team for the first time.
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“Oxford Psychological Medicine is already regarded as a beacon of integrated mental and physical care nationally and internationally, and the creation of this centre will enable us to do even more to help our patients.”

Psychological medicine refers to the psychological and psychiatric care of the medically ill.

As well as providing learning for medical students, the centre’s teaching programme will also be used by trust nurses, doctors and other staff, while the research programme will help deliver clinical advances to help people with co-existing psychiatric and medical conditions.

Once such ongoing projects include the HOME study - a trial of enhanced psychiatric care looking at the length of time inpatients spend on a hospital ward.
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full article here:
https://www.oxfordtimes.co.uk/news/...centre-at-john-radcliffe-hospital/?ref=twtrec
 
NelliePledge said:
Hopefully she was eating him for breakfast
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I very much doubt it, as I am sure he's not quite..... 'kosher".......?

http://www.ok.org/companies/what-is-kosher/meat-dairy-pareve-setting-boundaries/
  • Kosher meat must come from an animal that chews its cud (he certainly knows how to do that!) and has split hooves. (Cows, sheep and goats are kosher; rabbits, kangaroos and fox are not).
  • Kosher fowl are identified by a universally accepted tradition and include the domesticated species of chickens, Cornish hens, ducks, geese and turkeys. The Torah names the species of fowl that are forbidden, including all predatory and scavenger birds ('nuff said)..............
 
protocol for the HOME study now published pdf here:
https://link.springer.com/epdf/10.1186/s13063-019-3502-5?shared_access_token=kKR11aoSLtkBjA0nbDFrWW_BpE1tBhCbnbw3BuzI2RPoOrDaODCRPsFTJ102iBRHzzgPihI_9ZFKGH9yyKIN-4vKqWgzB8ieeW71_QSfLrO9G86jQ1JYmcod-63Sy54EeV-BBl-w6xaOlj2KTyaLnHG3iqnS_ErF7pvDe5s4mL0=

We have developed a new service model called Proactive Psychological Medicine (PPM), which aims to be more effective in reducing time in hospital. The new model aims to address the limitations of the current approach: (a) it is proactive in seeing all admitted patients (building on the experience of a proactive psychiatric consultation service initiated in Yale Newhaven Hospital in the USA [8, 9]), (b) it takes a broad biopsychosocial approach focussing on facilitating prompt discharge, (c) it provides an intensive contribution to care with comprehensive consultant assessment and daily follow-up and (d) it is integrated, with PPM clinicians working as members of the patient’s extended medical team. We have piloted this new PPM service model and found it to be both feasible and acceptable in an NHS general hospital setting.
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Trial treatment: intervention The intervention is usual care supplemented with PPM, which has four main components:
1. Early proactive biopsychosocial assessment of newly admitted patients using a biopsychosocial approach to identify all problems, including psychiatric illness.
2. The creation of a systematic management plan to address those problems that pose potential barriers to prompt discharge.
3. Implementation of the management plan with daily progress reviews.
4. Integrated working with ward teams (doctors, nurses, allied health professionals and social care professionals) and out of hospital services to ensure that the management plan is implemented.
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PPM will be delivered at each trial site by a spe-cially trained consultant in psychological medicine/liaison psychiatry and an assisting clinician, who willwork as additional members of the patient’s medicalteam (the assisting clinician may be a junior doctor,a nurse or an allied health professional with experi-ence of working in psychological medicine/liaisonpsychiatry).
Each of these clinicians will have abackup to cover leave. To ensure fidelity to the ser-vice model, the PPM clinicians will:
(a) deliver PPMaccording to a service manual,
(b) use a PPM check-list for each patient,
(c) be required to pass quality assessments prior to treating trial participants,
(d) partici-pate in weekly joint supervision by video-conferenceand
(e) undergo regular quality assurance checksthroughout the trial.
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Primary outcome The primary outcome is the number of days spent as an inpatient in a general hospital in the month (30 days) post-randomisation.
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Secondary outcomesThe following secondary outcomes will be assessed:
cognitive function, measured by the MontrealCognitive Assessment, telephone version, at 1 and 3months post-randomisation [10].

independent functioning, measured by the BarthelIndex of Activities of Daily Living at 1 and 3 monthspost-randomisation [11].

health-related quality of life, measured by theEQ-5D-5L at 1 and 3 months post-randomisation[12].symptoms of anxiety and depression, each measuredby the relevant two items of the Patient HealthQuestionnaire-4 at 1 and 3 months post-randomisation [13].

overall quality of life, measured by a trial-specificitem (0 to 10 scale) at 1 and 3 months post-randomisation.patient’s experience of hospital stay, measured by atrial-specific item (0 to 10 scale) at 1 month post-randomisation.

patient’s view on the length of their hospital stay,measured by a trial-specific item at 1 month post-randomisation.

discharge destination.

secondary healthcare use in the year post-randomisation (including total length of index ad-mission, number of readmissions and number ofdays in hospital).

death in the year post-randomisation.
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published here:
https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-019-3502-5

would be interesting to see the 'service manual'
eta: not sure what to think about the last secondary outcome on the list
"death in the year post-randomisation"; but I'm sure they'd just say it's 'perfectly normal'
 
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