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2. Pre-existing musculoskeletal pain and its association with mortality in newly diagnosed co-morbid conditions: an electronic health record cohort study

Author

Marshall, Michelle, primary, Mason, Kayleigh J, additional, Edwards, John J, additional, Mamas, Mamas A, additional, Bailey, James, additional, Heron, Neil, additional, Achana, Felix A, additional, Frisher, Martin, additional, Huntley, Alyson L, additional, Mallen, Christian D, additional, Png, May Ee, additional, Tatton, Stephen, additional, White, Simon, additional, and Jordan, Kelvin P, additional

Published
2023
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4. Pre-existing musculoskeletal pain and its association with mortality in newly diagnosed co-morbid conditions: an electronic health record cohort study.

Author

Marshall, Michelle, Mason, Kayleigh J, Edwards, John J, Mamas, Mamas A, Bailey, James, Heron, Neil, Achana, Felix A, Frisher, Martin, Huntley, Alyson L, Mallen, Christian D, Png, May Ee, Tatton, Stephen, White, Simon, and Jordan, Kelvin P

Subjects
MUSCULOSKELETAL pain, MORTALITY, ELECTRONIC health records
Abstract

Objective Musculoskeletal pain is a common risk factor for co-morbid conditions and might increase the risk of poor outcomes. The objective was to determine whether patients with pre-existing musculoskeletal pain have an increased risk for mortality following a new diagnosis of a co-morbid condition. Methods Patients aged ≥45 years with a new diagnosis of acute coronary syndrome (ACS), stroke, cancer, dementia or pneumonia recorded in a UK electronic primary care database linked to hospital and mortality records were examined. The association of mortality with musculoskeletal pain (inflammatory conditions, OA and regional pain) was determined. Results The sample size varied from 128 649 (stroke) to 406 289 (cancer) by cohort, with 22–31% having pre-existing musculoskeletal conditions. In the ACS cohort, there was a higher rate of mortality for all musculoskeletal types. There were also higher unadjusted mortality rates in patients with inflammatory arthritis compared with those without musculoskeletal pain in the stroke, cancer and dementia cohorts and for patients with OA in the stroke and cancer cohorts. After adjustment for the number of prescribed medications and age, the increased risk of mortality remained only for patients with inflammatory arthritis in the ACS cohort (adjusted hazard ratio = 1.07; 95% CI 1.03, 1.10). Conclusion Older adults with inflammatory arthritis and OA have increased risk of mortality when they develop a new condition, which seems to be related to the prescription of multiple medicines. Pre-existing musculoskeletal pain is an indicator of a complex patient who is at risk of poorer outcomes at the onset of new illnesses. [ABSTRACT FROM AUTHOR]

Published
2024
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6. P181 Musculoskeletal pain and prognosis of acute coronary syndrome and cerebrovascular accident: a linked electronic health record cohort study

Author

Mason, Kayleigh J, primary, Jordan, Kelvin P, additional, Achana, Felix A, additional, Bailey, James, additional, Chen, Ying, additional, Frisher, Martin, additional, Huntley, Alyson L, additional, Mallen, Christian D, additional, Mamas, Mamas A, additional, Png, May Ee, additional, Tatton, Stephen, additional, White, Simon, additional, and Edwards, John J, additional

Published
2022
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7. Nocturia and chronic kidney disease: Systematic review and nominal group technique consensus for primary care assessment and treatment

Author

Cotterill, Nikki, Ridgway, Alex, Dawson, Shoba, Drake, Marcus J, Henderson, Emily J, Huntley, Alyson L, Rees, Jonathan, Strong, Eddie, Dudley, Christopher, and Udayaraj, Udaya

Subjects
urologic and male genital diseases, female genital diseases and pregnancy complications
Abstract

Context: Reduced renal function impairs salt and water homeostasis, which can drive nocturnal or 24-h polyuria. Nocturia can arise early in chronic kidney disease (CKD). Evidence-based recommendations can facilitate management outside nephrology clinics. Objective: To conduct a systematic review (SR) of nocturia in CKD and achieve expert consensus for management in primary care and in specialist clinics outside nephrology. Evidence acquisition: Four databases were searched from January 2000 to April 2020. A total of 4011 titles and abstracts were screened, and 108 studies underwent full-text screening. Seven studies met the inclusion criteria and two were identified through other sources. Consensus was achieved among an expert panel with public involvement using the nominal group technique (NGT). Evidence synthesis: Several plausible mechanisms contribute to nocturnal or 24-h polyuria in CKD, but there is little evidence on interventions to improve nocturia. NGT assessment recommendations for nocturia (at least two voids per night) in patients with CKD or at risk of CKD being assessed in a non-nephrology setting are: history (thirst, fluid intake), medication review (diuretics, lithium, calcium channel antagonists, nonsteroidal anti-inflammatory medications), examination (oedematous state, blood pressure), urinalysis (haematuria and albumin/creatinine ratio), blood tests (blood urea, serum creatinine and electrolytes, estimated glomerular filtration rate), and a bladder diary. Renal ultrasound should follow local CKD guidelines. Treatment options include optimising blood pressure control, dietary adjustment to reduce salt intake, fluid advice, and a medication review. Referral to specialist nephrology services should follow local guidelines. Conclusions: CKD should be considered when evaluating patients with nocturia. The aim of assessment is to identify mechanisms and instigate therapy, but the latter may be more applicable to reducing wider morbidity associated with CKD than nocturia itself. Patient summary: People with kidney disease can suffer severe sleep disturbance because of a need to pass urine overnight. We looked at published research and found some useful information about the underlying mechanisms. A group of experts was able to develop practical approaches for assessing and treating this condition.

Published
2022

10. Research priorities in advanced heart failure: James Lind alliance priority setting partnership

Author

Taylor, Clare, Huntley, Alyson L., Burden, John, Gadoud, Amy, Gronlund, Toto, Jones, Nicholas Roberts, Wicks, Eleanor, McKelvie, Sara, Byatt, Kit, Lehman, Richard, King, Anna, Mumford, Bev, Feder, Gene, Mant, Jonathan, Hobbs, Richard, Johnson, Rachel, Taylor, Clare, Huntley, Alyson L., Burden, John, Gadoud, Amy, Gronlund, Toto, Jones, Nicholas Roberts, Wicks, Eleanor, McKelvie, Sara, Byatt, Kit, Lehman, Richard, King, Anna, Mumford, Bev, Feder, Gene, Mant, Jonathan, Hobbs, Richard, and Johnson, Rachel

Abstract

Objective To determine research priorities in advanced heart failure (HF) for patients, carers and healthcare professionals. Methods Priority setting partnership using the systematic James Lind Alliance method for ranking and setting research priorities. An initial open survey of patients, carers and healthcare professionals identified respondents’ questions, which were categorised to produce a list of summary research questions; questions already answered in existing literature were removed. In a second survey of patients, carers and healthcare professionals, respondents ranked the summary research questions in order of priority. The top 25 unanswered research priorities were then considered at a face-to-face workshop using nominal group technique to agree on a ‘top 10’. Results 192 respondents submitted 489 responses each containing one or more research uncertainty. Outof-scope questions (35) were removed, and collating the responses produced 80 summary questions. Questions already answered in the literature (15) were removed. In the second survey, 65 questions were ranked by 128 respondents. The top 10 priorities were developed at a consensus meeting of stakeholders and included a focus on quality of life, psychological support, the impact on carers, role of the charity sector and managing prognostic uncertainty. Ranked priorities by physicians and patients were remarkably divergent. Conclusions Engaging stakeholders in setting research priorities led to a novel set of research questions that might not have otherwise been considered. These priorities can be used by researchers and funders to direct future research towards the areas which matter most to people living with advanced HF.

Published
2020

15. Research priorities in advanced heart failure: James Lind alliance priority setting partnership

Author

Taylor, Clare J, primary, Huntley, Alyson L, additional, Burden, John, additional, Gadoud, Amy, additional, Gronlund, Toto, additional, Jones, Nicholas Robert, additional, Wicks, Eleanor, additional, McKelvie, Sara, additional, Byatt, Kit, additional, Lehman, Richard, additional, King, Anna, additional, Mumford, Bev, additional, Feder, Gene, additional, Mant, Jonathan, additional, Hobbs, Richard, additional, and Johnson, Rachel, additional

Published
2020
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22. Measures of Multimorbidity and Morbidity Burden for Use in Primary Care and Community Settings: A Systematic Review and Guide.

Author

Huntley, Alyson L., Johnson, Rachel, Purdy, Sarah, Valderas, Jose M., and Salisbury, Chris

Subjects
*MEDICAL care research, *DISEASES, *PRIMARY care, *PUBLISHED articles, *MEDICINE
Abstract

The article presents a study on measures of morbidity and morbidity burden for research in primary care and community populations. It discusses how the study was conducted which involved 194 articles describing various measures including Adjusted Clinical Groups, Charlson index, and the Duke Severity of Illness Checklist. It details the results which revealed that different methods are appropriate according to the result of interest.

Published
2012
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