8 results on '"Barnett, Karen N."'
Search Results
2. Association between faecal occult bleeding and medicines prescribed for chronic disease: a data linkage study.
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Libby, Gillian, Barnett, Karen N., Fraser, Callum G., and Steele, Robert J. C.
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HEMORRHAGE ,HDL cholesterol ,CHRONIC diseases - Published
- 2021
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3. The contribution of a negative colorectal screening test result to symptom appraisal and help-seeking behaviour among patients subsequently diagnosed with an interval colorectal cancer
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Barnett, Karen N, Weller, David, Smith, Steve, Steele, Robert JC, Vedsted, Peter, Orbell, Sheina, Moss, Sue M, Melia, Jane W, Patnick, Julietta, and Campbell, Christine
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Male ,interval cancer ,Time Factors ,negative screening result ,understanding of screening ,colorectal cancer screening ,Interviews as Topic ,symptom appraisal ,Help-Seeking Behavior ,Journal Article ,Humans ,Mass Screening ,Early Detection of Cancer ,Qualitative Research ,Aged ,Awareness ,Middle Aged ,Original Research Paper ,England ,Scotland ,Occult Blood ,Female ,Colorectal Neoplasms ,Guaiac ,Original Research Papers ,help‐seeking - Abstract
BACKGROUND: Colorectal cancer (CRC) screening programmes using a guaiac faecal occult blood test (gFOBt) reduce CRC mortality. Interval cancers are diagnosed between screening rounds: reassurance from a negative gFOBt has the potential to influence the pathway to diagnosis of an interval colorectal cancer.METHODS: Twenty-six semi-structured face-to-face interviews were carried out in Scotland and England, with individuals diagnosed with an interval colorectal cancer following a negative gFOBt result.RESULTS: Participants reported they were reassured by a negative gFOBt, interpreting their result as an "all clear". Therefore, most did not suspect cancer as a possible cause of symptoms and many did not recall their screening result during symptom appraisal. Among those who did consider cancer, and did think about their screening test result, reassurance from a negative gFOBt led some to "downplay" the seriousness of their symptoms with some interviewees explicitly stating that their negative test result contributed to a delayed decision to seek help.CONCLUSION: Screening participants need to be informed of the limitations of screening and the ongoing risk of developing colorectal cancer even when in receipt of a negative result: the importance of minimizing delay in seeking medical advice for colorectal symptoms should be emphasized.
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- 2018
4. The contribution of a negative colorectal screening test result to symptom appraisal and help‐seeking behaviour among patients subsequently diagnosed with an interval colorectal cancer.
- Author
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Barnett, Karen N., Weller, David, Smith, Steve, Steele, Robert J. C., Vedsted, Peter, Orbell, Sheina, Moss, Sue M., Melia, Jane W., Patnick, Julietta, and Campbell, Christine
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COLON tumors , *DIAGNOSIS , *DIAGNOSTIC errors , *HELP-seeking behavior , *INTERVIEWING , *RESEARCH methodology , *MEDICAL errors , *RESEARCH funding , *THEMATIC analysis , *DATA analysis software , *EARLY detection of cancer , *SYMPTOMS ,RECTUM tumors - Abstract
Abstract: Background: Colorectal cancer (CRC) screening programmes using a guaiac faecal occult blood test (gFOBt) reduce CRC mortality. Interval cancers are diagnosed between screening rounds: reassurance from a negative gFOBt has the potential to influence the pathway to diagnosis of an interval colorectal cancer. Methods: Twenty‐six semi‐structured face‐to‐face interviews were carried out in Scotland and England, with individuals diagnosed with an interval colorectal cancer following a negative gFOBt result. Results: Participants reported they were reassured by a negative gFOBt, interpreting their result as an “all clear”. Therefore, most did not suspect cancer as a possible cause of symptoms and many did not recall their screening result during symptom appraisal. Among those who did consider cancer, and did think about their screening test result, reassurance from a negative gFOBt led some to “downplay” the seriousness of their symptoms with some interviewees explicitly stating that their negative test result contributed to a delayed decision to seek help. Conclusion: Screening participants need to be informed of the limitations of screening and the ongoing risk of developing colorectal cancer even when in receipt of a negative result: the importance of minimizing delay in seeking medical advice for colorectal symptoms should be emphasized. [ABSTRACT FROM AUTHOR]
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- 2018
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5. Prevalence and outcomes of use of potentially inappropriate medicines in older people: cohort study stratified by residence in nursing home or in the community
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Barnett, Karen N, McCowan, Colin, Evans, Josie, Gillespie, Neil D, Davey, Peter G, and Fahey, Tom P
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Objectives: To compare the prevalence of use of potentially inappropriate medicines (PIMs) between older patients living in their own homes versus those living in nursing or residential homes, and to test the association between exposure to PIMs and mortality. Design: Cohort study stratified by place of residence. Setting: Tayside, Scotland. Participants: All people aged between 66 and 99 years who were resident or died in Tayside from 2005 to 2006. Main outcome measures: The exposure variable was PIM use as defined by Beers' Criteria. All cause mortality was the main outcome measure. Results: 70 299 people were enrolled in the cohort of whom 96% were exposed to any medicine and 31% received a PIM. Place of residence was not associated with overall risk of receiving PIMs, adjusted OR 0.94, 95% CI 0.87 to 1.01. Exposure to five of the PIMs (including long-acting benzodiazepines) was significantly higher in nursing homes whereas exposure to five other PIMs (including amitriptyline and NSAIDs) was significantly lower. Exposure to PIMs was similar (20e46%) across all 71 general practices in Tayside and was not associated with increased risk of mortality after adjustment for age, gender and polypharmacy (adjusted OR 0.98, 95% CI 0.92 to 1.05). Conclusions: The authors question the validity of the full list of PIMs as an indicator of safety of medicines in older people because one-third of the population is exposed with little practice variation and no significant impact on mortality. Future studies should focus on management of a shorter list of genuinely high-risk medicines.
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- 2011
6. Understanding of a negative bowel screening result and potential impact on future symptom appraisal and help-seeking behaviour: a focus group study.
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Barnett, Karen N., Weller, David, Smith, Steve, Orbell, Sheina, Vedsted, Peter, Steele, Robert J. C., Melia, Jane W., Moss, Sue M., Patnick, Julietta, and Campbell, Christine
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COLON tumors , *CONSUMER attitudes , *EMOTIONS , *FAMILY medicine , *FECAL occult blood tests , *FOCUS groups , *HELP-seeking behavior , *MEDICAL screening , *RESEARCH funding , *DATA analysis software , *DIAGNOSIS ,RECTUM tumors - Abstract
Background Colorectal cancer ( CRC) screening using a faecal occult blood test ( FOBt) has the potential to reduce cancer-related mortality. Symptom vigilance remains crucial as a proportion of cancers will be diagnosed between screening rounds. A negative FOBt has the potential to influence how participants respond to future symptoms of CRC. Objective To explore (i) understanding of a negative FOBt and (ii) the potential impact of a negative FOBt upon future symptom appraisal and help-seeking behaviour. Design Qualitative methodology utilizing focus groups with participants who received a negative FOBt within the National Bowel Cancer Screening Programme in Coventry and Lothian. Topics explored included: experience of screening participation, interpretation and understanding of a negative result, symptom awareness and attitudes towards help-seeking. Results Four broad themes were identified: (i) emotional response to a negative FOBt, (ii) understanding the limitations of FOBt screening, (iii) symptom knowledge and interpretation and (iv) over-reassurance from a negative FOBt. Participants were reassured by a negative FOBt, but there was variability in the extent to which the result was interpreted as an 'all clear'. Some participants acknowledged the residual risk of cancer and the temporal characteristic of the result, while others were surprised that the result was not a guarantee that they did not have cancer. Discussion and conclusions Participants recognized that reassurance from a negative FOBt could lead to a short-term delay in help-seeking if symptoms developed. Screening programmes should seek to emphasize the importance of the temporal nature of FOBt results with key messages about symptom recognition and prompt help-seeking behaviour. [ABSTRACT FROM AUTHOR]
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- 2017
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7. Effective Feedback to Improve Primary Care Prescribing Safety (EFIPPS) a pragmatic three-arm cluster randomised trial: designing the intervention (ClinicalTrials.gov registration NCT01602705).
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Barnett, Karen N., Bennie, Marion, Treweek, Shaun, Robertson, Christopher, Petrie, Dennis J., Ritchie, Lewis D., and Guthrie, Bruce
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CUSTOMER feedback , *MEDICATION errors , *PRIMARY care , *PRIMARY health care , *RANDOMIZED controlled trials , *FAMILY medicine , *BEHAVIOR modification - Abstract
Background High-risk prescribing in primary care is common and causes considerable harm. Feedback interventions have small/moderate effects on clinical practice, but few trials explicitly compare different forms of feedback. There is growing recognition that intervention development should be theory-informed, and that comprehensive reporting of intervention design is required by potential users of trial findings. The paper describes intervention development for the Effective Feedback to Improve Primary Care Prescribing Safety (EFIPPS) study, a pragmatic three-arm cluster randomised trial in 262 Scottish general practices. Methods The NHS chose to implement a feedback intervention to utilise a new resource, new Prescribing Information System (newPIS). The development phase required selection of high-risk prescribing outcome measures and design of intervention components: + educational material (the usual care comparison), (2) feedback of practice rates of high-risk prescribing received by both intervention arms and (3) a theory-informed behaviour change component to be received by one intervention arm. Outcome measures, educational material and feedback design, were developed with a National Health Service Advisory Group. The behaviour change component was informed by the Theory of Planned Behaviour and the Health Action Process Approach. A focus group elicitation study and an email Delphi study with general practitioners (GPs) identified key attitudes and barriers of responding to the prescribing feedback. Behaviour change techniques were mapped to the psychological constructs, and the content was informed by the results of the elicitation and Delphi study. Results Six high-risk prescribing measures were selected in a consensus process based on importance and feasibility. Educational material and feedback design were based on current NHS Scotland practice and Advisory Group recommendations. The behaviour change component was resource constrained in development, mirroring what is feasible in an NHS context. Four behaviour change interventions were developed and embedded in five quarterly rounds of feedback targeting attitudes, subjective norms, perceived behavioural control and action planning (2x). Conclusions The paper describes a process which is feasible to use in the resource-constrained environment of NHS-led intervention development and documents the intervention to make its design and implementation explicit to potential users of the trial findings. Trial registration ClinicalTrials.gov: NCT01602705 [ABSTRACT FROM AUTHOR]
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- 2014
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8. Faecal Haemoglobin Estimated by Faecal Immunochemical Tests—An Indicator of Systemic Inflammation with Real Clinical Potential.
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Barnett, Karen N., Clark, Gavin R. C., Steele, Robert J. C., and Fraser, Callum G.
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HEMOGLOBINS , *COLORECTAL cancer , *GLOBAL burden of disease , *MORTALITY , *CARDIOVASCULAR diseases , *GASTROINTESTINAL hemorrhage , *PARTICULATE matter - Abstract
Multimorbidity is the major cause of ill-health and premature death in developed countries. The ability to identify individuals at risk of developing chronic disease, particularly multimorbidity, reliably, and simply, and to identify undiagnosed disorders, is vital to reducing the global burden of disease. This narrative review, the first of recent studies, demonstrates that raised faecal haemoglobin concentration (f-Hb) is associated with increased all-cause and cause-specific mortality and with longer-term conditions including diabetes, hypertension, cardiovascular disease, and psoriasis, and with probable intake of particulate matter. We and others have hypothesized that elevated f-Hb (measured using a faecal immunochemical test) has considerable potential to identify individuals at risk of, or who already have, early stage, undiagnosed chronic disease. If f-Hb does prove to be an effective biomarker for chronic disease and multimorbidity, individuals with detectable f-Hb, but without an obvious source of gastrointestinal blood loss, could benefit from further assessment and early intervention. To test this hypothesis rigorously, longitudinal data-linkage methodology is required linking colorectal cancer screening data, and data on patients presenting with lower gastrointestinal symptoms, with routinely collected health information. [ABSTRACT FROM AUTHOR]
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- 2021
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