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27 results on '"Bowden, Joanna"'

2. Results from a randomised, open-label trial of a multimodal intervention (exercise, nutrition and anti-inflammatory medication) plus standard care versus standard care alone to attenuate cachexia in patients with advanced cancer undergoing chemotherapy.

Author

Solheim, Tora S., primary, Laird, Barry J A, additional, Balstad, Trude R., additional, Stene, Guro Birgitte, additional, Baracos, Vickie, additional, Bye, Asta, additional, Dajani, Olav, additional, Hendifar, Andrew Eugene, additional, Strasser, Florian, additional, Chasen, Martin Robert, additional, Maddocks, Matthew, additional, Simpson, Melanie R., additional, Skovlund, Eva, additional, Griffiths, Gareth Owen, additional, Hicks, Jonathan, additional, Graham, Janet Shirley, additional, Kyle, Fiona, additional, Bowden, Joanna, additional, Fallon, Marie T., additional, and Kaasa, Stein, additional

Published
2024
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7. Healthcare trajectories and costs in the last year of life: a retrospective primary care and hospital analysis

Author

Luta, Xhyljeta, Diernberger, Katharina, Bowden, Joanna, Droney, Joanne, Howdon, Daniel, Schmidlin, Kurt, Rodwin, Victor, Hall, Peter, and Marti, Joachim

Abstract

ObjectivesTo analyse healthcare utilisation and costs in the last year of life in England, and to study variation by cause of death, region of patient residence and socioeconomic status.MethodsThis is a retrospective cohort study. Individuals aged 60 years and over (N=108 510) who died in England between 2010 and 2017 were included in the study.ResultsHealthcare utilisation and costs in the last year of life increased with proximity to death, particularly in the last month of life. The mean total costs were higher among males (£8089) compared with females (£6898) and declined with age at death (£9164 at age 60–69 to £5228 at age 90+) with inpatient care accounting for over 60% of total costs. Costs decline with age at death (0.92, 95% CI 0.88 to 0.95, p<0.0001 for age group 90+ compared with to the reference category age group 60–69) and were lower among females (0.91, 95% CI 0.90 to 0.92, p<0.0001 compared with males). Costs were higher (1.09, 95% CI 1.01 to 1.14, p<0.0001) in London compared with other regions.ConclusionsHealthcare utilisation and costs in the last year of life increase with proximity to death, particularly in the last month of life. Finer geographical data and information on healthcare supply would allow further investigating whether people receiving more planned care by primary care and or specialist palliative care towards the end of life require less acute care.

Published
2024
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9. Advance care planning in primary care for cancer patients:Feasibility randomised trial

Author

Canny, Anne, Mason, Bruce, Stephen, Jacqueline, Hopkins, Samantha, Wall, Lucy, Christie, Alan, Skipworth, Richard, Bowden, Joanna, Graham, Louise, Kendall, Marilyn, Weir, Christopher J, and Boyd, Kirsty

Subjects
primary health care, general practice, mixed methods research, anticipatory care planning, cancer, advance care planning
Abstract

BACKGROUND: Advance (anticipatory) care planning (ACP) requires discussions between patients and healthcare professionals about planning for future deterioration in health. ACP improves care coordination but uptake is limited and often deferred.AIM: To assess the feasibility and acceptability to patients, carers, and GPs of a primary care ACP intervention for people with incurable oesophageal, gastric, or pancreatic cancer.DESIGN AND SETTING: A 12-month feasibility randomised controlled trial (RCT) in a Scottish Cancer Network.METHOD: Patients aged ≥18 years starting palliative oncology treatment were randomised 1:1 to an ACP intervention or standard care. Patients in the intervention group received an oncologist letter supporting them to request a GP review along with a patient information leaflet about ACP. Pre-specified analyses with masking included trial recruitment and retention, ACP completion, and quality-of-life questionnaires (EuroQol EQ-5D-5L and ICECAP Supportive Care Measure) at baseline, 6, 12, 24, and 48 weeks. Qualitative interviews with purposive sampling explored patient, carer, and GP experiences.RESULTS: Of 99 eligible participants (269 screened), 46% were recruited ( n = 46) and randomised; 25 to intervention and 21 to control. By 12 weeks, 45% ( n = 9/20) of the individuals in the intervention and 59% ( n = 10/17) in the control group had a documented ACP plan. By 24 weeks, 30% ( n = 14) had died; in the remaining participants quality of life was maintained at 24 weeks except for physical symptoms. Social norms associating ACP with dying were prevalent among 23 participants interviewed. No psychological or clinical harms were identified. CONCLUSION: An RCT of ACP for people with incurable cancer in primary care is feasible. Patient, carer, and GP attitudes and behaviours determined acceptability and timing of care planning.

Published
2022

10. Advance care planning in primary care for patients with gastrointestinal cancer: feasibility randomised trial

Author

Canny, Anne, primary, Mason, Bruce, additional, Stephen, Jacqueline, additional, Hopkins, Samantha, additional, Wall, Lucy, additional, Christie, Alan, additional, Skipworth, Richard JE, additional, Bowden, Joanna, additional, Graham, Louise, additional, Kendall, Marilyn, additional, Weir, Christopher J, additional, and Boyd, Kirsty, additional

Published
2022
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26. Developing learning outcomes for medical students and foundation doctors in palliative care: A national consensus-seeking initiative in Scotland.

Author

Linklater, Gordon T., Bowden, Joanna, Pope, Lindsey, McFatter, Fiona, Hutchison, Stephen M. W., Carragher, Pat J., Walley, John, Fallon, Marie, and Murray, Scott A.

Subjects
*CURRICULUM planning, *LEARNING, *MEDICAL cooperation, *MEDICAL students, *PALLIATIVE treatment, *PHYSICIANS, *RESEARCH, *TEACHING aids, *HUMAN services programs
Abstract

Background: Undergraduate education in palliative care is essential if doctors are to be competent to care for dying patients and their families in a range of specialties and healthcare settings. However, creating space for this within existing undergraduate and foundation year curricula poses significant challenges. We aimed to develop consensus learning outcomes for palliative care teaching in the university medical schools in Scotland. Methods: The General Medical Council (GMC) outlines a number of learning outcomes with clear relevance to palliative care. Leaders from the five Scottish medical schools identified and agreed a small number of outcomes, which we judged most relevant to teaching palliative care and collated teaching resources to support these. Results: Consensus learning outcomes for undergraduate palliative care were agreed by our mixed group of clinician educators over a number of months. There were many secondary gains from this process, including the pooling of educational resources and best practice, and the provision of peer support for those struggling to establish curriculum time for palliative care. Discussion: The process and outcomes were presented to the Scottish Teaching Deans, with a view to their inclusion in undergraduate and foundation year curricula. It is through a strong commitment to achieving these learning outcomes that we will prepare all doctors for providing palliative care to the increasing numbers of patients and families that require it. [ABSTRACT FROM AUTHOR]

Published
2014
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