Complications following hip or knee surgery are more likely for people with long-term illness, but benefits are still worthwhile

The work of CLAHRC researcher Dr Bélène Podmore has been highlighted as “high quality” by the National Institute for Health Research. Bélène’s work, recently published in BMJ Open investigated how having a long-term condition impacts access to and benefit from hip and knee surgery. The research was promoted by NIHR via their “Signals” service. NIHR Signals summarise the latest important research on health care, public health and social care, along with implications for practice.

Joint replacement benefits and harms for people with other illness

Why was this study needed? In the UK, over 210,000 hip and knee replacements were performed in 2017 at an average age of 68 for hips and 69 for knees. One in six of these people had an illness affecting their day to day life.

Read the paper

Podmore B, Hutchings A, van der Meulen J, et al
Impact of comorbid conditions on outcomes of hip and knee replacement surgery: a systematic review and meta-analysis
BMJ Open 2018;8:e021784. doi: 10.1136/bmjopen-2018-021784

 

Dr Elena Pizzo

Elena is a Senior Health Economics. She holds a PhD in Economics and Management from Padua University, a Master degree in Economics and Management of Health Care Services from Ferrara University and a first degree in Economics from Padua University.

Prior to coming to UCL she was a Research Associate at the Imperial College Business School, working on the economic evaluation of the Collaborations for Leadership in Applied Health Research and Care (CLAHRC) for Northwest London.

She previously held a research post at the Department of Economics, Ferrara University, where she collaborated to a multi-year research project and undertook an economic evaluation of a Regional Colorectal Cancer Screening Program.

Dr Elena Pizzo

Elena is a Senior Health Economics. She holds a PhD in Economics and Management from Padua University, a Master degree in Economics and Management of Health Care Services from Ferrara University and a first degree in Economics from Padua University.

Prior to coming to UCL she was a Research Associate at the Imperial College Business School, working on the economic evaluation of the Collaborations for Leadership in Applied Health Research and Care (CLAHRC) for Northwest London.

She previously held a research post at the Department of Economics, Ferrara University, where she collaborated to a multi-year research project and undertook an economic evaluation of a Regional Colorectal Cancer Screening Program.

Capturing the views of patients in emergency care

CLAHRC researchers highlight potential to use patient-reported outcomes for emergency admissions.

Patient-reported outcome measures or PROMs are a well-established method of capturing the views of NHS patients, allowing the service to assess the quality of care delivered, from the patient perspective.

PROMs use pre- and post-operative surveys completed by patients to calculate their health gains after surgical treatment.

While there is an extensive PROM programme across the English NHS, they have yet to be used in emergency admissions. These account for nearly 40% of all hospital admissions and are an area of increasing demand. However, this is also an area where the NHS knows least about;

  • the quality of patient outcomes,
  • whether resources are being used effectively,
  • and whether there are unexpected variation between different providers

CLAHRC researcher and PhD Dr Esther Kwong investigated how to use PROMs to evaluate the quality of acute and emergency hospital care in the NHS. Esther developed and tested PROMS with patients who underwent emergency admissions, establishing that it is feasible to use PROMS in this clinical area.

They are presented in four new CLAHRC BITEs – postcard summaries of Esther’s published academic papers.

Can Patient Reported Outcomes Measures (PROMs) be used in emergency admissions?

Feasibility of collecting retrospective patient reported outcome measures (PROMs) in emergency hospital admissions

Using patient-reported outcome measures (PROMs) for primary percutaneous coronary intervention

Assessing Patient Reported Outcomes (PROMS) for emergency admissions: laparotomy for gastrointestinal conditions