Antonio holds a BSc in Psychology and an MSc in Research Methods and Implementation in Psychology and Health, both from the University of Granada, Spain. He has also been awarded a Ph.D. from the University of Granada, for his work in the Andalusian School of Public Health. During this time, he was part of several research projects, mostly focused on health inequalities and health systems, prior to joining UCL. Antonio has particular interest in research methods in health, mostly systematic reviews and meta-analysis.
New CLAHRC research looks at how comorbidities – multiple conditions experienced by patients – influence referrals to, and outcomes of hip and knee replacement surgery.
Taking a 360-degree view of the referral and treatment process our researchers, led by Bélène Podmore, investigated current evidence in this area for patients with multiple conditions undergoing surgery. We examined;
- the short-term outcomes relating to the safety of the hip or knee replacement surgery
- long-term outcomes relating to the benefits of undergoing hip and knee replacement surgery.
We found comorbidities predominantly impact the safety of hip and knee replacement surgery but have little impact on its effectiveness.
Bélène also interviewed a variety of health professionals and therapists for their take on referring and selecting patients with comorbidities for joint replacement surgery. We found some disagreement among professionals – ranging from GPs to surgeons – on roles and responsibilities in the management of these patients.
The two pieces of research are presented in handy new “BITE-sized” summaries with links to full papers and further reading –
Helen is a consultant in public health medicine and a health services researcher. She is a member of the CLAHRC research partnership team, and Deputy Director of the CLAHRC Academy. Her research uses qualitative and quantitative methods to evaluate health care and public health services.
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.
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
New knowledge generated by our research impacts commissioning and funding decisions on welfare advice
Our work to investigate the impact of locating welfare advisers in GP surgeries is bearing fruit as the new knowledge and evidence we have generated is influencing commissioning decisions for these services across London and beyond.
We know that a significant amount of General Practitioners workload is generated by patients approaching them with non-clinical issues such as debt, housing and immigration.
While these concerns undoubtedly impact health and wellbeing, doctors are not necessarily the best professionals to assist. Haringey Council trialled a scheme to locate welfare advice, and welfare advisers in GP surgeries to deal with these issues.
We evaluated the impact of this advice (provided by Citizen’s Advice Bureau staff) on both GP workloads and on the health, wellbeing and use of services by the patients affected.
Our evidence has been used to support the following decisions –
Haringey: our evidence was used to support retention of all except one primary care co-located welfare advice service in and to provide an additional more intensive service at a mental health hospital (St Ann’s Hospital);
Camden: although the CCG decided to cease funding for GP outreach two GP practices have used the study findings to support ongoing funding for services at their practices (including an application for Big Lottery funding)
Deryshire; Citizens Advice services in Derbyshire have requested study findings to support a business case for ongoing funding of GP outreach in the region
Sussex: our study has been used as a basis to develop an evaluation framework in Sussex
Read our evidence
Read more about the study: