Category: Themes
The impact of comorbidities on referral to and outcomes of hip and knee replacement surgery
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 –
What is the impact of comorbidities on outcomes of hip and knee replacement surgery? A review of the evidence
How do comorbidities impact on the referral pathway to access joint replacement surgery in the NHS? An interview study with healthcare professionals in the NHS
Prof Chris Griffiths
Prof Chris Griffiths
Evaluation of heath impact of Low Emisison Zones makes the news
CLAHRC research investigating the impact of low emission zones on children’s physical activity and health has been featured on the BBC News
CLAHRC North Thames, in collaboration with three other CLAHRCs and a number of other research bodies, is evaluating the effects of London’s new Ultra Low Emission Zone (ULEZ) on children’s physical health and activity.
Our work is an offshoot of the CHILL (Children’s Health in London and Luton) study investigating the impact of pollution on children’s lungs. We are using the data created by CHILL to focus specifically on the impacts on children’s physical activity and health. CHILL featured on BBC News on January 16th.
Watch a clip below to see how school children are recording the effects of pollution on their lungs.
Professor Chris Griffiths, Chief Investigator for our work and part of the CHILL study is interviewed in the clip
Dr Helen Barratt
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.
From theoretically informed to theoretically informative improvement research
A new BMJ Quality and Safety editorial by Dr Roman Kislov, Senior Research Fellow at the Alliance Manchester Business School, has highlighted CLAHRC work as an example of successful engagement with management theory by researchers.
Dr Kislov’s research focus is the processes and practices of knowledge mobilisation, and his editorial highlights our recent paper on how different NHS Boards implement a quality improvement intervention – the QUASER guide.
He cites the paper as “an example of successfully deployed theoretically informative approach, highlighting some practical tips for researchers who aspire to move from merely applying theory towards entering into dialogue with it and, through doing so, refining its assumptions.”
Read the editorial
Engaging with theory: from theoretically informed to theoretically informative improvement research
Repeated calls have been made for the increased use of theory in designing and evaluating improvement and implementation interventions.1-4 The benefits are argued to include identifying contextual influences on quality improvement (QI), supporting the generalisability of findings and anticipating how future phenomena might unfold.2 5 Most importantly, the ability of
Read the iQUASER paper
Explaining organisational responses to a board-level quality improvement intervention: findings from an evaluation in six providers in the English National Health Service
Background Healthcare systems worldwide are concerned with strengthening board-level governance of quality. We applied Lozeau, Langley and Denis’ typology (transformation, customisation, loose coupling and corruption) to describe and explain the organisational response to an improvement intervention in six hospital boards in England.
Read our BITE sized summary of the iQUASER paper
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
