Protocol for a mixed-methods longitudinal study to identify factors influencing return to work in the over 50s participating in the UK Work Programme: Supporting Older People into Employment (SOPIE)

INTRODUCTION Out of programme (OOP) experience from training increases the skill pool of the neurosurgical workforce and drives innovation in the specialty. OOP approval criteria are well defined but transition back to clinical work can be challenging with a paucity of data published on trainee perspectives. Our study aimed to investigate factors influencing transition from OOP back to clinical work among neurosurgical trainees in the UK. METHODS An online survey was sent to all members of the Society of British Neurological Surgeons. Questions pertained to details of OOP and factors influencing transition back to clinical work. RESULTS Among the 73 respondents, 7 were currently on OOP and 27 had completed OOP in the past. Research was the most common reason for OOP (28/34, 82%) and this was generally motivated by the aspiration of an academic neurosurgery career (17/34, 50%). Although the majority (27/34, 79%) continued clinical work during OOP, 37% of this group (10/27) reported a reduction in their surgical skills. Fewer than half (15/34, 44%) had a return to work plan, of which only half (8/34, 24%) were formal plans. The majority of respondents who had completed OOP in the past (22/27, 81%) felt that they were able to apply the skills gained during OOP to their clinical work on return. CONCLUSIONS Skills learnt during OOP are relevant and transferable to the clinical environment but mainly limited to research with OOP for management and education underrepresented. Deterioration of surgical skills is a concern. However, recognition of this problem has prompted new methods and schemes to address challenges faced on return to work.

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Continuous glucose monitoring in older people with diabetes and memory problems: a mixed-methods feasibility study in the UK

BMJ Open ◽

10.1136/bmjopen-2019-032037 ◽

2019 ◽

Vol 9 (11) ◽

pp. e032037 ◽

Cited By ~ 3

Author(s):

Katharina Mattishent ◽

Kathleen Lane ◽

Charlotte Salter ◽

Ketan Dhatariya ◽

Helen M May ◽

...

Keyword(s):

Mixed Methods ◽

Adverse Events ◽

Older People ◽

Feasibility Study ◽

Continuous Glucose Monitoring ◽

Glucose Monitoring ◽

Data Capture ◽

Secondary Outcome ◽

Memory Problems ◽

The Uk

ObjectivesOlder people with diabetes are at increased risk of harm from hypoglycaemia, particularly where there are coexisting memory problems. Continuous glucose monitoring (CGM) offers important benefits in terms of detecting hypoglycaemia, but the feasibility of use and extent of data capture has not been tested in this patient group. Our objective was to investigate the feasibility of trialling a CGM intervention in the community setting in older people with diabetes and memory problems.DesignMixed-methods feasibility study.SettingCommunity dwellings in the UK.ParticipantsPatients aged ≥65 with diabetes and abbreviated mental test score ≤8 or known dementia.InterventionFreeStyle Libre CGM.Primary and secondary outcome measuresFeasibility criteria were numbers of eligible patients, recruitment, attrition, extent of capture of glucose readings and adverse events. Qualitative interview.ResultsWe identified 49 eligible participants; 17 consented, but 5 withdrew before recording of data because they or their carers felt unable to manage study procedures. 12 participants (mean age 85 years) completed the study without adverse events. Data capture across 14 days ranged between 3% and 92% (mean 55%); 6 participants had <60% capture. Hypoglycaemic events were recorded in six out of nine insulin users. Qualitative interviews found: the device does not interfere with daily activities, usability and comfort was positive, and it was helpful for carers in monitoring participants’ glucose concentrations.ConclusionsThe device was acceptable to participants, and carers reported greater ease in monitoring the participant’s glucose concentrations. However, completeness of data capture varied considerably with this device due to the need for users to conduct ≥3 scans per day. Real-time devices with automated data transfer may be more suitable in older people with memory problems.

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Factors influencing trends in opioid prescribing for older people: a scoping review

Primary Health Care Research & Development ◽

10.1017/s1463423620000365 ◽

2020 ◽

Vol 21 ◽

Cited By ~ 1

Author(s):

Rasa Mikelyte ◽

Vanessa Abrahamson ◽

Emma Hill ◽

Patricia M. Wilson

Keyword(s):

Older Adults ◽

Chronic Pain ◽

Pain Management ◽

Older People ◽

Grey Literature ◽

Prescribing Patterns ◽

Opioid Prescribing ◽

Factors Influencing ◽

Prescribing Trends ◽

The Uk

Abstract Aim: The review aimed to identify factors influencing opioid prescribing as regular pain-management medication for older people. Background: Chronic pain occurs in 45%–85% of older people, but appears to be under-recognised and under-treated. However, strong opiate prescribing is more prevalent in older people, increasing at the fastest rate in this age group. Methods: This review included all study types, published 1990–2017, which focused on opioid prescribing for pain management among older adults. Arksey and O’Malley’s framework was used to scope the literature. PubMed, EBSCO Host, the UK Drug Database, and Google Scholar were searched. Data extraction, carried out by two researchers, included factors explaining opioid prescribing patterns and prescribing trends. Findings: A total of 613 papers were identified and 53 were included in the final review consisting of 35 research papers, 10 opinion pieces and 8 grey literature sources. Factors associated with prescribing patterns were categorised according to whether they were patient-related, prescriber-driven, or system-driven. Patient factors included age, gender, race, and cognition; prescriber factors included attitudes towards opioids and judgements about ‘normal’ pain; and policy/system factors related to the changing policy landscape over the last three decades, particularly in the USA. Conclusions: A large number of context-dependent factors appeared to influence opioid prescribing for chronic pain management in older adults, but the findings were inconsistent. There is a gap in the literature relating to the UK healthcare system; the prescriber and the patient perspective; and within the context of multi-morbidity and treatment burden.

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Co-resident care-giving and problematic sleep among older people: evidence from the UK Household Longitudinal Study

Ageing and Society ◽

10.1017/s0144686x1800168x ◽

2019 ◽

Vol 40 (6) ◽

pp. 1195-1222 ◽

Cited By ~ 1

Author(s):

Emma Maun ◽

Karen Glaser ◽

Laurie Corna

Keyword(s):

Longitudinal Study ◽

Older People ◽

Longitudinal Research ◽

Sleep Problems ◽

Poor Sleep ◽

Care Needs ◽

Care Givers ◽

Care Giving ◽

Resident Care ◽

The Uk

AbstractIn light of current pressures within formal social care services, informal carers assume an important role in meeting the care needs of a growing number of older people. Research suggests relationships between care-giving and health are complex and not yet fully understood. Recently, wide-ranging associations between sleep and health have been identified, however, our understanding of the links between care-giving and sleep is limited at present. This study assesses longitudinal patterns in co-resident care-giving and problematic sleep among older people in the United Kingdom. Our sample included 2,470 adults aged 65 years and older from the UK Household Longitudinal Study. Problematic sleep was defined as two or more problems in going to sleep, staying asleep or sleep quality. Using logistic regression models, we assessed how co-resident care-giving status, intensity and transitions influence the likelihood of problematic sleep in the following year, adjusting for potential confounding factors. Adjusted analyses found co-resident care-givers were 1.49 (95% confidence interval = 1.06–2.08) times more likely to report problematic sleep in the following year, relative to those not providing care. Care-giving over 20 hours per week and continuous co-resident care-giving also significantly increased the odds of problematic sleep. This suggests older co-resident care-givers may be at greater risk of incurring sleep problems than non-care-givers. Further longitudinal research is needed to investigate care-giver-specific consequences of poor sleep.

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A MIXED METHODS SYSTEMATIC REVIEW OF COMMUNITY-BASED GROUPS FOR SOCIAL ISOLATION AND LONELINESS IN OLDER PEOPLE

Innovation in Aging ◽

10.1093/geroni/igz038.3147 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S856-S856

Author(s):

Brenda A Hayanga ◽

Dylan Kneale ◽

Ann Phoenix

Keyword(s):

Systematic Review ◽

Mixed Methods ◽

Older People ◽

Life Course ◽

Ethnic Groups ◽

Social Isolation ◽

Friendship Networks ◽

Community Based ◽

Course Experiences ◽

The Uk

Abstract In the UK, many older people from minoritised ethnic groups are vulnerable to social isolation and loneliness. Yet, we know little about which interventions are effective for them. With existing systematic reviews of social isolation and loneliness lacking a theory-based framework of their life-course experiences, we set out to address this gap. This review aims to explore the effectiveness and suitability of community-based group interventions (CBGIs) for social isolation and loneliness in older people. The decision to focus on CBGIs was based on findings from an exploratory study of the friendship networks of older people and narrative interviews with older minoritised people living in the UK. The findings suggested that community groups of shared interests/backgrounds were protective of social isolation and loneliness. To address the objectives, we searched for randomised controlled trials and process evaluations of CBGIs published in English, which included older people living in countries with membership to the Organisation for Economic Co-operation and Development. We identified 4791 studies, 36 of which were eligible for inclusion. In this poster, we present the preliminary findings of this mixed-methods systematic review, which seeks to not only assess whether CBGIs are effective but also to understand the underlying processes that make interventions (in)effective. As this review is guided by findings from two exploratory studies with older people from minoritised ethnic groups, it takes into account their life-course experiences. It is the results of reviews such as this that can produce generalisable findings which are directly applicable to policy.

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Connected communities? LGB older people and their risk of exclusion from decent housing and neighbourhoods

Quality in Ageing and Older Adults ◽

10.1108/qaoa-04-2015-0019 ◽

2016 ◽

Vol 17 (2) ◽

pp. 107-118 ◽

Cited By ~ 5

Author(s):

Dylan Kneale

Keyword(s):

Social Networks ◽

Longitudinal Study ◽

Older People ◽

Design Methodology ◽

Home Ownership ◽

Content Type ◽

Property Wealth ◽

And Bisexual ◽

The Uk ◽

English Longitudinal Study

Purpose – The purpose of this paper is to explore the way in which the housing and neighbourhood accessibility and neighbourhood connectedness of older lesbian, gay and bisexual (LGB) people aged 50 and over, differ compared to non-LGB older people. Design/methodology/approach – This paper utilises data collected as part of the English Longitudinal Study of Ageing as well as theories around social exclusion to explore these issues, using information from 5,442 survey respondents including 260 identified as LGB. Findings – Little evidence is uncovered of a link between being LGB and experiencing exclusion from decent housing, public transport or neighbourhood amenities. Significant differences were uncovered in levels of home ownership and the numbers who reported having seen a friend the previous day, the likelihood of which were both lower for LGB people compared to non-LGB people. Research limitations/implications – All analyses are subject to caveats around the size of the sample and the method of identifying LGB older people. The findings could suggest older LGB people may be less likely to have property wealth from which to draw down in retirement. Furthermore, the findings on older LGB people being less likely to have seen a friend the previous day, may suggest a need for more opportunities to be made available for LGB people to maintain their social networks closer to home to offset the risk of social isolation. Originality/value – This is one of the first studies to examine how the housing and neighbourhood accessibility and connectedness patterns of older LGB people differ from non-LGB people in the UK.

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