Patterning in Patient Referral to and Uptake of a National Exercise Referral Scheme (NERS) in Wales from 2008 to 2017: A Data Linkage Study

Exercise referral schemes have shown small but positive impacts in randomized controlled trials (RCTs). Less is known about the long-term reach of scaled up schemes following a RCT. A RCT of the National Exercise Referral Scheme (NERS) in Wales was completed in 2010, and the scheme scaled up across Wales. In this study, using a retrospective data linkage design, anonymized NERS data were linked to routine health records for referrals between 2008 and 2017. Rates of referral and uptake were modelled across years and a multilevel logistic regression model examined predictors of uptake. In total, 83,598 patients have been referred to the scheme and 67.31% of eligible patients took up NERS. Older adults and referrals for a musculoskeletal or level four condition were more likely to take up NERS. Males, mental health referrals, non-GP referrals and those in the most deprived groupings were less likely to take up NERS. Trends revealed an overall decrease over time in referrals and uptake rates among the most deprived grouping relative to those in the least deprived group. Findings indicate a widening of inequality in referral and uptake following positive RCT findings, both in terms of patient socioeconomic status and referrals for mental health.

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OP18 Mental health disorders amongst children and young people involved in family justice court proceedings: a longitudinal national data linkage study

10.1136/jech-2021-ssmabstracts.18 ◽

2021 ◽

Author(s):

Lucy J Griffiths ◽

Joanna McGregor ◽

Theodora Pouliou ◽

Rhodri Johnson ◽

Karen Broadhurst ◽

...

Keyword(s):

Mental Health ◽

Young People ◽

Data Linkage ◽

Mental Health Disorders ◽

Linkage Study ◽

National Data ◽

Children And Young People ◽

Health Disorders ◽

Court Proceedings

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Frailty Assessed by Administrative Tools and Mortality in Patients With Pneumonia Admitted to the Hospital and ICU: a Population-based Data-linkage Study

10.21203/rs.3.rs-450880/v1 ◽

2021 ◽

Author(s):

Tamas Szakmany ◽

Joe Hollinghurst ◽

Richard Pugh ◽

Ashley Akbari ◽

Rowena Griffiths ◽

...

Keyword(s):

Data Linkage ◽

Social Deprivation ◽

Frailty Index ◽

Significant Risk ◽

Population Based ◽

Linkage Study ◽

Increased Risk ◽

Comorbidity Index ◽

Population Scale

Abstract Background: The ideal method of identifying frailty is uncertain, and data on long-term outcomes is relatively limited. We examined frailty indices derived from population-scale linked data on Intensive Care Unit (ICU) and hospitalised non-ICU patients with pneumonia to elucidate the influence of frailty on mortality.Methods: Longitudinal cohort study between 2010-2018 using population-scale anonymised data linkage of healthcare records for adults admitted to hospital with pneumonia in Wales. Primary outcome was in-patient mortality. Age, hospital frailty risk score (HFRS), electronic frailty index (eFI), Charlson comorbidity index (CCI), and social deprivation index were entered in the multivariate regression models.Results: Of the 107,188 patients, mean (SD) age was 72.6 (16.6) years, 50% were men. The two frailty indices and the comorbidity index had an increased risk of mortality for individuals with an ICU admission. Advancing age, increased frailty and comorbidity affected short- and long-term mortality. For predicting inpatient deaths, the CCI and HFRS based models were similar, however for longer term outcomes the CCI based model was superior. Discussion: Frailty and comorbidity are significant risk factors for patients admitted to hospital with pneumonia. Frailty and comorbidity scores based on administrative data have only moderate ability to predict outcome.

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Effects of the COVID-19 pandemic on the mental health of shielded children and children living in shielded households in Wales: a data linkage study

The Lancet ◽

10.1016/s0140-6736(21)02579-4 ◽

2021 ◽

Vol 398 ◽

pp. S36

Author(s):

Laura Cowley ◽

Jiao Song ◽

Alisha Davies

Keyword(s):

Mental Health ◽

Data Linkage ◽

Linkage Study

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Chlamydia retesting and retest positivity rates: results from a state-wide laboratory data linkage study in Tasmania, 2012–13

Sexual Health ◽

10.1071/sh16137 ◽

2017 ◽

Vol 14 (3) ◽

pp. 261 ◽

Cited By ~ 1

Author(s):

Nicola Stephens ◽

David Coleman ◽

Kelly Shaw ◽

Maree O'Sullivan ◽

Alistair McGregor ◽

...

Keyword(s):

Data Linkage ◽

Safer Sex ◽

Laboratory Data ◽

Partner Notification ◽

Linkage Study ◽

Chlamydia Infection ◽

Socioeconomic Indicators ◽

Safer Sex Practices ◽

Positive Results

Background Chlamydia re-infection increases the likelihood of adverse long-term sequelae. Clinical guidelines recommend retesting at 3–12 months for individuals with positive results, to detect re-infections. Retesting and test positivity levels were measured in young people who previously tested positive for chlamydia infection. Methods: All chlamydia tests conducted during 2012–13 in Tasmanian residents aged 15–29 years were linked. Retesting and retest positivity rates were calculated by sex, age, socioeconomic indicators and test timeframe. Results: Retesting rates were higher in females than males at 3 months (14.5%, n = 242/1673 vs 10%, n = 71/721) (P < 0.01) and 12 months (27%, 265/968 vs 24%, 98/410) (P = 0.24). The retesting rate was higher in females living in areas of most disadvantage (35.5%, 154/434) compared with areas of middle and least disadvantage (26% 139/534) (P < 0.01). Males were more likely than females to retest positive at 3 months (35%, 25/71 vs 23%, 55/242) (P < 0.01); retest positivity at 12 months was 32% in both sexes (males 98/140; females 265/968). Retest positivity was higher in males living in areas of least disadvantage (43%, 3/7) compared with middle (24%, 16/67) (P = 0.27) and most (27%, 10/37) (P = 0.09); and higher in females living in areas of least disadvantage (39%, 7/18) compared with middle (24%, 29/121) (P < 0.01) and most (31%, 48/154) (P = 0.02). Conclusions: Retesting rates are low in Tasmania and retest positivity is high, reinforcing the importance of promoting safer sex practices, partner notification and treatment, and retesting.

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A new model of exercise referral scheme in primary care: is the effect on adherence to physical activity sustainable in the long term? A 15-month randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2017-017211 ◽

2018 ◽

Vol 8 (3) ◽

pp. e017211 ◽

Cited By ~ 15

Author(s):

Carme Martín-Borràs ◽

Maria Giné-Garriga ◽

Anna Puig-Ribera ◽

Carlos Martín ◽

Mercè Solà ◽

...

Keyword(s):

Physical Activity ◽

Social Support ◽

Primary Care ◽

Randomised Controlled Trial ◽

Controlled Trial ◽

Community Resources ◽

Randomised Controlled ◽

Exercise Referral ◽

Exercise Referral Scheme

IntroductionStudies had not yet overcome the most relevant barriers to physical activity (PA) adherence. An exercise referral scheme (ERS) with mechanisms to promote social support might enhance adherence to PA in the long term.SettingA randomised controlled trial in 10 primary care centres in Spain.ObjectiveTo assess the effectiveness of a primary care-based ERS linked to municipal resources and enhancing social support and social participation in establishing adherence to PA among adults over a 15-month period.Participants422 insufficiently active participants suffering from at least one chronic condition were included. 220 patients (69.5 (8.4) years; 136 women) were randomly allocated to the intervention group (IG) and 202 (68.2 (8.9) years; 121 women) to the control group (CG).InterventionsThe IG went through a 12-week standardised ERS linked to community resources and with inclusion of mechanisms to enhance social support. The CG received usual care from their primary care practice.OutcomesThe main outcome measure was self-report PA with the International Physical Activity Questionnaire and secondary outcomes included stages of change and social support to PA practice.Data collectionParticipant-level data were collected via questionnaires at baseline, and at months 3, 9 and 15.BlindingThe study statistician and research assessors were blinded to group allocation.ResultsCompared with usual care, follow-up data at month 15 for the ERS group showed a significant increase of self-reported PA (IG: 1373±1845 metabolic equivalents (MET) min/week, n=195; CG: 919±1454 MET min/week, n=144; P=0.009). Higher adherence (in terms of a more active stage of change) was associated with higher PA level at baseline and with social support.ConclusionsPrescription from ordinary primary care centres staff yielded adherence to PA practice in the long term. An innovative ERS linked to community resources and enhancing social support had shown to be sustainable in the long term.Trial registration numberNCT00714831; Results.

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