alan hassey - Academia.edu (original) (raw)

Papers by alan hassey

International Journal of Pharmacy Practice, Dec 1, 2005

Objective It is generally accepted that greater use could be made of community pharmacy-based int... more Objective It is generally accepted that greater use could be made of community pharmacy-based interventions. Diabetes care has been proposed as an area for enhanced community pharmacy involvement. However there is no published structured review of available evidence of either effectiveness or acceptability. This review aims to identify and assess such evidence and to synthesise findings to inform the design and delivery of future community pharmacy-based interventions in diabetes care. Method A systematic search of published literature was conducted using a defined search strategy, electronic databases and targeted hand searching of non Index Medicus journals. The search dates were 1990-2003. The scope was international and we included only articles in the English language. Key findings Seven experimental studies which tested community pharmacy-based interventions were reviewed. Four different primary outcomes were studied: diabetes control (three studies), adherence (two studies), medication problems (one study) and patient knowledge (one study). Six studies showed positive outcomes, and the findings were statistically significant in two. The theoretical basis of the interventions was unclear. Only one study included a cost-effectiveness analysis, and the interventions were provided free of charge to patients in all seven studies. Nine attitudinal studies were included, five involving pharmacists and four with patients. Members of the public do not currently expect community pharmacists to become involved in discussions about diabetes treatment and its monitoring, but when such services are offered they are well used by patients. Pharmacists were positive about the provision of services for people with diabetes. Patients' experiences indicated that community pharmacists overestimate their current provision of information and advice to people with diabetes. Conclusions There is limited evidence of effectiveness of community pharmacy-based interventions in diabetes care. Components of pharmacy-based intervention which appear to contribute to effectiveness include: elicitation and discussion of patient beliefs about their diabetes and its treatment; discussion of how patients are using their medicines; review of haemoglobin A 1c (HbA 1c) levels; and assessing and supporting necessary lifestyle changes. Further research is needed and future interventions need to incorporate evidence from the literature on patient and pharmacist perspectives on diabetes. The findings of this review will be useful to researchers and service planners involved in developing community pharmacy-based diabetes care.

International Journal of Medical Informatics, Dec 1, 2022

Quality in primary care, 2007

Access to, and use of, medicines were key areas identified for improvement in the NHS Plan in 200... more Access to, and use of, medicines were key areas identified for improvement in the NHS Plan in 2000. In this discussion paper and in relation to the primary care setting we:. consider the problems that patients have in accessing and using medicines. review relevant initiatives in NHS policy and practice, and their effects. propose standards for patient-centred medicines management

BMJ, Jul 13, 2006

Isle of Wight and Scottish projects are not opt out schemes Editor-Watson and Halamka debate whet... more Isle of Wight and Scottish projects are not opt out schemes Editor-Watson and Halamka debate whether patients should have to opt in or out of the national electronic care record. 1 However, the Isle of Wight and Scottish electronic emergency care summary models cannot be truly compared with that proposed for the NHS summary care record because patients control access to their data in both, which makes them nearer to opt in systems. In the Isle of Wight and Scotland data are initially collected under opt out arrangements, but they are accessed only with active patient consent once collected and held on the common repository-that is, under opt in rules. The fact that the initial collection operates on presumed consent is only part of the overall process. The overall system is opt in for record access. In the proposed NHS summary care record data will be accessed once collected with no further input from the patient. This distinction is profound, causes the medical profession concern (as evidenced by the motions passed supporting opt in at the BMA's annual representative meeting), and is not being made sufficiently clear to the public. The complex issues in this debate are not helped by the counter intuitive labelling of the so called opt in and opt out positions. The key is that patients and clinicians must have confidence that information will be secure and shared only with patient consent.

Family Practice, Dec 1, 2002

Background. Opportunities exist to develop an advanced nursing role in general practice and there... more Background. Opportunities exist to develop an advanced nursing role in general practice and there is growing evidence that appropriately trained nurses can reduce cost and GP workload without compromising quality of care or patient satisfaction. Despite the shortfall of doctors entering British general practice and the difficulties doctors report in managing an increasing workload in primary care, few British practices have chosen to adopt this potential solution. An exploration of the barriers to the development of a nurse practitioner role is therefore timely. Objective. To explore the views of British GPs regarding their attitudes towards developing an advanced nursing role in general practice. Methods. A focus group study of GPs from four general practices in Yorkshire selected purposefully to represent a spectrum of experience in working with different nursing roles in general practice. Each focus group consisted of between 6 and 8 participants. A structured framework was used to elicit views, the group meetings were recorded and subjected to content analysis by two independent assessors. Inter-rater reliability was high (K = 0.921; 95% confidence limits 0.86-0.98). Results. The study highlighted significant concerns by GPs with regard to the nurse practitioner role in general practice. Four themes were identified that may be impeding the development of advanced nursing roles in general practice. These are concerned with threats to GP status, including job and financial security, nursing capabilities, including training and scope of responsibility, and structural and organizational barriers. Conclusions. There is a need to acknowledge GP concerns and encourage a more widespread debate about the appropriate mix of skills required in primary care. Joint educational events and the development of GP preceptorship may help to develop a greater understanding of the potential value of advanced nursing roles in general practice.

BMJ health & care informatics, Jul 1, 2021

Objectives Until this point there was no national core competency framework for clinical informat... more Objectives Until this point there was no national core competency framework for clinical informatics in the UK. We report on the final two iterations of work carried out in the formation of a national core competency framework. This follows an initial systematic literature review of existing skills and competencies and a job listing analysis. Methods An iterative approach was applied to framework development. Using a mixed-methods design we carried out semi-structured interviews with participants involved in informatics (n=15). The framework was updated based on the interview findings and was subsequently distributed as part of a bespoke online digital survey for wider participation (n=87). The final version of the framework is based on the findings of the survey. Results Over 102 people reviewed the framework as part of the interview or survey process. This led to a final core competency framework containing 6 primary domains with 36 subdomains containing 111 individual competencies. Conclusions An iterative mixed-methods approach for competency development involving the target community was appropriate for development of the competency framework. There is some contention around the depth of technical competencies required. Care is also needed to avoid professional burnout, as clinicians and healthcare practitioners already have clinical competencies to maintain. Therefore, how the framework is applied in practice and how practitioners meet the competencies requires careful consideration.

BMJ, May 15, 2003

Objective To systematically review measures of data quality in electronic patient records (EPRs) ... more Objective To systematically review measures of data quality in electronic patient records (EPRs) in primary care. Design Systematic review of English language publications, 1980-2001. Data sources Bibliographic searches of medical databases, specialist medical informatics databases, conference proceedings, and institutional contacts. Study selection Studies selected according to a predefined framework for categorising review papers. Data extraction Reference standards and measurements used to judge quality. Results Bibliographic searches identified 4589 publications. After primary exclusions 174 articles were classified, 52 of which met the inclusion criteria for review. Selected studies were primarily descriptive surveys. Variability in methods prevented meta-analysis of results. Forty eight publications were concerned with diagnostic data, 37 studies measured data quality, and 15 scoped EPR quality. Reliability of data was assessed with rate comparison. Measures of sensitivity were highly dependent on the element of EPR data being investigated, while the positive predictive value was consistently high, indicating good validity. Prescribing data were generally of better quality than diagnostic or lifestyle data. Conclusion The lack of standardised methods for assessment of quality of data in electronic patient records makes it difficult to compare results between studies. Studies should present data quality measures with clear numerators, denominators, and confidence intervals. Ambiguous terms such as "accuracy" should be avoided unless precisely defined.

Mental Health and Learning Disabilities Research and Practice, Oct 1, 2004

Alcohol abuse is recognised as a serious problem in the UK and there is a strong correlation betw... more Alcohol abuse is recognised as a serious problem in the UK and there is a strong correlation between average consumption, the prevalence of heavy drinking and associated harm. Alcohol abuse disorders are thought to be common in older people and associated with impairments in physical, psychological, social and cognitive wellbeing. The effects of co-morbidity, medication and age may exacerbate the risks of alcohol abuse. We conducted a review of published literature using a defined search strategy of electronic databases, including articles in English, between 1960-2004. This yielded 74 papers that matched the search criteria. Six papers were selected for detailed analysis. Alcohol abuse in older people has a prevalence of between 1-4% in the general population, rising to between 7-22% in inpatients and 23-44% for psychiatric inpatients. The health-related effects of alcohol use in older people are still uncertain. Neither screening for elderly alcohol abuse in a general population nor the use of validated tools such as the CAGE questionnaire may not be effective in the general population. However, for rapid assessment in a clinical setting, the CAGE questionnaire, with a cutoff score of >=2, will effectively discriminate older patients with a history of drinking problems from those without such a history. In the UK there has been little high-quality research reporting the prevalence, identification and treatment of alcohol use disorders in older people. There is a clear need for a specific research programme to address these issues in line with the government's Alcohol Harm Reduction Strategy and the NSF for Older People.

International Journal of Medical Informatics

This document developed by The University of Manchester and the Faculty of Clinical Informatics U... more This document developed by The University of Manchester and the Faculty of Clinical Informatics UK outlines the core competencies required of a clinical informatician.

BMJ, 2006

An outline of the accreditation scheme and process for the Faculty of Clinical Informatics.