Carmel Hughes
Dados Biográficos
| ID | 3886537 |
|---|---|
| NOME | Carmel Hughes |
| PRENOMES | Carmel |
| SOBRENOME | Hughes |
| ASSINATURA | HUGHES C |
| AFILIAÇÕES | Queen's University Belfast |
| ORCID | 0000-0002-4656-6021 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 25 |
| TOTAL DE CITAÇÕES | 12 |
| TOTAL COMO AUTOR | 25 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1996 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 1 |
Integrating informal carers who support medication management into hospital to home transitions
Background: Integrating informal carers into patient care around the transition from hospital to home can be beneficial to patient and carer outcomes, avoiding adverse medication events and readmission, yet the practices of how this is achieved are unclear. Approach; Informal carers are defined as somebody who looks after a person who cannot cope without support, these people are often family and friends. Using a realist review approach, this wor…
Barriers and Facilitators to Medicines Use in Patients With Vision Impairment
INTRODUCTION: Previous studies have highlighted numerous challenges with medicines use for patients with vision impairment, but evidence is lacking on interventions to support safe and effective medicine use for this population. This study aimed to identify potential barriers/facilitators of medicines use from the viewpoint of patients/caregivers, to establish a theory-informed foundation for a future intervention. METHODS: Semi-structured interv…
Carers' experiences and perspectives of the use of anticholinergic medications in people living with dementia
INTRODUCTION: There is concern about the use of anticholinergic medications in people living with dementia (PLWD). Such medicines may increase cognitive decline and may be associated with higher mortality in PLWD who take these medicines. The aim of this study was to analyse data from an online dementia discussion forum to explore the experiences and perspectives of PLWD and carers about the use of anticholinergic medicines in this population. ME…
Creating opportunities for patient participation in managing medications across transitions of care through formal and informal modes of communication
BACKGROUND: Communicating about medications across transitions of care is important in older patients who frequently move between health care settings. While there is increasing interest in understanding patient communication across transitions of care, little is known about older patients' involvement in formal and informal modes of communication regarding managing medications. OBJECTIVE: The aim of this paper was to explore how older patients p…
Enhancing deprescribing
The English National Overprescribing Review identified that older people often take eight or more medicines a day. The report recommended pharmacists in primary care should take responsibility for addressing polypharmacy. Overprescribing is a safety concern in care homes as approximately half of older care home residents are prescribed at least one medicine that is unnecessary or now harmful. This predisposes them to adverse outcomes including ho…
Interprofessional and Intraprofessional Communication about Older People’s Medications across Transitions of Care
Communication breakdowns contribute to medication incidents involving older people across transitions of care. The purpose of this paper is to examine how interprofessional and intraprofessional communication occurs in managing older patients' medications across transitions of care in acute and geriatric rehabilitation settings. An ethnographic design was used with semi-structured interviews, observations and focus groups undertaken in an acute t…
Knowledge and Power Relations in Older Patients' Communication About Medications Across Transitions of Care
Communicating about medications across transitions of care is a challenging process for older patients. In this article, we examined communication processes between older patients, family members, and health professionals about managing medications across transitions of care, focusing on older patients' experiences. A focused ethnographic design was employed across two metropolitan hospitals. Data collection methods included interviews, observati…
Developing pharmacist‐facilitated medicines review services for community‐dwelling Māori older adults in New Zealand – A qualitative study exploring stakeholder views
Māori (Indigenous people of New Zealand [NZ]) experience inequitable health outcomes compared to non-Māori, across the spectrum of clinical care, including those relating to medicines. Internationally, pharmacist-facilitated medicines review services have been shown to benefit older adults. Despite national policies calling for the increased implementation of these services, NZ data relating to them remain limited, and these services may increase…
Everyone needs to understand each other’s systems”
The role of an innovative Pharmacist Independent Prescriber (PIP) for care homes to optimise medications has not been examined. We explored stakeholders' views on issues and barriers that the PIP might address to inform a service specification for the PIP intervention in older people's care homes. Focus groups (n = 72 participants) and semi-structured interviews (n = 13) undertaken in 2015 across four sites in the United Kingdom captured the view…
Improving adherence to multiple medications in older people in primary care
BACKGROUND: Medication adherence is vital to ensuring optimal patient outcomes, particularly amongst multimorbid older people prescribed multiple medications. Interventions targeting adherence often lack a theoretical underpinning and this may impact on effectiveness. The theoretical domains framework (TDF) of behaviour can aid intervention development by systematically identifying key determinants of medication adherence. OBJECTIVES: This study …
‘All illness is personal to that individual’
BACKGROUND: Adherence to treatment is low in bronchiectasis and is associated with poorer health outcomes. Factors affecting adherence decisions have not been explored in patients with bronchiectasis. OBJECTIVE: We aimed to explore patients' perspectives on adherence, factors affecting adherence decision making and to develop a conceptual model explaining this decision-making process in adults with bronchiectasis. METHODS: Adults with bronchiecta…
A patient perspective of pharmacist prescribing
BACKGROUND: The drive for non-medical prescribing has progressed quickly since the late 1990s and involves a range of healthcare professionals including pharmacists. As part of a commissioned research project, this qualitative element of a larger case study focused on the views of patients of pharmacist prescribers. OBJECTIVE: The aim of this study was to explore patients' perspectives of pharmacists as prescribers. METHODS: Three pharmacists wor…
Exploring the prevalence of and factors associated with pain
Few pain studies have made community-dwelling people with dementia (PWD) their focus. The aim of this study was to determine the prevalence of pain among this patient population and to explore medication use. Moreover, we sought to investigate patient and caregiver variables associated with the presence of pain. Community-dwelling PWD and their caregivers were recruited between May 2009 and July 2012 from outpatient memory clinics in Northern Ire…
The relationship between BMI and the prescription of anti-obesity medication according to social factors
There is evidence of relative under-prescribing in males compared to females despite a similar prevalence of obesity. While the prevalence (and presumably the health consequences) of obesity worsens with age, younger females are more likely to be prescribed anti-obesity medication. This suggests an element of patient demand. Educational material to improve the understanding of the role of anti-obesity medication, for patients and practitioners, i…
Prescribing for weight loss in primary care
BACKGROUND: Taking antiobesity medication can be a cost effective way to lose weight. Uptake is determined in part by a General Practitioner's decision to prescribe weight loss medication and, in part, by patient preference. It is probable that the latter may indicate a patient's readiness to lose weight. METHODS: Analysis of cross-sectional data (from February 2003 to March 2011) from a population based prescribing database (∼1.75 million people…
P1-163 Increased incidence and detection rates of carcinoma in situ of the breast
Background Increased incidence of carcinoma in situ (CIS) has generally been attributed to widespread application of mammography screening. However, direct evidence for the impact of screening is rare. Methods Screen detected and total CIS (ICD-10 D05) incidence data were obtained, between 1990 and 2007 where possible, from regional cancer registries in the UK and the Republic of Ireland (ROI). Age-standardised incidence rates for the UK and ROI,…
Does the use of psychotropic medications increase on entering a care home? A prospective pharmacoepidemiological study
Background There is ongoing concern about the extensive use of psychotropic agents in nursing and residential home care. These drugs have been described as ‘chemical restraints’ in that they can be used to sedate and subdue patients. However, it is possible that the high usage in this population reflects patient characteristics rather than treatment policies within institutions. Objectives To compare the use of antidepressant and anxiolytic drugs…
O4-4.1 Non-steroidal anti-inflammatory drug and aspirin use and the risk of head and neck cancer
Introduction The use of non-steroidal anti-inflammatory drugs (NSAIDs) has been associated with a reduced risk of several cancers. Evidence for NSAIDs preventing head and neck cancer (HNC) is inconclusive. We conducted a prospective cohort study to examine the association between NSAID use and HNC risk. Methods Using data from the National Cancer Institute (NCI) Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial, we examined the…
P1-24 Joined up data for joined up thinking—prescription data as a surveillance tool for diabetes morbidity
The introduction of a prescribing database as a new tool for disease surveillance (March 2009–March 2010), and its future potential for record linkage. The assessment of population health has traditionally focused on mortality data because it is readily available and there are systematic methods of data collection which are recognised internationally. However, morbidity data are now considered more relevant to current public health concerns, thou…
Which Organizational Characteristics Are Associated With Increased Management of Depression Using Antidepressants in US Nursing Homes
BACKGROUND: There is universal agreement that organizational characteristics of nursing facilities can and do influence the quality of care and resident outcomes. OBJECTIVE: This study evaluated the relation between organizational characteristics and management of depression using antidepressants. RESEARCH DESIGN: This was a cross-sectional study of Medicare/Medicaid certified nursing homes in 6 states in 2000. SUBJECTS: We studied 87,907 residen…
An Evaluation of the Impact of the Prospective Payment System on Antidepressant Use in Nursing Home Residents
OBJECTIVES: To determine the impact of the prospective payment system (PPS) for skilled nursing facilities on the pharmacologic treatment of depression. METHODS: We used a quasi-experimental study comparing the pharmacological treatment rates for depression in the pre-PPS period (1997) to the post-PPS period (2000) in 8149 residents with documented depression living in over 500 nursing facilities in Ohio. Logistic regression models adjusting for …
Physician and family assisted suicide
Influence of Facility Characteristics on Use of Antipsychotic Medications in Nursing Homes
OBJECTIVES: This study investigated the effect of facility and resident characteristics on the use of antipsychotic medications in the long-term care setting. RESEARCH DESIGN: This research used data available from the On-Line Survey and Certification of Automated Records (OSCAR) for all Medicare/Medicaid-certified nursing homes in the contiguous United States in 1997. The data consisted of 14,631 facilities. MEASURES: A multiple linear regressio…
Transverse (Harris) lines in irish archaeological remains
Transverse lines were examined in 633 long bones from 73 individuals exhumed from two burial sites in the Republic of Ireland: Waterford City and Tintern Abbey. The burials cover four distinct periods between the 11th and 17th centuries. Lines were most numerous in the tibia, especially in the distal segment, and were not seen in the humerus nor the proximal part of the femur. The number of lines varied between the proximal and distal segments of…
Transverse (Harris) lines in irish archaeological remains
Transverse lines were examined in 633 long bones from 73 individuals exhumed from two burial sites in the Republic of Ireland: Waterford City and Tintern Abbey. The burials cover four distinct periods between the 11th and 17th centuries. Lines were most numerous in the tibia, especially in the distal segment, and were not seen in the humerus nor the proximal part of the femur. The number of lines varied between the proximal and distal segments of…
Physician and family assisted suicide
Enhancing deprescribing
The English National Overprescribing Review identified that older people often take eight or more medicines a day. The report recommended pharmacists in primary care should take responsibility for addressing polypharmacy. Overprescribing is a safety concern in care homes as approximately half of older care home residents are prescribed at least one medicine that is unnecessary or now harmful. This predisposes them to adverse outcomes including ho…
Everyone needs to understand each other’s systems”
The role of an innovative Pharmacist Independent Prescriber (PIP) for care homes to optimise medications has not been examined. We explored stakeholders' views on issues and barriers that the PIP might address to inform a service specification for the PIP intervention in older people's care homes. Focus groups (n = 72 participants) and semi-structured interviews (n = 13) undertaken in 2015 across four sites in the United Kingdom captured the view…
Transverse (Harris) lines in irish archaeological remains
Transverse lines were examined in 633 long bones from 73 individuals exhumed from two burial sites in the Republic of Ireland: Waterford City and Tintern Abbey. The burials cover four distinct periods between the 11th and 17th centuries. Lines were most numerous in the tibia, especially in the distal segment, and were not seen in the humerus nor the proximal part of the femur. The number of lines varied between the proximal and distal segments of…
Transverse (Harris) lines in irish archaeological remains
Transverse lines were examined in 633 long bones from 73 individuals exhumed from two burial sites in the Republic of Ireland: Waterford City and Tintern Abbey. The burials cover four distinct periods between the 11th and 17th centuries. Lines were most numerous in the tibia, especially in the distal segment, and were not seen in the humerus nor the proximal part of the femur. The number of lines varied between the proximal and distal segments of…
Influence of Facility Characteristics on Use of Antipsychotic Medications in Nursing Homes
OBJECTIVES: This study investigated the effect of facility and resident characteristics on the use of antipsychotic medications in the long-term care setting. RESEARCH DESIGN: This research used data available from the On-Line Survey and Certification of Automated Records (OSCAR) for all Medicare/Medicaid-certified nursing homes in the contiguous United States in 1997. The data consisted of 14,631 facilities. MEASURES: A multiple linear regressio…
Physician and family assisted suicide
Which Organizational Characteristics Are Associated With Increased Management of Depression Using Antidepressants in US Nursing Homes
BACKGROUND: There is universal agreement that organizational characteristics of nursing facilities can and do influence the quality of care and resident outcomes. OBJECTIVE: This study evaluated the relation between organizational characteristics and management of depression using antidepressants. RESEARCH DESIGN: This was a cross-sectional study of Medicare/Medicaid certified nursing homes in 6 states in 2000. SUBJECTS: We studied 87,907 residen…
An Evaluation of the Impact of the Prospective Payment System on Antidepressant Use in Nursing Home Residents
OBJECTIVES: To determine the impact of the prospective payment system (PPS) for skilled nursing facilities on the pharmacologic treatment of depression. METHODS: We used a quasi-experimental study comparing the pharmacological treatment rates for depression in the pre-PPS period (1997) to the post-PPS period (2000) in 8149 residents with documented depression living in over 500 nursing facilities in Ohio. Logistic regression models adjusting for …
P1-163 Increased incidence and detection rates of carcinoma in situ of the breast
Background Increased incidence of carcinoma in situ (CIS) has generally been attributed to widespread application of mammography screening. However, direct evidence for the impact of screening is rare. Methods Screen detected and total CIS (ICD-10 D05) incidence data were obtained, between 1990 and 2007 where possible, from regional cancer registries in the UK and the Republic of Ireland (ROI). Age-standardised incidence rates for the UK and ROI,…
Does the use of psychotropic medications increase on entering a care home? A prospective pharmacoepidemiological study
Background There is ongoing concern about the extensive use of psychotropic agents in nursing and residential home care. These drugs have been described as ‘chemical restraints’ in that they can be used to sedate and subdue patients. However, it is possible that the high usage in this population reflects patient characteristics rather than treatment policies within institutions. Objectives To compare the use of antidepressant and anxiolytic drugs…
O4-4.1 Non-steroidal anti-inflammatory drug and aspirin use and the risk of head and neck cancer
Introduction The use of non-steroidal anti-inflammatory drugs (NSAIDs) has been associated with a reduced risk of several cancers. Evidence for NSAIDs preventing head and neck cancer (HNC) is inconclusive. We conducted a prospective cohort study to examine the association between NSAID use and HNC risk. Methods Using data from the National Cancer Institute (NCI) Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial, we examined the…
P1-24 Joined up data for joined up thinking—prescription data as a surveillance tool for diabetes morbidity
The introduction of a prescribing database as a new tool for disease surveillance (March 2009–March 2010), and its future potential for record linkage. The assessment of population health has traditionally focused on mortality data because it is readily available and there are systematic methods of data collection which are recognised internationally. However, morbidity data are now considered more relevant to current public health concerns, thou…
Prescribing for weight loss in primary care
BACKGROUND: Taking antiobesity medication can be a cost effective way to lose weight. Uptake is determined in part by a General Practitioner's decision to prescribe weight loss medication and, in part, by patient preference. It is probable that the latter may indicate a patient's readiness to lose weight. METHODS: Analysis of cross-sectional data (from February 2003 to March 2011) from a population based prescribing database (∼1.75 million people…
The relationship between BMI and the prescription of anti-obesity medication according to social factors
There is evidence of relative under-prescribing in males compared to females despite a similar prevalence of obesity. While the prevalence (and presumably the health consequences) of obesity worsens with age, younger females are more likely to be prescribed anti-obesity medication. This suggests an element of patient demand. Educational material to improve the understanding of the role of anti-obesity medication, for patients and practitioners, i…
‘All illness is personal to that individual’
BACKGROUND: Adherence to treatment is low in bronchiectasis and is associated with poorer health outcomes. Factors affecting adherence decisions have not been explored in patients with bronchiectasis. OBJECTIVE: We aimed to explore patients' perspectives on adherence, factors affecting adherence decision making and to develop a conceptual model explaining this decision-making process in adults with bronchiectasis. METHODS: Adults with bronchiecta…
A patient perspective of pharmacist prescribing
BACKGROUND: The drive for non-medical prescribing has progressed quickly since the late 1990s and involves a range of healthcare professionals including pharmacists. As part of a commissioned research project, this qualitative element of a larger case study focused on the views of patients of pharmacist prescribers. OBJECTIVE: The aim of this study was to explore patients' perspectives of pharmacists as prescribers. METHODS: Three pharmacists wor…
Exploring the prevalence of and factors associated with pain
Few pain studies have made community-dwelling people with dementia (PWD) their focus. The aim of this study was to determine the prevalence of pain among this patient population and to explore medication use. Moreover, we sought to investigate patient and caregiver variables associated with the presence of pain. Community-dwelling PWD and their caregivers were recruited between May 2009 and July 2012 from outpatient memory clinics in Northern Ire…
Improving adherence to multiple medications in older people in primary care
BACKGROUND: Medication adherence is vital to ensuring optimal patient outcomes, particularly amongst multimorbid older people prescribed multiple medications. Interventions targeting adherence often lack a theoretical underpinning and this may impact on effectiveness. The theoretical domains framework (TDF) of behaviour can aid intervention development by systematically identifying key determinants of medication adherence. OBJECTIVES: This study …
Developing pharmacist‐facilitated medicines review services for community‐dwelling Māori older adults in New Zealand – A qualitative study exploring stakeholder views
Māori (Indigenous people of New Zealand [NZ]) experience inequitable health outcomes compared to non-Māori, across the spectrum of clinical care, including those relating to medicines. Internationally, pharmacist-facilitated medicines review services have been shown to benefit older adults. Despite national policies calling for the increased implementation of these services, NZ data relating to them remain limited, and these services may increase…
Everyone needs to understand each other’s systems”
The role of an innovative Pharmacist Independent Prescriber (PIP) for care homes to optimise medications has not been examined. We explored stakeholders' views on issues and barriers that the PIP might address to inform a service specification for the PIP intervention in older people's care homes. Focus groups (n = 72 participants) and semi-structured interviews (n = 13) undertaken in 2015 across four sites in the United Kingdom captured the view…
Interprofessional and Intraprofessional Communication about Older People’s Medications across Transitions of Care
Communication breakdowns contribute to medication incidents involving older people across transitions of care. The purpose of this paper is to examine how interprofessional and intraprofessional communication occurs in managing older patients' medications across transitions of care in acute and geriatric rehabilitation settings. An ethnographic design was used with semi-structured interviews, observations and focus groups undertaken in an acute t…
Knowledge and Power Relations in Older Patients' Communication About Medications Across Transitions of Care
Communicating about medications across transitions of care is a challenging process for older patients. In this article, we examined communication processes between older patients, family members, and health professionals about managing medications across transitions of care, focusing on older patients' experiences. A focused ethnographic design was employed across two metropolitan hospitals. Data collection methods included interviews, observati…
Creating opportunities for patient participation in managing medications across transitions of care through formal and informal modes of communication
BACKGROUND: Communicating about medications across transitions of care is important in older patients who frequently move between health care settings. While there is increasing interest in understanding patient communication across transitions of care, little is known about older patients' involvement in formal and informal modes of communication regarding managing medications. OBJECTIVE: The aim of this paper was to explore how older patients p…
Enhancing deprescribing
The English National Overprescribing Review identified that older people often take eight or more medicines a day. The report recommended pharmacists in primary care should take responsibility for addressing polypharmacy. Overprescribing is a safety concern in care homes as approximately half of older care home residents are prescribed at least one medicine that is unnecessary or now harmful. This predisposes them to adverse outcomes including ho…
Carers' experiences and perspectives of the use of anticholinergic medications in people living with dementia
INTRODUCTION: There is concern about the use of anticholinergic medications in people living with dementia (PLWD). Such medicines may increase cognitive decline and may be associated with higher mortality in PLWD who take these medicines. The aim of this study was to analyse data from an online dementia discussion forum to explore the experiences and perspectives of PLWD and carers about the use of anticholinergic medicines in this population. ME…
Barriers and Facilitators to Medicines Use in Patients With Vision Impairment
INTRODUCTION: Previous studies have highlighted numerous challenges with medicines use for patients with vision impairment, but evidence is lacking on interventions to support safe and effective medicine use for this population. This study aimed to identify potential barriers/facilitators of medicines use from the viewpoint of patients/caregivers, to establish a theory-informed foundation for a future intervention. METHODS: Semi-structured interv…
Integrating informal carers who support medication management into hospital to home transitions
Background: Integrating informal carers into patient care around the transition from hospital to home can be beneficial to patient and carer outcomes, avoiding adverse medication events and readmission, yet the practices of how this is achieved are unclear. Approach; Informal carers are defined as somebody who looks after a person who cannot cope without support, these people are often family and friends. Using a realist review approach, this wor…
Medicine (24 obras) · Nursing (15 obras) · Pharmaceutical Practices and Patient Outcomes (12 obras) · Family medicine (11 obras) · Health care (9 obras) · Population (9 obras) · Psychology (9 obras) · Psychiatry (8 obras) · Qualitative research (8 obras) · Internal Medicine (7 obras)