Evidence map›Paper›PMID 31133585›Full record

ArticleBMJ open2019

Evidence-based intervention to reduce avoidable hospital admissions in care home residents (the Better Health in Residents in Care Homes (BHiRCH) study): protocol for a pilot cluster randomised trial.

Elizabeth L Sampson, Alexandra Feast, Alan Blighe, Katherine Froggatt, Rachael Hunter, Louise Marston, Brendan McCormack, Shirley Nurock, Monica Panca, Catherine Powell and 5 more

Open access · goldAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
4.2field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Trial
  4. Review
  5. Article
  6. Article
  7. Article
  8. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 7 institutions in 4 countries.

Elizabeth L SampsonMarie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK.
Alexandra FeastMarie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK.
Alan BligheCentre for Applied Dementia Studies, University of Bradford, Bradford, West Yorkshire, UK.
Katherine FroggattInternational Observatory on End of Life Care, Lancaster University, Lancaster, UK.
Rachael HunterResearch Dept of Primary Care and Population Health and PRIMENT Clinical Trials Unit, University College London, London, UK.ORCID 0000-0002-7447-8934
Louise MarstonResearch Dept of Primary Care and Population Health and PRIMENT Clinical Trials Unit, University College London, London, UK.
Brendan McCormackSchool of Health Studies, Queen Margaret University, Edinburgh, UK.
Shirley NurockMarie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK.
Monica PancaResearch Dept of Primary Care and Population Health and PRIMENT Clinical Trials Unit, University College London, London, UK.
Catherine PowellCentre for Applied Dementia Studies, University of Bradford, Bradford, West Yorkshire, UK.
Greta RaitResearch Dept of Primary Care and Population Health and PRIMENT Clinical Trials Unit, University College London, London, UK.
Louise RobinsonInstitute for Health and Society and Newcastle University Institute for Ageing, Newcastle University, Newcastle, UK.ORCID 0000-0003-0209-2503
Barbara Woodward-CarltonCentre for Applied Dementia Studies, University of Bradford, Bradford, West Yorkshire, UK.
John YoungAcademic Unit of Elderly Care and Rehabilitation, Bradford Institute for Health Research, University of Leeds, Bradford, UK.
Murna DownsCentre for Applied Dementia Studies, University of Bradford, Bradford, West Yorkshire, UK.
Primary Health Care · QAUniversity of Bradford · GBUniversity College London · GBNational Observatory · BRNewcastle Hospitals - Campus for Ageing and Vitality · GBQueen Margaret University · GBUniversity of Leeds · GB

Funding

Department of Health RP-PG-0612-20010Marie Curie MCCC-FCO-11-U
6 · The paper itself

Abstract

introductionAcute hospital admission is distressing for care home residents. Ambulatory care sensitive conditions, such as respiratory and urinary tract infections, are conditions that can cause unplanned hospital admission but may have been avoidable with timely detection and intervention in the community. The Better Health in Residents in Care Homes (BHiRCH) programme has feasibility tested and will pilot a multicomponent intervention to reduce these avoidable hospital admissions. The BHiRCH intervention comprises an early warning tool for noting changes in resident health, a care pathway (clinical guidance and decision support system) and a structured method for communicating with primary care, adapted for use in the care home. We use practice development champions to support implementation and embed changes in care. METHODS AND ANALYSIS: Cluster randomised pilot trial to test study procedures and indicate whether a further definitive trial is warranted. Fourteen care homes with nursing (nursing homes) will be randomly allocated to intervention (delivered at nursing home level) or control groups. Two nurses from each home become Practice Development Champions trained to implement the intervention, supported by a practice development support group. Data will be collected for 3 months preintervention, monthly during the 12-month intervention and 1 month after. Individual-level data includes resident, care partner and staff demographics, resident functional status, service use and quality of life (for health economic analysis) and the extent to which staff perceive the organisation supports person centred care. System-level data includes primary and secondary health services contacts (ie, general practitioner and hospital admissions). Process evaluation assesses intervention acceptability, feasibility, fidelity, ease of implementation in practice and study procedures (ie, consent and recruitment rates). ETHICS AND DISSEMINATION: Approved by Research Ethics Committee and the UK Health Research Authority. Findings will be disseminated via academic and policy conferences, peer-reviewed publications and social media (eg, Twitter). TRIAL REGISTRATION NUMBER: ISRCTN74109734; Pre-results.

Indexed as

Evidence-Based MedicineHomes for the AgedNursing HomesAgedCluster AnalysisHumansMulticenter Studies as TopicPatient AdmissionPatient TransferPilot ProjectsQuality of Health CareQuality of LifeRandomized Controlled Trials as Topicdementiageriatric medicineheart failureprimary carerespiratory infectionsurinary tract infections

Identifiers

PMID31133585
PMCPMC6538003
OpenAlexW2947791147

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.