Learn More
OBJECTIVE Supporting patients' self care could have a major effect on the management of long-term conditions, which has led to worldwide interest in effective self care interventions. In England, self care support is being developed through the "Expert Patients Programme", which provides lay-led generic courses to improve patients' self care skills.(More)
STUDY OBJECTIVE s: To examine changing inequality in the coverage of cervical screening and its relation to organisational aspects of primary care and to inequality in cervical cancer incidence and mortality. DESIGN Retrospective time trends analysis (1991-2001) of screening coverage and cervical cancer incidence and mortality in England. SETTING The 99(More)
OBJECTIVE To measure changes in quality of care for three major chronic diseases (coronary heart disease, asthma, and type 2 diabetes) between 1998 and 2003. DESIGN Longitudinal cohort study. SETTING 42 general practices in six geographical areas of England (Avon, Bury/Rochdale, Enfield, Oldham, Somerset, South Essex). PARTICIPANTS Medical record data(More)
OBJECTIVE To assess the cost effectiveness of the Expert Patients Programme (EPP) intervention compared to a treatment as usual alternative. DESIGN Two-arm pragmatic randomised controlled trial design with waiting list control. SETTING Community settings in England. PATIENTS Patients with a wide range of self-defined long-term conditions. (More)
Since the late 1990s, the possible adverse effects of the combined measles, mumps, and rubella (MMR) vaccine have caused intense public debate. After the vaccine was introduced in 1988, coverage was high, increasing from 80% in 1989 to 92% in 1997. After 1997 coverage began to decline, and by 2001 had fallen by 4.1%, which gave some cause for concern. We(More)
BACKGROUND Screening for cardiovascular disease is an important primary preventive measure, yet research has documented that not all population groups receive the same quality of preventive healthcare. DESIGN Longitudinal analysis of cardiovascular disease risk factor recording. METHODS Data were made available from a local population-based screening(More)
OBJECTIVE To assess how much patients with long-term conditions value self-efficacy (i.e., confidence in their ability to manage their condition) compared with other health outcomes, including measures of quality of life, and process outcomes including access to General Practitioners. METHODS Discrete Choice Experiment (DCE) set in UK community settings.(More)
BACKGROUND This study was carried out in order to examine changes in cardiovascular risk associated with a population-based screening programme. METHOD Cardiovascular disease (CVD) risk factor data from a representative sample of residents aged between 45 and 55 years who attended screening a total of three times over a 10-year period were chosen for(More)
Chronic disease management (CDM) is now widely available in primary care, but methods of delivery are highly variable. The focus of this study was to examine whether CDM provided in asthma clinics was more effective in reducing the severity of asthma symptoms, particularly for deprived populations. There was no evidence of 'inverse care' in the provision of(More)