New treatment pathways in the post-COVID-19 era最新文献

{"title":"P158 Thoracic ultrasound on the respiratory post-take ward round: assessing the impact on clinical decision-making and the patient journey","authors":"M. Steward, H. Bakere, T. Burden","doi":"10.1136/thorax-2021-btsabstracts.267","DOIUrl":"https://doi.org/10.1136/thorax-2021-btsabstracts.267","url":null,"abstract":"","PeriodicalId":285482,"journal":{"name":"New treatment pathways in the post-COVID-19 era","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114993273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P154 A pathway transformation to transition from a ‘routine’ to a ‘responsive’ severe asthma service in the post COVID era","authors":"L. Wiffen, R. Harvey, L. Fox, A. Mathias, K. Harbour, A. Chauhan, T. Brown","doi":"10.1136/thorax-2021-btsabstracts.263","DOIUrl":"https://doi.org/10.1136/thorax-2021-btsabstracts.263","url":null,"abstract":"P154 Figure 1A pathway transformation to transition from a ‘routine’ to a ‘responsive’ severe asthma service in the post COVID era[Figure omitted. See PDF]ConclusionsThe COVID-19 pandemic has necessitated a comprehensive re-evaluation of services and care pathways across the NHS. Transitioning from a ‘routine’ to ‘responsive’ patient-triggered service has facilitated flexible but personalised care empowering patients in the self-management of their asthma and significantly reducing the burden of ‘routine’ follow-up for patients and the MDT. This has reduced waiting times and increased capacity for new patient assessments whilst ensuring patients are offered timely reviews when their asthma control deteriorates, delivering equitable access across the system with the potential to improve patient outcomes.","PeriodicalId":285482,"journal":{"name":"New treatment pathways in the post-COVID-19 era","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122546853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P160 Community Respiratory staff In-Reach into care Homes finds unmet need and allows optimization of patient care plus care home staff Education","authors":"HS Hill, K. Keeling, I. Young, J. Chandler, Mcp Apps","doi":"10.1136/thorax-2021-btsabstracts.269","DOIUrl":"https://doi.org/10.1136/thorax-2021-btsabstracts.269","url":null,"abstract":"IntroductionDuring the Covid epidemic the care of patients in care homes to optimize their therapy and prevent admission has become a national Priority. In the Basildon and Brentwood CCG area staff normally working in the community respiratory service were redeployed to visit all the care homes in the area and review all patients with respiratory disease to optimize therapy, advise flu immunisation and support their care.MethodsAll care homes in the area of Basildon, Brentwood , Billericay and Wickford were visited and a review carried out on all patients resident there with respiratory disease. This included reviewing both notes and patients to find patients with respiratory disease. Therapy was reviewed and optimised, including obtaining new inhalers, spacer devices and rescue packs.Results163 patients were reviewed, of whom 116 had evidence of respiratory disease. 31 of these were already known to the community respiratory services and 85 were not known. 75% of patients needed a new salbutamol inhaler or aero-chamber spacer device. 58% of patients did not have a rescue pack of antibiotics and steroids and this was provided. 85% of those not already known to the service required salbutamol,. A spacer and a rescue pack.These were all provided.ConclusionsIn this area there was a large unmet need for treatment in patients in care homes with respiratory disease as one of their diagnoses. This project untaken during the covid epidemic has demonstrated that it was possible to provide this in a covid-secure manner and found a need for education of care home staff and a need for a wider application of this project which is now being rolled out to the other CCG (Thurrock) in our area. Educational materials are being produced and distributed to all care homes in the area. The in-reach of community respiratory team staff into care homes can be used as an avenue to ensure good education of care home staff and increase vaccination of staff and residents and optimization of therapy for residents to reduce the risk of hospital admission","PeriodicalId":285482,"journal":{"name":"New treatment pathways in the post-COVID-19 era","volume":"275 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131616241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P157 Effectiveness of a multi-disciplinary community respiratory team during the COVID-19 pandemic","authors":"E. Johnson, E. Turner, S. Gingles, K. Levin, E. Mackay, C. Roux, M. Milligan, M. Mackie, K. Farrell, K. Murray, S. Adams, J. Brand, D. Anderson, H. Bayes","doi":"10.1136/thorax-2021-btsabstracts.266","DOIUrl":"https://doi.org/10.1136/thorax-2021-btsabstracts.266","url":null,"abstract":"P157 Figure 1ConclusionsThe NHS GGC CRRT was able to safely and appropriately risk stratify patients and complement tertiary care by providing support at home with potential impact on reducing hospital admissions and deaths. Wider implementation of multidisciplinary community respiratory care could benefit patients and the healthcare service.","PeriodicalId":285482,"journal":{"name":"New treatment pathways in the post-COVID-19 era","volume":"136 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121453031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P159 Outcome from invasive ventilation for patients with learning disability","authors":"D. McCourt, H. Tedd, T. Fretwell, T. Doris, PB Messer","doi":"10.1136/thorax-2021-btsabstracts.268","DOIUrl":"https://doi.org/10.1136/thorax-2021-btsabstracts.268","url":null,"abstract":"The annual learning disability mortality review (LeDeR)1 highlights that patients with learning disability (LD) are twice as likely to die of avoidable causes, with inappropriate ceilings of treatment being instigated in patients with LD: 23% of ‘Do Not Attempt Cardiopulmonary Resuscitation’ forms documented inappropriate medical conditions such as a learning disability as the sole reason to not attempt resuscitation1. The COVID19 pandemic has further highlighted this issue, with people with LD being at 6 times the risk of death from COVID19 than those without LD;people with LD aged 18–34 were 30 times more likely to die of COVID19.2 However, there is little data out there to help support decision making around invasive ventilation in people with LD.We aimed to explore the outcomes of patients with LD admitted to a single critical care unit for invasive ventilationWe reviewed the notes of patients with learning disability requiring intubation and ventilation over a 5-year period (2016–2020). Data was retrospectively collected on survival, rates of tracheostomy insertion and requirement for long term ventilation (LTV) or cough augmentation.Results15 patients were identified with LD who required invasive ventilation. 93% survived critical care admission. 7% required tracheostomy with subsequent decannulation, whilst a further 7% required long term tracheostomy. 40% were commenced on LTV. 46% required long term cough augmentation via cough assist device. 46% have subsequently died, with a mean survival following critical care admission of 2.5 years. Mean duration from invasive ventilation in the survivor group is 5.5 years.ConclusionWe have demonstrated good outcomes in patients with LD admitted to critical care for invasive ventilation. Although there was a high requirement for LTV and cough augmentation following admission to critical care for invasive ventilation, we have demonstrated both good survival to discharge from critical care and good long term survival in this group. This small single centre study highlights the need for further research to aid decision making around escalation decisions in patients with LD.ReferencesThe learning disability mortality review (LeDeR): Annual report. 2020.COVID19 deaths of people identified as having learning disabilities: summary. Public Health England. 2020.","PeriodicalId":285482,"journal":{"name":"New treatment pathways in the post-COVID-19 era","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120935709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P156 A regional study of the availability, uptake and barriers to inhaler recycling: promoting environmental sustainability","authors":"K. Liatsikos, R. Robinson, A. Khashkhusha, F. Shiham, H. Joplin, A. Collins, H. Burhan","doi":"10.1136/thorax-2021-btsabstracts.265","DOIUrl":"https://doi.org/10.1136/thorax-2021-btsabstracts.265","url":null,"abstract":"","PeriodicalId":285482,"journal":{"name":"New treatment pathways in the post-COVID-19 era","volume":"113 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115741340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P155 Delivering physiotherapy outpatient assessment and treatment in a severe asthma clinic in the era of COVID-19","authors":"C. Mason, T. Brown, R. Harvey, B. Reeves, S. Folini, M. Tolson, L. Fox, L. Wiffen, A. Chauhan, R. De Vos","doi":"10.1136/thorax-2021-btsabstracts.264","DOIUrl":"https://doi.org/10.1136/thorax-2021-btsabstracts.264","url":null,"abstract":"Introduction and ObjectivesThe global SARS-CoV-2 pandemic has forced clinicians to consider alternative methods of service provision to patients with respiratory conditions who were clinically vulnerable and/or advised to shield.Breathing pattern disorders (BPD) are a common comorbidity affecting approximately one third of patients with asthma. The respiratory physiotherapy team within the Portsmouth Severe Asthma Service (PSAS) recognised the need to continue to assess and deliver treatment for patients with BPD particularly at a time of heightened anxiety.Breathing retraining requires precise and highly specific assessment and treatment to ensure optimal outcomes and the decision to use a video conferencing platform was made to utilise the visual medium. To ensure quality service was being delivered, patients using the video conferencing platform to receive respiratory physiotherapy in the PSAS were asked for feedback.MethodsAt the end of every video consultation, written feedback was requested. Sixty-nine responses were received from July 2020-May 2021. Patients were asked to rate their physiotherapy consultation from very good to very poor;how they would prefer to receive treatment;if they would use this method of consultation again and the ease of use of the video consultation.ResultsOf the 69 responses:68/69 (98%) would use the service again58/69 (84%) rated the service as very good35/69 (51%) would choose video over face to face appointments23/69 (33%) would prefer to be seen face to face63/69 (91%) felt that accessibility of the video platform could be improvedQualitative feedback was also gathered from patients and included statements suchExcellent quality and a very thorough appointment.It was helpful to actually see a clinician face to face via video instead of a phone callConclusionsVideo consultations have proven to be a feasible and successful way of assessing BPD in asthma patients. Despite feedback regarding the ease of accessing the online platform being suboptimal, overarching positive responses to video consultations was received. With 51% favouring being seen via video consultation rather than face to face, this has wider implications for patients and the NHS including reduced travel time to appointments and reduced waiting room pressures.","PeriodicalId":285482,"journal":{"name":"New treatment pathways in the post-COVID-19 era","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116201238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P161 Understanding the role of a patient-led pulmonary fibrosis charity on enabling support groups to thrive: A UK wide survey of support group leaders and members experiences","authors":"D. Chand, J. Ruck","doi":"10.1136/thorax-2021-btsabstracts.270","DOIUrl":"https://doi.org/10.1136/thorax-2021-btsabstracts.270","url":null,"abstract":"P162 Table 1 Results of search strategies and extrapolation to Welsh population","PeriodicalId":285482,"journal":{"name":"New treatment pathways in the post-COVID-19 era","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126418707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}