Dyfrig Hughes
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View article: A rapid review of the literature contrasting cost-effectiveness analysis and value-based healthcare approaches to assess how these paradigms are complemented in the context of health care in Wales
A rapid review of the literature contrasting cost-effectiveness analysis and value-based healthcare approaches to assess how these paradigms are complemented in the context of health care in Wales Open
Methods of economic evaluation, such as Cost-Effectiveness Analysis (CEA), and approaches to Value Based Health Care (VBHC) are both being used in Wales, UK. They have similar goals in terms of maximising benefit as described by costs and …
View article: Medication adherence during the run‐in phase of clinical trials: A systematic review of methodological and reporting rigour
Medication adherence during the run‐in phase of clinical trials: A systematic review of methodological and reporting rigour Open
Aims Trial run‐in phases are sometimes used to select adherent participants as a strategy to enrich trials, but the methods employed lack clear regulatory guidance and there are concerns about the transparency of reporting. This review aim…
View article: Exploring patient and professional perspectives on implementing pharmacogenomic testing in the UK primary care setting and estimating the cost-effectiveness: a mixed-methods study protocol
Exploring patient and professional perspectives on implementing pharmacogenomic testing in the UK primary care setting and estimating the cost-effectiveness: a mixed-methods study protocol Open
Introduction Pharmacogenomic testing could potentially reduce the number of adverse drug reactions and improve treatment outcomes through tailoring treatment to an individual’s genetic makeup. Despite its benefits and the ambitions to inte…
View article: What is the effectiveness and cost-effectiveness of at-home time-limited reablement service for improving an individual’s independence and health outcomes and reducing the need for long term care: a rapid review
What is the effectiveness and cost-effectiveness of at-home time-limited reablement service for improving an individual’s independence and health outcomes and reducing the need for long term care: a rapid review Open
Local authorities and health services in Wales are tasked with reablement, to help individuals who are at risk of frailty maintain and improve independence. However, social care resource constraints, mean that the balance of funds and work…
View article: Carer administration of as-needed subcutaneous medication for breakthrough symptoms in people dying at home: the CARiAD feasibility RCT
Carer administration of as-needed subcutaneous medication for breakthrough symptoms in people dying at home: the CARiAD feasibility RCT Open
Objectives To determine if carer administration of as-needed subcutaneous medication for common breakthrough symptoms in people dying at home is feasible and acceptable in the UK, and if it would be feasible to test this intervention in a …
View article: Clinical and Cost-Effectiveness of an Online Parent-Directed Behavioural Sleep Intervention in addition to Standard Care for Sleep Problems in Children with Epilepsy in the UK: the CASTLE Sleep-E Multicentre, Randomised Controlled Trial
Clinical and Cost-Effectiveness of an Online Parent-Directed Behavioural Sleep Intervention in addition to Standard Care for Sleep Problems in Children with Epilepsy in the UK: the CASTLE Sleep-E Multicentre, Randomised Controlled Trial Open
Objectives Sleep problems are common in children with epilepsy. We aimed to evaluate the clinical effectiveness and incremental cost-effectiveness of an online resource for parents of children with epilepsy (CASTLE Online Sleep Interventio…
View article: Carboprost versus Oxytocin as the first-line treatment of primary postpartum haemorrhage (COPE): protocol for a phase IV, double-blind, double-dummy, randomised controlled trial and economic analysis
Carboprost versus Oxytocin as the first-line treatment of primary postpartum haemorrhage (COPE): protocol for a phase IV, double-blind, double-dummy, randomised controlled trial and economic analysis Open
Introduction Excessive bleeding after childbirth (postpartum haemorrhage, PPH) affects 5% of births and causes 75 000 maternal deaths worldwide annually. It is the leading cause of direct maternal deaths globally and continues to be a majo…
View article: Influencing Factors for the Acceptability of Accessing HIV Pre‐exposure Prophylaxis via Community Pharmacies in Wales
Influencing Factors for the Acceptability of Accessing HIV Pre‐exposure Prophylaxis via Community Pharmacies in Wales Open
Introduction HIV prevention methods, such as pre‐exposure prophylaxis (PrEP), have been a significant contributing factor to a global decline in HIV transmission. PrEP has been available through the NHS in Wales since 2017. However, access…
View article: Improving medication adherence in the community: a purposive umbrella review of effective patient-directed interventions that are readily implementable in the United Kingdom National Health Service
Improving medication adherence in the community: a purposive umbrella review of effective patient-directed interventions that are readily implementable in the United Kingdom National Health Service Open
View article: Risk of bias tools for medication adherence research: RoBIAS and RoBOAS
Risk of bias tools for medication adherence research: RoBIAS and RoBOAS Open
Aims An unbiased means of documenting medication‐taking is important to ensure quality evidence about adherence research and to accurately identify individuals at risk of suboptimal adherence for the development of targeted and effective i…
View article: Relative Forgiveness of Different Allopurinol Implementation Patterns in People with Gout and their Impact on Clinical Outcomes: a Simulation Study
Relative Forgiveness of Different Allopurinol Implementation Patterns in People with Gout and their Impact on Clinical Outcomes: a Simulation Study Open
Our study provides evidence that missing one or two doses of allopurinol, even repeatedly over a year, does not significantly impact serum urate target achievement or clinical outcomes. However, people who take repeated drug holidays of mo…
View article: OP41 Pharmaceutical Technologies Conditionally Approved By The National Institute For Health And Care Excellence: A Critical Analysis
OP41 Pharmaceutical Technologies Conditionally Approved By The National Institute For Health And Care Excellence: A Critical Analysis Open
Introduction There are concerns with the National Institute for Health and Care Excellence (NICE) conditional approval process with respect to the quality and reliability of the methods of evidence generation, analysis, and reporting; and …
View article: PD06 Automated Systems For Hospital Inpatient Safety: A Cost-Utility Analysis
PD06 Automated Systems For Hospital Inpatient Safety: A Cost-Utility Analysis Open
Introduction Deployment of an electronic automated advisory vital signs monitoring and notification system to signal clinical deterioration is associated with significant improvement in clinical outcomes. This study aimed to estimate the i…
View article: PD222 Balancing Patient Preferences With Feasible Healthcare Delivery: Using Discrete Choice Experiments Alongside Knowledge Exchange To Inform Care Pathways
PD222 Balancing Patient Preferences With Feasible Healthcare Delivery: Using Discrete Choice Experiments Alongside Knowledge Exchange To Inform Care Pathways Open
Introduction Emergency department (ED) visits for epilepsy are common, costly, and often clinically unnecessary. Configuration of care pathways (CPs) that could divert people away from ED offer an alternative. The aim was to measure patien…
View article: Association of child weight and adverse outcomes following antibiotic prescriptions in children: a national data study in Wales, UK
Association of child weight and adverse outcomes following antibiotic prescriptions in children: a national data study in Wales, UK Open
Objective To examine if the weight of a child determines adverse events following oral antibiotics prescription. Design Population respective cohort using linked general practice (GP), hospital data and linkage with the Welsh Demographic S…
View article: Patient preferences for using remote care technology in heart failure: A discrete choice experiment (Preprint)
Patient preferences for using remote care technology in heart failure: A discrete choice experiment (Preprint) Open
The results show that, in this cohort of patients with heart failure, the most preferred factor, clinical care, has enough value to be traded for approximately any two other factors. It also shows that the factor of communication is the le…
View article: Patient preferences for using remote care technology in heart failure: A discrete choice experiment (Preprint)
Patient preferences for using remote care technology in heart failure: A discrete choice experiment (Preprint) Open
BACKGROUND Remote care technology can bridge the gap between healthcare and community settings, provide more continuous and frequent monitoring of the disease process, and aid in self-care. A common barrier however is the lack of patient …
View article: Evidence Following Conditional NICE Technology Appraisal Recommendations: A Critical Analysis of Methods, Quality and Risk of Bias
Evidence Following Conditional NICE Technology Appraisal Recommendations: A Critical Analysis of Methods, Quality and Risk of Bias Open
View article: Developing feasible person-centred care alternatives to emergency department responses for adults with epilepsy: a discrete choice analysis mixed-methods study
Developing feasible person-centred care alternatives to emergency department responses for adults with epilepsy: a discrete choice analysis mixed-methods study Open
Background Calls have been made for paramedics to have some form of care pathway that they could use to safely divert adults with epilepsy away from emergency departments and instigate ambulatory care improvements. Different configurations…
View article: A proposal for using benefit-risk methods to improve the prominence of adverse event results when reporting trials
A proposal for using benefit-risk methods to improve the prominence of adverse event results when reporting trials Open
View article: The experiences and perspectives of people with gout on urate self‐monitoring
The experiences and perspectives of people with gout on urate self‐monitoring Open
Introduction Gout management remains suboptimal despite safe and effective urate‐lowering therapy. Self‐monitoring of urate may improve gout management, however, the acceptability of urate self‐monitoring by people with gout is unknown. Th…
View article: A model-based cost-utility analysis of an automated notification system for deteriorating patients on general wards
A model-based cost-utility analysis of an automated notification system for deteriorating patients on general wards Open
Background Delayed response to clinical deterioration of hospital inpatients is common. Deployment of an electronic automated advisory vital signs monitoring and notification system to signal clinical deterioration is associated with signi…
View article: Service users' preferences and feasibility – which alternative care pathway for adult ambulance users achieves the optimal balance? Workshops for the COLLABORATE project
Service users' preferences and feasibility – which alternative care pathway for adult ambulance users achieves the optimal balance? Workshops for the COLLABORATE project Open
Stakeholders are of the view that the CP configuration favoured by service users could be NHS feasible. It should be developed and evaluated.
View article: Developing an alternative care pathway for emergency ambulance responses for adults with epilepsy: A Discrete Choice Experiment to understand which configuration service users prefer. Part of the COLLABORATE project
Developing an alternative care pathway for emergency ambulance responses for adults with epilepsy: A Discrete Choice Experiment to understand which configuration service users prefer. Part of the COLLABORATE project Open
Preferences differ to current practice but have minimal variation by seizure type or stakeholder. Further work on feasibility of these pathways in England, and potentially beyond, is required.
View article: <scp>Patient‐Led</scp> Urate <scp>Self‐Monitoring</scp> to Improve Clinical Outcomes in People With Gout: A Feasibility Study
<span>Patient‐Led</span> Urate <span>Self‐Monitoring</span> to Improve Clinical Outcomes in People With Gout: A Feasibility Study Open
Objective Self‐monitored point‐of‐care urate‐measuring devices are an underexplored strategy to improve adherence to urate‐lowering therapy and clinical outcomes in gout. This study observed patient‐led urate self‐monitoring practice and a…
View article: The costs and cost-effectiveness of different service models of palliative care, focusing on end of life care: A rapid review
The costs and cost-effectiveness of different service models of palliative care, focusing on end of life care: A rapid review Open
Some people receive palliative or end of life care at home, others in hospitals or hospices, or a combination of home and hospice/home and hospital models. This rapid review aims to determine the costs and cost-effectiveness of different s…
View article: Supporting people with type 2 diabetes in effective use of their medicine through mobile health technology integrated with clinical care (SuMMiT-D pilot): results of a feasibility randomised trial
Supporting people with type 2 diabetes in effective use of their medicine through mobile health technology integrated with clinical care (SuMMiT-D pilot): results of a feasibility randomised trial Open
View article: Exploring students’ and examiners’ perceptions of the sequential OSCE: A qualitative study
Exploring students’ and examiners’ perceptions of the sequential OSCE: A qualitative study Open
View article: Superiority and cost-effectiveness of monthly extended-release buprenorphine versus daily standard of care medication: a pragmatic, parallel-group, open-label, multicentre, randomised, controlled, phase 3 trial
Superiority and cost-effectiveness of monthly extended-release buprenorphine versus daily standard of care medication: a pragmatic, parallel-group, open-label, multicentre, randomised, controlled, phase 3 trial Open
View article: Best step-up treatments for children with uncontrolled asthma: a systematic review and network meta-analysis of individual participant data
Best step-up treatments for children with uncontrolled asthma: a systematic review and network meta-analysis of individual participant data Open
Background There is uncertainty about the best treatment option for children/adolescents with uncontrolled asthma despite inhaled corticosteroids (ICS) and international guidelines make different recommendations. We evaluated the pharmacol…