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Article ; Online: Advanced heart failure: parenteral diuretics for breathlessness and peripheral oedema - systematic review.

Hughes, Alex / Oluyase, Adejoke O / Below, Natalie / Bajwah, Sabrina

BMJ supportive & palliative care

2024 Volume 14, Issue 1, Page(s) 1–13

Abstract: Background: Advanced heart failure patients suffer with breathlessness and peripheral oedema, which are frequently treated with parenteral diuretics despite limited evidence.: Aim: To analyse the effectiveness of parenteral diuretics on ... ...

Abstract	Background: Advanced heart failure patients suffer with breathlessness and peripheral oedema, which are frequently treated with parenteral diuretics despite limited evidence. Aim: To analyse the effectiveness of parenteral diuretics on breathlessness and peripheral oedema in advanced heart failure patients. Methods: We searched Embase, MEDLINE(R), PsycINFO, CINAHL and CENTRAL from their respective inceptions to 2021, and performed handsearching, citation searching and grey literature search; limited to English publications. Selection criteria included parenteral (intravenous/subcutaneous) diuretic administration in advanced heart failure patients (New York Heart Association class III-IV). Two authors independently assessed articles for inclusion; one author extracted data. Data were synthesised through narrative synthesis or meta-analysed as appropriate. Results: 4646 records were screened; 6 trials (384 participants) were included. All were randomised controlled trials (RCTs) comparing intravenous continuous furosemide infusion (CFI) versus intravenous bolus furosemide infusion (BFI). Improvement in breathlessness and peripheral oedema (two studies, n=161, OR 2.80, 95% CI 1.45 to 5.40; I Conclusions: CFI appears to improve congestion in advanced heart failure patients in the short term. Available data came from small trials. Larger, prospective RCTs are recommended to address the evidence gap.
MeSH term(s)	Humans ; Diuretics/therapeutic use ; Furosemide/therapeutic use ; Heart Failure/complications ; Heart Failure/drug therapy ; Dyspnea/drug therapy ; Dyspnea/etiology ; Edema/drug therapy
Chemical Substances	Diuretics ; Furosemide (7LXU5N7ZO5)
Language	English
Publishing date	2024-02-21
Publishing country	England
Document type	Journal Article
ISSN	2045-4368
ISSN (online)	2045-4368
DOI	10.1136/spcare-2022-003863
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Intersectional effects of gender and ethnicity? A quantitative analysis of bonus pay gap data for Shelford Hospital consultants.

Bajwah, Sabrina / Oluyase, Adejoke

BMJ leader

2021 Volume 6, Issue 2, Page(s) 140–142

Abstract: Background: Male hospital consultants earn 13% more than their female counterparts. The intersectional effects of ethnicity and gender are not known.: Objective: To describe and analyse the mean bonus pay gap in terms of gender and ethnicity for ... ...

Abstract	Background: Male hospital consultants earn 13% more than their female counterparts. The intersectional effects of ethnicity and gender are not known. Objective: To describe and analyse the mean bonus pay gap in terms of gender and ethnicity for consultants across the Shelford Group. Design: Cross-sectional study. Setting: Hospitals in the Shelford Group. Participants: Shelford Group hospitals. Main outcome measures: Mean bonus pay gap for male vs female and White vs Black, Asian, Minority Ethnic (BAME) consultants. Results: Seven of the 10 Shelford Group hospitals provided data for financial year 2018/2019. The average mean bonus gender pay gap was in favour of male consultants (30%; range 12%-48%), and also favoured White consultants compared with BAME consultants (17%; range 7%-31%). The average mean bonus pay gap between White male and BAME male consultants was 20% (range 7%-34%) in favour of White male consultants, while that for White male and BAME female consultants was 46% (range 26%-60%) in favour of White male consultants. Conclusions: Our data show for the first time that there may be an intersectional effect of gender and ethnicity associated with mean bonus pay for consultants. Action is needed to address this imbalance.
MeSH term(s)	Consultants ; Cross-Sectional Studies ; Ethnicity ; Female ; Hospitals ; Humans ; Male ; Minority Groups
Language	English
Publishing date	2021-12-08
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	2398-631X
ISSN (online)	2398-631X
DOI	10.1136/leader-2021-000507
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Article ; Online: Researching minoritised communities in palliative care: An agenda for change.

Koffman, Jonathan / Bajwah, Sabrina / Davies, Joanna M / Hussain, Jamilla Akhter

Palliative medicine

2022 Volume 37, Issue 4, Page(s) 530–542

Abstract: Background: Palliative care access, experiences and outcomes of care disadvantage those from ethnically diverse, Indigenous, First nation and First people communities. Research into this field of inquiry raises unique theoretical, methodological, and ... ...

Abstract	Background: Palliative care access, experiences and outcomes of care disadvantage those from ethnically diverse, Indigenous, First nation and First people communities. Research into this field of inquiry raises unique theoretical, methodological, and moral issues. Without the critical reflection of methods of study and reporting of findings, researchers may inadvertently compromise their contribution to reducing injustices and perpetuating racism. Aim: To examine key evidence of the place of minoritised communities in palliative care research to devise recommendations that improve the precision and rigour of research and reporting of findings. Methods: Narrative review of articles identified from PubMed, CINAHL and Google Scholar for 10 years augmented with supplementary searches. Results: We identified and appraised 109 relevant articles. Four main themes were identified (i) Lack of precision when working with a difference; (ii) 'black box epidemiology' and its presence in palliative care research; (iii) the inclusion of minoritised communities in palliative care research; and (iv) the potential to cause harm. All stymie opportunities to 'level up' health experiences and outcomes across the palliative care spectrum. Conclusions: Based on the findings of this review palliative care research must reflect on and justify the classification of minoritised communities, explore and understand intersectionality, optimise data quality, decolonise research teams and methods, and focus on reducing inequities to level up end-of-life care experiences and outcomes. Palliative care research must be forthright in explicitly indentifying instances of structural and systemic racism in palliative care research and engaging in non-judgemental debate on changes required.
MeSH term(s)	Humans ; Palliative Care/methods ; Hospice Care ; Terminal Care ; Hospice and Palliative Care Nursing ; Population Groups
Language	English
Publishing date	2022-10-21
Publishing country	England
Document type	Review ; Journal Article
ZDB-ID	639247-7
ISSN	1477-030X ; 0269-2163
ISSN (online)	1477-030X
ISSN	0269-2163
DOI	10.1177/02692163221132091
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Article ; Online: Regular, low-dose, sustained-release morphine for persisting breathlessness in interstitial lung disease: a randomised, double-blind, placebo-controlled, crossover trial.

Ferreira, Diana H / Ekström, Magnus / Bajwah, Sabrina / Fazekas, Belinda / Currow, David C

The European respiratory journal

2023 Volume 62, Issue 3

MeSH term(s)	Humans ; Morphine/therapeutic use ; Delayed-Action Preparations/therapeutic use ; Cross-Over Studies ; Dyspnea/drug therapy ; Dyspnea/etiology ; Double-Blind Method ; Lung Diseases, Interstitial/complications ; Lung Diseases, Interstitial/drug therapy ; Treatment Outcome
Chemical Substances	Morphine (76I7G6D29C) ; Delayed-Action Preparations
Language	English
Publishing date	2023-09-28
Publishing country	England
Document type	Randomized Controlled Trial ; Letter ; Research Support, Non-U.S. Gov't
ZDB-ID	639359-7
ISSN	1399-3003 ; 0903-1936
ISSN (online)	1399-3003
ISSN	0903-1936
DOI	10.1183/13993003.00702-2023
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Zs.A 2322: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Invited Editorials.

Hussain, Jamilla Akhter / Koffman, Jonathan / Bajwah, Sabrina

Palliative medicine

2021 Volume 35, Issue 5, Page(s) 810–813

Language	English
Publishing date	2021-04-20
Publishing country	England
Document type	Editorial
ZDB-ID	639247-7
ISSN	1477-030X ; 0269-2163
ISSN (online)	1477-030X
ISSN	0269-2163
DOI	10.1177/02692163211012887
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Article ; Online: Palliative care and interstitial lung disease.

Bajwah, Sabrina / Yorke, Janelle

Current opinion in supportive and palliative care

2017 Volume 11, Issue 3, Page(s) 141–146

Abstract: Purpose of review: The palliative care needs of people with interstitial lung disease (ILD) have recently been highlighted by the National Institute for Health and Care Excellence. All people with progressive ILD should receive best supportive care to ... ...

Abstract	Purpose of review: The palliative care needs of people with interstitial lung disease (ILD) have recently been highlighted by the National Institute for Health and Care Excellence. All people with progressive ILD should receive best supportive care to improve symptom control and quality of life and where possible this should be evidence based. Recent findings: Deaths from ILD are increasing and deaths in hospital are more common compared to home. People with ILD experience a wide range of symptoms including breathlessness and cough. People living with ILD often suffer unmet physical and psychological needs throughout the disease journey. Few appropriately validated outcome measures exist for ILD which has hampered research on the longitudinal experience of symptoms and quality of life and the evaluation of interventions. Recent recommendations from the National Institute of Clinical Excellence promote the use of a new palliative care needs assessment tool. Use of a tool in busy respiratory clinics may help to highlight those requiring specialist input. Summary: Further research into the role of opioids, oxygen and neuromodulatory agents in symptom management are needed. In addition, exploration of breathlessness and case conference interventions in transitioning patients from the hospital to community settings is a priority. Further work is needed to identify a core set of validated ILD-specific patient-reported outcome measures for the robust evaluation of interventions.
Language	English
Publishing date	2017-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	2633726-5
ISSN	1751-4266 ; 1751-4258
ISSN (online)	1751-4266
ISSN	1751-4258
DOI	10.1097/SPC.0000000000000285
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Zs.A 6946: Show issues

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Article: Management of phenytoin toxicity in palliative care.

Bajwah, Sabrina

Palliative medicine

2007 Volume 21, Issue 1, Page(s) 63

MeSH term(s)	Anticonvulsants/poisoning ; Bone Neoplasms/secondary ; Breast Neoplasms ; Female ; Humans ; Palliative Care ; Phenytoin/poisoning ; Seizures/drug therapy ; Terminal Care
Chemical Substances	Anticonvulsants ; Phenytoin (6158TKW0C5)
Language	English
Publishing date	2007-01
Publishing country	England
Document type	Case Reports ; Comment ; Letter
ZDB-ID	639247-7
ISSN	1477-030X ; 0269-2163
ISSN (online)	1477-030X
ISSN	0269-2163
DOI	10.1177/0269216306074088
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Zs.A 2285: Show issues

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Article ; Online: Primary care contacts, continuity, identification of palliative care needs, and hospital use: a population-based cohort study in people dying with dementia.

Leniz, Javiera / Gulliford, Martin / Higginson, Irene J / Bajwah, Sabrina / Yi, Deokhee / Gao, Wei / Sleeman, Katherine E

The British journal of general practice : the journal of the Royal College of General Practitioners

2022

Abstract: Background: Reducing hospital admissions among people dying with dementia is a policy priority.: Aim: To explore associations between primary care contacts, continuity of primary care, identification of palliative care needs, and unplanned hospital ... ...

Abstract	Background: Reducing hospital admissions among people dying with dementia is a policy priority. Aim: To explore associations between primary care contacts, continuity of primary care, identification of palliative care needs, and unplanned hospital admissions among people dying with dementia. Design and setting: This was a retrospective cohort study using the Clinical Practice Research Datalink linked with hospital records and Office for National Statistics data. Adults (>18 years) who died between 2009 and 2018 with a diagnosis of dementia were included in the study. Method: The association between GP contacts, Herfindahl-Hirschman Index continuity of care score, palliative care needs identification before the last 90 days of life, and multiple unplanned hospital admissions in the last 90 days was evaluated using random-effects Poisson regression. Results: In total, 33 714 decedents with dementia were identified: 64.1% ( Conclusion: Multiple hospital admissions among people dying with dementia are increasing. Higher continuity of care and identification of palliative care needs are associated with a lower risk of multiple hospital admissions in this population, and might help prevent these admissions at the end of life.
Language	English
Publishing date	2022-04-07
Publishing country	England
Document type	Journal Article
ZDB-ID	1043148-2
ISSN	1478-5242 ; 0035-8797 ; 0960-1643
ISSN (online)	1478-5242
ISSN	0035-8797 ; 0960-1643
DOI	10.3399/BJGP.2021.0715
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Zs.B 576: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MO 100: Show issues

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Article ; Online: Adaptation and multicentre validation of a patient-centred outcome scale for people severely ill with COVID (IPOS-COV).

Hocaoglu, Mevhibe B / Murtagh, Fliss E M / Walshe, Catherine / Chambers, Rachel L / Maddocks, Matthew / Sleeman, Katherine E / Oluyase, Adejoke O / Dunleavy, Lesley / Bradshaw, Andy / Bajwah, Sabrina / Fraser, Lorna K / Preston, Nancy / Higginson, Irene J

Health and quality of life outcomes

2023 Volume 21, Issue 1, Page(s) 29

Abstract: Background: Patient-centred measures to capture symptoms and concerns have rarely been reported in severe COVID. We adapted and tested the measurement properties of the proxy version of the Integrated Palliative care Outcome Scale-IPOS-COV for severe ... ...

Abstract	Background: Patient-centred measures to capture symptoms and concerns have rarely been reported in severe COVID. We adapted and tested the measurement properties of the proxy version of the Integrated Palliative care Outcome Scale-IPOS-COV for severe COVID using psychometric approach. Methods: We consulted experts and followed consensus-based standards for the selection of health status measurement instruments and United States Food and Drug Administration guidance for adaptation and analysis. Exploratory Factor Analysis and clinical perspective informed subscales. We tested the internal consistency reliability, calculated item total correlations, examined re-test reliability in stable patients, and also evaluated inter-rater reproducibility. We examined convergent and divergent validity of IPOS-COV with the Australia-modified Karnofsky Performance Scale and evaluated known-groups validity. Ability to detect change was examined. Results: In the adaptation phase, 6 new items were added, 7 items were removed from the original measure. The recall period was revised to be the last 12-24 h to capture fast deterioration in COVID. General format and response options of the original Integrated Palliative care Outcome Scale were preserved. Data from 572 patients with COVID from across England and Wales seen by palliative care services were included. Four subscales were supported by the 4-factor solution explaining 53.5% of total variance. Breathlessness-Agitation and Gastro-intestinal subscales demonstrated good reliability with high to moderate (a = 0.70 and a = 0.67) internal consistency, and item-total correlations (0.62-0.21). All except the Flu subscale discriminated well between patients with differing disease severity. Inter-rater reliability was fair with ICC of 0.40 (0.3-0.5, 95% CI, n = 324). Correlations between the subscales and AKPS as predicted were weak (r = 0.13-0.26) but significant (p < 0.01). Breathlessness-Agitation and Drowsiness-Delirium subscales demonstrated good divergent validity. Patients with low oxygen saturation had higher mean Breathlessness-Agitation scores (M = 5.3) than those with normal levels (M = 3.4), t = 6.4 (186), p < 0.001. Change in Drowsiness-Delirium subscale correctly classified patients who died. Conclusions: IPOS-COV is the first patient-centred measure adapted for severe COVID to support timely management. Future studies could further evaluate its responsiveness and clinical utility with clinimetric approaches.
MeSH term(s)	Humans ; Reproducibility of Results ; Quality of Life ; COVID-19 ; Palliative Care ; Psychometrics ; Delirium ; Surveys and Questionnaires
Language	English
Publishing date	2023-03-24
Publishing country	England
Document type	Multicenter Study ; Journal Article
ZDB-ID	2098765-1
ISSN	1477-7525 ; 1477-7525
ISSN (online)	1477-7525
ISSN	1477-7525
DOI	10.1186/s12955-023-02102-4
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Article ; Online: Incident opioid drug use and adverse respiratory outcomes among older adults with COPD.

Ekström, Magnus / Bajwah, Sabrina / Johnson, Miriam J

The European respiratory journal

2017 Volume 49, Issue 3

MeSH term(s)	Aged ; Analgesics, Opioid ; Humans ; Opioid-Related Disorders ; Pulmonary Disease, Chronic Obstructive
Chemical Substances	Analgesics, Opioid
Language	English
Publishing date	2017-03-08
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	639359-7
ISSN	1399-3003 ; 0903-1936
ISSN (online)	1399-3003
ISSN	0903-1936
DOI	10.1183/13993003.02311-2016
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