3D study to improve care for patients
A nationwide £1.78 million study to improve the quality of life for patients suffering with multiple long-term health conditions began on 3 March.
Researchers from the Universities of Bristol, Glasgow, Manchester and Dundee are joining forces for the 3D Study – a project that will see a new management system trialled in selected GP practices. This three-year study is funded by the National Institute for Health Research Health Services and Delivery Research (NIHR HS&DR) Programme.
At present, patients with more than one health condition such as diabetes, heart disease or kidney disease usually attend separate appointments for regular reviews of each of their conditions, which can be inconvenient and inefficient for them. They see a lot of different doctors and nurses, and can feel that no-one takes overall responsibility for their care.
Under the new system, patients will be allocated a nurse and doctor to oversee their care and will be invited for a comprehensive health review every six months to discuss all their health issues. Patients’ concerns and priorities will be identified, their drugs will be reviewed and they’ll be checked for symptoms of depression.
The aim is to treat the patient in a consistent, joined-up manner in order to improve their overall quality of life.
Professor Chris Salisbury, from the Centre for Academic Primary Care at the University of Bristol, is leading the study. He said:
“We know that an increasing number of people have more than one long-term health condition. At the moment, each disease is managed in isolation, and this can lead to confusion and inconvenience for the patient.
“We hope this study will show that a more consistent and joined-up approach will benefit the patient greatly and ultimately improve their wellbeing.”
The new management system will first be tested in four practices before being refined and rolled out in Bristol, Manchester and Glasgow. A total of 32 GP practices and over 1,300 patients with three or more long-term conditions will take part in the main study.
To ensure a direct comparison, half of these practices will be randomly assigned to the new system while the other half will continue to work in the same way that they do now.
Participants from both groups will fill in questionnaires after six and 12 months about their wellbeing, illness and treatments, and their experience of their care. Researchers will also compare the cost of the old and new approaches, both to the NHS and to the patient.
The research is being carried out by a collaborative team including researchers from the University of Bristol, the University of Manchester, the University of Glasgow, the University of Dundee, the Royal College of General Practitioners, NHS England and NHS Bristol Clinical Commissioning Group (CCG).
About 3D health reviews
The 3D health review takes place every six months and is designed to cover all the patient’s health issues.
The patient will first see their named nurse, who will identify the patient’s concerns and priorities (Dimensions of health), and perform any routine checks required for each of the patient’s conditions.
The patient’s drugs will be reviewed by a pharmacist and the GP to check that they are being correctly prescribed (without dangerous interactions) and taken properly, and where possible, the doctor will try to simplify the patient’s prescriptions, e.g. by arranging for all of them to be taken once a day.
The named GP will check for and treat symptoms of depression, since it is known that people with several long-term health problems frequently get depressed.