Managing Complex Needs

Through this theme, we will implement a step change in the delivery of care for people with complex needs arising from long term conditions (LTCs). This will result in services that are more person-centred, cost effective and that will improve quality of life for patients and their ability to undertake gainful employment.

Initially, the theme will focus upon musculoskeletal and neurological conditions as exemplar LTCs that may run throughout life, and which are associated with the development of complex physical, psychological and social needs arising from diseases themselves or as a consequence of therapy. Both conditions have a serious negative impact on health and quality of life, need long-term therapy with a variety of medicines (each with many potential major side effects) and require care to be delivered between hospitals and the community.

Lessons learnt about the organisation and delivery of services for these conditions will directly inform changes needed in service delivery for other complex neurological and rheumatological LTCs that will be addressed.

If you would like to find out more about our work in the area, please contact the Theme Leader, Professor Tony Marson via a.g.marson@liv.ac.uk

Read more about the CAPS project or a summary via our CLAHRC NWC "Bite"

Read more about Transitional Care for Young Adults with Long Term Conditions

Publications

S Allen et al. Is Social Inequality Related to Different Patient Concerns in Routine Oral Cancer Follow-Up Clinics? Eur Arch Otorhinolaryngol 274 (1), 451-459. 2016 Jul 22
DOI: 10.1007/s00405-016-4208-x

Bonnett LJ, Powell GA, Tudur Smith C, et al Risk of a seizure recurrence after a breakthrough seizure and the implications for driving: further analysis of the standard versus new antiepileptic drugs (SANAD) randomised controlled trial BMJ Open 2017;7:e015868.
DOI: 10.1136/bmjopen-2017-015868

Grainger R, Pearson M, Dixon P, et al Referral patterns after a seizure admission in an English region: an opportunity for effective intervention? An observational study of routine hospital data BMJ Open 2016;6:e010100.
DOI: 10.1136/bmjopen-2015-010100

K. L. Hanna & F. J. Rowe (2017): Clinical versus Evidence-based Rehabilitation Options for Post-stroke Visual Impairment, Neuro-Ophthalmology,
http://dx.doi.org/10.1080/01658107.2017.1337159

Hanna, KL , Hepworth, LR and Rowe, F (2016) Screening methods for post-stroke visual impairment: a systematic review. Disabil Rehabil. 1 - 13. ISSN 1464-5165
http://dx.doi.org/10.1080/09638288.2016.1231846

B. Ziso, P.A. Dixon, A.G. Marson, Epilepsy management in older people: Lessons from National Audit of  Seizure management in Hospitals (NASH)Volume 50, August 2017, Pages 33-37 https://doi.org/10.1016/j.seizure.2017.05.002

Leanne Male, Adam Noble, Jessica Atkinson, Tony Marson; Measuring patient experience: a systematic review to evaluate psychometric properties of patient reported experience measures (PREMs) for emergency care service provision, International Journal for Quality in Health Care, Volume 29, Issue 3, 1 June 2017, Pages 314–326,
https://doi.org/10.1093/intqhc/mzx02

Maguire MJ, Jackson CF, Marson AG, Nevitt SJ. Treatments for the prevention of Sudden Unexpected Death in Epilepsy (SUDEP). Cochrane Database of Systematic Reviews 2016, Issue 7. Art. No.: CD011792.
DOI: 10.1002/14651858.CD011792.pub2

Leone MA, Giussani G, Nevitt SJ, Marson AG, Beghi E. Immediate antiepileptic drug treatment, versus placebo, deferred, or no treatment for first unprovoked seizure. Cochrane Database of Systematic Reviews 2016, Issue 5. Art. No.: CD007144.
DOI: 10.1002/14651858.CD007144.pub2

Nevitt SJ, Sudell M, Tudur Smith C, Marson AG. Topiramate versus carbamazepine monotherapy for epilepsy: an individual participant data review. Cochrane Database of Systematic Reviews 2016, Issue 12. Art. No.: CD012065.
DOI: 10.1002/14651858.CD012065.pub2

Weston J, Bromley R, Jackson CF, Adab N, Clayton-Smith J, Greenhalgh J, Hounsome J, McKay AJ, Tudur Smith C, Marson AG. Monotherapy treatment of epilepsy in pregnancy: congenital malformation outcomes in the child. Cochrane Database of Systematic Reviews 2016, Issue 11. Art. No.: CD010224.
DOI: 10.1002/14651858.CD010224.pub2

Nevitt  SJ, Marson  AG, Tudur Smith  C. Carbamazepine versus phenobarbitone monotherapy for epilepsy: an individual participant data review. Cochrane Database of Systematic Reviews 2018, Issue 10. Art. No.: CD001904.
DOI: 10.1002/14651858.CD001904.pub4.

Nevitt SJ, Marson AG, Weston J, Tudur Smith C. Phenytoin versus valproate monotherapy for partial onset seizures and generalised onset tonic-clonic seizures: an individual participant data review. Cochrane Database of Systematic Reviews 2016, Issue 4. Art. No.: CD001769.
DOI: 10.1002/14651858.CD001769.pub3

Ramaratnam S, Panebianco M, Marson AG. Lamotrigine add-on for drug-resistant partial epilepsy. Cochrane Database of Systematic Reviews 2016, Issue 6. Art. No.: CD001909.
DOI: 10.1002/14651858.CD001909.pub2

Powell G, Saunders M, Rigby A, Marson AG. Immediate-release versus controlled-release carbamazepine in the treatment of epilepsy. Cochrane Database of Systematic Reviews 2016, Issue 12. Art. No.: CD007124.
DOI: 10.1002/14651858.CD007124.pub5

Nevitt SJ, Tudur Smith C, Weston J, Marson AG. Lamotrigine versus carbamazepine monotherapy for epilepsy: an individual participant data review. Cochrane Database of Systematic Reviews 2016, Issue 11. Art. No.: CD001031.
DOI: 10.1002/14651858.CD001031.pub3

Atim-Oluk M, Jackson CF, Marson AG. Oxcarbazepine add-on for drug-resistant partial epilepsy (Protocol). Cochrane Database of Systematic Reviews 2016, Issue 11. Art. No.: CD012433.
DOI: 10.1002/14651858.CD012433

Nevitt SJ, Sudell M, Weston J, Tudur Smith C, Marson AG. Antiepileptic drug monotherapy for epilepsy: a network meta-analysis of individual participant data. Cochrane Database of Systematic Reviews 2017, Issue 6. Art. No.: CD011412.
DOI: 10.1002/14651858.CD011412.pub2.

Doherty, A.J., Jones, S.P., Chauhan, U. and Gibson, J.M., 2017. An integrative review of multicomponent weight management interventions for adults with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities.
DOI: 10.1111/jar.12367

Tucker A. et al. BMC Public Health (2017) 17:881 Quantifying the need for enhanced case management for TB patients as part of TB cohort audit in the North West of England: a descriptive study  DOI 10.1186/s12889-017-4892-5

Nevitt SJ, Sudell M, Weston J, Tudur Smith C, Marson AG. Antiepileptic drug monotherapy for epilepsy: a network meta-analysis of individual participant data. Cochrane Database of Systematic Reviews 2017, Issue 6. Art. No.: CD011412. DOI: 10.1002/14651858.CD011412.pub3  

Bonnett LJ, Powell GA, Tudur Smith C, Marson AG (2017) Breakthrough seizures—Further analysis of the Standard versus New Antiepileptic Drugs (SANAD) study. PLoS ONE 12(12): e0190035. https://doi.org/10.1371/journal.pone.0190035