Background
Over half of all patients admitted to hospital are aged 65 or older, and many of them have several long-term health conditions. However, hospital services have not developed sufficiently to meet the needs of these patients who may be frail or have dementia or delirium (new or worsened confusion caused by illness).
What we did
- The Oxford Cognitive Comorbidity, Frailty and Ageing Research Database (ORCHARD) is used for audit and research to improve care for older and frail patients in hospital.
- To ensure that the studies using ORCHARD are relevant to the needs of older, frail patients and their carers, we set up the ORCHARD PPI group. This includes patients who have complex multimorbidity and who were previously inpatients, as well as carers for people with dementia, previous delirium or frailty, and a retired GP.
- Research areas of particular concern to patients and their families are discussed and suggestions for future studies are welcomed.
- An example was around obtaining information on longer term thinking/memory outcomes for patients who had delirium in hospital.
- ORCHARD is now being linked to in-hospital measures of illness severity obtained using patient observations including blood pressure, breathing rate, temperature, etc, as well as to data from disease cohorts including stroke, Parkinson’s disease and palliative care. We have also obtained ethics and patient data guardian approvals to link with Oxford Health NHS Foundation Trust data on dementia and mild cognitive impairment.
What difference did it make?
- ORCHARD has facilitated a number of other Oxford BRC projects that have worked with the PPI group.
- Involving patient and carer perspectives has been particularly important because this is an under-researched group of healthcare users.
- The ORCHARD PPI group helps to ensure that the research is relevant to patients and carers and addresses the research questions of most interest to service users.