Publications by authors named "Charlie Kenward"

Background: Outreach clinics were part of efforts to maximise uptake in COVID-19 vaccination.

Methods: We used controlled interrupted time series, matching on age, sex, deprivation and vaccination eligibility date, to determine the effect of outreach clinics on time to first COVID-19 vaccine, using a population-based electronic health record database of 914,478 people, from December 2020 to December 2021; people living within 1 mile of each outreach clinics were exposed.

Results: 50% of 288,473 exposed citizens were white British, and 71% were aged 0-49 years.

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Background: Survival from colorectal cancer depends on stage at detection. In England, bowel cancer mortality has historically been highest in deprived areas. During the initial stages of the COVID-19 pandemic, it was necessary to temporarily halt many screening programmes, which may have led to inequalities in uptake since screening restarted.

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Article Synopsis
  • The study aimed to evaluate the effectiveness of flash glucose monitoring (Abbott FreeStyle Libre) in improving glucose control and assessing healthcare costs for children with type 1 diabetes compared to traditional blood glucose monitoring.
  • Researchers conducted a controlled before and after study over approximately 12 months, analyzing health data from children using flash monitors (n=114) and a control group using self-monitoring (n=80).
  • Results indicated a slight improvement in HbA1c for flash monitoring users but not enough to be clinically significant, with increased costs mainly due to sensor expenses despite low rates of short-term complications among all participants.
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The devastating impact of COVID-19 on individuals and communities has accelerated the development of vaccines and the deployment of ambitious vaccination programmes to reduce the risks of infection, infection transmission and symptom severity. However, many people delay or refuse to get vaccinated against COVID-19, for many complex reasons. Vaccination programmes that are tailored to address individual and communities' COVID-19 concerns can improve vaccine uptake rates and help achieve the required herd-immunity threshold.

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Within the relatively early stages of the COVID-19 pandemic, there had been an awareness of the potential longer-term effects of infection (so called Long-COVID) but little was known of the ongoing demands such patients may place on healthcare services. To investigate whether COVID-19 illness is associated with increased post-acute healthcare utilisation. Using linked data from primary care, secondary care, mental health and community services, activity volumes were compared across the 3 months preceding and proceeding COVID-19 diagnoses for 7,791 individuals, with a distinction made between whether or not patients were hospitalised for treatment.

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Background: Long-term nitrofurantoin (NF) treatment can result in pulmonary and hepatic injury. Current guidelines do not outline the type or frequency of monitoring required for detection of these injuries.

Aim: To assess 1) awareness of NF complications among prescribers; 2) monitoring practice; and 3) to describe the pulmonary sequelae of NF-related complications.

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Background: During the COVID-19 pandemic, many intensive care units have been overwhelmed by unprecedented levels of demand. Notwithstanding ethical considerations, the prioritization of patients with better prognoses may support a more effective use of available capacity in maximizing aggregate outcomes. This has prompted various proposed triage criteria, although in none of these has an objective assessment been made in terms of impact on number of lives and life-years saved.

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Objectives: To use Population Health Management (PHM) methods to identify and characterise individuals at high-risk of severe COVID-19 for which shielding is required, for the purposes of managing ongoing health needs and mitigating potential shielding-induced harm.

Design: Individuals at 'high risk' of COVID-19 were identified using the published national 'Shielded Patient List' criteria. Individual-level information, including current chronic conditions, historical healthcare utilisation and demographic and socioeconomic status, was used for descriptive analyses of this group using PHM methods.

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'Sustainable value' considers patient and population outcomes against environmental, social and economic costs or impacts, providing a framework for driving sustainable improvements in healthcare for current and future generations. Measuring the impact of a quality improvement initiative on sustainable value is a new endeavour. For this to be both meaningful and useful, we must balance academic rigour (using a reproducible methodology to capture the most relevant and important impacts) against pragmatism (working within the constraints of available time and data).

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Acute tendon injuries to the hand are common. In the UK, there are approximately 12000 inpatient admissions annually for injuries to the tendons and muscles of the hand and wrist (Dew, 2009). Hand injuries involving the dominant hand can cause long-term disability if not appropriately managed.

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