The "unknown territory" of goal-setting: Negotiating a novel interactional activity within primary care doctor-patient consultations for patients with multiple chronic conditions.

Goal-setting is widely recommended for supporting patients with multiple long-term conditions. It involves a proactive approach to a clinical consultation, requiring doctors and patients to work together to identify patient's priorities, values and desired outcomes as a basis for setting goals for the patient to work towards. Importantly it comprises a set of activities that, for many doctors and patients, represents a distinct departure from a conventional consultation, including goal elicitation, goal-setting and action planning.

Can goal-setting for patients with multimorbidity improve outcomes in primary care? Cluster randomised feasibility trial.

Introduction: Goal-setting is recommended for patients with multimorbidity, but there is little evidence to support its use in general practice.

Objective: To assess the feasibility of goal-setting for patients with multimorbidity, before undertaking a definitive trial.

Design And Setting: Cluster-randomised controlled feasibility trial of goal-setting compared with control in six general practices.

Setting goals with patients living with multimorbidity: qualitative analysis of general practice consultations.

Background: Establishing patient goals is widely recommended as a way to deliver care that matters to the individual patient with multimorbidity, who may not be well served by single-disease guidelines. Though multimorbidity is now normal in general practice, little is known about how doctors and patients should set goals together.

Aim: To determine the key components of the goal-setting process in general practice.

Management of Patients With High Baseline Hip Fracture Risk by FRAX Reduces Hip Fractures-A Post Hoc Analysis of the SCOOP Study.

The Screening for Osteoporosis in Older Women for the Prevention of Fracture (SCOOP) study was a community-based screening intervention in women aged 70 to 85 years in the United Kingdom. In the screening arm, licensed osteoporosis treatments were recommended in women identified to be at high risk of hip fracture using the FRAX risk assessment tool (including bone mineral density measurement). In the control arm, standard care was provided.

The Cost-Effectiveness of Screening in the Community to Reduce Osteoporotic Fractures in Older Women in the UK: Economic Evaluation of the SCOOP Study.

The SCOOP study was a two-arm randomized controlled trial conducted in the UK in 12,483 eligible women aged 70 to 85 years. It compared a screening program using the FRAX® risk assessment tool in addition to bone mineral density (BMD) measures versus usual management. The SCOOP study found a reduction in the incidence of hip fractures in the screening arm, but there was no evidence of a reduction in the incidence of all osteoporosis-related fractures.

Screening in the community to reduce fractures in older women (SCOOP): a randomised controlled trial.

Background: Despite effective assessment methods and medications targeting osteoporosis and related fractures, screening for fracture risk is not currently advocated in the UK. We tested whether a community-based screening intervention could reduce fractures in older women.

Methods: We did a two-arm randomised controlled trial in women aged 70-85 years to compare a screening programme using the Fracture Risk Assessment Tool (FRAX) with usual management.

Relationship between the Mediterranean dietary pattern and musculoskeletal health in children, adolescents, and adults: systematic review and evidence map.

An understanding of the modifiable effects of diet on bone and skeletal muscle mass and strength over the life course will help inform strategies to reduce age-related fracture risk. The Mediterranean diet is rich in nutrients that may be important for optimal musculoskeletal health. The aim of this systematic review was to investigate the relationship between a Mediterranean diet and musculoskeletal outcomes (fracture, bone density, osteoporosis, sarcopenia) in any age group.

Enclosing a pen reduced time to response to questionnaire mailings.

Objectives: To assess the effectiveness of including a pen in postal questionnaires on response rate, necessity of reminders, time to response, and completeness of response to the primary outcome question (POQ).

Study Design And Setting: A two-arm randomized controlled trial (RCT) embedded within the screening of older women for prevention of fracture trial (SCOOP). Women, aged 70-75 years, were randomized to receive a pen with their questionnaire (n = 3,826) or to receive the questionnaire alone (n = 3,829).

Prior notification of trial participants by newsletter increased response rates: a randomized controlled trial.

Objective: To assess the effectiveness of prenotification using a newsletter to increase questionnaire response rates within a randomized controlled trial (RCT).

Study Design And Setting: An RCT set within the context of the Medical Research Council's SCOOP trial of screening older women for fracture risk.

Results: A subsample of SCOOP participants were randomized in equal numbers to receive a newsletter approximately 6 weeks before the follow-up questionnaire or no newsletter.

Acceptability of screening to prevent osteoporotic fractures: a qualitative study with older women.

Background: Osteoporotic fractures have a detrimental impact on health and quality of life, are more common in older women and are costly to treat. Screening to identify older women at high risk of fracture has the potential to offer substantial benefits. Understanding women's and professionals' experiences of screening will inform the implementation of screening in routine care.

Risk, significance and biomedicalisation of a new population: older women's experience of osteoporosis screening.

This article explores the illness experience associated with being diagnosed at risk of a long term chronic condition and discusses the implications of an emergent form of predictive medicine. We report on findings from a study involving 30 older women between the ages of 73-85 years of age recently screened for osteoporosis and informed that they are at a higher than average risk of breaking a bone in the next 10 years, but not formally diagnosed with osteoporosis. Data were gathered by the Adherence to Osteoporosis Medicine (ATOM) study using in-depth interviews with women in their own homes in Norfolk & Suffolk, UK in 2009-2010.

Effectiveness of visits from community pharmacists for patients with heart failure: HeartMed randomised controlled trial.

Objective: To test whether a drug review and symptom self management and lifestyle advice intervention by community pharmacists could reduce hospital admissions or mortality in heart failure patients.

Design: Randomised controlled trial.

Setting: Home based intervention in heart failure patients.

Home-based medication review in a high risk elderly population in primary care--the POLYMED randomised controlled trial.

Objective: To assess whether home-based medication review by a pharmacist for at-risk older patients in a primary care setting can reduce hospital admissions.

Design: Randomised controlled trial comparing home-based medication review with standard care.

Setting: Home-based medication review of 136 patients registered with one general practice.

Does home based medication review keep older people out of hospital? The HOMER randomised controlled trial.

Objective: To determine whether home based medication review by pharmacists affects hospital readmission rates among older people.

Design: Randomised controlled trial.

Setting: Home based medication review after discharge from acute or community hospitals in Norfolk and Suffolk.

Assessing quality of life in the elderly: a direct comparison of the EQ-5D and AQoL.

As more research is undertaken on the elderly, accurately assessing changes in their quality of life becomes increasingly important. Generic instruments are the most popular method to assess quality of life, and one of the most widely used is the EQ-5D. However, the range of dimensions, sensitivity of scales and completion rates have been raised as concerns when using this measure with the elderly.