Brief description of media:

Doha: The Minister of Public Health, H E Dr. Hanan Mohammed Al Kuwari, has urged the public to get vaccinated, particularly those who are 60 years of age or older and people with chronic health conditions to reduce the risk of chronic COVID-19 syndrome.

Brief description of media:

“We need to prioritise the elderly, we need to prioritise those with comorbidities because if we don’t protect them first, then the hospitals will continue to see the worst of Covid-19, which is deaths and severe disease,” Dr Sim

Brief description of media:

Imagine being told you have been diagnosed with a life-altering illness and as a result, will need to deliver your baby prematurely, or that your son or daughter was involved in a car crash and has suffered severe head trauma, or your significant other needs open heart surgery after a positive stress test. There is no doubt you and your family will experience feelings of great anxiety, fear, and sadness. Each of these experiences may lead to an intensive care unit (ICU) admission for your loved one. An ICU stay will further exacerbate these overwhelming emotions and leave you emotionally and mentally changed.
According to Davidson, Jones, and Bienvenu (2012), one-third of parents with a child in the ICU have clinically significant symptoms of acute stress disorder. Additionally, 40% of relatives with loved ones who are critically ill suffer from anxiety. Depression, anxiety, and post-traumatic stress disorder (PTSD) are found to be at the highest levels in families of patients in the ICU (Jones, Backman, & Griffiths, 2012).

Brief description of media:

Employers wishing to minimise the impact of Long Covid on both their employees and their organisation, should ensure that their health and wellbeing programmes include holistic and personalised support for staff for as long as they need it, according to RedArc’s team of nurses.
Long Covid, a condition currently affecting approximately 60,000 people in the UK – which will inevitably continue to rise - and characterised by a variety of physiological and psychological issues, including fatigue, breathlessness, cognitive blunting (‘brain fog’) and pain, requires practical, medical and emotional support, similar to that already offered by employers for conditions such as cancer, ME and diabetes.
Christine Husbands, managing director for RedArc, said: “This is clearly an emerging situation and one which is likely to be challenging for employers, in terms of providing support for those with this new relatively unknown condition and its long-term implications. Offering practical help and emotional support for those diagnosed with the condition will help ensure that staff receive the most appropriate course of treatment, helping to steer them back on the path to recovery.”

Brief description of media:

Palliative care is an approach that improves quality of life for patients and their families facing problems associated with a life-threatening illness. Care planning is particularly important in CF, where predicting a time of death is extremely difficult. The patient and family should receive realistic information about health status and further options of care. Particularly important is the explanation that treatment does not stop during the terminal phase of the disease, instead the primary aim is to alleviate unpleasant symptoms. More invasive end of life care is becoming the norm in patients awaiting lung transplantation. Terminal care should be organised in the place chosen by the patient and their family.Ideally terminal care should not end when the patient dies, instead psychological and spiritual support should continue to bereaved families.

Brief description of media:

Health systems, granting agencies, and professional societies are increasingly involving patients and their family members in the delivery of health care and the improvement of health sciences. This is a laudable advance toward fully patient-centered medicine. However, patient engagement is not a simple matter, either practically or ethically. The complexities include (1) the physical limitations that
patients and their family members may have, from traveling to meetings to special dietary needs; (2) the emotional sensitivities patients and their families might experience—from distress at discussions of disease prognosis, outcomes, and therapies to being inexperienced at public speaking; and (3) the fact that advocacy efforts by patients and family members, which may be encouraged at the national level, may threaten individual professionals providing care to individual patients and may result in risk to patients. In this article, a patient-physician and patient-bioethicist set out the obstacles, including ones that they have encountered in their own advocacy efforts. The aim is to survey the practical and ethical landscape so that solutions to various problems may be identified and solved as we move forward in our efforts to involve patients and their families in research, policy, and quality improvement in critical care medicine.

Brief description of media:

The guideline covers diagnosing, treating and managing epilepsy and seizures in children, young people and adults in primary and secondary care. It offers best practice advice on managing epilepsy to improve health outcomes so that people with epilepsy can fully participate in daily life.

Brief description of media:

Following the new ESPEN Standard Operating Procedures, the previous guidelines to provide best medical nutritional therapy to critically ill patients have been updated. These guidelines define who are the patients at risk, how to assess nutritional status of an ICU patient, how to define the amount of energy to provide, the route to choose and how to adapt according to various clinical conditions. When to start and how to progress in the administration of adequate provision of nutrients is also described. The best determination of amount and nature of carbohydrates, fat and protein are suggested. Special attention is given to glutamine and omega-3 fatty acids. Particular conditions frequently observed in intensive care such as patients with dysphagia, frail patients, multiple trauma patients, abdominal surgery, sepsis, and obesity are discussed to guide the practitioner toward the best evidence based therapy. Monitoring of this nutritional therapy is discussed in a separate document.

Brief description of media:

Demand for intensive care unit (ICU) services is increasing [1], and at a rate that is higher than the average for all health care services [2]. Increase in treatment and monitoring technology, patients' expectations, and ageing population all contribute to this increased demand for intensive care services [1]. Indeed, intensive care is increasingly being provided to older and sicker patients, whom in the past were not treated in intensive care [3]. Intensive care services accounted for 10% of the US$2.1 trillion total health expenditures on health care in the United States in 2006 [4] and has been estimated to cost more than £700 million in the United Kingdom in 1999 [5]. The cost of intensive care services coupled with increasing demand provides the rationale for improved modelling of outcomes of critically ill patients.

Brief description of media:

Researchers at the University of Tartu have analyzed the data from the first eight months of 2020 on nearly 32,000 people, including those who had been tested positive for coronavirus during that period and those who had not. The initial results of the analysis showed that a coronavirus patient was mostly likely hospitalized due to pneumonia or acute bronchitis. Those who did not have COVID-19 went to the hospital mostly to give birth or for a medical repeat procedure.

Brief description of media:

Introduction: Post-intensive care syndrome (PICS) is associated with an increased risk of mortality. Critical illness recovery clinics have been recommended by the Faculty of Intensive Care Medicine (FICM) as an approach to manage the complexity of PICS. The COVID-19 pandemic has provided many healthcare challenges, not least how to support those who have survived critical illness related to the virus. Recent guidance from the FICM also recommends pharmacist involvement in rehabilitation and recovery clinics for patients discharged from hospital following COVID-19 critical illness. This evaluation was undertaken to determine the impact of the inclusion of a clinical pharmacist in this setting.
Method: All patients discharged following a COVID-19-related intensive care unit (ICU) admission in the Belfast Health and Social Care Trust, Northern Ireland, from 26 March 2020 to 15 May 2020 were offered enrolment in a rehabilitation and recovery programme. This involved an initial 6-week remote review, followed by a multidisciplinary face-to-face assessment at 12 weeks post-discharge. Each healthcare professional at the clinic contributed to an overall treatment plan, which was communicated to the patient’s GP. The clinical pharmacist carried out a structured medicines optimisation review and identified medication-related interventions, which were recorded and graded according to the Eadon criteria. Cost savings resulting from these interventions were estimated using the model described by the University of Sheffield School of Health and Related Research (ScHARR), a type of economic modelling that uses literature-based values of the costs of medication errors and compares this with the benefits of different medication-related interventions.
Results: A total of 42 patients were discharged during this period following COVID-19 ICU admission, with 93% (n=39) agreeing to enrolment in the follow-up clinic. Medication-related interventions were identified in 82% (n=32) of the 39 patients. The most common medication-related intervention was patient education, accounting for 38% (n=24) of all interventions.
Discussion: Analgesics were the class of medications most associated with requiring an intervention and 65% of interventions were graded as significant, resulting in improved care standards (i.e. Eadon ≥grade 4). Clinical pharmacist interventions yielded potential savings of £4.20–£8.59 per £1 invested, based on total potential savings in the range of £6,204–£12,699, with a total pharmacist investment of £1,478.
Conclusion: Clinical pharmacists have a role in medicines optimisation for patients recovering from COVID-19-related critical illness. Most interventions by a clinical pharmacist in a post-ICU recovery clinic were related to symptom management and patient education. Their role in this setting can help rationalise medicines and improve patients’ understanding, resulting in potential healthcare-related cost-savings and safer patient-centred care.
Keywords: Clinical pharmacy, COVID-19, critical care, integrated care, intensive care, interventions, medicines optimisation, outpatient clinic.

Brief description of media:

NHS patients who are critically ill are usually cared for in critical care units. These units provide close nursing and medical attention and combine both intensive (highest level) and high dependency (intermediate level) care. Over the past fifty years, a wealth of experience from treating critically ill patients in the NHS has been accumulated. It is important that all patients requiring critical care benefit from this experience and get it as soon as it is required this involves those working on general wards recognising when a patient is deteriorating.Over the past three years, critical care outreach teams, usually led by an experienced critical care nurse, have been established: to help staff identify deteriorating patients; to provide advice or treatment; to ensure swift admission into the critical care unit; and to share skills. Monitoring systems have been created, such that, when the patients blood pressure, heart rate, breathing rate, temperature or conscious level reaches a certain threshold, the outreach team is called. Outreach teams also monitor the recovery of patients after discharge to the ward from the critical care unit. By increasing communication between critical care unit and ward staff, it is hoped that critical care skills will be shared and that both sides and the patient will benefit.