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Adrian Cook

Publications and source records attributed to Adrian Cook.

5 recordsLinked to original sources
PubMed2005

Scientific evaluation of community-based Parkinson's disease nurse specialists on patient outcomes and health care costs.

OBJECTIVE: To determine the effects of community based nurses specialising in Parkinson's disease on health outcomes and healthcare costs. DESIGN: Two year randomised controlled trial in 438 general practices in nine randomly selected health authority areas of England. PARTICIPANTS: 1859 patients with Parkinson's disease identified by the participating general practices. MAIN OUTCOME MEASURES: Survival, stand-up test, dot in square test, bone fracture, global health question, PDQ-39, Euroqol, and healthcare costs. RESULTS: After two years 315 (17.3%) patients had died, although mortality did not differ between those who were attended by nurse specialists and those receiving standard care from their general practitioner (hazard ratio for nurse group v control group 0.91, 95% confidence interval 0.73 to 1.13). No significant differences were found between the two groups for the stand-up test (odds ratio 1.15, 0.93 to 1.42) and dot in square score (difference -0.7, -3.25 to 1.84). Scores on the global health question were significantly better in patients attended by nurse specialists than in controls (difference -0.23, -0.4 to -0.06), but no difference was observed in the results of the PDQ-39 or Euroqol questionnaires. Direct costs for patient health care increased by an average of pound2658 during the study, although not differentially between groups: the average increase was pound266 lower among patients attended by a nurse specialist (- pound981 to pound449). CONCLUSIONS: Nurse specialists in Parkinson's disease had little effect on the clinical condition of patients, but they did improve their patients' sense of wellbeing, with no increase in patients' healthcare costs.

Adult↗
PubMed2002

Effects of community based nurses specialising in Parkinson's disease on health outcome and costs: randomised controlled trial.

OBJECTIVE: To determine the effects of community based nurses specialising in Parkinson's disease on health outcomes and healthcare costs. DESIGN: Two year randomised controlled trial. SETTING: 438 general practices in nine randomly selected health authority areas of England. PARTICIPANTS: 1859 patients with Parkinson's disease identified by the participating general practices. MAIN OUTCOME MEASURES: Survival, stand-up test, dot in square test, bone fracture, global health question, PDQ-39, Euroqol, and healthcare costs. RESULTS: After two years 315 (17.3%) patients had died, although mortality did not differ between those who were attended by nurse specialists and those receiving standard care from their general practitioner (hazard ratio for nurse group v control group 0.91, 95% confidence interval 0.73 to 1.13). No significant differences were found between the two groups for the stand-up test (odds ratio 1.15, 0.93 to 1.42) and dot in square score (difference -0.7, -3.25 to 1.84). Scores on the global health question were significantly better in patients attended by nurse specialists than in controls (difference -0.23, -0.4 to -0.06), but no difference was observed in the results of the PDQ-39 or Euroqol questionnaires. Direct costs for patient health care increased by an average of 2658 pounds sterling during the study, although not differentially between groups: the average increase was 266 pounds sterling lower among patients attended by a nurse specialist (-981 pounds sterling to 449 pounds sterling ). CONCLUSIONS: Nurse specialists in Parkinson's disease had little effect on the clinical condition of patients, but they did improve their patients' sense of wellbeing, with no increase in patients' healthcare costs.

Adult↗
PubMed2002

A 5-star system for rating the quality of information based on DISCERN.

OBJECTIVE: To develop an explicit scheme for calculating a 5-star quality rating for consumer health information, and to test if there is good agreement be tween this and the final DISCERN quality question. DESIGN: A sample of 15 consumers and health professionals rated 26 health information leaflets covering a broad range of conditions and treatments using two new 5-star-rating schemes and the existing DISCERN final quality rating. Each scheme is based on the 15 DISCERN criteria, but the 5-star schemes provide more explicit methods for summarizing overall quality. The level of agreement between the three different rating systems was compared using Kappa scores with quadratic weights. Participants were also asked to complete a brief questionnaire that was designed to elicit their views on using a visual summary of the quality of health information. RESULTS: The level of agreement between each 5-star-rating system and the existing DISCERN quality rating question was high (kappa = 0.86, 95% CI 0.83-0.89 in both instances). Seventy-seven per cent of the sample preferred the second star-rating scheme, and 80% reported they would use such a scheme. CONCLUSION: Assigning a single quality score using an explicit scoring scheme (represented by stars) based on answers to the DISCERN questionnaire is a reliable and valid way of rating consumer health information.

Adult↗