Annette F Schwartz

East Surrey Hospital

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Nadina B. Lincoln

University of Nottingham

Sara E Carr

East Surrey Hospital

Roshan das Nair

University of Nottingham

T. M. McMillan

University of Glasgow

Joshua E. J. Buckman

University College London

Jenny M Astley

City, University of London

Anthea Dendy

Carly A. Anderson

Hospital for Sick Children

Andrea Sollom

Salford Royal NHS Foundation Trust

Kathryn Smale

University of Nottingham

Cooperative Institutions

University of Nottingham

University College London

King's College London

Queen's Medical Centre

Versus Arthritis

University of Manchester

University of Glasgow

Gartnavel General Hospital

National Heart Lung and Blood Institute

Eunice Kennedy Shriver National Institute of Child Health and Human Development

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The Neurorehabilitation Pathways Team (NRPT): a model of good practice?

International Journal of Therapy and Rehabilitation (2013)

Joshua E. J. Buckman Jenny M Astley Andrea Sollom Carly A. Anderson Anthea Dendy

Background: It is suggested that community based neurorehabilitation can provide benefits to both patients and health care providers in the shape of improved clinical outcomes and lower costs relative to inpatient care in tertiary centres. National guidelines within the UK have also called for care to be delivered ‘closer to home’. However, there is very little research on community based models of care for complex neurological patients and little evidence of how these models can deliver improved outcomes. Content: This article describes the model of care employed by Central Surrey Health and presents data from an audit of clinical records to support its effectiveness. Conclusions: This article has shown that the Neurorehabilitation Pathways Team (NRPT) achieve important clinical improvements for our patients whether treated as inpatients or in the community. As a group of experienced senior clinicians the NRPT accurately predict the likely clinical outcomes for each patient (90–97%) and give health care purchasers accurate predictions of the care pathway each patient will follow (84%). This provides a model of care which meets national guidelines and is potentially delivering both good clinical outcomes and cost savings for the health service compared to the former and more common model of care used in the UK.

Neurorehabilitation

Clinical Pathway

Best practice

10.12968/ijtr.2013.20.1.25

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Group memory rehabilitation for people with multiple sclerosis: a feasibility randomized controlled trial

Clinical Rehabilitation (2014)

Sara E Carr Roshan das Nair Annette F Schwartz Nadina B. Lincoln

Objective: To assess the feasibility and effectiveness of a group memory rehabilitation programme combining compensation and restitution strategies. Design: Randomized controlled trial. Setting: Community. Participants: People with multiple sclerosis who reported memory difficulties were recruited. Interventions: A group memory rehabilitation programme, comprising ten 1.5-hour sessions, was compared with a waiting list control. Main measures: The primary outcome was the Everyday Memory Questionnaire. Secondary outcomes included the General Health Questionnaire 28 and MS Impact Scale administered four and eight months after randomization. In addition, those in the intervention group gave feedback about the intervention. Results: Forty-eight participants were recruited. They were aged 34–72 years (mean 54.3, SD 11.0) and 33 (69%) were women. There were no significant differences between the two groups on the Everyday Memory Questionnaire or MS Impact Scale ( P > 0.05) at four or eight months after randomization. However, the intervention group reported significantly better mood than controls on the GHQ-28 at eight months ( P = 0.04). Participants showed minimal benefit from the memory rehabilitation programme on quantitative measures but the intervention was well received, as indicated by positive feedback at the end of the intervention. Conclusions: There was no significant effect of the intervention on memory but there was a significant effect on mood. The results suggest a larger scale study is justified.

General Health Questionnaire

10.1177/0269215513512336

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An evaluation of treatment integrity in a randomised controlled trial of memory rehabilitation for people with multiple sclerosis

Clinical Rehabilitation (2014)

Kathryn Smale Sara E Carr Annette F Schwartz Roshan das Nair Nadina B. Lincoln

Objective: To assess the treatment integrity of a memory rehabilitation programme for people with multiple sclerosis. Subjects: Data were drawn from the intervention group of a randomised controlled trial of memory rehabilitation. This comprised 24 participants with multiple sclerosis. Measures: Four core session components were identified from the treatment manual: recap, activities, take-home activity and other. One video-recording of each of ten intervention sessions was transcribed and amount of time spent on components recorded. Results: There were no significant differences between early and late stages of the programme in time spent on the core components (recap Z= −0.87, P=0.49; activities Z = −0.29, P=0.89; take-home activity Z = −0.59, P=0.69; other Z = −0.58, P=0.69). Thus, adherence to the manual was good with no evidence of programme drift. Conclusions: Good adherence indicates the intervention was delivered as described in the manual and strengthens confidence in the findings of the randomised controlled trial.

10.1177/0269215514548733

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Assessment of Everyday Memory After Severe Head Injury

Cortex (1989)

Annette F Schwartz T. M. McMillan

Memory disorder

Memory problems

10.1016/s0010-9452(89)80026-7

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Citations (33)