Amara Nwosu

MBCHB MRCP PhD


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The use of advance consent to enable hydration assessments, for research, at the end of life

As the need for palliative care increases, it is essential for research opportunities to be offered to patients with palliative care needs to ensure patients can receive evidence-based treatments and services to improve care. Although it is recognised that palliative, and in particular end of life, research can be both methodically and ethically challenging it is important to note that palliative patients are keen to be involved with research.
Over the past three years, patients in Marie Curie Hospice Liverpool have been recruited to a research study evaluating hydration, where advance consent methodology is used to facilitate participation at the end of life. In this study, participants provided ‘advanced consent’ to receive research assessments, in anticipation of the deterioration of their health and loss of the ability to provide consent to ongoing research participation. During this process, recruiting participants will nominate a consultee (who can be any family member, friend or healthcare professional), who is contacted by the researcher prior to completion of research assessments. Participants will generally choose a caregiver or friend to act as a personal consultee; however, there may be some instances where a healthcare professional is chosen.
In this, we share our experiences using advanced consent methodology and a healthcare professional acting as a consultee, to facilitate research assessments in a patient who was lacking capacity at the end of life.

More information can be found in our case report here:

Stanley S and Nwosu AC. Case Report: The use of advanced consent methodology and healthcare professional consultee to facilitate research participation in dying patients [version 1; peer review: awaiting peer review]. AMRC Open Res 2021, 3:3 (https://doi.org/10.12688/amrcopenres.12961.1)


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AmiPal podcast – Assessing hydration in POEMS syndrome using bioimpedance analysis – episode 21

In this episode I provide an overview of the use of bioimpedance analysis to assess hydration over time in a patient with POEMS syndrome. This was published in the BMJ Supportive and Palliative Care journal and can be found through the link provided below.

Nwosu AC, Morris L, Mayland C, Mason S, Pettitt A, Ellershaw J.

Longitudinal bioimpedance assessments to evaluate hydration in POEMS syndrome. BMJ Supportive and Palliative Care doi:10.1136/bmjspcare-2015-000991
spcare.bmj.com/content/early/201…-2015-000991.full

Nwosu AC, Mayland CR, Mason S, Khodabukus AF, Varro A, Ellershaw JE. Hydration in advanced cancer: can bioelectrical impedance analysis improve the evidence base? A systematic review of the literature. Journal of Pain and Symptom Management 2013; 46(3):433-446.e6
www.jpsmjournal.com/article/S0885-3…0499-X/abstract

Researchgate link: www.researchgate.net/publication/23…the_Literature

Nwosu AC, Mayland CR, Mason SR, Varro A, Ellershaw JE. Patients want to be involved in end-of-life care research. BMJ Support Palliat Care 2013, Dec;3(4):45.
spcare.bmj.com/content/early/201…13-000537.extract

Copyright Dr Amara Nwosu, AmiPal Media 2016.
www.amaranwosu.com
twitter.com/amaranwosu

Music by Bensound
www.bensound.com/royalty-free-music

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MyPal Podcast: Bioelectrical impedance to assess hydration in advanced cancer (overview) – Twycross prize – episode 11

I provide an overview of my PhD research “The use of bioelectrical impedance vector analysis (BIVA) to assess hydration in patients with advanced cancer in a specialist palliative care inpatient unit”. This study won the 2014 Twycross Research prize of the Association of Palliative Medicine.

National Cancer Research Institute (NCRI) Conference prize winning abstract presented in 2014:
conference.ncri.org.uk/abstracts/201…cts/A222.html

Information about Early Career Researcher Award of the European Association of Palliative Care (EAPC)
www.eapc-2015.org/Early_Researcher_Award.html

Nwosu AC, Mayland CR, Mason S, Khodabukus AF, Varro A, Ellershaw JE. Hydration in advanced cancer: can bioelectrical impedance analysis improve the evidence base? A systematic review of the literature. Journal of Pain and Symptom Management 2013; 46(3):433-446.e6
www.jpsmjournal.com/article/S0885-3…0499-X/abstract

Nwosu AC, Mayland CR, Mason SR, Varro A, Ellershaw JE. Patients want to be involved in end-of-life care research. BMJ Support Palliat Care 2013, Dec;3(4):45.
spcare.bmj.com/content/early/201…13-000537.extract

Copyright Dr Amara Nwosu, KingAmi media 2014.www.amaranwosu.com

Music by ‘Year of the Fiery Horse’ (YOTFH). Soundcloud link: @year-of-the-fiery-horse