Amara Nwosu

MBCHB MRCP PhD

Tag Archives: palliative medicine


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Investigation and management of iron deficiency anaemia in a specialist palliative care setting and the role of intravenous iron: a descriptive analysis of hospice data

Anaemia is common in hospice populations and associated with significant symptom burden. Guidelines recommend investigating for and treating iron deficiency (ID), but there is little evidence of this practice in palliative care populations. Our paper (published in AMRC Open Research) describes the results of investigations for and subsequent management of ID in Marie Curie Hospice Liverpool.

Our data demonstrates that iron deficiency is common and can be safely treated with intravenous iron replacement, within current guidelines, in a hospice setting. Further research should define the optimum use of this approach in palliative care patients.

More information can be found here:

Steele T, Bonwick H, Nwosu AC and Chapman L. Investigation and management of iron deficiency anaemia in a specialist palliative care setting and the role of intravenous iron: a descriptive analysis of hospice data [version 1; peer review: awaiting peer review]. AMRC Open Res 2021, 3:6 (https://doi.org/10.12688/amrcopenres.12963.1)

Medical photo created by rawpixel.com – www.freepik.com


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Implantable cardioverter defibrillator (ICD) deactivation in palliative care – a case involving best interest decisions for someone lacking capacity at the end of life

The use of implantable cardioverter-defibrillators (ICD) has increased due to benefits of preventing death from cardiac arrhythmia. However, the increasing use of ICDs has created new challenges for how to proactively manage deactivation of these devices in people who are dying, especially for those who lack capacity to make decisions about their care. The aim of this case report is to discuss the challenges of planning for deactivation of an ICD for a patient who lacked capacity at the end of life.


In this case report (published on AMRC Open Research) we describe the challenges of managing ICD deactivation in a dying patient with fluctuating capacity who had previously expressed a wish for the ICD to remain active. Although it is preferable to use advance care planning (ACP), to provide care in-line with patient-identified care preferences, we demonstrate how a best interest process can be used to make decisions about ICD deactivation at the end of life.

More information can be found in our case report here:

https://amrcopenresearch.org/articles/3-4


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Improving Palliative Care Through Digital Health Technology

I’m delighted to write a geust blog for BMJ Supportive and Palliative Care about how palliative care care be improved through use of digital health technology. I also reflect on how this presents an opportunity to learn from the COVID19 pandemic. Specifically, I reference an article by Clabburn and colleagues, which describes the novel use of ‘Ivy Street’, a Virtual Learning Environment to support palliative and end of life care education. 

Read my guest blog here:

Improving Palliative Care Through Digital Health Technology


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Big Data and Palliative Care

 

I was delighted that our letter about Big Data and palliative medicine was published in ‘Palliative Medicine’. This was in response to an editorial by Peter Tanuesputro which described how Big Data analysis of linked data has the potential to support care by indentifying patient needs. Our letter describes five challenges which need to be considered in order to make meaningful use of Big Data analysis in palliative care.

The letter is freely available in full from the link below.

Nwosu AC, Collins B, Mason S. Big Data analysis to improve care for people living with serious illness: the potential to use new emerging technology in palliative care. Palliative Medicine 2017; doi:10.1177/0269216317726250.


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Learning through listening: The development of the ‘SAGE Palliative Medicine & Chronic Care’ podcast

I was delighted to be invited to write a guest blog for the European Association of Palliative Care (EAPC) website, about my role in developing podcasts for ‘Palliative Medicine’ in my role Digital Editor for the journal.

The full blog post can be found here:

Learning through listening EAPC guest blog

Screen Shot 2017-08-22 at 15.16.17

 

How to access the ‘SAGE Palliative Medicine & Chronic Care’ podcasts

  • Subscribe to the podcasts from iTunes here.

 


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Poster about the ‘Palliative Medicine’ podcasts presented at the 2017 North West Annual Medical Leadership and Management Conference

I am currently the Digital Editor of the Palliative Medicine journal (the world’s highest ranked journal, peer reviewed scholarly journal dedicated to improving knowledge and clinical practice in the palliative care of patients with far advanced disease: http://journals.sagepub.com/home/pmj ). In this role I lead the development of podcasts to enable dissemination of the journals’ work to a wider audience. Essentially this work follows on from my foray into the podcast world through my AmiPal podcasts (https://soundcloud.com/mypal), which are podcasts about palliative care, technology and innovation.

On the 14th June I was delighted to present a poster about the development of these Palliative Medicine podcasts at the 2017 North West Annual Medical Leadership and Management Conference which took place in the AJ Bell stadium. The poster featured some initial data on the popularity of the podcasts and some download data. Essentially the podcasts are doing very well with many authors getting into the process of recording podcasts which have been well received.

Slide1

A link to the ‘SAGE Palliative Medicine & Chronic Care’ podcasts can be found through the Palliative Medicine site here: http://journals.sagepub.com/page/pmj/podcasts

You can subscribe to the podcasts from iTunes here: https://itunes.apple.com/gb/podcast/sage-palliative-medicine-chronic/id1179036261?mt=2

The podcasts are available from most podcast app services by simply searching for ‘Palliative Medicine’. However, if you need the RSS feed to subscribe to can do find that here: http://sagepalliativemedicine.sage-publications.libsynpro.com/rss

If you’re an author of a paper published in Palliative Medicine are interested in recording a podcast, please feel free to contact me.


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Sensor City: Connected cows and better mousetraps

This evening I had the pleasure to attend a networking event at ‘Sensor City’ Liverpool. Sensor City is a Liverpool-based technical innovation centre and University Enterprise Zone; it aims to support the creation, development, production and promotion of cutting edge sensor technologies for use in a wide range of sectors.

http://www.sensorcity.co.uk/

Sensor City

The event was entitled ‘Connected cows and better mousetraps’ and detailed myriad potential  ‘use-cases’ for the application of Internet of Things (IoT) technology in industry.

http://www.sensorcity.co.uk/event/connected-cows-better-mousetraps/

The session was led by Mark Maidman, a representative from Actility (https://www.actility.com/) a company specialising in IoT devices.

As a palliative care doctor interested in technology my immediate thoughts are about the potential uses of IoT to support care of people with advanced disease and complex needs. Events like these are excellent in fostering cross-disciplinary collaboration which will hopefully lead to innovation through sharing expertise and resources.

Further information about sensor cities events can be found here:

http://www.sensorcity.co.uk/events/

Are you interested in the role of emerging technologies in facilitating supportive and palliative care for individuals and populations? If so, please free to comment and get in touch with me.


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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

Sciencepalliative carepalliative medicinebioimpedancehydrationcancerresearchmedicineTechnology

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AmiPal podcast: A comparison between studies: research, audit and service evaluation – episode 20

In this episode I will provide an overview between the differences between research, audit and service evaluation. This is important to distinguish as research studies require ethical approval before they commence, whereas the other project types do not.

Is your project research, evaluation or audit? (Avon Primary Care Research Collaborative website)
www.apcrc.nhs.uk/governance/is_it_research.htm

NRES Defining Research leaflet.
www.hra.nhs.uk/documents/2013/09…ning-research.pdf

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

Music by Purple Planet
www.purple-planet.com


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AmiPal Podcast: Virtual reality and palliative care – episode 18

In this episode of MyPal I discuss the potential uses of virtual reality (VR) in healthcare and what this may mean for palliative care.

 

Beyond gaming: virtual reality in healthcare. Claire Bower. BMJ Blogs 2014.
blogs.bmj.com/bmj-journals-devel…ity-in-healthcare/

What can Oculus Rift do for healthcare?Mike Miliard. HealthcareIT news 2014.
www.healthcareitnews.com/news/what-ca…o-healthcare

The future of pain relief? Dutch burns unit trialling new virtual reality computer system that distracts patients from the agony of their wounds. Paul Donnelly, Daily Mail 9th Aug 2014.
www.dailymail.co.uk/sciencetech/art…ony-wounds.html

IS VR CHANGING HEALTHCARE?
weareformation.com/is-vr-changing-healthcare/

A Survey of Health-Related Activities on Second Life. Leslie Beard et al. J Med Internet Res. 2009 Apr-Jun; 11(2): e17.
www.ncbi.nlm.nih.gov/pmc/articles/PMC2762804/

Virtual reality for the palliative care of cancer. Oyama 1997
www.ncbi.nlm.nih.gov/pubmed/10175345

Copyright Dr Amara Nwosu, KingAmi Media 2016. www.amaranwosu.com

Music by Purple Planet
www.purple-planet.com

Photo by Jordi Boixareu
www.flickr.com/photos/jobopa/166…ycL-49wC8u-4HYWqe