Heather Gage

Heather Gage
University of Surrey · Surrey Health Economics Centre, Department of Clinical and Experimental Medicine

About

249
Publications
39,815
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5,844
Citations
Citations since 2016
117 Research Items
3473 Citations
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Introduction
Heather Gage currently directs the Surrey Health Economics Centre (SHEC) in the Department of Clinical and Experimental Medicine at the University of Surrey, England. Heather does research in Health Economics and Health Services Research. SHEC has multiple research projects in these areas covering a variety of topics.

Publications

Publications (249)
Preprint
Full-text available
Background: Coronavirus disease 2019 (COVID-19) is associated with significant mortality and morbidity in care homes. Novel or repurposed antiviral drugs may reduce infection and disease severity through reducing viral replication and inflammation. Objective: To compare the safety and efficacy of antiviral agents (ciclesonide, niclosamide) for prev...
Conference Paper
Introduction As we approach the final stages of Hepatitis C virus (HCV) elimination, we are left with increasingly more complex individuals to treat. Based on our initial novel “one stop” community HCV care model in Brighton focussed at people who use drugs (ITTREAT) and people who are homeless, we set up the END C study to achieve HCV micro elimin...
Article
Full-text available
Aim: To compare the satisfaction of patients managed by independent nurse prescribers with that of patients managed by nurses using PGDs with respect to experience of the consultation and information received about the medication. Design: Survey. Methods: Patients receiving medications from nurses in five urban sexual health services in the Un...
Article
Full-text available
Background Local services in the United Kingdom National Health Service enable autonomous provision of medication by nurses, supporting individual nurses to gain prescribing qualifications or by introducing local patient group directions. Aim To compare nurse prescribing and patient group directions about clinic processes, patients' experiences, a...
Article
Background: Many people prefer to die at home when the time comes. Hospice at home services aim to support patients to achieve this. A range of hospice at home services exist; some services have been evaluated, but there has been limited evidence synthesis. Objectives: The main objective was to find out what models of hospice at home services work...
Article
Full-text available
Background Cognitive–behavioural therapy (CBT) is recommended for all patients with psychosis, but is offered to only a minority. This is attributable, in part, to the resource-intensive nature of CBT for psychosis. Responses have included the development of CBT for psychosis in brief and targeted formats, and its delivery by briefly trained therap...
Article
Full-text available
Objectives To explore the supportive care needs of cancer survivors, the characteristics of patients with high levels of unmet need, changes in unmet need after treatment ends and differences in unmet needs of breast, colorectal and testicular survivors. Methods The method used was a prospective longitudinal mailed survey. Unmet needs, measured by...
Article
Full-text available
Background Individuals who are ‘moderately’ or ‘severely’ dependent consume alcohol at levels that are likely to have a severe impact on their own health and mortality, the health and behaviours of others (family members) and to have economic and social implications. Treatment guidelines suggest that treatment needs to be planned with medically ass...
Preprint
Full-text available
Key points: • Quality Improvement Collaboratives bring staff from different organisations together to improve healthcare in care homes. • Healthcare improvement should align with existing work priorities and be led by staff with experience of collaboration. 2 • Care home staff can lead healthcare improvement if approaches and structures are adopted...
Article
Background: Quality improvement collaboratives (QICs) bring together multidisciplinary teams in a structured process to improve care quality. How QICs can be used to support healthcare improvement in care homes is not fully understood. Methods: A realist evaluation to develop and test a programme theory of how QICs work to improve healthcare in...
Article
Objective In autosomal recessive dystrophic Epidermolysis bullosa, repeat blistering results in finger webbing and severe contractures of the hands. The aim of this study was to codesign patient-reported outcome indicators for hand therapy with patients, carers and clinicians, and use these to proof-of-concept test a novel dressing glove for recess...
Article
Full-text available
Background Increasing numbers of nurses, pharmacists and allied health professionals across the world have prescribing rights for medicines: over 90,000 of the eligible United Kingdom workforce are qualified as non-doctor prescribers. In order to inform future developments, it is important to understand the benefits and impact of prescribing by all...
Article
Full-text available
Objectives: Young onset dementia is associated with distinctive support needs but existing research on service provision has been largely small scale and qualitative. Our objective was to explore service use, cost and satisfaction across the UK. Methods: Information about socio-demographic characteristics, service use and satisfaction were gathe...
Article
Full-text available
Objectives To compare the contribution of physician associates to the processes and outcomes of emergency medicine consultations with that of foundation year two doctors-in-training. Design Mixed-methods study: retrospective chart review using 4 months’ anonymised clinical record data of all patients seen by physician associates or foundation year...
Article
Full-text available
Background Palliative care remains suboptimal in end‐stage liver disease. Aims To inform a definitive study, we assessed palliative long‐term abdominal drains in end‐stage liver disease to determine recruitment, attrition, safety/potential effectiveness, questionnaires/interview uptake/completion and make a preliminary cost comparison. Methods A...
Preprint
Full-text available
Background Individuals who are ‘moderately’ or ‘severely’ dependent consume alcohol at levels that are likely to have a severe impact on their own health and mortality, the health and behaviours of others (family members), and to have economic and social implications. Treatment guidelines suggest that treatment needs to be planned with medically as...
Preprint
Full-text available
Background Increasing numbers of nurses, pharmacists and allied health professionals across the world have prescribing rights: over 90,000 of the eligible United Kingdom workforce are qualified as non-doctor prescribers. In order to inform future developments, it is important to understand the benefits and impact of prescribing by allied health pro...
Preprint
Full-text available
Background Increasing numbers of nurses, pharmacists and allied health professionals across the world have prescribing rights for medicines: over 90,000 of the eligible United Kingdom workforce are qualified as non-doctor prescribers. In order to inform future developments, it is important to understand the benefits and impact of prescribing by all...
Preprint
Full-text available
Background Increasing numbers of nurses, pharmacists and allied health professionals across the world have prescribing rights for medicines: over 90,000 of the eligible United Kingdom workforce are qualified as non-doctor prescribers. In order to inform future developments, it is important to understand the benefits and impact of prescribing by all...
Preprint
Full-text available
Background: Increasing numbers of nurses, pharmacists and allied health professionals across the world have prescribing rights for medicines: over 90,000 of the eligible United Kingdom workforce are qualified as non-doctor prescribers. In order to inform future developments, it is important to understand the benefits and impact of prescribing by al...
Article
Full-text available
Background: The National Institute for Health and Care Excellence (NICE) recommends that Cognitive Behaviour Therapy for psychosis (CBTp) is offered to all patients with a psychosis diagnosis. However, only a minority of psychosis patients in England and Wales are offered CBTp. This is attributable, in part, to the resource-intensive nature of CBT...
Article
Background : United Kingdom legislation allows nurses to autonomously provide medications as independent nurse prescribers or using patient group directions. Evidence of medication safety and appropriateness is limited. We compared nurse prescribers and patient group direction users in terms of prevalence, types and severity of medication provision...
Article
Full-text available
Background: Despite the established evidence and theoretical advances explaining human judgments under uncertainty, developments of mobile health (mHealth) Clinical Decision Support Systems (CDSS) have not explicitly applied the psychology of decision making to the study of user needs. We report on a user needs approach to develop a prototype of a...
Article
Objectives: Studies on service needs of people with young onset dementia have taken a problem-oriented approach with resulting recommendations focusing on reducing service shortcomings. This study aimed to build on ‘what works’ in real-life practice by exploring the nature of post-diagnostic support services that were perceived positively by younge...
Article
Background/aims: Direct acting antivirals (DAA) provide an unprecedented opportunity for a "find-and-treat strategy". We aimed to report real-world clinical, patient reported and health economic outcomes of community-based HCV screening/treatment in people who use drugs (PWUD). Methods: Project ITTREAT (2013-2021), established at a drug and alco...
Preprint
Full-text available
Background The National Institute for Health and Care Excellence (NICE) recommends that Cognitive Behaviour Therapy for psychosis (CBTp) is offered to all patients with a psychosis diagnosis. However, only a minority of psychosis patients in England and Wales are offered CBTp. This is attributable, in part, to the resource-intensive nature of CBTp....
Preprint
Full-text available
Background The National Institute for Health and Care Excellence (NICE) recommends that Cognitive Behaviour Therapy for psychosis (CBTp) is offered to all patients with a psychosis diagnosis. However, only a minority of psychosis patients in England and Wales are offered CBTp. This is attributable, in part, to the resource-intensive nature of CBTp....
Preprint
Full-text available
Background Increasing numbers of nurses, pharmacists and allied health professionals across the world have prescribing rights: over 90,000 of the eligible United Kingdom workforce are qualified as non-doctor prescribers. In order to inform future developments, it is important to understand the benefits and impact of prescribing by allied health pro...
Article
Full-text available
Objective Hospice at Home (HAH) services aim to enable patients to be cared for and die at home, if that is their choice and achieve a ‘good death’. A national survey, in 2017, aimed to describe and compare the features of HAH services and understand key enablers to service provision. Methods Service managers of adult HAH services in the ‘Hospice...
Preprint
Full-text available
BACKGROUND mhealth, predominantly wearable technology and mobile apps, have been considered in Parkinson’s Disease to provide valuable ecological data between face to face visits and improve monitoring of motor symptoms remotely. OBJECTIVE In this study we explore the feasibility of using a technology based mhealth platform comprising a smartphone...
Article
Full-text available
Background Mobile health, predominantly wearable technology and mobile apps, have been considered in Parkinson disease to provide valuable ecological data between face-to-face visits and improve monitoring of motor symptoms remotely. Objective We explored the feasibility of using a technology-based mHealth platform comprising a smartphone in combi...
Article
Full-text available
Background Increasing demand for hospital services and staff shortages has led NHS organisations to review workforce configurations. One solution has been to employ physician associates (PAs). PAs are trained over 2 years at postgraduate level to work to a supervising doctor. Little is currently known about the roles and impact of PAs working in h...
Article
Full-text available
This is the scientific summary (2,000 words) of the full report. Citation: Drennan VM, Halter M, Wheeler C, Nice L, Brearley S, Ennis J, et al. The role of physician associates in secondary care: the PA-SCER mixed-methods study. Health Serv Deliv Res 2019;7(19) Health Services and Delivery Research Volume: 7, Issue: 19, Published in June 2019 htt...
Article
Objectives: Maintaining physical activity for older residents in care homes maximises their physical and mental health and wellbeing, independence, dignity and quality of life. Unfortunately, most residents do not participate in regular physical activity. Active Residents in Care Homes, ARCH, was designed to increase physical activity by facilitat...
Conference Paper
Full-text available
Introduction Ascites develops in about 90% with advanced cirrhosis; when refractory to medical therapy, standard of care is repeated large volume paracentesis (LVP) with albumin support. Refractory ascites (RA) confers a median life expectancy of six months without liver transplantation (LT). LVP is not an optimal palliative strategy. One alternati...
Article
Full-text available
Purpose: Evidence is increasing for effective virtual reality therapy for motor rehabilitation for children with Cerebral Palsy. We assessed the feasibility of a virtual reality therapy mode of intervention, appropriateness of measures, and potential cost-effectiveness. Methods: A 12-week, 2-group, parallel-feasibility trial (ISRCT 17624388) using...
Article
Objectives The European RHAPSODY project sought to develop and test an online information and support programme for caregivers of individuals diagnosed with young‐onset dementia. The objectives were to assess user acceptability and satisfaction with the programme, and to test outcome measures for a larger effectiveness study. Design A pilot random...
Article
Full-text available
Background Alcohol-related harm is currently estimated to cost the National Health Service (NHS) in England £3.5 bn a year. Of the estimated 1.6 million people with some degree of alcohol dependence, some 600,000 are believed to be moderately or severely dependent and may benefit from intensive treatment. Outcomes from medically assisted withdrawal...
Article
Full-text available
Background Alternative models of cancer follow-up care are needed to ameliorate pressure on services and better meet survivors’ long-term needs. This paper reports an evaluation of a service improvement initiative for the follow-up care of prostate cancer patients based on remote monitoring and supported self-management. Methods This multi-centred...
Article
Full-text available
Objective Complex cardiac devices including implantable cardioverter defibrillator (ICD) and cardiac resynchronisation therapy (CRT) devices can safely be implanted as a day case procedure as opposed to overnight stay. We assess how common day case complex device therapy is and the cost implications of more widespread adoption across the UK. Metho...
Article
Background Early or timely recognition of dementia is a key policy goal of the National Dementia Strategy. However, older people who are homeless are not considered in this policy and practice imperative, despite their high risk of developing dementia. Objectives and study design This 24-month study was designed to (1) determine the prevalence of...
Article
Full-text available
Objectives To investigate the deployment of physician associates (PAs); the factors supporting and inhibiting their employment and their contribution and impact on patients’ experience and outcomes and the organisation of services. Design Mixed methods within a case study design, using interviews, observations, work diaries and documentary analysi...
Article
Full-text available
Introduction care home residents are often unable to complete health-related quality of life questionnaires for themselves because of prevalent cognitive impairment. This study compared care home resident and staff proxy responses for two measures, the EQ-5D-5L and HowRU. Methods a prospective cohort study recruited residents ≥60 years across 24 c...
Method
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This paper outlines the statistical analysis plan for the PEACH study, describing how these challenges have been addressed. It acts as reference point for further publications from the PEACH study. https://www.nottingham.ac.uk/emran/documents/issue-22-emran-sep-2018.pdf
Article
Full-text available
Background: Parkinson's disease is a degenerative neurological condition causing multiple motor and non-motor symptoms that have a serious adverse effect on quality of life. Management is problematic due to the variable and fluctuating nature of symptoms, often hourly and daily. The PD_Manager mHealth platform aims to provide a continuous feed of...
Article
Full-text available
Following publication of the original article [1], the authors reported that the figure legend for Figure 3 was absent. In addition, they have requested additional funding information to be added. In this Correction the initial and updated funding information are shown. The original publication of this article has been corrected.
Article
Full-text available
This study appraises the effectiveness and cost-effectiveness of consumption of plant sterol-enriched margarine-type spreads for the prevention of cardiovascular disease (CVD) in people with hypercholesterolemia in England, compared to a normal diet. A nested Markov model was employed using the perspective of the British National Health Service (NH...
Article
Full-text available
Background Measuring service use and costs is an important aspect of service delivery evaluation. In end-of-life care, there is heavy reliance on care by family/friends (informal carers) and this should be reflected in the total cost of care alongside formal services. The Ambulatory and Home Care Record, developed in Canada, is both comprehensive i...