Paula Hickey

Paula Hickey
Health Service Executive | HSE · Medical Department

Doctor of Medicine

About

29
Publications
5,205
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119
Citations

Publications

Publications (29)
Article
Background Approximately 6,000 people in Ireland had a stroke in 2020. Early Supported Discharge (ESD) is an international model of care for stroke patients. ESD improves patient outcomes while facilitating a faster discharge, through provision of stroke specific rehab at home. ESD can be expected to improve disability outcomes, quality of life and...
Article
Background Vertebral Fractures (VFs) are the most common fragility fracture—with an incidence of 1 in 5 women over 70. A Vertebral Fragility Fracture (VFF) is a powerful predictor of another VF and of future hip fractures. Yet nearly 70% of VFs do not come to medical attention. Opportunities to identify a VFF and institute secondary prevention aris...
Article
Background A model ward adheres to formal processes and combines input from all members of the Multi-Disciplinary Team (MDT) from admission to discharge ensuring high quality patient care. A stroke and specialist gerontology ward in a level three hospital in Ireland leads this approach with MDT meetings every morning. Research has demonstrated that...
Article
Background Incontinence in hospital patients can result in a longer length of stay, a greater risk of being discharged to a residential care setting, as well as increased healthcare and personal costs. Older adults may find it difficult to regain continence post discharge contributing to caregiver strain, social isolation and functional decline. Th...
Article
Background Transient Ischaemic Attack (TIA) is a common presentation to hospitals and portends a high risk for eventual stroke. The EXPRESS study suggested the benefit of urgent outpatient assessment of TIA, which was associated with a 80% risk reduction of early recurrent stroke when compared to usual care. The HSE model of care for stroke endorse...
Article
Full-text available
Background Rates of dementia in Ireland are rapidly increasing in line with our ageing population. Cases are predicted to more than double in the next 30 years from a prevalence of 55,000 in 2018, to 141,000 in 2050. Dementia services will be placed under significant pressure. It is essential that patients referred to specialist memory services are...
Article
Background The Integrated Care Team (founded 2018) provides community rehabilitation in the home. The Covid 19 pandemic, a new Reablement Service (June 2020) and Community Falls Service (September 2020) led to changes in the service, providing access to comprehensive geriatric assessment in the community when hospital outpatient services were limit...
Article
Background Early Supported Discharge (ESD) for stroke is an international model of best care for stroke patients. ESD improves patient outcomes while facilitating a faster hospital discharge through providing stroke specific rehabilitation at home. ESD can be expected to improve disability outcomes and quality of life and reduce length of hospital...
Article
Background Integrated Care Teams for Older Persons (ICTOP) aim to transform care away from hospitals towards multidisciplinary community team care. Seventy percent of injuries requiring acute admission are caused by falls, costing €59 million annually, in addition to the overall morbidity and mortality burden. The Screening Tool of Older Person’s P...
Article
Full-text available
Background Anticholinergic burden is associated with an increase in cognitive decline, delirium and confusion. We aimed to examine the Anticholinergic Cognitive Burden (ACB) of patients referred to local dementia services, and the prescribing of acetylcholinesterase inhibitors in patients with a significant anticholinergic burden. We also looked at...
Article
Background The Integrated Care Team (founded 2018) provides community rehabilitation in the home for frail older adults. Frail older adults are at increased risk of hospitalisation, and frailty is associated with increased length of stay and mortality. This retrospective cohort study aims to explore the acute hospital admissions of this frail cohor...
Article
Full-text available
Neuropilates, that is, the practice of pilates in a patient with a neurological condition, may benefit post stroke patients through improving their strength, postural control, alignment and stability, with previous studies showing significant improvements in balance and gait parameters post pilates interventions. This case study aimed to investigat...
Article
Full-text available
Cerebrovascular pathologies occur in up to 80% of cases of Alzheimer's disease; however, the underlying mechanisms that lead to perivascular pathology and accompanying blood-brain barrier (BBB) disruption are still not fully understood. We have identified previously unreported mutations in colony stimulating factor-1 receptor (CSF-1R) in an ultra-r...
Article
Full-text available
Objective: This study aimed to investigate the feasibility and potential effectiveness of mirror-aided cross-education compared to cross-education alone in post-stroke upper limb recovery. Design: A pilot randomized controlled parallel group study was carried out. Thirty-two chronic stroke patients followed a 4-week isometric strength-training p...
Article
Introduction: A large proportion of patients with chronic stroke have permanent lower limb functional disability leading to reduced levels of independent mobility. Individually, both mirror therapy and treadmill training have been shown to improve aspects of lower limb functioning in patients with stroke. This case report examined whether a new co...
Chapter
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: Primary: To determine if physical treatment interventions are effective in preventing or minimising activity limitation and participation restrictions in those patients developing spasticity post stroke. Secondary: To determine if physical treatment intervention...

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