Professor Heather Gage

Teaching

Occasional lectures and workshops on health economics. 

Undergraduate and postgraduate project supervision.

Contact Me

E-mail:
Phone: 01483 68 6948

Find me on campus
Room: 22 AC 04


My office hours

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Publications

Journal articles

  • Halter MF, Drennan VM, Joly LM, Gabe J, Gage HM, de Lusignan S. (2017) 'The patients’ perspective of physician associates in primary care in England: a qualitative study'. Wiley Health Expectations,
    [ Status: Accepted ]

    Abstract

    Background: Physician Associates are new to English general practice and set to expand in numbers. Objective: To investigate the patients’ perspective on consulting with PAs in general practice. Design: A qualitative study, using semi structured interviews, with thematic analysis. Setting and participants: Thirty volunteer patients of 430 who had consulted PAs for a same day appointment and had returned a satisfaction survey, in six general practices employing physician associates in England. Findings: Some participants only consulted once with a physician associate and others more frequently. The conditions consulted for ranged from minor illnesses to those requiring immediate hospital admission. Understanding the role of the physician associate varied from: certain and correct, to uncertain, to certain and incorrect, where the patient believed the physician associate to be a doctor. Most, but not all, reported positive experiences and outcomes of their consultation, with some choosing to consult the physician. Those with negative experiences described problems when the limits of the role was reached, requiring additional GP consultations or prescription delay. Trust and confidence in the physician associate was derived from trust in the NHS, the general practice and the individual physician associate. Willingness to consult a physician associate was contingent on the patient’s assessment of the severity or complexity of the problem and the desire for provider continuity. Conclusion: Patients saw PAs as an appropriate general practitioner substitute. Patients’ experience could inform delivery redesign.

  • Parker W, Gage HM, Sterr A, Williams P. (2017) 'Holiday play for disabled children in England: access, choice and parents’ views about integration'. Taylor & Francis International Journal of Disability, Development and Education,
    [ Status: Accepted ]
  • Sandsund C, Towers R, Thomas K, Tigue R, Lalji A, Doyle N, Jordan J, Gage HM, Shaw C. (2017) 'Holistic needs assessment and care plans for women with gynaecological cancer – do they improve cancer specific health related quality of life? A Randomised Controlled Trial using mixed-methods'. BMJ Publishing Group BMJ Supportive & Palliative Care, 72 (1), pp. S175-S175.
  • Jordan J, Gage HM, Benton B, Lalji A, Norton C, Andreyev HJN. (2017) 'Gastroenterologist and nurse management of symptoms after pelvic radiotherapy for cancer: an economic evaluation of a clinical Randomized Controlled Trial (the ORBIT study).'. Dove Medical Press ClinicoEconomics and Outcomes Research, 9, pp. 241-249.

    Abstract

    Background: Over 20 distressing gastrointestinal symptoms affect many patients after pelvic radiotherapy, but in the United Kingdom few are referred for assessment. Algorithmic-based treatment delivered by either a consultant gastroenterologist or clinical nurse specialist has been shown in a randomised trial to be statistically and clinically more effective than provision of a self-help booklet. In this study we assessed cost-effectiveness. Methods: Outcomes were measured at baseline (pre randomisation) and six months. Change in quality adjusted life years (QALY) was the primary outcome for the economic evaluation; a secondary analysis used change in the bowel subset score of the modified Inflammatory Bowel Disease Questionnaire (IBDQ-B). Intervention costs, British pounds 2013, covered visits with the gastroenterologist or nurse, investigations, medications and treatments. Incremental outcomes and incremental costs were estimated simultaneously using multivariate linear regression. Uncertainty was handled non-parametrically using bootstrap with replacement. Results: The mean (SD) cost of treatment was £895 (499) for the nurse, £1101 (567) for the consultant. The nurse was dominated by usual care which was cheaper and achieved better outcomes. The mean cost per QALY gained from the consultant, compared to usual care, was £250,455; comparing the consultant to the nurse, it was £25,875. Algorithmic care produced better outcomes compared to the booklet only, as reflected in the IBDQ-B results, at a cost of approximately £1,000. Conclusion: Algorithmic treatment of radiation bowel injury by consultant or nurse results in significant symptom relief for patients, but was not found to be cost-effective according to the NICE criteria.

  • Halter M, Wheeler C, Drennan VM, de Lusignan S, Grant R, Gabe J, Gage HM, Ennis J, Parle J. (2017) 'Physician associates in England's hospitals: a survey of medical directors exploring current usage and factors affecting recruitment'. Royal College of Physicians Clinical Medicine, 17 (2), pp. 126-131.
  • Farr W, Green D, Male I, Morris C, Bailey S, Gage HM, Speller S, Colville V, Jackson M, Bremner S, Memon A. (2017) 'Therapeutic potential and ownership of commercially available consoles in children with cerebral palsy'. Sage British Journal of Occupational Therapy, 80 (2), pp. 108-116.

    Abstract

    Introduction: We conducted a survey amongst families of children with cerebral palsy to ascertain the ownership and therapeutic use and potential of commercial games consoles to improve motor function. Method: Three hundred families in South East England were identified through clinical records, and were requested to complete an anonymised questionnaire. Results: A total of 61 families (20% response) returned a completed questionnaire with 41 (68%) identified males and 19 (32%) identified females with cerebral palsy, with a mean age of 11 years 5 months (SD 3Y 7M). The large majority of families, 59 (97%), owned a commercial console and the child used this for 50–300 minutes a week. Returns by severity of motor impairment were: Gross Motor Function Classification System I (22%), II (32%), III (13%), IV (15%), V (18%). Consoles were used regularly for play across all Gross Motor Function Classification System categories. Conclusion: The potential of games consoles, as home-based virtual reality therapy, in improving the motor function of children with cerebral palsy should be appropriately tested in a randomised controlled trial. Wide ownership, and the relative ease with which children engage in the use of commercially-based virtual reality therapy systems, suggests potential as a means of augmenting therapy protocols, taking advantage of interest and participation patterns of families.

  • Gage HM, Egan B, Williams P, Brands B, Györei E, López-Robles J-C, Campoy C, Decsi T, Koletzko B, Raats M. (2016) 'Importance of mental performance in parental choice of food for children aged 4 – 10 years: a study in four European countries'. Cambridge University Press Public Health Nutrition,

    Abstract

    Objective: Typically, attention focuses on how nutrition affects physical health. The present study investigated the importance that parents attach to the impact of diet on mental performance when choosing food for their child. Design: Questionnaire. Setting: Four European countries. Subjects: Parents of children aged 4–10 years (n 1574): England (n 397), Germany (n 389), Hungary (n 398) and Spain (n 390). Results: Most parents (80–85 %) considered the effect of food on four elements of mental performance (child’s ability to learn, attention, behaviour, mood) to be moderately, very, extremely (v. slightly, not at all) important in food choices; over 90% considered healthiness of food and making food appealing to their child important; 79·8% cost; 76·8% convenience. Belief that food affects mental performance was 57·4% (ability to learn), 60·5% (attention); less than 40% of parents agreed they were aware which foods had an effect. Parents with lower general interest in healthy eating were less likely to consider the effect of food on mental performance elements as important. Respondents from Germany were more likely to rate mental performance as important (except behaviour); those in Hungary less likely. The most important influence on parents’ decisions about feeding their child was their own experience, except Spain, where family/friends/ health professionals were more important. Conclusions: Nutrition affects brain development and cognitive functioning. Low prioritisation of the effect of food on mental performance indicates potential for educating parents.

  • Kassianos AP, Raats MM, Gage HM. (2016) 'Post-diagnostic dietary changes in prostate cancer: associations with patients’ wellbeing and the perceptions of GPs'. Wiley European Journal of Cancer Care, , pp. 1-8.
  • Waterman H, Ballinger C, Brundle C, Chastin S, Gage H, Harper R, Henson D, Laventure B, McEvoy L, Pilling M, Olleveant N, Skelton DA, Stanford P, Todd C. (2016) 'A feasibility study to prevent falls in older people who are sight impaired: the VIP2UK randomised controlled trial'. BIOMED CENTRAL LTD TRIALS, 17 (464) Article number ARTN 464
  • Goodman C, Dening T, Gordon AL, Davies SL, Meyer J, Martin FC, Gladman JRF, Bowman C, Victor C, Handley M, Gage H, Iliffe S, Zubair M. (2016) 'Effective health care for older people living and dying in care homes: a realist review'. BIOMED CENTRAL LTD BMC HEALTH SERVICES RESEARCH, 16 Article number ARTN 269
  • Kassianos AP, Raats MM, Gage HM. (2016) 'An exploratory study on the information needs of prostate cancer patients and their partners'. PAGEPress Publications Health Psychology Research, 4 (1) Article number 4786
  • Raats MM, Malcolm RN, Lahteenmaki L, Pravst I, Gage H, Cleary A, Karatzia A, Kusar A, Yang W, Jackson DL, Hodgkins CE, Klopcic M. (2016) 'Understanding the impact of legislation on 'reduction of disease risk' claims on food and drinks: the REDICLAIM project'. TEKNOSCIENZE PUBL AGRO FOOD INDUSTRY HI-TECH, 27 (3), pp. 30-32.
  • Nilforooshan R, Benson L, Gage H, Williams P, Zoha M, Warner J. (2016) 'Comparison of service utilisation and costs of working age adults and older adults receiving treatment for psychosis and severe non-psychotic conditions in England: implications for commissioning.'. Wiley International journal of geriatric psychiatry,

    Abstract

    Current plans in the English National Health Service are to replace block contracts for mental health providers with a single tariff for each 'cluster' of conditions. A single tariff will not take into account the potential additional complexity and costs inherent in caring for older people. To examine the basis for a uniform tariff, differences in service utilisation and costs between working age adults and older adults in two populous clusters (non-psychotic, psychotic) were investigated across five mental health healthcare providers in and around London.Retrospective review of records over 3 months assessing service utilisation and costs using the Client Services Receipt Inventory.Records of 362 patients were reviewed, 179 older adults (90 non-psychotic, 89 psychotic) and 183 adults of working age (83 non-psychotic, 100 psychotic). Older adults in both clusters had more tests, assessments and home visits. Overall costs of care of older adults were significantly higher in the non-psychotic cluster (£5634, vs £4405 psychotic, p = 0.044).An appropriate age-related tariff is required for each cluster. Copyright © 2016 John Wiley & Sons, Ltd.

  • Iliffe S, Davies SL, Gordon AL, Schneider J, Dening T, Bowman C, Gage H, Martin FC, Gladman JRF, Victor C, Meyer J, Goodman C. (2016) 'Provision of NHS generalist and specialist services to care homes in England: review of surveys'. CAMBRIDGE UNIV PRESS PRIMARY HEALTH CARE RESEARCH AND DEVELOPMENT, 17 (2), pp. 122-137.
  • Gage H, Avery M, Flannery C, Williams P, Fader M. (2016) 'Community prevalence of long-term urinary catheters use in England.'. Wiley Neurourology and urodynamics,

    Abstract

    To calculate the prevalence of long term catheter use in the community in two areas in the south and west of England.People in England register with general practices to access health care through a National Health Service. Catheters are provided by prescription free of charge. In 2008, patients using urinary catheters for over 3 months were identified, and demographic information collected, from databases of general practices, using catheter prescribing records. The age and sex distributions of people in each practice were obtained from capitation claims. Overall, and age and sex-specific prevalence were calculated separately for each area, and compared.A total of 583 long term catheter users (329 south, 254 west) were identified from 404,328 people registered with practices. The overall population prevalence is similar in both locations (0.146% southern, 0.141% western). Extrapolating for the United Kingdom, this is over 90,000 long term catheter users. Prevalence increases with age (0.732% in over 70 years, 1.224% over 80), especially amongst men. Overall, higher proportions have neurological (vs. non-neurological) reasons (62.9% vs. 37.1%) and use urethral (vs. suprapubic) catheters (59.7% vs. 40.3%). Compared to men, more women tend to use suprapubic (56.4% vs. 29.3%) and have a catheter for neurological reasons (71.8% vs. 56.2%, P = 0.053).Previous evidence on prevalence of long term catheter use is sparse, and of variable quality. The strength of this study is utilisation of a reliable source of data (catheter prescriptions) from a large population of patients. Neurourol. Urodynam. © 2016 Wiley Periodicals, Inc.

  • Egan B, Gage H, Williams P, Brands B, Györei E, López-Robles JC, Campoy C, Decsi T, Koletzko B, Raats M. (2016) 'The effect of diet on the physical and mental development of children: views of parents and teachers in four European countries.'. Cambridge University Press The British journal of nutrition, , pp. 1-9.

    Abstract

    Although the impact of diet on physical health is an important public health issue, less attention has been devoted to the relationship between nutrition and children's mental development. The views of parents and teachers about the extent to which diet affects physical and mental development of children were compared in four European countries. An online questionnaire (developed in English and translated) was circulated through a market research agency. Participants were parents or teachers of children aged 4-10 years without learning or behavioural issues. Questionnaires were returned by 1606 parents (401 in England, Germany and Hungary; 403 in Spain) and 403 teachers (100 in each country, except for 103 in Hungary). Teachers were older than parents (35·3 % v. 18·3 % over 45 years; P<0·001) and less likely to smoke (15·9 % v. 26·3 %, P<0·001). There was no difference between the proportions of parents and teachers who felt that a child's physical development depended very much/extremely (v. moderately/slightly/not at all) on diet (overall 79·8 %). Lower proportions of both groups thought that mental development was very much/extremely influenced by diet (67·4 %). In the regression modelling, believing that physical and mental performance was greatly influenced by diet was significantly and positively associated with living in Hungary, scoring higher on a measure of General Health Interest and (parents only) level of education attained. Differences existed among countries in most views. Lower levels of awareness of the importance of diet for brain development and cognition (compared with physical health outcomes) indicate the potential for educating consumers, especially parents with lower educational attainment.

  • Sutton J, Family HE, Scott JA, Gage H, Taylor DA. (2016) 'The influence of organisational climate on care of patients with schizophrenia: a qualitative analysis of health care professionals' views.'. Springer International journal of clinical pharmacy, 38 (2), pp. 344-352.
  • Jones F, Gage H, Drummond A, Bhalla A, Grant R, Lennon S, McKevitt C, Riazi A, Liston M. (2016) 'Feasibility study of an integrated stroke self-management programme: a cluster-randomised controlled trial'. BMJ PUBLISHING GROUP BMJ OPEN, 6 (1) Article number ARTN e008900
  • Kurz A, Bakker C, Böhm M, Diehl-Schmid J, Dubois B, Ferreira C, Gage HM, Graff C, Hergueta T, Jansen T, Jones B, Komar A, de Mendonça A, Metcalfe A, Milecka K, Millenaar J, Orrung Wallin A, Oyebode J, Schneider-Schelte H, Saxl S, de Vugt M. (2016) 'RHAPSODY – Internet-Based Support For Caregivers of People with Young Onset Dementia: Program Design and Methods of a Pilot Study'. International Psychogeriatrics,
    [ Status: Accepted ]
  • Gage H, Holdsworth LM, Flannery C, Williams P, Butler C. (2015) 'Impact of a hospice rapid response service on preferred place of death, and costs'. BIOMED CENTRAL LTD BMC PALLIATIVE CARE, 14 Article number ARTN 75

    Abstract

    Background Many people with a terminal illness would prefer to die at home. A new palliative rapid response service (RRS) provided by a large hospice provider in South East England was evaluated (2010) to provide evidence of impact on achieving preferred place of death and costs. The RRS was delivered by a team of trained health care assistants and available 24/7. The purpose of this study was to (i) compare the characteristics of RRS users and non-users, (ii) explore differences in the proportions of users and non-users dying in the place of their choice, (iii) monitor the whole system service utilisation of users and non-users, and compare costs. Methods All hospice patients who died with a preferred place of death recorded during an 18 month period were included. Data (demographic, preferences for place of death) were obtained from hospice records. Dying in preferred place was modelled using stepwise logistic regression analysis. Service use data (period between referral to hospice and death) were obtained from general practitioners, community providers, hospitals, social services, hospice, and costs calculated using validated national tariffs. Results Of 688 patients referred to the hospice when the RRS was operational, 247 (35.9 %) used it. Higher proportions of RRS users than non-users lived in their own homes with a co-resident carer (40.3 % vs. 23.7 %); more non-users lived alone or in residential care (58.8 % vs. 76.3 %). Chances of dying in the preferred place were enhanced 2.1 times by being a RRS user, compared to a non-user, and 1.5 times by having a co-resident carer, compared to living at home alone or in a care home. Total service costs did not differ between users and non-users, except when referred to hospice very close to death (users had higher costs). Conclusions Use of the RRS was associated with increased likelihood of dying in the preferred place. The RRS is cost neutral.

  • Koskela SA, Jones F, Clarke N, Anderson L, Kennedy B, Grant R, Gage H, Hurley MV. (2015) 'Active Residents in Care Homes (ARCH): study protocol to investigate the implementation and outcomes of a whole-systems activity programme in residential care homes for older people.'. Physiotherapy,
  • Flannery C, Burke LA, Grainger L, Williams P, Gage H. (2015) 'Risky sun tanning behaviours amongst Irish University students: a quantitative analysis.'. Springer Irish journal of medical science,
  • Iliffe S, Kendrick D, Morris R, Griffin M, Haworth D, Carpenter H, Masud T, Skelton DA, Dinan-Young S, Bowling A, Gage H. (2015) 'Promoting physical activity in older people in general practice: ProAct65+cluster randomised controlled trial'. ROYAL COLL GENERAL PRACTITIONERS BRITISH JOURNAL OF GENERAL PRACTICE, 65 (640), pp. E731-E738.
  • Holdsworth LM, Gage H, Coulton S, King A, Butler C. (2015) 'A quasi-experimental controlled evaluation of the impact of a hospice rapid response community service for end-of-life care on achievement of preferred place of death'. SAGE PUBLICATIONS LTD PALLIATIVE MEDICINE, 29 (9), pp. 817-825.

    Abstract

    Background: Rapid response services operating 24 h a day have been advocated in UK health policy to support dying patients at home, though there is limited evidence of their effectiveness. Aim: To assess the impact of a rapid response hospice at home service (intervention) on people dying in their preferred place, and carer quality of life, compared to usual care (control). Design: Quasi-experimental multi-centred controlled evaluation. Patient data were collected from hospice records; carers completed postal questionnaires to report quality of life, anxiety and depression. Setting and participants: Community served by one hospice (three contiguous sites) in South East England; 953 patients who died with a preferred place of death recorded and 64 carers who completed questionnaires. Results: There was no significant difference between control and intervention groups in proportions achieving preferred place of death (61.9% vs 63.0% (odds ratio: 0.949; 95% confidence interval: 0.788–1.142)). People living at home alone were less likely to die where they wanted (0.541; 95% confidence interval: 0.438–0.667). Carers in the intervention group reported worse mental health component summary scores (short form-12, p = 0.03) than those in the control group; there were no differences in other carer outcomes. Conclusion: The addition of a rapid response hospice at home service did not have a significant impact on helping patients to die where they wanted in an area already well served by community palliative care. Recording preferences, and changes over time, is difficult and presented challenges for this study.

  • Courtenay M, Carey N, Gage H, Stenner K, Williams P. (2015) 'A comparison of prescribing and non-prescribing nurses in the management of people with diabetes'. WILEY-BLACKWELL JOURNAL OF ADVANCED NURSING, 71 (12), pp. 2950-2964.
  • Macaulay M, Broadbridge J, Gage H, Williams P, Birch B, Moore KN, Cottenden A, Fader MJ. (2015) 'A trial of devices for urinary incontinence after treatment for prostate cancer'. WILEY-BLACKWELL BJU INTERNATIONAL, 116 (3), pp. 432-442.

    Abstract

    Objective To compare the performance of three continence management devices and absorbent pads used by men with persistent urinary incontinence (>1 year) after treatment for prostate cancer. Patients and Methods Randomised, controlled trial of 56 men with 1-year follow-up. Three devices were tested for 3 weeks each: sheath drainage system, body-worn urinal (BWU) and penile clamp. Device and pad performance were assessed. Quality of life (QoL) was measured at baseline and follow-up with the King's Health Questionnaire. Stated (intended use) and revealed (actual use) preference for products were assessed. Value-for-money was gathered. Results Substantial and significant differences in performance were found. The sheath was rated as ‘good’ for extended use (e.g. golf and travel) when pad changing is difficult; for keeping skin dry, not leaking, not smelling and convenient for storage and travel. The BWU was generally rated worse than the sheath and was mainly used for similar activities but by men who could not use a sheath (e.g. retracted penis) and was not good for seated activities. The clamp was good for short vigorous activities like swimming/exercise; it was the most secure, least likely to leak, most discreet but almost all men described it as uncomfortable or painful. The pads were good for everyday activities and best for night-time use; most easy to use, comfortable when dry but most likely to leak and most uncomfortable when wet. There was a preference for having a mixture of products to meet daytime needs; around two-thirds of men were using a combination of pads and devices after testing compared with baseline. Conclusions This is the first trial to systematically compare different continence management devices for men. Pads and devices have different strengths, which make them particularly suited to certain circumstances and activities. Most men prefer to use pads at night but would choose a mixture of pads and devices during the day. Device limitations were important but may be overcome by better design.

  • Brooke-Wavell K, Duckham RL, Taylor R, Kendrick D, Carpenter H, Iliffe S, Morris R, Skelton DA, Dinan S, Gage H, Masud T. (2015) 'DOES ADHERENCE TO FALLS PREVENTION EXERCISE PROGRAMMES BENEFIT BONE MINERAL DENSITY IN OLDER PEOPLE? THE PROACT65+BONE STUDY'. OXFORD UNIV PRESS AGE AND AGEING, 44, pp. 13-13.
  • Duckham RL, Masud T, Taylor R, Kendrick D, Carpenter H, Iliffe S, Morris R, Gage H, Skelton DA, Dinan-Young S, Brooke-Wavell K. (2015) 'Randomised controlled trial of the effectiveness of community group and home-based falls prevention exercise programmes on bone health in older people: the ProAct65+bone study'. OXFORD UNIV PRESS AGE AND AGEING, 44 (4), pp. 573-579.
  • Drennan VM, Halter M, Joly L, Gage H, Grant RL, Gabe J, Brearley S, Carneiro W, de Lusignan S. (2015) 'Physician associates and GPs in primary care: a comparison'. ROYAL COLL GENERAL PRACTITIONERS BRITISH JOURNAL OF GENERAL PRACTICE, 65 (634)
  • Drennan VM, Halter M, Joly L, Gage HM, Grant RL, Gabe J, Brearley S, Carneiro W, de Lusignan S. (2015) 'Physician associates and GPs in primary care: a comparison.'. British Journal of General Practice, , pp. e344-e350.
  • Jones F, Lennon S, Gage H, Bhalla A, Drummond A, Grant R, McKevitt C, Riazi A, Liston M. (2015) 'A feasibility study of an integrated stroke self-management program: A cluster randomized controlled trial'. WILEY-BLACKWELL INTERNATIONAL JOURNAL OF STROKE, 10, pp. 91-91.
  • Kassianos AP, Raats MM, Gage H, Peacock M. (2015) 'Quality of life and dietary changes among cancer patients: a systematic review'. SPRINGER QUALITY OF LIFE RESEARCH, 24 (3), pp. 705-719.
  • Gage H, Family H, Murphy F, Williams P, Sutton J, Taylor D. (2015) 'Comparison of sole nurse and team-delivered community clozapine services for people with treatment-resistant schizophrenia'. WILEY-BLACKWELL JOURNAL OF ADVANCED NURSING, 71 (3), pp. 547-558.
  • Gage H, Cheynel J, Williams P, Mitchell K, Stinton C, Katz J, Holland C, Sheehan B. (2015) 'Service utilisation and family support of people with dementia: A cohort study in England'. John Wiley & Sons, Ltd. International Journal of Geriatric Psychiatry, 30 (2), pp. 166-177.
  • Gage HM, Grainger L, Ting S, Williams P, Chorley, C, Carey G, Borg N, Bryan K, Castleton B, Trend P, Kaye J, Jordan J, Wade D. (2014) 'Specialist rehabilitation for people with Parkinson’s disease in the community: a randomized controlled trial'. NIHR Journals Library Health Services and Delivery Research, 2 (51)
  • Kumar A, Carpenter H, Cook J, Skelton DA, Stevens Z, Haworth D, Belcher CM, Gawler SJ, Gage H, Masud T, Bowling A, Pearl M, Morris RW, Iliffe S, Zijlstra GAR, Delbaere K, Kendrick D. (2014) 'EXERCISE FOR REDUCING FEAR OF FALLING IN OLDER PEOPLE LIVING IN THE COMMUNITY: A COCHRANE SYSTEMATIC REVIEW'. OXFORD UNIV PRESS AGE AND AGEING, 43
  • Gordon AL, Goodman C, Dening T, Davies S, Gladman JRF, Bell BG, Zubair M, Handley MJ, Meyer J, Bowman C, Gage H, Iliffe SR, Martin FC, Schneider J, Victor C. (2014) 'The optimal study: Describing the key components of optimal health care delivery to UK care home residents: A research protocol'. Journal of the American Medical Directors Association, 15 (9), pp. 681-686.
  • Barclay S, Froggatt K, Crang C, Mathie E, Handley M, Iliffe S, Manthorpe J, Gage H, Goodman C. (2014) 'Living in uncertain times: trajectories to death in residential care homes'. ROYAL COLL GENERAL PRACTITIONERS BRITISH JOURNAL OF GENERAL PRACTICE, 64 (626), pp. E576-E583.

    Abstract

    Background Older people living in care homes often have limited life expectancy. Practitioners and policymakers are increasingly questioning the appropriateness of many acute hospital admissions and the quality of end-of-life care provided in care homes.Aim To describe care home residents’ trajectories to death and care provision in their final weeks of life.Design and setting Prospective study of residents in six residential care homes in three sociodemographically varied English localities: Hertfordshire, Essex, and Cambridgeshire. Method Case note reviews and interviews with residents, care home staff, and healthcare professionals.Results Twenty-three out of 121 recruited residents died during the study period. Four trajectories to death were identified: ‘anticipated dying’ with an identifiable end-of-life care period and death in the care home (n = 9); ‘unexpected dying’ with death in the care home that was not anticipated and often sudden (n = 3); ‘uncertain dying’ with a period of diagnostic uncertainty or difficult symptom management leading to hospital admission and inpatient death (n = 7); and ‘unpredictable dying’ with an unexpected event leading to hospital admission and inpatient death (n = 4). End-of-life care tools were rarely used. Most residents who had had one or more acute hospital admission were still alive at the end of the study.Conclusion For some care home residents there was an identifiable period when they were approaching the end-of-life and planned care was put in place. For others, death came unexpectedly or during a period of considerable uncertainty, with care largely unplanned and reactive to events.

  • Iliffe S, Kendrick D, Morris R, Masud T, Gage H, Skelton D, Dinan S, Bowling A, Griffin M, Haworth D, Swanwick G, Carpenter H, Kumar A, Stevens Z, Gawler S, Barlow C, Cook J, Belcher C. (2014) 'Multicentre cluster randomised trial comparing a community group exercise programme and home-based exercise with usual care for people aged 65 years and over in primary care'. NIHR JOURNALS LIBRARY HEALTH TECHNOLOGY ASSESSMENT, 18 (49), pp. 1-+.
  • Gage H, Cheynel J, Williams P, Mitchell K, Stinton C, Katz J, Holland C, Sheehan B. (2014) 'Service utilisation and family support of people with dementia: a cohort study in England'. WILEY-BLACKWELL INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, 30 (2), pp. 166-177.
  • Drennan VM, Halter M, Brearley S, Carneiro W, Gabe J, Gage HM, Grant R, Joly L, de Lusignan S. (2014) 'Investigating the contribution of physician assistants to primary care in England: a mixed-methods study'. NIHR Journals Library Health Services and Delivery Research, 2 (16)
  • Fader MJ, Cottenden AM, Gage HM, Williams P, Getliffe K, Clarke-O'Neill S, Jamieson KM, Green NJ. (2014) 'Individual budgets for people with incontinence: Results from a 'shopping' experiment within the British National Health Service'. Health Expectations, 17 (2), pp. 186-196.
  • Handley M, Goodman C, Froggatt K, Mathie E, Gage H, Manthorpe J, Barclay S, Crang C, Iliffe S. (2014) 'Living and dying: responsibility for end-of-life care in care homes without on-site nursing provision - a prospective study'. WILEY-BLACKWELL HEALTH & SOCIAL CARE IN THE COMMUNITY, 22 (1), pp. 22-29.
  • Gage H, Egan B, Williams P, Gyoerei E, Brands B, Lopez-Robles J-C, Campoy C, Koletzko B, Decsi T, Raats M. (2014) 'Views of parents in four European countries about the effect of food on the mental performance of primary school children'. NATURE PUBLISHING GROUP EUROPEAN JOURNAL OF CLINICAL NUTRITION, 68 (1), pp. 32-37.

    Abstract

    Background/Objectives: Several factors affect the mental performance of children. The importance that parents attribute to food-related determinants, compared with genetic, socio-economic and school environment, was investigated. Subjects/Methods: Parents of school children (aged 4–11) were recruited through state primary schools in four European countries. Interviews were conducted in which participants were asked to sort 18 cards representing possible determinants of four elements of mental performance (attention, learning, mood and behaviour) according to perceived strength of effect. Determinants were identified from the literature and grouped in six categories: food-related, school environment, physical, social, psychological and biological. Effects were scored: 0=none; 1=moderate; and 2=strong. Views were compared between and within countries. Results: Two hundred parents took part (England: 53; Germany: 45; Hungary: 52; Spain: 50). Differences existed between countries in the proportions reporting university education and being in employment. Taking all countries together, parents consider the food category (mean 1.33) to have a lower impact on a child’s mental performance than physical (activity and sleep, 1.77), psychological (mood and behaviour, 1.69) and school environment (1.57). Social (1.12) and biological (0.91) determinants were ranked lower than food. Of determinants in the food category, parents thought regularity of meals had more influence on mental performance (1.58) than what a child eats now (1.36), food at school (1.35), nutrition as a baby/infant (1.02). Conclusion: Scope exists to improve parental awareness of the repercussions of their dietary choices for the mental performance of their children.

  • Jordan J, Dowson H, Gage H, Jackson D, Rockall T. (2014) 'Laparoscopic versus open colorectal resection for cancer and polyps: A cost-effectiveness study'. ClinicoEconomics and Outcomes Research, 6, pp. 415-422.

    Abstract

    © 2014 Jordan et al.Methods: Participants were recruited in 2006-2007 in a district general hospital in the south of England; those with a diagnosis of cancer or polyps were included in the analysis. Quality of life data were collected using EQ-5D, on alternate days after surgery for 4 weeks. Costs per patient, from a National Health Service perspective (in British pounds, 2006) comprised the sum of operative, hospital, and community costs. Missing data were filled using multiple imputation methods. The difference in mean quality adjusted life years and costs between surgery groups were estimated simultaneously using a multivariate regression model applied to 20 imputed datasets. The probability that laparoscopic surgery is cost-effective compared to open surgery for a given societal willingness-to-pay threshold is illustrated using a cost-effectiveness acceptability curve.Background: Available evidence that compares outcomes from laparoscopic and open surgery for colorectal cancer shows no difference in disease free or survival time, or in health-related quality of life outcomes, but does not capture the short term benefits of laparoscopic methods in the early postoperative period.Aim: To explore the cost-effectiveness of laparoscopic colorectal surgery, compared to open methods, using quality of life data gathered in the first 6 weeks after surgery.Results: The sample comprised 68 laparoscopic and 27 open surgery patients. At 28 days, the incremental cost per quality adjusted life year gained from laparoscopic surgery was £12,375. At a societal willingness-to-pay of £30,000, the probability that laparoscopic surgery is cost-effective, exceeds 65% (at £20,000 ≈60%). In sensitivity analyses, laparoscopic surgery remained cost-effective compared to open surgery, provided it results in a saving £699 in hospital bed days and takes no more than 8 minutes longer to perform.Conclusion: The study provides formal evidence of the cost-effectiveness of laparoscopic approaches and supports current guidelines that promote use of laparoscopy where suitably trained surgeons are available.

  • Kendrick D, Kumar A, Carpenter H, Zijlstra GAR, Skelton DA, Cook JR, Stevens Z, Belcher CM, Haworth D, Gawler SJ, Gage H, Masud T, Bowling A, Pearl M, Morris RW, Iliffe S, Delbaere K. (2014) 'Exercise for reducing fear of falling in older people living in the community'. WILEY-BLACKWELL COCHRANE DATABASE OF SYSTEMATIC REVIEWS, (11) Article number ARTN CD009848
  • Andreyev HJN, Benton BE, Lalji A, Norton C, Mohammed K, Gage H, Pennert K, Lindsay JO. (2013) 'Algorithm-based management of patients with gastrointestinal symptoms in patients after pelvic radiation treatment (ORBIT): a randomised controlled trial'. ELSEVIER SCIENCE INC LANCET, 382 (9910), pp. 2084-2092.
  • Goodman C, Davies SL, Norton C, Fader M, Morris J, Wells M, Gage H. (2013) 'Can district nurses and care home staff improve bowel care for older people using a clinical benchmarking tool?'. British Journal of Community Nursing, 18 (12), pp. 580-587.
  • Sheehan B, Lall R, Gage H, Holland C, Katz J, Mitchell K. (2013) 'A 12-month follow-up study of people with dementia referred to general hospital liaison psychiatry services'. OXFORD UNIV PRESS AGE AND AGEING, 42 (6), pp. 786-790.
  • Gage H, Von Rosen-Von Hoewel J, Laitinen K, Jakobik V, Martin-Bautista E, Schmid M, Egan B, Morgan J, Williams P, Decsi T, Campoy C, Koletzko B, Raats M. (2013) 'Health effects of infant feeding: Information for parents in leaflets and magazines in five European countries'. SAGE PUBLICATIONS LTD PUBLIC UNDERSTANDING OF SCIENCE, 22 (3), pp. 365-379.
  • Trivedi D, Goodman C, Gage H, Baron N, Scheibl F, Iliffe S, Manthorpe J, Bunn F, Drennan V. (2013) 'The effectiveness of inter-professional working for older people living in the community: A systematic review'. Health and Social Care in the Community, 21 (2), pp. 113-128.
  • Dowson HM, Ballard K, Gage H, Jackson D, Williams P, Rockall TA. (2013) 'Quality of Life in the First 6 Weeks Following Laparoscopic and Open Colorectal Surgery'. ELSEVIER SCIENCE INC VALUE IN HEALTH, 16 (2), pp. 367-372.
  • Gage H, Ting S, Williams P, Drennan V, Goodman C, Iliffe S, Manthorpe J, Davies SL, Masey H. (2013) 'Nurse-led case management for community dwelling older people: An explorative study of models and costs'. Journal of Nursing Management, 21 (1), pp. 191-201.
  • Katz J, Holland C, Mitchell K, Gage H, Thein N, Sheehan B. (2013) 'Carers' perspectives on choosing a care home for a relative with dementia'. POLICY PRESS FAMILIES RELATIONSHIPS AND SOCIETIES, 2 (2), pp. 211-228.
  • Halter M, Drennan V, Chattopadhyay K, Carneiro W, Yiallouros J, de Lusignan S, Gage H, Gabe J, Grant R. (2013) 'The contribution of Physician Assistants in primary care: a systematic review'. BIOMED CENTRAL LTD BMC HEALTH SERVICES RESEARCH, 13 Article number ARTN 223
  • Halimic A, Gage H, Vrikki M, Williams P. (2013) 'Diabetes Awareness and Behavioural Risk Factors among University Students in Saudi Arabia'. Middle East Journal of Family Medicine, 11 (3)
  • Dowson HM, Gage H, Jackson D, Qiao Y, Williams P, Rockall TA. (2012) 'Laparoscopic and open colorectal surgery: A prospective cost analysis'. Colorectal Disease, 14 (11), pp. 1424-1430.
  • Iliffe S, Haworth D, Stevens Z, Barlow C, Gawler S, Pearl M, Belcher C, Gage H, Carpenter H, Kendrick D, Dinan-Young S, Bowling A, Masud T, Skelton DA. (2012) 'THE PROACT65+ EXERCISE TRIAL SYMPOSIUM: AN OVERVIEW, PRACTICAL IMPLICATIONS AND LESSONS LEARNED'. HUMAN KINETICS PUBL INC JOURNAL OF AGING AND PHYSICAL ACTIVITY, 20, pp. S115-S115.
  • Butler C, Holdsworth LM, Coulton S, Gage H. (2012) 'Evaluation of a hospice rapid response community service: A controlled evaluation'. BMC Palliative Care, 11

    Abstract

    Background: While most people faced with a terminal illness would prefer to die at home, less than a third in England are enabled to do so with many dying in National Health Service hospitals. Patients are more likely to die at home if their carers receive professional support. Hospice rapid response teams, which provide specialist palliative care at home on a 24/7 on-call basis, are proposed as an effective way to help terminally ill patients die in their preferred place, usually at home. However, the effectiveness of rapid response teams has not been rigorously evaluated in terms of patient, carer and cost outcomes. Methods/Design: The study is a pragmatic quasi-experimental controlled trial. The primary outcome for the quantitative evaluation for patients is dying in their preferred place of death. Carers quality of life will be evaluated using postal questionnaires sent at patient intake to the hospice service and eight months later. Carers perceptions of care received and the patients death will be assessed in one to one interviews at 6 to 8 months post bereavement. Service utilisation costs including the rapid response intervention will be compared to those of usual care. Discussion: The study will contribute to the development of the evidence base on outcomes for patients and carers and costs of hospice rapid response teams operating in the community. Trial registration: Current controlled trials ISRCTN32119670. © 2012 Butler et al.; licensee BioMed Central Ltd.

  • Andreyev HJ, Thomas K, Benton B, Lalji A, Lindsay JO, Gage H, Norton C. (2012) 'OPTIMISING RADIATION BOWEL INJURY THERAPY, THE ORBIT STUDY, A RANDOMISED CONTROLLED TRIAL'. B M J PUBLISHING GROUP GUT, 61, pp. A36-A36.
  • Sheehan BD, Lall R, Stinton C, Mitchell K, Gage H, Holland C, Katz J. (2012) 'Patient and proxy measurement of quality of life among general hospital in-patients with dementia'. Aging and Mental Health, 16 (5), pp. 603-607.
  • Gage H, Williams P, Von Rosen-Von Hoewel J, Laitinen K, Jakobik V, Martin-Bautista E, Schmid M, Egan B, Morgan J, Decsi T, Campoy C, Koletzko B, Raats M. (2012) 'Influences on infant feeding decisions of first-time mothers in five European countries'. European Journal of Clinical Nutrition, 66 (8), pp. 914-919.

    Abstract

    BACKGROUND/OBJECTIVES:Infant feeding decisions made by new parents have significant health implications. The study aimed to investigate: influences on infant feeding decisions; characteristics of mothers reporting reliance on alternative information sources; associations between reliance on different sources and intentions to exclusively breastfeed and introduce complementary foods later; and subsequent breastfeeding and weaning behaviours.SUBJECTS/ METHODS:First-time mothers in five European countries (England, Finland, Germany, Hungary, Spain) completed questionnaires about the importance of 17 influences on infant feeding choices at birth and 8 months later, during 2007-2008. Use of individual sources and reliance on four categories (family and friends, health professionals, written materials, audio-visual media) were compared between countries. Associations between information sources used and mother characteristics, feeding intentions and behaviours were investigated using appropriate statistical tests.RESULTS:In all, 2071 first-time mothers provided baseline data; 78% at 8 months. Variation exists between countries in the influence of different sources on feeding decisions of first-time mothers. Across all countries, the most important influences at both time points were books, partner and antenatal midwife. Mothers in higher income quintiles and remaining at school beyond age 16 years reported greater reliance on written sources (P0.0005). Mothers relying most on written sources reported longer exclusive breastfeeding (P0.002), and a tendency to introduce foods other than milk later (P0.079) than mothers relying most on personal or professional contacts.CONCLUSION:Further research is required about which dissemination strategies are most effective at improving infant feeding behaviours in varied cultural settings, and for different socio-economic groups. © 2012 Macmillan Publishers Limited.

  • Gage H, Schmid M, Egan B, Morgan J, Raats M, Williams P, Von Rosen-Von Hoewel J, Koletzko B, Laitinen K, Jakobik V, Martin-Bautista E, Decsi T, Campoy C. (2012) 'Influences on infant feeding decisions of first-time mothers in five European countries'. European Journal of Clinical Nutrition,
  • Drennan VM, Chattopadhyay K, Halter M, Brearley S, de Lusignan S, Gabe J, Gage H. (2012) 'Physician assistants in English primary care teams: A survey.'. J Interprof Care,
  • Gage H, Erdal E, Saigal P, Qiao Y, Williams P, Raats MM. (2012) 'Recognition and management of overweight and obese children: A questionnaire survey of general practitioners and parents in England.'. Wiley-Blackwell Journal of Paediatrics and Child Health, 48 (2), pp. 146-152.

    Abstract

    Aims:  To (i) compare the views of general practitioners (GPs) and parents about the causes, consequences and management of childhood overweight/obesity; and (ii) explore the extent to which they can identify overweight/obesity in children. Methods:  A questionnaire was mailed to all GPs in one Primary Care Trust and all parents in one primary school in southern England, 2008. Information was gathered on socio-demographic background, views about causes, consequences and management of childhood overweight/obesity; judgements about the weight status of 14 images of children (seven boys, seven girls) in the Children's Body Image Scale (CBIS). Comparisons were made between GP and parents' responses using unpaired bivariate tests. Results:  The response rate was 33%. Differences exist between the views of GPs and parents about childhood weight management: 86.4% of parents felt GPs should be involved, compared to 73.3% of GPs (P < 0.001). Parents thought GPs should be more proactive than the GPs stated they would be. GPs were significantly more likely than parents to see a role for school nurses and dieticians. One third of respondents thought GPs lacked expertise in child weight management. Most GPs and parents correctly identified obese children from the images, but inaccuracies occurred at category margins. Conclusions:  Childhood overweight/obesity is a serious public health concern, and primary care has a role to play in tackling it. GPs in England need more training in childhood overweight/obesity management. Their role needs to be clarified in the context of multiagency approaches.

  • Gage H, Ting S, Williams P, Drennan V, Goodman C, Iliffe S, Manthorpe J, Davies SL, Masey H. (2012) 'Nurse-led case management for community dwelling older people: An explorative study of models and costs'. Journal of Nursing Management,
  • Brands B, Egan B, Györei E, López-Robles JC, Gage H, Campoy C, Decsi T, Koletzko B, Raats MM. (2012) 'A qualitative interview study on effects of diet on children's mental state and performance. Evaluation of perceptions, attitudes and beliefs of parents in four European countries'. Elsevier Appetite, 58 (2), pp. 739-746.
  • Gage H, Erdal E, Saigal P, Qiao Y, Williams P, Raats MM. (2012) 'Recognition and management of overweight and obese children: A questionnaire survey of general practitioners and parents in England'. Journal of Paediatrics and Child Health, 48 (2), pp. 146-152.
  • Trivedi D, Goodman C, Baron N, Scheibl F, Bunn F, Gage H, Iliffe S, Manthorpe J, Drennan V. (2012) 'The effectiveness of inter-professional working for older people living in the community: A systematic review'. Health and Social Care in the Community,
  • Axelrod L, Bryan K, Gage H, Kaye J, Ting S, Williams P, Trend P, Wade D. (2012) 'Disease-specific training in Parkinson's disease for care assistants: A comparison of interactive and self-study methods'. Clinical Rehabilitation, 26 (6), pp. 545-557.

    Abstract

    Objective: To compare two approaches to providing training to care assistants in Parkinson's disease.Design: Pragmatic parallel arm controlled trial.Setting: Training either by an interactive training day at a local medical education establishment or self study.Subjects: Care assistants recruited from local health and social care providers.Interventions: The content of both interventions was similar, covering causes, symptoms, diagnosis of Parkinson's disease, multidisciplinary management, mobility, communication, swallowing, and involving 5 hours of study time.Main measures: Knowledge about Parkinson's (assessed by true/false quizzes and identifying 'four facts' about Parkinson's) immediately post training and six weeks later; views on training methods of care assistants and employers/managers.Results: Thirty-seven employers nominated 100 care staff who were allocated to interactive training (49) and self study (51). Training completion rates (retained to six-week follow-up) were lower for self study (42.1% vs. 83.7% training day). There were no significant differences between groups on quiz or 'four facts' scores at baseline or six-week follow-up. Immediately post training, the self-study group (with access to written materials) had significantly higher quiz scores than the training day group (no access to materials at test). Within-group comparisons showed improvements post training. Although interactive training may be preferred, obtaining release from duties can be problematic.Conclusions: Both approaches have similar effects on knowledge of care assistants without prior specific training. Providing a variety of approaches will cater for all preferences. The findings may be generalizable to training the care workforce for other specific roles. © The Author(s) 2011.

  • Gage H, Cheynel J, Dickinson A, Davies SL, Goodman C, Victor C, Martin W, Williams P, Iliffe S, Froggatt K. (2012) 'Integrated working between residential care homes and primary care: A survey of care homes in England'. BMC Geriatrics, 12
  • Egan B, Gage H, Hood J, Poole K, McDowell C, Maguire G, Storey L. (2012) 'Availability of complementary and alternative medicine for people with cancer in the British National Health Service: Results of a national survey'. Complementary Therapies in Clinical Practice, 18 (2), pp. 75-80.
  • Egan B, Gage H, Hood J, Poole K, McDowell C, Maguire G, Storey L. (2012) 'Availability of complementary and alternative medicine for people with cancer in the British National Health Service: Results of a national survey'. Elsevier Complementary Therapies in Clinical Practice, 18 (2), pp. 75-80.
  • Gage H, Ting S, Williams P, Bryan K, Kaye J, Castleton B, Trend P, Wade D. (2011) 'A comparison of specialist rehabilitation and care assistant support with specialist rehabilitation alone and usual care for people with Parkinson's living in the community: study protocol for a randomised controlled trial.'. BioMed Central Trials, England: 12
  • Jakobik V, Martin-Bautista E, Gage H, Von Rosen-Von Hoewel J, Laitinen K, Schmid M, Morgan J, Williams P, Campoy C, Koletzko B, Raats M, Decsi T. (2011) 'Programming effect of breast-feeding in infant nutrition policy documents in Hungary'. Orvosi Hetilap, 152 (41), pp. 1641-1647.
  • Gage H, Raats MM, Williams P, Egan B, Jakobik V, Laitinen K, Martin-Bautista E, Schmid M, von Rosen-von Hoewel J, Campoy C, Decsi T, Morgan J, Koletzko B. (2011) 'Developmental origins of health and disease: the views of first-time mothers in 5 European countries on the importance of nutritional influences in the first year of life.'. American Society for Nutrition American Journal of Clinical Nutrition, 94 (6S), pp. 2018S-2024S.
  • Drennan V, Goodman C, Manthorpe J, Davies S, Scott C, Gage H, Iliffe S. (2011) 'Establishing new nursing roles: a case study of the English community matron initiative'. WILEY-BLACKWELL JOURNAL OF CLINICAL NURSING, 20 (19-20), pp. 2948-2957.
  • Gage H, Kaye J, Kimber A, Storey L, Egan M, Qiao Y, Trend P. (2011) 'Correlates of constipation in people with Parkinson's'. Parkinsonism and Related Disorders, 17 (2), pp. 106-111.

    Abstract

    Purpose: To investigate clinical, demographic and dietary factors associated with constipation in a sample of community dwelling people with Parkinson's disease, recruited through a specialist outpatient clinic. Partners/carers provided a convenience control group. Scope: Participants completed a baseline questionnaire (background information, diet and exercise, activities of daily living: mobility and manual dexterity, health-related quality of life (SF-12), stool frequency and characteristics, extent of concern due to constipation, laxative taking), and a four-week stool diary. The Rome criterion was used to determine constipation status. Multiple regression methods were used to explore the correlates of constipation. Baseline data were provided by 121 people with Parkinson's, (54 controls), of whom 73% (25%) met the Rome criterion. Prospective diary data from 106 people with Parkinson's (43 controls) showed lower proportions: 35% (7%) meeting the Rome criterion. Among all study subjects, i.e. Parkinson's patients and controls taken together, the presence of constipation is predicted by having Parkinson's disease (p=.003; odds ratio 4.80, 95% CI 1.64-14.04) and mobility score (p=.04; odds ratio 1.15, 95% CI 1.01-1.31), but not by dietary factors. Amongst people with Parkinson's constipation is predicted by number of medications (p=.027). Laxative taking masks constipation, and is significantly associated with wearing protection against bowel incontinence (p=.009; odds ratio 4.80, 95% CI: 1.48-15.52). Conclusions: Constipation is disease-related, not a lifestyle factor. More research is needed on optimal management and laxative use. © 2010 Elsevier Ltd.

  • Davies SL, Goodman C, Bunn F, Dickinson A, Victor C, Martin W, Iliffe S, Gage H, Froggatt K. (2011) 'A systematic review of integrated working between care homes and health care services'. BMC Health Services Research, 11
  • Goodman C, Mathie E, Cowe M, Mendoza A, Westwood D, Munday D, Wilson PM, Crang C, Froggatt K, Iliffe S, Manthorpe J, Gage H, Barclay S. (2011) 'Talking about living and dying with the oldest old: Public involvement in a study on end of life care in care homes'. BMC Palliative Care, 10
  • Metta V, Logishetty K, Martinez-Martin P, Gage HM, Schartau PES, Kaluarachchi TK, Martin A, Odin P, Barone P, Stocchi F, Antonini A, Chaudhuri KR. (2011) 'The possible clinical predictors of fatigue in parkinson's disease: A study of 135 patients as part of international nonmotor scale validation project'. Parkinson's Disease,
  • Poltawski L, Goodman C, Iliffe S, Manthorpe J, Gage H, Shah D, Drennan V. (2011) 'Frailty scales - Their potential in interprofessional working with older people: A discussion paper'. Journal of Interprofessional Care, 25 (4), pp. 280-286.
  • Drennan V, Goodman C, Manthorpe J, Davies S, Scott C, Gage H, Iliffe S. (2011) 'Establishing new nursing roles: A case study of the English community matron initiative'. Journal of Clinical Nursing, 20 (19-20), pp. 2948-2957.
  • Iliffe S, Drennan V, Manthorpe J, Gage H, Davies SL, Massey H, Scott C, Brearley S, Goodman C. (2011) 'Nurse case management and general practice: Implications for GP consortia'. British Journal of General Practice, 61 (591), pp. e658-e665.
  • Goodman C, Scheibl F, Drennan V, Shah D, Manthorpe J, Gage H, Iliffe S. (2011) 'Models of inter professional working for older people living at home: A survey and review of the local strategies of English health and social care statutory organisations'. BMC Health Services Research, 11
  • Gage H, Kaye J, Kimber A, Storey L, Egan M, Qiao Y, Trend P. (2010) 'Correlates of constipation in people with Parkinson's'. ELSEVIER SCI LTD PARKINSONISM & RELATED DISORDERS, 17 (2), pp. 106-111.
  • Axelrod L, Gage H, Kaye J, Bryan K, Trend P, Wade D. (2010) 'Workloads of Parkinson's specialist nurses: Implications for implementing national service guidelines in England'. Journal of Clinical Nursing, 19 (23-24), pp. 3575-3580.
  • Gage H, Ting S, Chorley C, Kaye J, Bryan K, Williams P, Axelrod L, Trend P, Wade D. (2010) 'Disease-Specific Training for Care Assistants: A Randomized Controlled Trial Comparing Two Approaches for Improving Understanding of Parkinson's'. WILEY-LISS MOVEMENT DISORDERS, 25, pp. S700-S700.
  • Kassianos A, Raats M, Rayman M, Gage H. (2010) 'Information needs and information-seeking behaviour'. TAYLOR & FRANCIS LTD PSYCHOLOGY & HEALTH, 25, pp. 250-251.
  • Gage H, Goodman C, Davies SL, Norton C, Fader M, Wells M, Morris J, Williams P. (2010) 'Laxative use in care homes'. WILEY-BLACKWELL JOURNAL OF ADVANCED NURSING, 66 (6), pp. 1266-1272.
  • Iliffe S, Kendrick D, Morris R, Skelton D, Gage H, Dinan S, Stevens Z, Pearl M, Masud T. (2010) 'Multi-centre cluster randomised trial comparing a community group exercise programme with home based exercise with usual care for people aged 65 and over in primary care: Protocol of the ProAct 65+ trial'. Trials, 11
  • Martin-Bautista E, Gage H, Von Rosen-Von Hoewel J, Jakobik V, Laitinen K, Schmid M, Morgan J, Williams P, Decsi T, Campoy C, Koletzko B, Raats M. (2010) 'Lifetime health outcomes of breast-feeding: A comparison of the policy documents of five European countries'. Public Health Nutrition, 13 (10), pp. 1653-1662.
  • Gage H, Knibb W, Evans J, Williams P, Rickman N, Bryan K. (2009) 'Why are some care homes better than others? An empirical study of the factors associated with quality of care for older people in residential homes in Surrey, England'. WILEY-BLACKWELL PUBLISHING, INC HEALTH & SOCIAL CARE IN THE COMMUNITY, 17 (6), pp. 599-609.
  • Gage H, Knibb W, Evans J, Williams P, Rickman N, Bryan K. (2009) 'Nursing homes More on quality of care'. B M J PUBLISHING GROUP BRITISH MEDICAL JOURNAL, 339 Article number ARTN b3526
  • Gage H, Storey L, McDowell C, Maguire G, Williams P, Faithfull S, Thomas H, Poole K. (2009) 'Integrated care: Utilisation of complementary and alternative medicine within a conventional cancer treatment centre'. Complementary Therapies in Medicine, 17 (2), pp. 84-91.
  • Fader M, Cottenden A, Getliffe K, Gage H, Clarke-O'Neill S, Jamieson K, Green N, Williams P, Brooks R, Malone-Lee J. (2008) 'Absorbent products for urinary/faecal incontinence: a comparative evaluation of key product designs - Introduction'. Health Technology Assessment, 12 (29), pp. 1-+.
  • Fader M, Cottenden A, Getliffe K, Gage H, Clarke-O'Neill S, Jamieson K, Green N, Williams P, Brooks R, Malone-Lee J. (2008) 'Absorbent products for urinary/faecal incontinence: a comparative evaluation of key product designs - Introduction'. GRAY PUBLISHING Health Technology Assessment, 12 (29)
  • Fader M, Cottenden A, Getliffe K, Gage H, Clarke-O'Neill S, Jamieson K, Green N, Williams P, Brooks R, Malone-Lee J. (2008) 'Absorbent products for urinary/faecal incontinence: A comparative evaluation of key product designs'. Health Technology Assessment, 12 (29), pp. iii-129.
  • Dowson HM, Cowie AS, Ballard K, Gage H, Rockall TA. (2008) 'Systematic review of quality of life following laparoscopic and open colorectal surgery'. Colorectal Disease, 10 (8), pp. 757-768.
  • Fader M, Cottenden A, Getliffe K, Gage H, Clarke-O'Neill S, Jamieson K, Green N, Williams P, Brooks R, Malone-Lee J. (2008) 'Absorbent products for urinary/faecal incontinence: A comparative evaluation of key product designs'. Health Technology Assessment, 12 (29), pp. iii-129.
  • Dowson HM, Huang A, Soon Y, Gage H, Lovell DP, Rockall TA. (2007) 'Systematic review of the costs of laparoscopic colorectal surgery'. Diseases of the Colon and Rectum, 50 (6), pp. 908-919.
  • Poole K, Gage H, Storey L, Egan B, Thomas H. (2007) 'Home Chemotherapy: should patients have a choice?'. British Journal of Home Healthcare, 2 (2), pp. 12-14.
  • Paul S, Kokossis A, Gage H, Storey L, Lawrenson R, Trend P, Walmsley K, Morrison S, Kaye J, Gradwell E, Baker M. (2006) 'A semantically enabled formalism for the knowledge management of Parkinson's disease.'. Med Inform Internet Med, England: 31 (2), pp. 101-120.
  • Bryan K, Gage H, Gilbert K. (2006) 'Delayed transfers of older people from hospital: Causes and policy implications.'. Health Policy, Ireland: 76 (2), pp. 194-201.

    Abstract

    Health and social care agencies in the UK. have been under pressure for some time to reduce delayed transfers of older people from hospital because they absorb scarce health service resources and incur a human cost through inappropriate placement. A local study based on an analysis of records and interviews with managers showed that delays reflect the complex needs of older people, and arise from financing and organisational problems at both the planning and implementation stages of a discharge. Family resistance may also be a factor. Budgetary constraints result in delays in confirming public support for some clients. Shortages of professional staff and care assistants limit the provision of domiciliary packages. The contraction of the residential sector has reduced the availability of beds and increased the cost of care home placements. Scope exists for expediting administrative aspects of transfers by coordinating health and social services. More recent legislation that imposes fines on social service departments for delayed transfers does not address underlying causes.

  • Paul S, Kokossis A, Gage H, Storey L, Lawrenson R, Trend P, Walmsley K, Morrison S, Kaye J, Gradwell E, Baker M. (2006) 'A semantically enabled formalism for the knowledge management of Parkinson's disease'. Informatics for Health and Social Care, 31 (2), pp. 101-120.
  • Gage H, Kaye J, Owen C, Trend P, Wade D. (2006) 'Evaluating rehabilitation using cost-consequences analysis: An example in Parkinson's disease'. Clinical Rehabilitation, 20 (3), pp. 232-238.
  • Kaye J, Gage H, Kimber A, Storey L, Trend P. (2006) 'Excess burden of constipation in Parkinson's disease: A pilot study'. Movement Disorders, 21 (8), pp. 1270-1273.
  • Bird A, Gage H, Owen C, Storey L. (2005) 'Understanding of blood pressure and behavioural risk factors amongst British adolescents'. Public Health, 119 (12), pp. 1069-1079.
  • Gage H, Hampson S, Skinner TC, Hart J, Storey L, Foxcroft D, Kimber A, Cradock S, McEvilly EA. (2004) 'Educational and psychosocial programmes for adolescents with diabetes: approaches, outcomes and cost-effectiveness'. Patient Education and Counseling, 53 (3), pp. 333-346.
  • Gage H, Storey L. (2004) 'Rehabilitation for Parkinson's disease: A systematic review of available evidence'. Clinical Rehabilitation, 18 (5), pp. 463-482.
  • Gage H, Hendricks A, Zhang S, Kazis L. (2003) 'The relative health related quality of life of veterans with Parkinson's disease'. Journal of Neurology Neurosurgery and Psychiatry, 74 (2), pp. 163-169.
  • Wade DT, Gage H, Owen C, Trend P, Grossmith C, Kaye J. (2003) 'Multidisciplinary rehabilitation for people with Parkinson's disease: A randomised controlled study'. Journal of Neurology Neurosurgery and Psychiatry, 74 (2), pp. 158-162.
  • Gage HM, Pope R, Lake F. (2002) 'Retaining nurses in the NHS - Nurses' loyalty may be underestimated'. BRITISH MED JOURNAL PUBL GROUP BRITISH MEDICAL JOURNAL, 325 (7376), pp. 1362-1362.
  • Crow R, Gage H, Hampson S, Hart J, Kimber A, Storey L, Thomas H. (2002) 'The measurement of satisfaction with healthcare: implications for practice from a systematic review of the literature.'. Health technology assessment (Winchester, England), 6 (32), pp. 1-244.
  • Gage H, Kenward G, Hodgetts TJ, Castle N, Ineson N, Shaikh L. (2002) 'Health system costs of in-hospital cardiac arrest'. Resuscitation, 54 (2), pp. 139-146.
  • Crow R, Gage H, Hampson S, Hart J, Kimber A, Storey L, Thomas H. (2002) 'The measurement of satisfaction with healthcare: implications for practice from a systematic review of the literature.'. Health technology assessment (Winchester, England), 6 (32), pp. 1-244.
  • Trend P, Kaye J, Gage H, Owen C, Wade D. (2002) 'Short-term effectiveness of intensive multidisciplinary rehabilitation for people with Parkinson's disease and their carers'. Clinical Rehabilitation, 16 (7), pp. 717-725.
  • Crow R, Gage H, Hampson S, Hart J, Kimber A, Storey L, Thomas H. (2002) 'The measurement of satisfaction with healthcare: Implications for practice from a systematic review of the literature'. Health Technology Assessment, 6 (32)
  • Gage H. (2001) 'NHS malaise: Diagnosis and treatment options'. Economic Affairs, 21 (4), pp. 9-13.
  • Gage H. (2001) 'Keeping nurses nursing: a quantitative analysis.'. Nursing times, 97 (7), pp. 35-37.
  • Hampson SE, Skinner TC, Hart J, Storey L, Gage H, Foxcroft D, Kimber A, Shaw K, Walker J. (2001) 'Effects of educational and psychosocial interventions for adolescents with diabetes mellitus: A systematic review'. Health Technology Assessment, 5 (10)
  • Hampson SE, Skinner TC, Hart J, Storey L, Gage H, Foxcroft D, Kimber A, Cradock S, McEvilly EA. (2000) 'Behavioral interventions for adolescents with type 1 diabetes: How effective are they?'. Diabetes Care, 23 (9), pp. 1416-1422.
  • Getliffe KA, Crouch R, Gage H, Lake F, Wilson SL. (2000) 'Hypertension awareness, detection and treatment in a university community: Results of a worksite screening'. Public Health, 114 (5), pp. 361-366.
  • Meyers AR, Gage H, Hendricks A. (2000) 'Health-related quality of life in neurology'. Archives of Neurology, 57 (8), pp. 1224-1227.
  • Gage H. (1998) 'Objective and subjective evidence of success with WinEcon'. Computers in Higher Education Economics Review, 12 (2), pp. 14-16.

Conference papers

  • Brooke-Wavell K, Duckham RL, Taylor R, Kendrick D, Carpenter H, Iliffe S, Morris R, Dinan S, Skelton DA, Gage H, Masud T. (2014) 'EFFECTIVENESS OF COMMUNITY GROUP AND HOME BASED FALLS PREVENTION EXERCISE PROGRAMMES ON BONE HEALTH IN OLDER PEOPLE: THE PROACT65+BONE STUDY'. SPRINGER LONDON LTD OSTEOPOROSIS INTERNATIONAL, Birmingham, ENGLAND: Osteoporosis Conference 25, pp. S676-S676.
  • Duckham R, Brooke-Wavell K, Masud T, Taylor R, Kendrick D, Carpenter H, Skelton DA, Dinan S, Gage H, Morris R, Iliffe S. (2014) 'Effectiveness of Community Group and Home Based Falls Prevention Exercise Programmes on Bone Health in Older People: the ProAct65+Bone Study.'. WILEY-BLACKWELL JOURNAL OF BONE AND MINERAL RESEARCH, Houston, TX: Annual Meeting of the American-Society-for-Bone-and-Mineral-Research 29, pp. S224-S224.
  • Andreyev HJ, Benton B, Lalji A, Pennert K, Lindsay JO, Gage H, Norton C. (2013) 'ALGORITHMIC MANAGEMENT OF RADIATION-INDUCED GI SYMPTOMS IS HIGHLY EFFECTIVE: THE ORBIT RANDOMISED CONTROLLED TRIAL'. BMJ PUBLISHING GROUP GUT, Glasgow, SCOTLAND: Annual General Meeting of the British-Society-of-Gastroenterology 62, pp. A29-A30.
  • Gage H, Egan B, Williams P, Lopez-Robles JC, Brands B, Gyoerei E, Campoy C, Desci T, Koletzko B, Raats M. (2013) 'ASSOCIATION BETWEEN DIET AND PHYSICAL AND MENTAL DEVELOPMENT OF CHILDREN: VIEWS OF PARENTS AND TEACHERS IN FOUR EUROPEAN COUNTRIES'. KARGER ANNALS OF NUTRITION AND METABOLISM, 63, pp. 1863-1863.
  • Gage H, Egan B, Williams P, Gyoerei E, Brands B, Lopez-Robles J-C, Brown KA, Campoy C, Koletzko B, Decsi T, Raats MM. (2013) 'VIEWS OF PARENTS IN FOUR EUROPEAN COUNTRIES ABOUT THE EFFECT OF FOOD ON THE MENTAL PERFORMANCE OF PRIMARY SCHOOL CHILDREN'. KARGER ANNALS OF NUTRITION AND METABOLISM, 63, pp. 1132-1132.
  • Egan B, Gage H, Williams P, Gyoerei E, Brands B, Lopez-Robles JC, Campoy C, Koletzko B, Desci T, Raats M. (2013) 'ASSOCIATION BETWEEN DIET AND MENTAL PERFORMANCE OF CHILDREN: VIEWS OF PARENTS AND TEACHERS IN FOUR EUROPEAN COUNTRIES'. KARGER ANNALS OF NUTRITION AND METABOLISM, 63, pp. 1862-1862.
  • Egan B, Gage H, Williams P, Brands B, Gyoerei E, Lopez-Robles JC, Koletzko B, Campoy C, Desci T, Raats M. (2013) 'FACTORS AFFECTING FOOD CHOICES OF PARENTS OF CHILDREN AGED 4-10 YEARS IN FOUR EUROPEAN COUNTRIES'. KARGER ANNALS OF NUTRITION AND METABOLISM, 63, pp. 1862-1862.
  • Lopez Robles J, Egan B, Brands B, Gyoerei E, Gage H, Raats M, Koletzko B, Decsi T, Campoy C. (2011) 'Teachers knowledge of the influence of nutrition on childrens mental performance in four European countries'. KARGER ANNALS OF NUTRITION AND METABOLISM, 58, pp. 409-409.
  • Eagan B, Gage H, Williams P, Raats M, Brands B, Gyoerei E, Lopez-Robles J, Campoy C, Koletzko B, Decsi T. (2011) 'Diet and mental performance of children: A questionnaire survey of parents in four European countries.'. KARGER ANNALS OF NUTRITION AND METABOLISM, 58, pp. 29-29.
  • Gyoerei E, Egan B, Gage H, Williams P, Raats M, Brands B, Lopez-Robles J, Campoy C, Koletzko B, Decsi T. (2011) 'Effect of food on learning: views of parents in four European countries'. KARGER ANNALS OF NUTRITION AND METABOLISM, 58, pp. 137-138.
  • Brands B, Egan B, Gage H, Lopez-Robles JC, Gyoerei E, Raats M, Martin-Bautista E, Decsi T, Campoy C, Koletzko B. (2010) 'THE EFFECT OF DIET ON CHILDREN'S MENTAL PERFORMANCE - A QUALITATIVE STUDY OF PERCEPTIONS, ATTITUDES AND BELIEFS OF PARENTS IN FOUR EUROPEAN COUNTRIES'. LIPPINCOTT WILLIAMS & WILKINS JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION, 50, pp. E189-E189.
  • Lopez-Robles JC, Egan B, Gage H, Gyorei E, Brands B, Raats M, Martin-Bautista E, Tamas D, Koletzko B, Campoy C. (2010) 'QUANTITATIVE STUDY OF SPANISH PARENTS BELIEFS OF WHAT EFFECTS CHILDREN'S MENTAL PERFORMANCE'. LIPPINCOTT WILLIAMS & WILKINS JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION, 50, pp. E191-E191.
  • von Rosen-von Hoewel J, Laitinen K, Martin-Bautista E, Campoy C, Jakobik V, Decsi T, Schmid MA, Morgan J, Gage H, Koletzko B, Raats M. (2009) 'Obesity Related Programming Statements in Materials on Infant Feeding Aimed at Parents in Five European Countries'. SPRINGER EARLY NUTRITION PROGRAMMING AND HEALTH OUTCOMES IN LATER LIFE: OBESITY AND BEYOND, Budapest, HUNGARY: International Conference on Early Nutrition Programming and Health Outcomes in Later Life 646, pp. 175-181.
  • Schmid MA, von Rosen-von Hoewel J, Martin-Bautista E, Szabo E, Campoy C, Decsi T, Morgan J, Gage H, Koletzko B, Raats M. (2009) 'Infant Feeding and the Concept of Early Nutrition Programming: A Comparison of Qualitative Data from Four European Countries'. Springer Budapest, Hungary: Early Nutritional Programming and Health Outcome in Later Life: Obesity and Beyond, pp. 183-187.
  • Martin-Bautista E, Campoy C, Decsi T, Bokor S, von Rosen-von Hoewel J, Laitinen K, Schmid MA, Morgan J, Gage H, Koletzko B, Raats M. (2009) 'Obesity Related Programming Statements in Infant Feeding Policies in Five European Countries'. Springer Budapest, Hungary: International Conference on Early Nutrition Programming and Health Outcomes in Later Life: Obesity and Beyond, pp. 169-173.
  • Hoewel J, Laitinen K, Schmid MA, Decsi T, Martin-Bautista E, Koletzko B, Jakobik V, Campoy C, Gage H, Morgan J, Raats MM. (2007) 'Nutrition programming statements in materials on infant feeding aimed at parents: comparison among five European countries'. Proceedings of the Nutrition Society, 66 (Supp OCA-B), pp. 23A-23A.
  • von Rosen-von Hoewel J, Martin-Bautista E, Campoy C, Jakobik V, Decsi T, Laitinen K, Schmid MA, Morgan J, Gage H, Koletzko B, Raats M. (2007) 'Reflection of early nutrition programming in parental information of infant feeding: comparative analysis of five European countries'. Early Human Development, 83, pp. S126-S126.
  • Decsi T, Bokor SZ, Martin-Bautista E, Campoy C, Laitinen K, Hoewel J, Schmid MA, Gage H, Koletzko B, Morgan J, Raats MM. (2007) 'Representation of early nutritional programming in policy documents on infant nutrition: comparison of five European countries'. Proceedings of the Nutrition Society, 66, pp. 16A-16A.
  • Fader M, Clarke-O'Neill S, Green N, Jamieson K, Gage H, Getliffe K, Brooks R, Malone-Lee J, Cottenden A. (2007) 'Gender differences in performance of and preferences for absorbent products for men and women with moderate-heavy urinary incontinence: A randomized cross-over clinical trial'. Rotterdam, NETHERLANDS : Wiley-Liss Politics: 37th Annual Meeting of the International-Continence-Society
  • Fader M, Clarke-O'Neill S, Green N, Jamieson K, Gage H, Getliffe K, Brooks R, Malone-Lee J, Cottenden A. (2007) 'Gender differences in performance of and preferences for absorbent products for men and women with moderate-heavy urinary incontinence: A randomized cross-over clinical trial'. WILEY-BLACKWELL NEUROUROLOGY AND URODYNAMICS, Rotterdam, NETHERLANDS: 37th Annual Meeting of the International-Continence-Society 26 (5), pp. 635-636.
  • Dowson HM, Huang A, Soon Y, Gage H, Lovell DP, Rockall TA. (2006) 'Systematic review of the costs of laparoscopic colorectal surgery'. Berlin, GERMANY : Springer Economics: 14th International Congress of the European-Association-of-Endoscopic-Surgeons, pp. 908-919.
  • Mitra R, Gage H, Leatham EW. (2005) 'Cost-effectiveness of transoesophageal echocardiography guided direct current cardioversion for acute atrial fibrillation'. OXFORD UNIV PRESS EUROPEAN HEART JOURNAL, Stockholm, SWEDEN: 27th Congress of the European-Society-of-Cardiology 26, pp. 370-371.
  • Mitra R, Gage H, Leatham EW. (2005) 'Cost-effectiveness of transoesophageal echocardiography guided direct current cardioversion for acute atrial fibrillation'. Stockholm, SWEDEN : Oxford Univ Press Economics: 27th Congress of the European-Society-of-Cardiology

Book chapters

  • Goodman C, Davies S, Leyshon S, Fader M, Norton C, Morris J, Gage H, Wells M, See Tai S. (2007) 'Collaborating with primary care: promoting shared working between district nurses and care home staff.'. in K.Froggatt , J.Meyer , S.Davies (eds.) Understanding Care Homes: a Research and Development Perspective Jessica Kingsley

Reports

  • Gage HM, Goodman C, Dickinson A, Davies S, Froggatt K, Morbey H, Victor C, Martin W, Masey H, Gage H, Iliffe S. (2012) Approach: A study to develop integrated working between primary health care services and care homes. in (ed.) Report for NIHR Service Delivery and Organisation
  • Goodman C, Drennan V, Manthorpe J, Gage H, Trivedi D, Shah D, Scheibl F, Poltawski L, Handley M, Nash A, Iliffe S. (2012) A study of the effectiveness of interprofessional working for community dwelling older people. in (ed.) Report for NIHR Service Delivery and Organisation
  • Goodman C, Froggatt K, Mathie E, Craig C, Wright J, Handley M, Gage H, Iliffe S. (2010) The experiences and expectations of older people resident in care homes, their carers and professionals: a prospective study. in (ed.) Report for NIHR Research for Patient Benefit
  • Goodman C, Drennan V, Davies S, Masey H, Gage H, Scott C, Manthorpe G, Brearley S, Iliffe S. (2009) The nursing contribution to chronic disease management: nursing case management. in (ed.) Report for NIHR Service Delivery and Organisation
  • Kendall S, Wilson P, Proctor S, McNeilly E, Bunn F, Brooks F, Gage H. (2009) The nursing, midwifery and health visitor contribution to chronic disease management: a whole system approach. in (ed.) Report for NIHR Service Delivery and Organisation
  • Goodman C, Davies S, Norton C, Leyshon S, Gage H, Fader M, Morris J, See Tai S, Wells M. (2007) Can clinical benchmarking improve bowel care in care homes for older people?. Report for Nursing Quality Research Initiative, Dept of Health

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