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Barriers to Dementia Care Services in Europe: Key Insights and Ways Forward

Dementia, including Alzheimer's disease, is a significant public health challenge in Europe, with nearly 14 million people currently affected. Despite available healthcare and social care services, utilisation of these services by people living with dementia remains suboptimal due to various barriers. Our recent systematic review published in BMC Geriatrics provides critical insights into these challenges, highlighting barriers across informational, organisational, cultural, stigma-related, financial, and logistical domains. Informational and Educational Barriers A lack of awareness and insufficient knowledge among caregivers and healthcare professionals stands out as a key barrier. Inadequate dissemination of dementia-related information contributes to difficulties in planning and accessing appropriate care. Enhancing educational resources and improving health literacy among caregivers and healthcare workers are essential for overcoming these challenges. Organisational Barriers F...
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The Covid-19 pandemic five years on

As we reach the fifth anniversary of the onset of the Covid-19 pandemic, this moment provides an opportunity for reflection on the many challenges faced by healthcare workers like me during the early days of the pandemic. At that time, the SARS-CoV-2 virus was a largely unknown entity. Clinical guidelines were still under development and personal protective equipment (PPE) was scarce. For those on the NHS frontline, the experience was marked by a mix of anxiety, urgency, and dedication to the patients we were trained to serve.  Unfamiliar Territory  In the initial stages, Covid-19 was a "novel" infection. There was a scarcity of data on the illness, and the disease was manifesting in ways that were not entirely well understood. As primary care physicians, we were suddenly thrust into the realm of the unknown, treating patients with undifferentiated respiratory illnesses that did not yet have well-defined and evidence-based treatment protocols.  The Personal Risk Factor...

Medical Journals Should Use the Term "Public Health and Social Measures"

The COVID-19 pandemic brought many terms into the spotlight, one of which was "non-pharmaceutical interventions" (NPIs). Used widely in academic papers, public health guidelines, and media reports, NPIs became a catch-all phrase for measures like contact tracing, quarantine, and hand hygiene; essentially anything that wasn’t a drug or vaccine. However, BMJ Editor Kamran Abbasi and I argue in our editorial  it is time to end the use of this term in favour of "public health and social measures." Here’s why this shift matters. The Problem with Defining by Negation The term "non-pharmaceutical interventions" defines these strategies by what they aren’t rather than what they are. This framing is inherently limiting. Imagine calling surgery a "non-drug intervention"—it sounds absurd because surgery stands on its own as a complex, evidence-based practice. Similarly, public health measures like sanitation or hand hygiene aren’t just stopgaps until a drug...

Missed Appointments: An Opportunity to Address Patient Safety

Our recent article in the Journal of Patient Safety discusses the topic of missed appointments in healthcare. Missed appointments are often seen as an administrative inconvenience in healthcare; wasting appointments that could have gone to other patients. However, missed appointments are also a critical patient safety concern that can delay necessary interventions, worsen health outcomes, and erode trust between patients and clinicians. Instead of viewing them as patient noncompliance, we must shift our perspective to understand the underlying barriers that prevent people from attending their scheduled appointments. Understanding the Root Causes of Missed Appointments Patients miss appointments for a variety of reasons, many of which are outside their control. Socioeconomic challenges, work obligations, caregiving responsibilities, mental health issues, transportation difficulties, and previous negative experiences with the healthcare system all contribute to non-attendance. Disadva...

The Role of Virtual Consultations in People with Type 2 Diabetes

Living with Type 2 Diabetes (T2D) can feel like a full-time job. Regular check-ups, monitoring blood sugar levels, adjusting medications, and managing lifestyle changes all demand time and effort. For the 460 million people worldwide dealing with diabetes (a number projected to climb to 700 million by 2045), finding convenient and effective healthcare solutions is more critical than ever. Enter virtual consultations (VC); a modern approach to healthcare delivery that is transforming how people with T2D manage their condition. Our recent systematic review and meta-analysis published in the Journal of Diabetes Science and Technology sheds light on just how powerful this tool can be. Let’s examine the benefits of virtual consultations for people with T2D and why they’re becoming more important in the care of people with long-term conditions like T2D.  Convenience Without Compromise: Effectiveness Matches In-Person Care One of the key findings from the review is that virtual consultat...

The Hidden Cost of Cheaper NHS Contracts: Losing Community Trust

NHS budgets are under considerable pressure. It is therefore unsurprising that many NHS Integrated Care Boards (ICBs) In England will aim to prioritise price in contract awards, But this approach is a significant threat to community-centred healthcare. While competitive tendering is a legally required, an excessive focus on costs in awarding NHS contracts risks overshadowing key factors such as established community trust, local expertise, and the long-term impact on continuity of care. This shift towards cheaper, often external, commercial providers threatens to cut the links between communities and their local health services. The argument that competitive tendering is solely about legal compliance, and not cost, is undermined by the very nature of such tendering, which by design encourages the lowest bid. This approach risks eroding the social fabric of local healthcare provision, where established relationships and understanding of specific community needs are essential. Establishe...

Why we need diversity, equity and inclusion (DEI) in clinical and public health research

Diversity, equity, and inclusion (DEI) are essential in clinical and public health research, ensuring discoveries and interventions benefit all sections of society; and enhancing the quality, relevance, and impact of research. Ensuring that diverse populations are represented appropriately within research is a scientific necessity. By embedding DEI principles into research design and execution, researchers can generate findings that are broadly applicable across the population while also addressing long-standing health disparities. DEI is needed in clinical and public health research because it improves the generalisability and relevance of research findings. Research outcomes must apply to the diverse populations they are intended to serve. By including participants from different racial, ethnic, gender, socioeconomic, and geographic backgrounds, studies can avoid biases that result from the narrower recruitment into research studies we often saw in the past. Without such diversity, r...