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1.
BMC Vet Res ; 16(1): 85, 2020 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-32156275

RESUMO

BACKGROUND: Dog walking may have multiple physical and mental health advantages, but not all dog owners appear to benefit. Dog health is a described barrier to dog walking activity, but specific causes and impacts of reduced exercise in owners of dogs with health problems have not previously been reported. The current study used a qualitative methodology to explore the impact of canine osteoarthritis on dog walking activity. METHODS: Owners of dogs with osteoarthritis living in the United Kingdom (UK) were recruited through veterinary practices for semi-structured interview about life with an osteoarthritic dog. Participants were asked to reflect on walks that they had taken with their dog before he/she developed osteoarthritis, and to describe how those walks had changed. Interviews were transcribed verbatim and thematic analysis was used to construct key themes. RESULTS: Forty owners of 35 osteoarthritic dogs were interviewed. Prior to their dog's development of osteoarthritis, dog walking distance, speed and location were usually decided by the owner to satisfy the needs and enjoyment of dog and walker. A diagnosis of canine osteoarthritis led to both dogs and their owners altering the walks undertaken. Walks were typically slower, shorter and limited to locations where physical infrastructure, underfoot surface and gradients were perceived by the owner to be navigable by their dog. Most owners did not go on additional walks without their dog due to feelings of guilt and because walking without a dog was less enjoyable. Many owners described negative effects on their own physical health and diminished enjoyment of walking as a result of their dog's condition. CONCLUSION: Our research suggests that osteoarthritic dogs may reduce the walking exercise their owners are able or willing to undertake. Since osteoarthritis is a common condition in older dogs, this is an important finding for those advocating dog ownership as a positive public health intervention. Strategies may be needed to ensure that owners of dogs that develop physical incapacities can continue to enjoy the health benefits they previously associated with dog walking. Future studies investigating dog walking activity should ensure that the health status of the dog has been considered.

2.
Vet Rec ; 186(3): 98, 2020 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-31974188

RESUMO

This month Rachel Dean sets out why information given at CPD courses needs to be assessed for relevance and bias, and how a move from 'eminence-based' to evidence-based will lead to better patient care.

3.
BMC Vet Res ; 15(1): 434, 2019 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-31796018

RESUMO

BACKGROUND: Thousands of injured, stray and relinquished cats are received at the RSPCA Greater Manchester Animal Hospital each year. A significant and challenging proportion of these cats are confiscated from multicat households by RSPCA Inspectors, due to the owners' inability to care for them. These households share many characteristics of animal hoarding, including poor owner compliance with suggested welfare improvements and recidivism. The relatively poor adoption potential of animals from such households are a perennial problem for the charity. The aim of this study was to determine if offering female cat neutering assistance to multi-cat owners significantly improved colony welfare. RESULTS: Ten multicat households with a history of public complaint to the RSPCA were recruited. An RSPCA veterinary surgeon (VS) initially assessed the overall welfare of each household's cat population, individual cat welfare and the living environment. All entire female cats aged over 8 weeks were neutered and basic animal care education provided. Follow up visits were completed two and 12 months later to reassess welfare parameters and population numbers. The total number of cats was 176 across ten households (range 7-33, median 16). All owners consented to having all entire female cats spayed. At the first visit, mean individual cat welfare scores ranged from 5.4-8.7/ 16 across the 10 households, where 16 represented best possible welfare. Overall household mean welfare scores were significantly improved at both the 2 month and 12 month revisits (p = 0.011 and p = 0.01 respectively) when compared to the initial visits. By the end of the study period, three out of the ten households had voluntarily relinquished all of their cats, and overall there was a 40% reduction in the number of cats. CONCLUSIONS: Animal hoarding has previously been an intractable welfare concern with little evidence informing intervention techniques. These results show that positive veterinary engagement on site, focused on preventative care and population control, can yield significant improvement in welfare scoring systems in relatively short timescales. Promptly collecting and neutering all female cats at a site, combined with advice and support, show promise in improving welfare.

4.
Vet Rec ; 185(17): 545, 2019 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-31676624

RESUMO

Research waste reduces the usefulness of research. Rachel Dean describes the problem in veterinary science and suggests a way to increase the use of research results by practitioners.

5.
J Vet Med Educ ; : e1018124r1, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31738684

RESUMO

The patient-centered clinical method (PCCM), a model developed to characterize communication during patient-physician visits in the 1980s, identifies elements of patient-orientated, physician-orientated, and shared dialogue during the encounter. The model also includes elements that reflect the emotional aspects of these interactions, recognizing expressions of feelings and exchanges related to both personal and medical interests. Fifty-five routine veterinary patient visits in the United Kingdom and United States were analyzed using the novel application of a PCCM adapted for veterinary patient visits. The patient visits were video recorded, transcribed, coded, and analyzed for frequency and proportion of PCCM elements observed. Elements representing the greatest proportion of patient visits were related to gathering information and shared decision making. Those representing the smallest proportion were related to signs of the presenting condition and effects of the condition on the clients' lives. Dialogue during the patient visits flowed iteratively and back and forth between the veterinarian and the client perspective. The findings suggest that patient visits are focused more on gathering information and planning rather than exploring effects of the health problem on the client's life, and that patient visits flow very iteratively and randomly between veterinarian and client perspectives. Both of these topics should be studied further and given emphasis in the way that communication models are developed and taught in order to enhance client-centeredness in veterinary patient visits.

6.
Vet Rec ; 185(20): 636, 2019 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-31757923

RESUMO

This month Rachel Dean says using all sorts of data can support innovation and safety.

7.
Vet Rec ; 185(13): 413, 2019 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-31582500

RESUMO

This month Rachel Dean argues that guidelines should be written by those that will use them, and be properly assessed, to ensure they actually improve patient outcomes.

8.
Vet Rec ; 185(8): 236, 2019 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-31439751

RESUMO

In this month's evidence column Rachel Dean argues that not only does veterinary research have to be replicable, it also must be relevant and accessible to clinicians.

9.
Vet Rec ; 185(2): 58-59, 2019 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-31296726

RESUMO

In the first of a new evidence column, Rachel Dean and Carl Heneghan argue that while evidence-based veterinary medicine is not perfect we need to stop grumbling about the shortcomings and get on with it in practice.

10.
Prev Vet Med ; 167: 61-67, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31027723

RESUMO

Electronic patient records from practice management software systems have been used extensively in medicine for the investigation of clinical problems leading to the creation of decision support frameworks. To date, technologies that have been utilised for this purpose such as text mining and content analysis have not been employed significantly in veterinary medicine. The aim of this research was to pilot the use of content analysis and text-mining software for the synthesis and analysis of information extracted from veterinary electronic patient records. The purpose of the work was to be able to validate this approach for future employment across a number of practices for the purposes of practice based research. The approach utilised content analysis (Prosuite) and text mining (WordStat) software to aggregate the extracted text. Text mining tools such as Keyword in Context (KWIC) and Keyword Retrieval (KR) were employed to identify specific occurrences of data across the records. Two different datasets were interrogated, a bespoke test dataset that had been set up specifically for the purpose of the research, and a functioning veterinary clinic dataset that had been extracted from one veterinary practice. Across both datasets, the KWIC analysis was found to have a high level of accuracy with the search resulting in a sensitivity of between 85.3-100%, a specificity of between 99.1-99.7%, a positive predictive value between 93.5-95.8% and a negative predictive value between 97.7-100%. The KR search, based on machine learning, was utilised for the clinic-based dataset and was found to perform slightly better than the KWIC analysis. This study is the first to demonstrate the application of content analysis and text mining software for validation purposes across a number of different datasets for the purpose of search and recall of specific information across electronic patient records. This has not been demonstrated previously for small animal veterinary epidemiological research for the purposes of large scale analysis for practice-based research. Extension of this work to investigate more complex diseases across larger populations is required to fully explore the use of this approach in veterinary practice.


Assuntos
Mineração de Dados , Registros Eletrônicos de Saúde , Administração da Prática da Medicina Veterinária , Software , Animais , Humanos , Projetos Piloto , Reino Unido
11.
Vet Rec ; 184(8): 252, 2019 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-30777883

RESUMO

Vaccination consultations account for a large proportion of the small animal veterinary caseload. The aim of this study was to determine the content of canine and feline booster vaccination consultations and gather opinions on strategies used to optimise these consultations. An online survey of UK veterinarians was conducted. Respondents were asked about the clinical examination performed and the topics discussed during vaccination consultations, as well as any strategies used to optimise these consultations. Finally, respondents were asked about the practicality and effectiveness of various potential strategies. A total of 662 responses were received. Most respondents always auscultated the chest during vaccination consultations (n=603/621, 97.1% canine consultations; n=587/610, 96.2% feline consultations). Microchipping was discussed more frequently during canine versus feline consultations (P<0.001). Over half of respondents (n=323/597; 54.1%) had tried strategies to optimise consultations, with supplementary reading material tried most frequently (n=203/597; 34.0%). There were a range of opinions around practicality and effectiveness of these strategies. The results from this novel study suggest that vaccination consultations vary in terms of the clinical examination performed, topics discussed and strategies used to optimise the consultation. This study has implications for practice by identifying potential ways to maximise the benefits of vaccination consultations.


Assuntos
Comunicação , Exame Físico/veterinária , Relações Profissional-Paciente , Vacinação/veterinária , Médicos Veterinários/psicologia , Animais , Gatos , Cães , Humanos , Inquéritos e Questionários , Reino Unido
12.
Vet Rec ; 184(11): 348, 2019 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-30765500

RESUMO

Preventive healthcare is the focus of a large proportion of UK small animal veterinary consultations. The evidence base for how to optimise these consultations is limited. Therefore, evidence-based practical recommendations are needed for veterinary surgeons conducting these consultations. The aim of this study was to use an evidence-based methodology to develop the first consensus recommendations to improve dog and cat preventative healthcare consultations (PHCs).Evidence from multiple sources was systematically examined to generate a list of 18 recommendations. Veterinary surgeons and pet owners with extensive experience of PHCs were recruited to an anonymous panel to obtain consensus on whether these recommendations would improve PHCs. A Delphi technique was followed during three rounds of online questionnaire, with consensus set at 80 per cent agreement or disagreement with each recommendation. Thirteen of the original 18 recommendations reached consensus (>80per cent agreement), while the five remaining recommendations did not reach consensus.Globally, these are the first evidence-based recommendations developed specifically in relation to small animal general practice PHCs, generated via a Delphi panel including both veterinary surgeons and pet owners. Future work is needed to understand how these recommendations can be implemented in a range of veterinary practice settings.

13.
Vet Rec ; 184(5): 154, 2019 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-30455188

RESUMO

The aim of this systematic review is to describe and assess the quality of the existing evidence base concerning factors that influence the compliance of cat and dog owners to pharmaceutical and specifically polypharmacy treatment recommendations. PubMed, CAB Abstracts and Google were searched to identify relevant literature and search results were filtered according to predetermined inclusion and exclusion criteria. Standardised data extraction and critical appraisal were carried out on each included study, and a Centre for Evidence-Based Medicine level of evidence grading was applied. Of the 8589 studies, eight studies were included in the review. Majority (five of eight) of the included studies were examining compliance with short-term antimicrobial therapies and none examined polypharmacy. Multiple definitions of compliance, methods of measurement and different factors potentially affecting compliance were used. Factors reported to have affected compliance in at least one study were dosing regimen, discussion of dosing regimen in light of owners' circumstances, consultation time, disease, month of consultation/treatment, physical risk, social risk and method of administration. The evidence available regarding factors affecting client compliance with pharmaceutical treatment recommendations in cats and dogs is scarce and of poor quality.


Assuntos
Doenças do Gato/tratamento farmacológico , Doenças do Cão/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Propriedade , Drogas Veterinárias/uso terapêutico , Animais , Gatos , Cães , Humanos , Polimedicação , Ensaios Clínicos Controlados Aleatórios como Assunto
15.
Vet Sci ; 5(4)2018 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-30274233

RESUMO

Clinical audit is a quality improvement tool used to assess and improve the clinical services provided to patients. This is the first study to investigate the extent to which clinical audit is understood and utilised in farm animal veterinary practice. A cross-sectional study to collect experiences and attitudes of farm animal veterinary surgeons in the UK towards clinical audit was conducted using an online nationwide survey. The survey revealed that whilst just under three-quarters (n = 237/325; 73%) of responding veterinary surgeons had heard of clinical audit, nearly 50% (n = 148/301) had never been involved in a clinical audit of any species. The participants' knowledge of what a clinical audit was varied substantially, with many respondents reporting not receiving training on clinical audit at the undergraduate or postgraduate level. Respondents that had participated in a clinical audit suggested that protected time away from clinical work was required for the process to be completed successfully. This novel study suggests that clinical audit is undertaken to some extent in farm animal practice and that practitioner perception is that it can bring benefits, but was felt that more resources and support were needed for it to be implemented successfully on a wider scale.

16.
Vet Rec ; 183(9): 296, 2018 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-29973384

RESUMO

Veterinary receptionists and veterinary nurses rarely feature in published practice-based research, yet are integral to small animal veterinary practice in the UK. The aim of this study was to investigate the perspectives of UK-based owners and veterinary surgeons about veterinary nurses and receptionists in relation to their role in preventive healthcare. Semistructured telephone interviews were conducted with 15 dog and cat owners and 14 veterinary surgeons. Interview transcripts were thematically analysed. Reception staff were identified as having a range of important roles, from rapport building to providing healthcare information and advice. The perceived importance of those roles appeared to differ between owners and veterinary surgeons. Veterinary nurses were described as performing a diversity of roles in relation to preventive healthcare, both in the reception area and in the consulting room. Many owners, and some veterinary surgeons, expressed uncertainty about the remit and status of veterinary nurses in relation to providing veterinary advice. This study identifies for the first time the degree of responsibility for preventive healthcare given to veterinary receptionists and veterinary nurses in UK small animal practices. Further work is needed involving reception and nursing staff to fully appreciate and define their roles in small animal practice.


Assuntos
Técnicos em Manejo de Animais , Propriedade , Papel Profissional/psicologia , Médicos Veterinários/psicologia , Animais , Gatos , Cães , Feminino , Humanos , Masculino , Medicina Preventiva/organização & administração , Pesquisa Qualitativa , Reino Unido , Médicos Veterinários/estatística & dados numéricos , Medicina Veterinária/organização & administração
17.
Vet Sci ; 5(2)2018 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-29865183

RESUMO

Treatment variation in medicine may be driven by evidence gaps, clinician factors, and patient preferences. Although well-documented in human medicine, variation in clinical management is relatively unexplored in veterinary practice. Clinical vignette questionnaires were administered to a cross section of general practitioners (GPs) and veterinarians with postgraduate training in ophthalmology (PGs) to survey recommended management of canine prolapsed nictitans gland ("cherry eye", PNG) and feline herpesvirus (FHV-1) keratitis. The majority of veterinarians (96.2%) suggested surgical replacement of cherry eye, with a pocketing technique being the most frequently nominated procedure. GPs were more likely to suggest gland excision in the event of surgical failure, while PGs more frequently nominated techniques incorporating a periosteal anchor for salvage repair. Most respondents managed FHV-1 keratitis with topical antibiotics (76.4%), with a minority suggesting topical antivirals (32.2%). GPs favoured topical acyclovir whilst PGs more frequently recommended topical trifluorothymidine. A significantly larger proportion of PGs nominated systemic famciclovir and lysine supplement for FHV-1 keratitis. This survey revealed moderate treatment variation for these conditions, both between and within practitioner groups. Additional research is needed to assess the reasons for this variation, particularly for conditions in which high quality evidence is scant.

18.
Prev Vet Med ; 154: 95-101, 2018 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-29685450

RESUMO

Routine use of preventative medicines is advocated as part of responsible dog and cat ownership. However, it has been suggested that the number of owners in the United Kingdom (UK) using preventative medicines to protect their pets is in decline. The aim of this novel study was to use a qualitative methodology to explore the attitudes of pet owners and veterinary surgeons in the UK to using preventative medicine products in dogs and cats. Preventative medicine was defined as "a drug or any other preparation used to prevent disease, illness or injury." Semi-structured interviews were conducted by telephone with owners and veterinary surgeons who had recently participated in a preventative healthcare consultation. Thematic analysis of transcribed recordings of these interviews identified four themes. This paper reports the theme related to motivators and barriers to using preventative medicines. Owners' understanding varied widely about the importance of preventative medicines for pets, as did their confidence in the safety of prescription products. A good relationship with their veterinary surgeon or practice, seeing adverts on the television about specific diseases, advice from a breeder and having personally seen infected animals appeared to be motivators for owners to use preventative medicines. Concern about adverse events and uncertainty about the necessity of using preventative medicines were barriers. Owners who trusted their veterinary surgeons to advise them on preventative medicine products described little use of alternative information sources when making preventative medicine choices. However, owners who preferred to do their own research described reading online opinions, particular in relation to the safety of preventative medicines, which they found confusing. In contrast, veterinary surgeons described broad confidence in the safety and efficacy of prescription preventative medicines and described protection of pet health as a strong motivator for their use. Several expressed some concern about being seen to "sell" products, which may present a barrier to their advocacy. Veterinary surgeons were unsure about owners' level of understanding of the necessity of preventative medicines, particularly in relation to vaccinations, and few recalled instigating conversations with owners about product safety. Owner uncertainties about preventative medicine products may not be adequately addressed in the consulting room. This first qualitative study to investigate dog and cat preventative medicines suggests strategies are needed to increase discussion between pet owners and veterinary surgeons in the UK about the necessity, safety, efficacy and cost of preventative medicines.


Assuntos
Propriedade , Medicina Preventiva/métodos , Vacinação/veterinária , Médicos Veterinários , Animais , Atitude , Doenças do Gato/prevenção & controle , Gatos , Doenças do Cão/prevenção & controle , Cães , Promoção da Saúde , Motivação , Reino Unido , Vacinação/psicologia , Médicos Veterinários/psicologia
19.
Vet Rec ; 183(1): 22, 2018 07 07.
Artigo em Inglês | MEDLINE | ID: mdl-29545354

RESUMO

Consultations are complex interactions, are central to achieving optimal outcomes for all stakeholders, yet what constitutes a successful consultation has not been defined. The aim of this systematic review was to describe the scope of the literature available on specific health problem consultations and appraise their identified success measures. Searches of CAB Abstracts and MEDLINE were performed in May 2016 using species and consultation terms. Systematic sorting of the results allowed identification of consultation 'success factors' cited in peer-reviewed veterinary literature which were appraised using an appropriate critical appraisal tool (AXIS). Searches returned 11 330 results with a total of 17 publications meeting the inclusion criteria, of which four measured consultation success. Journal of the American Veterinary Medical Association was the most common journal of publication (9 of 17) and the majority of included papers had been published since 2010 (12 of 17). Success factors measured were compliance, client satisfaction and veterinary surgeon satisfaction, and publications primarily used communication analysis tools to measure success. The review highlights the paucity of peer-reviewed literature examining small animal, health problem veterinary consultations. The available evidence is of variable quality and provides weak evidence as to which factors contribute to a successful consultation.


Assuntos
Cooperação do Paciente/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Encaminhamento e Consulta , Médicos Veterinários/psicologia , Medicina Veterinária , Animais , Atitude do Pessoal de Saúde , Gatos , Cães , Humanos
20.
Prev Vet Med ; 150: 60-69, 2018 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-29406085

RESUMO

The use of corpus linguistic techniques and other related mathematical analyses have rarely, if ever, been applied to qualitative data collected from the veterinary field. The aim of this study was to explore the use of a combination of corpus linguistic analyses and mathematical methods to investigate a free-text questionnaire dataset collected from 3796 UK veterinarians on evidence-based veterinary medicine, specifically, attitudes towards practice-based research (PBR) and improving the veterinary knowledge base. The corpus methods of key word, concordance and collocate analyses were used to identify patterns of meanings within the free text responses. Key words were determined by comparing the questionnaire data with a wordlist from the British National Corpus (representing general English text) using cross-tabs and log-likelihood comparisons to identify words that occur significantly more frequently in the questionnaire data. Concordance and collocation analyses were used to account for the contextual patterns in which such key words occurred, involving qualitative analysis and Mutual Information Analysis (MI3). Additionally, a mathematical topic modelling approach was used as a comparative analysis; words within the free text responses were grouped into topics based on their weight or importance within each response to find starting points for analysis of textual patterns. Results generated from using both qualitative and quantitative techniques identified that the perceived advantages of taking part in PBR centred on the themes of improving knowledge of both individuals and of the veterinary profession as a whole (illustrated by patterns around the words learning, improving, contributing). Time constraints (lack of time, time issues, time commitments) were the main concern of respondents in relation to taking part in PBR. Opinions of what vets could do to improve the veterinary knowledge base focussed on the collecting and sharing of information (record, report), particularly recording and discussing clinical cases (interesting cases), and undertaking relevant continuing professional development activities. The approach employed here demonstrated how corpus linguistics and mathematical methods can help to both identify and contextualise relevant linguistic patterns in the questionnaire responses. The results of the study inform those seeking to coordinate PBR initiatives about the motivators of veterinarians to participate in such initiatives and what concerns need to be addressed. The approach used in this study demonstrates a novel way of analysing textual data in veterinary research.


Assuntos
Atitude do Pessoal de Saúde , Medicina Baseada em Evidências/métodos , Médicos Veterinários/psicologia , Medicina Veterinária/métodos , Medicina Baseada em Evidências/instrumentação , Bases de Conhecimento , Linguística , Modelos Teóricos , Inquéritos e Questionários , Reino Unido , Medicina Veterinária/instrumentação
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