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Author F D Richard Hobbs

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Antibiotic Review Kit for Hospitals (ARK-Hospital): study protocol for a stepped-wedge cluster-randomised controlled trial.

Ann Sarah Walker, Eric Budgell, Magda Laskawiec-Szkonter, Katy Sivyer, Sarah Wordsworth, Jack Quaddy, Marta Santillo, Adele Krusche, Laurence S J Roope, Nicole Bright, Fiona Mowbray, Nicola Jones, Kieran Hand, Najib Rahman, Melissa Dobson, Emma Hedley, Derrick Crook, Mike Sharland, Chris Roseveare, F D Richard Hobbs, Chris Butler, Louella Vaughan, Susan Hopkins, Lucy Yardley, Timothy E A Peto, Martin J Llewelyn, ,

BACKGROUND:To ensure patients continue to get early access to antibiotics at admission, while also safely reducing antibiotic use in hospitals, one needs to target the continued need for antibiotics as more diagnostic information becomes available. UK Department of Health guidance promotes an initiative called 'Start Smart then Focus': early effective ... Read more >>

Trials (Trials)
[2019, 20(1):421]

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Natriuretic peptide-guided treatment for heart failure: a systematic review and meta-analysis.

Julie McLellan, Clare R Bankhead, Jason L Oke, F D Richard Hobbs, Clare J Taylor, Rafael Perera,

BACKGROUND:GUIDE-IT, the largest trial to date, published in August 2017, evaluating the effectiveness of natriuretic peptide (NP)-guided treatment of heart failure (HF), was stopped early for futility on a composite outcome. However, the reported effect sizes on individual outcomes of all-cause mortality and HF admissions are potentially clinically relevant. OBJECTIVE:This ... Read more >>

BMJ Evid Based Med (BMJ evidence-based medicine)
[2019, :]

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Cost-Effectiveness of Telemonitoring and Self-Monitoring of Blood Pressure for Antihypertensive Titration in Primary Care (TASMINH4).

Mark Monahan, Sue Jowett, Alecia Nickless, Marloes Franssen, Sabrina Grant, Sheila Greenfield, F D Richard Hobbs, James Hodgkinson, Jonathan Mant, Richard J McManus,

The use of self-monitoring of blood pressure, with or without telemonitoring, to guide therapy decisions by physicians for patients with hypertension has been recently demonstrated to reduce blood pressure compared with using clinic monitoring (usual care). However, both the cost-effectiveness of these strategies compared with usual care, and whether the ... Read more >>

Hypertension (Hypertension (Dallas, Tex. : 1979))
[2019, 73(6):1231-1239]

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Diagnostic tests, drug prescriptions, and follow-up patterns after incident heart failure: A cohort study of 93,000 UK patients.

Nathalie Conrad, Andrew Judge, Dexter Canoy, Jenny Tran, Johanna O'Donnell, Milad Nazarzadeh, Gholamreza Salimi-Khorshidi, F D Richard Hobbs, John G Cleland, John J V McMurray, Kazem Rahimi,

BACKGROUND:Effective management of heart failure is complex, and ensuring evidence-based practice presents a major challenge to health services worldwide. Over the past decade, the United Kingdom introduced a series of national initiatives to improve evidence-based heart failure management, including a landmark pay-for-performance scheme in primary care and a national audit ... Read more >>

PLoS Med. (PLoS medicine)
[2019, 16(5):e1002805]

Cited: 1 time

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The role of informal carers in the diagnostic process of heart failure: a secondary qualitative analysis.

Frances Bell-Davies, Clare Goyder, Nicola Gale, F D Richard Hobbs, Clare J Taylor,

BACKGROUND:Heart failure (HF) is a common clinical syndrome, particularly in older people, and symptoms can develop gradually. The aim of this study was to explore the role of informal carers in the HF diagnostic process. METHODS:Secondary analysis of qualitative interviews with 16 participants with a new diagnosis of HF. Original ... Read more >>

BMC Cardiovasc Disord (BMC cardiovascular disorders)
[2019, 19(1):92]

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Patient consultation rate and clinical and NHS outcomes: a cross-sectional analysis of English primary care data from 2.7 million patients in 238 practices.

Sarah Lay-Flurrie, Edouard Mathieu, Clare Bankhead, Brian D Nicholson, Rafael Perera-Salazar, Tim Holt, F D Richard Hobbs, Chris Salisbury, ,

BACKGROUND:Primary care workload is high and increasing in the United Kingdom. We sought to examine the association between rates of primary care consultation and outcomes in England. METHODS:Cross sectional observational study of routine electronic health care records in 283 practices from the Clinical Practice Research Datalink from April 2013 to ... Read more >>

BMC Health Serv Res (BMC health services research)
[2019, 19(1):219]

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Schedules for Self-monitoring Blood Pressure: A Systematic Review.

James A Hodgkinson, Richard Stevens, Sabrina Grant, Jonathan Mant, Emma P Bray, F D Richard Hobbs, Una Martin, Claire Schwartz, David McCartney, Rachel O'Mahony, Rafael Perera-Salazar, Nia Roberts, Sarah Stevens, Bryan Williams, Richard J McManus,

BACKGROUND:Self-monitoring of blood pressure better predicts prognosis than clinic measurement, is popular with patients, and endorsed in hypertension guidelines. However, there is uncertainty over the optimal self-monitoring schedule. We therefore aimed to determine the optimum schedule to predict future cardiovascular events and determine "true" underlying blood pressure. METHODS:Six electronic databases ... Read more >>

Am. J. Hypertens. (American journal of hypertension)
[2019, 32(4):350-364]

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Trends in survival after a diagnosis of heart failure in the United Kingdom 2000-2017: population based cohort study.

Clare J Taylor, José M Ordóñez-Mena, Andrea K Roalfe, Sarah Lay-Flurrie, Nicholas R Jones, Tom Marshall, F D Richard Hobbs,

OBJECTIVES:To report reliable estimates of short term and long term survival rates for people with a diagnosis of heart failure and to assess trends over time by year of diagnosis, hospital admission, and socioeconomic group. DESIGN:Population based cohort study. SETTING:Primary care, United Kingdom. PARTICIPANTS:Primary care data for 55 959 patients aged ... Read more >>

BMJ (BMJ (Clinical research ed.))
[2019, 364:l223]

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Benefits and Harms of Antihypertensive Treatment in Low-Risk Patients With Mild Hypertension.

James P Sheppard, Sarah Stevens, Richard Stevens, Una Martin, Jonathan Mant, F D Richard Hobbs, Richard J McManus,

Importance:Evidence to support initiation of pharmacologic treatment in low-risk patients with mild hypertension is inconclusive, with previous trials underpowered to demonstrate benefit. Clinical guidelines across the world are contradictory. Objective:To examine whether antihypertensive treatment is associated with a low risk of mortality and cardiovascular disease (CVD) in low-risk patients with ... Read more >>

JAMA Intern Med (JAMA internal medicine)
[2018, 178(12):1626-1634]

Cited: 2 times

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Practice variation in the use of tests in UK primary care: a retrospective analysis of 16 million tests performed over 3.3 million patient years in 2015/16.

Jack W O'Sullivan, Sarah Stevens, Jason Oke, F D Richard Hobbs, Chris Salisbury, Paul Little, Ben Goldacre, Clare Bankhead, Jeffrey K Aronson, Carl Heneghan, Rafael Perera,

BACKGROUND:The UK's National Health Service (NHS) is currently subject to unprecedented financial strain. The identification of unnecessary healthcare resource use has been suggested to reduce spending. However, there is little very research quantifying wasteful test use, despite the £3 billion annual expenditure. Geographical variation has been suggested as one metric ... Read more >>

BMC Med (BMC medicine)
[2018, 16(1):229]

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Temporal trends in use of tests in UK primary care, 2000-15: retrospective analysis of 250 million tests.

Jack W O'Sullivan, Sarah Stevens, F D Richard Hobbs, Chris Salisbury, Paul Little, Ben Goldacre, Clare Bankhead, Jeffrey K Aronson, Rafael Perera, Carl Heneghan,

OBJECTIVES:To assess the temporal change in test use in UK primary care and to identify tests with the greatest increase in use. DESIGN:Retrospective cohort study. SETTING:UK primary care. PARTICIPANTS:All patients registered to UK General Practices in the Clinical Practice Research Datalink, 2000/1 to 2015/16. MAIN OUTCOME MEASURES:Temporal trends in test ... Read more >>

BMJ (BMJ (Clinical research ed.))
[2018, 363:k4666]

Cited: 2 times

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Reduced Salt Intake for Heart Failure: A Systematic Review.

Kamal R Mahtani, Carl Heneghan, Igho Onakpoya, Stephanie Tierney, Jeffrey K Aronson, Nia Roberts, F D Richard Hobbs, David Nunan,

Importance:Recent estimates suggest that more than 26 million people worldwide have heart failure. The syndrome is associated with major symptoms, significantly increased mortality, and extensive use of health care. Evidence-based treatments influence all these outcomes in a proportion of patients with heart failure. Current management also often includes advice to ... Read more >>

JAMA Intern Med (JAMA internal medicine)
[2018, :]

Cited: 1 time

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OPtimising Treatment for MIld Systolic hypertension in the Elderly (OPTiMISE): protocol for a randomised controlled non-inferiority trial.

James P Sheppard, Jenni Burt, Mark Lown, Eleanor Temple, John Benson, Gary A Ford, Carl Heneghan, F D Richard Hobbs, Sue Jowett, Paul Little, Jonathan Mant, Jill Mollison, Alecia Nickless, Emma Ogburn, Rupert Payne, Marney Williams, Ly-Mee Yu, Richard J McManus,

INTRODUCTION:Recent evidence suggests that larger blood pressure reductions and multiple antihypertensive drugs may be harmful in older people, particularly frail individuals with polypharmacy and multimorbidity. However, there is a lack of evidence to support deprescribing of antihypertensives, which limits the practice of medication reduction in routine clinical care. The aim ... Read more >>

BMJ Open (BMJ open)
[2018, 8(9):e022930]

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Survival of patients with chronic heart failure in the community: a systematic review and meta-analysis protocol.

Nicholas R Jones, Andrea K Roalfe, Ibiye Adoki, F D Richard Hobbs, Clare J Taylor,

BACKGROUND:Heart failure (HF) is a common condition affecting more than 10% of those over 70 years of age. Reliable estimates of survival following a diagnosis of HF are important to guide management and facilitate advanced care planning. Most existing research has focused on survival rates for patients admitted to hospital with ... Read more >>

Syst Rev (Systematic reviews)
[2018, 7(1):151]

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Association of guideline and policy changes with incidence of lifestyle advice and treatment for uncomplicated mild hypertension in primary care: a longitudinal cohort study in the Clinical Practice Research Datalink.

James P Sheppard, Sarah Stevens, Richard J Stevens, Jonathan Mant, Una Martin, F D Richard Hobbs, Richard J McManus,

OBJECTIVES:Evidence to support initiation of pharmacological treatment in patients with uncomplicated (low risk) mild hypertension is inconclusive. As such, clinical guidelines are contradictory and healthcare policy has changed regularly. The aim of this study was to determine the incidence of lifestyle advice and drug therapy in this population and whether ... Read more >>

BMJ Open (BMJ open)
[2018, 8(9):e021827]

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2018 ESC/ESH Guidelines for the management of arterial hypertension.

Bryan Williams, Giuseppe Mancia, Wilko Spiering, Enrico Agabiti Rosei, Michel Azizi, Michel Burnier, Denis L Clement, Antonio Coca, Giovanni de Simone, Anna Dominiczak, Thomas Kahan, Felix Mahfoud, Josep Redon, Luis Ruilope, Alberto Zanchetti, Mary Kerins, Sverre E Kjeldsen, Reinhold Kreutz, Stephane Laurent, Gregory Y H Lip, Richard McManus, Krzysztof Narkiewicz, Frank Ruschitzka, Roland E Schmieder, Evgeny Shlyakhto, Costas Tsioufis, Victor Aboyans, Ileana Desormais, ,

Eur. Heart J. (European heart journal)
[2018, 39(33):3021-3104]

Cited: 80 times

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Do patients actually do what we ask: patient fidelity and persistence to the Targets and Self-Management for the Control of Blood Pressure in Stroke and at Risk Groups blood pressure self-management intervention.

Claire L Schwartz, Ashkon Seyed-Safi, Sayeed Haque, Emma P Bray, Shelia Greenfield, F D Richard Hobbs, Paul Little, Jonathan Mant, Bryan Williams, Richard J Mcmanus,

OBJECTIVE:Self-management of hypertension can reduce and control blood pressure (BP) compared with clinic monitoring. However, self-management relies on patients following an algorithm, which may be variably adhered to. This study reports fidelity of high-risk patients to the self-management algorithm set by the TASMIN-SR trial. METHODS:Patients with hypertension, above target clinic ... Read more >>

J. Hypertens. (Journal of hypertension)
[2018, 36(8):1753-1761]

Cited: 1 time

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Cardiac auscultation poorly predicts the presence of valvular heart disease in asymptomatic primary care patients.

Syed K M Gardezi, Saul G Myerson, John Chambers, Sean Coffey, Joanna d'Arcy, F D Richard Hobbs, Jonathan Holt, Andrew Kennedy, Margaret Loudon, Anne Prendergast, Anthony Prothero, Joanna Wilson, Bernard D Prendergast,

OBJECTIVE:Cardiac auscultation is a key clinical skill, particularly for the diagnosis of valvular heart disease (VHD). However, its utility has declined due to the widespread availability of echocardiography and diminishing emphasis on the importance of clinical examination. We aim to determine the contemporary accuracy of auscultation for diagnosing VHD in ... Read more >>

Heart (Heart (British Cardiac Society))
[2018, 104(22):1832-1835]

Cited: 2 times

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Comparison of an Oral Factor Xa Inhibitor With Low Molecular Weight Heparin in Patients With Cancer With Venous Thromboembolism: Results of a Randomized Trial (SELECT-D).

Annie M Young, Andrea Marshall, Jenny Thirlwall, Oliver Chapman, Anand Lokare, Catherine Hill, Danielle Hale, Janet A Dunn, Gary H Lyman, Charles Hutchinson, Peter MacCallum, Ajay Kakkar, F D Richard Hobbs, Stavros Petrou, Jeremy Dale, Christopher J Poole, Anthony Maraveyas, Mark Levine,

Purpose Venous thromboembolism (VTE) is common in patients with cancer. Long-term daily subcutaneous low molecular weight heparin has been standard treatment for such patients. The purpose of this study was to assess if an oral factor Xa inhibitor, rivaroxaban, would offer an alternative treatment for VTE in patients with cancer. ... Read more >>

J. Clin. Oncol. (Journal of clinical oncology : official journal of the American Society of Clinical Oncology)
[2018, 36(20):2017-2023]

Cited: 40 times

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Efficacy of self-monitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): an unmasked randomised controlled trial.

Richard J McManus, Jonathan Mant, Marloes Franssen, Alecia Nickless, Claire Schwartz, James Hodgkinson, Peter Bradburn, Andrew Farmer, Sabrina Grant, Sheila M Greenfield, Carl Heneghan, Susan Jowett, Una Martin, Siobhan Milner, Mark Monahan, Sam Mort, Emma Ogburn, Rafael Perera-Salazar, Syed Ahmar Shah, Ly-Mee Yu, Lionel Tarassenko, F D Richard Hobbs, ,

BACKGROUND:Studies evaluating titration of antihypertensive medication using self-monitoring give contradictory findings and the precise place of telemonitoring over self-monitoring alone is unclear. The TASMINH4 trial aimed to assess the efficacy of self-monitored blood pressure, with or without telemonitoring, for antihypertensive titration in primary care, compared with usual care. METHODS:This study ... Read more >>

Lancet (Lancet (London, England))
[2018, 391(10124):949-959]

Cited: 15 times

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Kidney age, not kidney disease.

Richard J Stevens, Julie Evans, Jason Oke, Benjamin Smart, F D Richard Hobbs, Elizabeth Holloway, Jeremy Horwood, Marion Judd, Louise Locock, Julie McLellan, Rafael Perera,

CMAJ (CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne)
[2018, 190(13):E389-E393]

Cited: 2 times

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Predicting Out-of-Office Blood Pressure in the Clinic for the Diagnosis of Hypertension in Primary Care: An Economic Evaluation.

Mark Monahan, Sue Jowett, Kate Lovibond, Paramjit Gill, Marshall Godwin, Sheila Greenfield, Janet Hanley, F D Richard Hobbs, Una Martin, Jonathan Mant, Brian McKinstry, Bryan Williams, James P Sheppard, Richard J McManus, ,

Clinical guidelines in the United States and United Kingdom recommend that individuals with suspected hypertension should have ambulatory blood pressure (BP) monitoring to confirm the diagnosis. This approach reduces misdiagnosis because of white coat hypertension but will not identify people with masked hypertension who may benefit from treatment. The Predicting ... Read more >>

Hypertension (Hypertension (Dallas, Tex. : 1979))
[2018, 71(2):250-261]

Cited: 1 time

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Underuse of anticoagulation therapy for atrial fibrillation: Are we failing our patients?

Nicholas R Jones, F D Richard Hobbs, Clare J Taylor,

Can Fam Physician (Canadian family physician Medecin de famille canadien)
[2017, 63(12):943-944]

Cited: 0 times

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Sous-utilisation de l’anticoagulothérapie dans la fibrillation auriculaire: Sommes-nous à la hauteur?

Nicholas R Jones, F D Richard Hobbs, Clare J Taylor,

Can Fam Physician (Canadian family physician Medecin de famille canadien)
[2017, 63(12):e510-e511]

Cited: 0 times

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Systematic Review and Metaanalysis Comparing the Bias and Accuracy of the Modification of Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration Equations in Community-Based Populations.

Emily C McFadden, Jennifer A Hirst, Jan Y Verbakel, Julie H McLellan, F D Richard Hobbs, Richard J Stevens, Chris A O'Callaghan, Daniel S Lasserson,

BACKGROUND:The majority of patients with chronic kidney disease are diagnosed and monitored in primary care. Glomerular filtration rate (GFR) is a key marker of renal function, but direct measurement is invasive; in routine practice, equations are used for estimated GFR (eGFR) from serum creatinine. We systematically assessed bias and accuracy ... Read more >>

Clin. Chem. (Clinical chemistry)
[2018, 64(3):475-485]

Cited: 4 times

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