Rob Horne (professor)

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Rob Horne is Professor of Behavioural Medicine at the School of Pharmacy, University College London (UCL). [1] In September 2006, he founded the Centre for Behavioural Medicine at UCL, which he continues to lead. [1] Horne was designated a Fellow of the Royal College of Physicians Faculty of Pharmaceutical Medicine in 2013 [2] and is a founding fellow of the Royal Pharmaceutical Society of Great Britain. [3] He was appointed as a National Institute for Health Research (NIHR) Senior Investigator in 2011. [3] He is an internationally recognised expert in self-management of chronic illness and adherence to medications. [4]

Contents

Biography

Career

Horne qualified as a pharmacist and has a PhD in medical psychology from King's College London. [5] Before joining UCL, Horne was Professor of Psychology in Health Care and Director of the Centre for Health Care Research at the University of Brighton. [5] Horne founded and is Director of the Centre for Behavioural Medicine, which is part of the UCL School of Pharmacy. The overall aim of the Centre is to make healthcare more efficient by understanding and addressing the psychological and behavioural factors explaining variation in response to treatment. [5]

Academic research

Horne's academic research focuses on the role of psychological and behavioural factors in explaining the variation in patients’ response to medication. [3] He has developed a range of tools and models for assessing patients’ perspectives of illness and treatment e.g. the Beliefs about Medicines Questionnaire (BMQ) and Medication Adherence Report (MARS) as well as frameworks for understanding treatment-related behaviours with a particular focus on adherence to medication e.g. the Necessity-Concerns Framework and Perceptions and Practicalities approach. [3] [6] To date, these tools have been validated in the following long-term medical conditions: renal dialysis; renal transplantation; asthma; cancer; coronary heart disease; hypertension; diabetes; HIV/AIDS; haemophilia; depression; bipolar disorder; rheumatoid arthritis; inflammatory bowel disease and also for newly prescribed medications in primary care. [7] [8] [9] [10] [11] [12] [13] [14] [15] [16] [17] His current research focuses on the development of theory-based interventions to support informed choice and optimal adherence to medication or other treatments in chronic illness. Other research interests include emotion and health and the placebo effect. [18] Over the past decade, his research has generated over 140 peer-reviewed publications and book chapters, and grants over £7 million. [1]

Health policy contributions

Horne and his research team regularly contribute to UK and international reports and guidelines on adherence, and to consultancy for national charities, the NHS and commercial health organisations. [3] Professor Horne’s recent contributions to health policy include adherence guidelines for the National Institute for Health and Clinical Excellence (NICE) published in 2009 [19] and a report for the National Co-ordinating Centre for NHS Service Delivery and Organisation R&D (NCCSDO) published in 2005. [20]

Application of research

In November 2011, Horne co-founded a UCLBusiness spinout company. [21] [22] The company, called Spoonful of Sugar, applies Horne's research to behavioural change consultancy, evidence-based adherence support, validated behavioural research and perspectives mapping and personalised communications. [22]

Medical innovation

Horne is an Academic Fellow of the Centre for the Advancement of Sustainable Medical Innovation (CASMI), a partnership between Oxford University and UCL created to develop new models for medical innovation. [23] In November 2012, Horne was appointed as UCL's academic lead for CASMI. [5]

Related Research Articles

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Asthma is a long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasms. Symptoms include episodes of wheezing, coughing, chest tightness, and shortness of breath. These may occur a few times a day or a few times per week. Depending on the person, asthma symptoms may become worse at night or with exercise.

Activities of daily living is a term used in healthcare to refer to people's daily self-care activities. Health professionals often use a person's ability or inability to perform ADLs as a measurement of their functional status. The concept of ADLs was originally proposed in the 1950s by Sidney Katz and his team at the Benjamin Rose Hospital in Cleveland, Ohio. The concept of ADLs has been added to and refined by a variety of researchers since that time. For example, many indexes that assess ADLs now include some measure of mobility. Additionally, to be more inclusive of the range of activities that support independent living, in 1969, Lawton and Brody developed the instrumental activities of daily living (IADLs). ADLs are often used in the care of people with disabilities, people with injuries, and elderly people. Younger children often require help from adults to perform ADLs, as they have not yet developed the skills necessary to perform them independently.

Palliative care is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex, and often terminal illnesses. Within the published literature, many definitions of palliative care exist. The World Health Organization (WHO) describes palliative care as "an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual". In the past, palliative care was a disease specific approach, but today the WHO takes a broader patient-centered approach that suggests that the principles of palliative care should be applied as early as possible to any chronic and ultimately fatal illness. This shift was important because if a disease-oriented approach is followed, the needs and preferences of the patient are not fully met and aspects of care, such as pain, quality of life, and social support, as well as spiritual and emotional needs, fail to be addressed. Rather, a patient-centered model prioritizes relief of suffering and tailors care to increase the quality of life for terminally ill patients.

<span class="mw-page-title-main">Ambulatory care</span> Medical care provided for outpatients

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<span class="mw-page-title-main">Pain management</span> Interdisciplinary approach for easing pain

Pain management is an aspect of medicine and health care involving relief of pain in various dimensions, from acute and simple to chronic and challenging. Most physicians and other health professionals provide some pain control in the normal course of their practice, and for the more complex instances of pain, they also call on additional help from a specific medical specialty devoted to pain, which is called pain medicine.

<span class="mw-page-title-main">Polypharmacy</span> Use of five or more medications daily

Polypharmacy (polypragmasia) is an umbrella term to describe the simultaneous use of multiple medicines by a patient for their conditions. Most commonly it is defined as regularly taking five or more medicines but definitions vary in where they draw the line for the minimum number of drugs. Polypharmacy is often the consequence of having multiple long-term conditions, also known as multimorbidity. An excessive number of medications is worrisome, especially for older patients with many chronic health conditions, because this increases the risk of an adverse event in those patients.

In medicine, patient compliance describes the degree to which a patient correctly follows medical advice. Most commonly, it refers to medication or drug compliance, but it can also apply to other situations such as medical device use, self care, self-directed exercises, or therapy sessions. Both patient and health-care provider affect compliance, and a positive physician-patient relationship is the most important factor in improving compliance. Access to care plays a role in patient adherence, whereby greater wait times to access care contributing to greater absenteeism. The cost of prescription medication also plays a major role.

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Multimorbidity, also known as multiple long-term conditions (MLTC), means living with two or more chronic illnesses. For example, a person could have diabetes, heart disease and depression at the same time. Multimorbidity can have a significant impact on people's health and wellbeing. It also poses a complex challenge to healthcare systems which are traditionally focused on individual diseases. Multiple long-term conditions are much more common in older people, affecting more than half of those over 65, however, they can also be found in young people.

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<span class="mw-page-title-main">Health management system</span>

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References

  1. 1 2 3 "Centre for Behavioural Medicine" . Retrieved 4 November 2013.
  2. ↑ https://www.fpm.org.uk/agm2013agenda.{{cite web}}: Missing or empty |title= (help)
  3. 1 2 3 4 5 "CASMI".
  4. ↑ "UKNSCC".
  5. 1 2 3 4 "IRIS" . Retrieved 4 November 2013.
  6. ↑ "Concordance, adherence and compliance in medicine taking. 2005" (PDF). Retrieved 4 November 2013.
  7. ↑ Clifford, S; et al. (2008). "Understanding different beliefs held by adherers, unintentional nonadherers, and intentional nonadherers: application of the Necessity-Concerns Framework". J Psychosom Res. 64 (1): 41–46. doi:10.1016/j.jpsychores.2007.05.004. PMID   18157998.
  8. ↑ Piette, JD; et al. (2004). "Health Insurance Status, Cost-Related Medication Underuse, and Outcomes Among Diabetes Patients in Three Systems of Care". Med Care. 42 (2): 102–109. doi:10.1097/01.mlr.0000108742.26446.17. PMID   14734946. S2CID   34860383.
  9. ↑ Horne, R; Weinman J (1999). "Patients' beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness". J Psychosom Res. 47 (6): 555–567. doi:10.1016/s0022-3999(99)00057-4. PMID   10661603.
  10. ↑ Horne, R; et al. (2009). "Patients' attitudes to medicines and adherence to maintenance treatment in inflammatory bowel disease". Inflamm Bowel Dis. 15 (6): 837–844. doi: 10.1002/ibd.20846 . PMID   19107771. S2CID   37346674.
  11. ↑ Clatworthy, J; et al. (2009). "Understanding medication non-adherence in bipolar disorders using a Necessity-Concerns Framework". J Affect Disord. 116 (1–2): 51–55. doi:10.1016/j.jad.2008.11.004. PMID   19101038.
  12. ↑ Clatworthy, J; et al. (2009). "The value of self-report assessment of adherence, rhinitis and smoking in relation to asthma control". Prim Care Resp J. 18 (4): 300–305. doi:10.4104/pcrj.2009.00037. PMC   6619365 . PMID   19562233.
  13. ↑ Horne, R; et al. (2007). "The Utility of the Necessity-Concerns Framework". J Acquir Immune Defic Syndr. 45 (3): 334–341. doi: 10.1097/QAI.0b013e31806910e3 . PMID   17514019. S2CID   23095019.
  14. ↑ Menckeberg, TT; et al. (2008). "Beliefs about medicines predict refill adherence to inhaled corticosteroids". J Psychosom Res. 64 (1): 47–54. doi:10.1016/j.jpsychores.2007.07.016. hdl: 1874/32598 . PMID   18157999. S2CID   26304324.
  15. ↑ Butler, JA; et al. (2004). "Modifiable risk factors for non-adherence to immunosuppressants in renal transplant recipients: a cross-sectional study". Nephrol Dial Transplant. 19 (12): 3144–3149. doi: 10.1093/ndt/gfh505 . PMID   15479748.
  16. ↑ Horne, R; Weinman J (2002). "Self-regulation and self-management in asthma: exploring the role of illness perceptions and treatment beliefs in explaining nonadherence to preventer medication". Psychology & Health. 17: 17–32. doi:10.1080/08870440290001502. S2CID   143886423.
  17. ↑ Horne, R; et al. (2001). "Haemodialysis patients' beliefs about treatment: implications for adherence to medication and fluid-diet restrictions". International Journal of Pharmacy Practice. 9 (3): 169–175. doi: 10.1111/j.2042-7174.2001.tb01045.x . S2CID   72991215.
  18. ↑ Polosa, Riccardo; Papale, Gabriella; Holgate, Stephen T, eds. (2012). Advances in Asthma Management. FSG eBook Collection. p. 3. ISBN   978-1-78084-042-0. ISSN   2047-332X.
  19. ↑ "CG76 Medicines adherence: 2009" (PDF). NICE guideline. Retrieved 4 November 2013.
  20. ↑ Horne, R. "Concordance, adherence and compliance in medicine taking. Report for the National Co-ordinating Centre for NHS Service Delivery and Organisation R&D (NCCSDO)" (PDF). Retrieved 4 November 2013.
  21. ↑ "Companies House" . Retrieved 4 November 2013.
  22. 1 2 "Spoonful of Sugar Website".
  23. ↑ "CASMI Homepage" . Retrieved 4 November 2013.
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