Layla Edwards is currently employed as a Research Assistant within IMPACCT – Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, University of Technology Sydney. She is involved in a range of projects in the area of advancd illness and chronic care.
Layla’s key research interests are in public health where is has expertisein epideiolody ad health promotion. This is driven by a passion for promoting health for vulnerabe popultions, by conducting research to build on evidence on the heath inequities and develop interventions to address them.
Hosie, A, Phillips, J, Lam, L, Kochovska, S, Noble, B, Brassil, M, Kurrle, SE, Cumming, A, Caplan, GA, Chye, R, Le, B, Ely, EW, Lawlor, PG, Bush, SH, Davis, JM, Lovell, M, Brown, L, Fazekas, B, Cheah, SL, Edwards, L & Agar, M 2019, 'Multicomponent non-pharmacological intervention to prevent delirium for hospitalised people with advanced cancer: study protocol for a phase II cluster randomised controlled trial.', BMJ open, vol. 9, no. 1, pp. e026177-e026177.View/Download from: UTS OPUS or Publisher's site
INTRODUCTION:Delirium is a significant medical complication for hospitalised patients. Up to one-third of delirium episodes are preventable in older inpatients through non-pharmacological strategies that support essential human needs, such as physical and cognitive activity, sleep, hydration, vision and hearing. We hypothesised that a multicomponent intervention similarly may decrease delirium incidence, and/or its duration and severity, in inpatients with advanced cancer. Prior to a phase III trial, we aimed to determine if a multicomponent non-pharmacological delirium prevention intervention is feasible and acceptable for this specific inpatient group. METHODS AND ANALYSIS:The study is a phase II cluster randomised wait-listed controlled trial involving inpatients with advanced cancer at four Australian palliative care inpatient units. Intervention sites will introduce delirium screening, diagnostic assessment and a multicomponent delirium prevention intervention with six domains of care: preserving natural sleep; maintaining optimal vision and hearing; optimising hydration; promoting communication, orientation and cognition; optimising mobility; and promoting family partnership. Interdisciplinary teams will tailor intervention delivery to each site and to patient need. Control sites will first introduce only delirium screening and diagnosis, later implementing the intervention, modified according to initial results. The primary outcome is adherence to the intervention during the first seven days of admission, measured for 40 consecutively admitted eligible patients. Secondary outcomes relate to fidelity and feasibility, acceptability and sustainability of the study intervention, processes and measures in this patient population, using quantitative and qualitative measures. Delirium incidence and severity will be measured to inform power calculations for a future phase III trial. ETHICS AND DISSEMINATION:Ethical approval was obtained for all four sites. Trial r...
Hosie, A, Siddiqi, N, Featherstone, I, Johnson, M, Lawlor, PG, Bush, SH, Amgarth-Duff, I, Edwards, L, Cheah, SL, Phillips, J & Agar, M 2019, 'Inclusion, characteristics and outcomes of people requiring palliative care in studies of non-pharmacological interventions for delirium: A systematic review.', Palliative medicine, vol. 33, no. 8, pp. 878-899.View/Download from: UTS OPUS or Publisher's site
BACKGROUND:Delirium is common, distressing, serious and under-researched in specialist palliative care settings. OBJECTIVES:To examine whether people requiring palliative care were included in non-pharmacological delirium intervention studies in inpatient settings, how they were characterised and what their outcomes were. DESIGN:Systematic review (PROSPERO 2017 CRD42017062178). DATA SOURCES:Systematic search in March 2017 for non-pharmacological delirium intervention studies in adult inpatients. Database search terms were 'delirium', 'hospitalisation', 'inpatient', 'palliative care', 'hospice', 'critical care' and 'geriatrics'. Scottish Intercollegiate Guidelines Network methodological checklists guided risk of bias assessment. RESULTS:The 29 included studies were conducted between 1994 and 2015 in diverse settings in 15 countries (9136 participants, mean age = 76.5 years (SD = 8.1), 56% women). Most studies tested multicomponent interventions (n = 26) to prevent delirium (n = 19). Three-quarters of the 29 included studies (n = 22) excluded various groups of people requiring palliative care; however, inclusion criteria, participant diagnoses, illness severity and mortality indicated their presence in almost all studies (n = 26). Of these, 21 studies did not characterise participants requiring palliative care or report their specific outcomes (72%), four reported outcomes for older people with frailty, dementia, cancer and comorbidities, and one was explicitly focused on people receiving palliative care. Study heterogeneity and limitations precluded definitive determination of intervention effectiveness and only allowed interpretations of feasibility for people requiring palliative care. Acceptability outcomes (intervention adverse events and patients' subjective experience) were rarely reported overall. CONCLUSION:Non-pharmacological delirium interventions have frequently excluded and under-characterised people requiring palliative care and infrequently reported ...
Hosie, A, Phillips, J, Lam, L, Kochovska, S, Brassil, M, Noble, B, Kurrle, S, Cumming, A, Caplan, G, Chye, R, Le, B, Ely, EW, Lawlor, P, Bush, S, Davis, JM, Lovell, M, Brown, L, Fazekas, B, Cheah, SL, Edwards, L & Agar, M 2018, 'A phase II cluster randomised controlled trial of a multicomponent non-pharmacological intervention to prevent delirium for in-patients with advanced cancer (The PRESERVE pilot study)', ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, WILEY, pp. 166-166.