What drives antibiotic use without prescription in low- and middle-income countries?

Dr Christie Cabral and Professor Helen Lambert

by Dr Christie Cabral,  Senior Lecturer, Centre for Academic Primary Care and Professor Helen Lambert, Professor of Medical Anthropology, Bristol Medical School, University of Bristol

Antibiotic resistance: a key problem

Antibiotics are life-saving drugs that treat infections caused by bacteria. However, every time antibiotics are used, bacteria can become resistant to them, making infections harder to treat. This is called antimicrobial resistance (AMR). In 2011, Dame Sally Davies, then the UK’s Chief Medical Officer, helped to make AMR a government priority. Since then, strategies have been created to help conserve antibiotics and keep them effective. These strategies are called antimicrobial stewardship (AMS) and are used in the UK and around the world.

However, there’s a major problem: it’s hard to figure out quickly which infections are caused by bacteria and need antibiotics, especially when medical tests are not available, which is most places outside hospitals. … Read more

World Health Summit 2024: Building Trust for a Healthier World

Kirsten Nothnagel

by Kerstin Nothnagel, Postgraduate researcher and PhD student, Centre for Academic Primary Care, University of Bristol

I recently got back from an inspiring and transformative few days at the World Health Summit 2024 in Berlin! Held from October 13-15, the summit brought together over 350 speakers and thousands of participants from across the globe, all united under the theme of “Building Trust for a Healthier World.” The discussions were not only enriching but a crucial reminder of how connected we are in tackling some of the world’s most pressing health challenges.

From pandemic preparedness to climate change, health equity, and the growing threat of antimicrobial resistance, the topics covered were vast. But what truly set this summit apart was the focus on local, community-based primary care as a bottom-up solution to global health issues. Over and over, the message came through loud and clear: real progress happens at … Read more

Why do GPs prescribe benzodiazepines in young adults with anxiety?

Dr Charlotte Archer

 

 

 

By Dr Charlotte Archer, Research Fellow in Primary Care Mental Health, Centre for Academic Mental Health and Centre for Academic Primary Care, University of Bristol

Why did we do the research?

Benzodiazepines like Valium can be used to help manage the symptoms of anxiety. Research has found that the number of new prescriptions of benzodiazepines for patients with anxiety decreased between 2003 and 2018. It is likely that this is because there are some concerns in the medical community about prescribing benzodiazepines, such as dependency. However, although numbers have declined overall, rates of prescribing actually increased in young adults (those aged 18-34) from 2008 onwards.

Further, the clinical guidelines for the management of anxiety state benzodiazepines should only be used on a short-terms basis, around two to four weeks. Despite this, in 2017, just under half of the prescriptions for benzodiazepines were issued for … Read more

Navigating perimenopause and menopause as a trans person: challenges, insights, and support

 

 

 

 

By Dr Yvette Pyne, GP and NIHR In-Practice Research Fellow, Centre for Academic Primary Care, University of Bristol

Coinciding with the 15th World Menopause Day on 18 October 2024, I am planning my travel to Birmingham for a screening of a film which describes the experiences of LGBTQ+ people going through menopause. As a clinician and an LGBTQ+ menopausal person myself, I was fortunate to be involved in this amazing project and to meet people passionate about providing better information and visibility around this topic. I’m a GP working both in menopause and trans healthcare (with the Welsh Gender Service), and I’m keen to hear and raise the voices of menopausal trans people who are currently not represented by the general discourse about this life stage.

Menopause and perimenopause: some facts

Menopause, which will happen to anyone who was born with ovaries, can occur … Read more

Co-production, equality, diversity & inclusion at the NIHR School for Primary Care Research Trainee Event 2024

Kirsten Nothnagel

 

 

 

by Kerstin Nothnagel, Postgraduate researcher and PhD student, Centre for Academic Primary Care, University of Bristol

This month, I had the privilege of attending the National Institute for Health and Care Research School for Primary Care Research (NIHR SPCR) Trainee event in Manchester, where I connected and collaborated with fellow SPCR researchers. The event was more than just an academic gathering—it was an inspiring opportunity to share insights and reflect on our work as a community.

A highlight of the event was the Co-Production, Equality, Diversity & Inclusion (CEDI) session, led by Patrick Nyikavaranda. This session was particularly significant for a few reasons. The purpose was to dive deep into understanding how our diverse experiences and backgrounds shape our research, with the aim of fostering a more inclusive research environment. In today’s globalized world, belonging is a crucial element. As researchers, the … Read more

Why do GPs prescribe beta-blockers for people with anxiety disorders?

Dr Charlotte Archer

 

 

 

By Dr Charlotte Archer, Research Fellow in Primary Care Mental Health, Centre for Academic Mental Health and Centre for Academic Primary Care, University of Bristol

Why did we do the research?

Research has shown that more people are now being prescribed beta-blockers, such as propranolol, by their GP for anxiety. This increase in prescriptions is particularly noticeable in young adults aged 18 to 34. Although beta-blockers can be used for anxiety, they are not recommended in clinical guidelines for the management of anxiety. It is possible that they are not recommended because, so far, the evidence is not clear for whether they work well in treating anxiety.

In addition, a recent report suggests that prescribing beta-blockers in patients with anxiety or depression could be problematic because there are concerns around what happens if too many are taken or when they are prescribed alongside antidepressants.… Read more

Good Grief Weston – bringing communities together to tackle inequities in bereavement and social isolation

James RobbLucy Selman

 

 

 

By Dr James Robb, Academic Clinical Fellow and Professor Lucy Selman, Palliative and End of Life Care Research Group, University of Bristol.

Almost all of us will experience the grief associated with bereavement, yet as a society we often struggle to talk about it. We have been working with the community of Weston-super-Mare to design and run Good Grief Weston, a festival to improve knowledge and support for local people. Our evaluation of the first festival, held in 2023, has now been published. As we gear up for Good Grief Weston 2024 in October (registrations are now live), we reflect here on the impact of the festival.

People often feel unsupported by their community after the death of a loved one. Moreover, experiences of grief and bereavement are unequal. People living in the UK’s most deprived areas – like Weston-super-Mare – are less likely … Read more

From the laboratory to the street: doing multidisciplinary research to understand the rising numbers of deaths involving opioids and benzodiazepines

A University of Bristol multidisciplinary team from Bristol and Bath University has been working to understand the increase in deaths from taking both opioids and benzodiazepines (benzos). Here they reflect on how this approach has enhanced their research and made it more useful.

The problem

Drug use is a leading cause of premature death in many countries. Such deaths are increasing.

There are many reasons for this increase, including changes in the types of people who use drugs, and the rise in the use of fentanyls and other synthetic opioids.

Taking more than one drug at a time is another cause. For example, taking benzodiazepine (diazepam, etizolam, bromazolam) or z-drugs (zolpidem, zopiclone) along with opioids (heroin, methadone, buprenorphine) increases the chances of overdose and death.

Although many epidemiological and post-mortem studies have identified this risk, we still don’t know why combining these drugs increases mortality.

As a team our expertise … Read more

The road to funding for a complex clinical trial – ingredients for success

Dr Eszter Szilassy

 

 

 

Dr Eszter Szilassy, IRIS+ Trial Principal Investigator, Senior Research Fellow and Senior Lecturer in Violence and Health, Centre for Academic Primary Care, University of Bristol

On 1 May 2024, I held the first meeting of the IRIS+ Trial, a complex clinical trial to improve the general practice response to domestic abuse, which had been made possible by an award of £2.2 million from the National Institute for Health and Care Research (NIHR). As I sat with colleagues, I couldn’t quite believe that we were finally ready to go. The journey started two and a half years ago on the back of a feasibility study, which was successful, but not yet published. As a mid-career researcher, this was my first major grant application as Principal Investigator. I had much to learn on the way and was reliant on a lot of support from both academic … Read more