Understanding the lethal interactions between benzodiazepines and opioids to develop new harm reduction strategies

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By Dr Jo Kesten

A multidisciplinary project to understand why taking benzodiazepines or z-drugs and opioids together leads to so many deaths, brought together qualitative researchers with other specialists. One paper from the study has now been published in the Harm Reduction Journal, a pre-print for another paper is available and a third is underway. Here the qualitative team discuss their findings.

The number of people dying because of drugs is rising in the UK, especially in Scotland. Many of these deaths involve a combination of opioids (heroin or methadone) and benzodiazepines or z-drugs (sedatives often used to treat anxiety and insomnia), which are either prescribed or obtained illegally.

We set out to understand how benzodiazepines or z-drugs and opioids work together and why this makes a fatal overdose more likely. We aimed to achieve this first by talking to people about their use of benzodiazepines or z-drugs and … Read more

The importance of an inclusive study design – the HepCAPP Study

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Dr Kirsty Roberts

 

 

by Dr Kirsty Roberts, Senior Lecturer in Trials Methodology and Deputy Research Director EDI, Bristol Medical School, University of Bristol

Background

HepCAPP (Hepatitis C Case-finding in Primary Care Pilot) was a pilot oral swab Hepatitis C Virus (HCV) screening study which was funded by NHS England in 2019 and completed in 2023. The study invited over 98,000 people aged 40-64 registered at selected GP practices to take part. 12,216 (12.4%) consented and returned their sample to the UK Health Security Agency (UKHSA) for testing.

The study participants found the approach to testing acceptable and the uptake was better than expected. However, the study also confirmed that those identified could have been found through lower-cost targeted screening. Therefore, we recommended that oral swab HCV screening shouldn’t be rolled out in the NHS.

Were there any groups of people or communities under-represented?

The study found … Read more

Integrating palliative and end-of-life care: working toward equity

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Lucy Selman

 

 

 

By Dr Alice Malpass, Senior Research Fellow, and Lucy Selman, Professor of Palliative and End of Life Care, Centre for Academic Primary Care, University of Bristol

“Death comes equally to us all, and makes us all equal when it comes.” – John Donne

While death is inevitable for everyone, the experience of dying and receiving support through bereavement varies greatly in the UK. Sadly, older people, ethnic minorities, and those living in poverty often face significant barriers to accessing end-of-life care and bereavement support. These challenges include a lack of awareness of available services, discomfort asking for help, discrimination, and a shortage of services tailored to the needs of diverse communities. People living with disadvantage are also more likely to face isolation and receive poorer-quality care during serious illness and bereavement. These disparities were even more pronounced during the COVID-19 pandemic.

Can integration improve … Read more

What was it like attending the RCGP Annual Conference as an early career GP academic?

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Dr Molly Dineen

 

 

by Dr Molly Dineen, ST2 Academic Clinical Fellow in General Practice, Centre for Academic Primary Care, University of Bristol

I was so pleased to receive a bursary from the Royal College of General Practitioners (RCGP) Severn Faculty, which enabled me to attend this year’s RCGP Annual Conference in Liverpool. I am an ST2 Academic Clinical Fellow in General Practice, and this was my first RCGP Annual Conference, as well as my first time in Liverpool!

Attending the conference was an incredible experience. I have created a short montage of my trip so that, if you haven’t been before, you can get a real taster of what it was like.

I would summarise my experience with the word ‘diversity’ and hopefully you get a sense of that from the video – diversity of experiences, diversity of sessions, diversity of people, and diversity of our profession.

There … Read more

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

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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

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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?

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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

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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

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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?

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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