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

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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

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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

Co-developing a theory of change to evaluate integrated working in two Locality Partnerships – Part 2

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Dr Natalia Lewis

 

 

 

By Dr Natalia Lewis, Senior Research Fellow in Primary Care, Centre for Academic Primary Care, University of Bristol and Researcher in Residence, Bristol, North Somerset and South Gloucestershire Integrated Care Board.

Back in 2022, I started my secondment as a researcher in residence at the Bristol, North Somerset and South Gloucestershire Integrated Care Board (BNSSG ICB). I was tasked with supporting the development of an evaluation framework for two Locality Partnerships.

My first blog and podcast in December 2023, described the process of co-developing theories of change for the Partnership Working, Ageing Well and Dying Well workstreams with stakeholders from the NHS, local authorities and voluntary and voluntary, community and social enterprise sector from the two Locality Partnerships. Co-developed from bottom up, these theories of change incorporated local knowledge and priorities which were linked with the BNSSG ICB population health … Read more

Co-developing a theory of change to evaluate integrated working in two Locality Partnerships – Part 1

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Dr Natalia Lewis

 

 

 

By Dr Natalia Lewis, Senior Research Fellow in Primary Care, Centre for Academic Primary Care, University of Bristol and Researcher in Residence, Bristol, North Somerset and South Gloucestershire Integrated Care Board.

This blog is in two parts. Read the second blog on the project final stage and report.

Since December 2022, I have been working part-time as a researcher in residence at the Bristol, North Somerset and South Gloucestershire Integrated Care Board (BNSSG ICB).

The Researcher-in-Residence (otherwise known as Embedded Researcher) model involves co-locating researchers within non-academic organisations to enhance the role of research evidence in informing decision-making. I applied for this job because I wanted to understand how decision-making in the real-world health system happens and how my research skills and expertise can be used to make local policies and practices evidence informed.

My post was established to support development of an evaluation … Read more

A global journey into primary care: insights from the NAPCRG Conference

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Chloe Gamlin

 

 

 

by Chloë Gamlin, GP Academic Clinical Fellow, Centre for Academic Primary Care, University of Bristol

Attending the North American Primary Care Research Group (NAPCRG) conference for the first time proved to be an enriching experience, offering a diverse array of presentations and discussions at the forefront of primary care. Held at the Hilton in downtown San Francisco, the conference brought together healthcare providers and researchers from across the globe.

Plenaries

The opening plenary by Professor Ed Maibach underscored the role of primary care physicians in addressing climate change, emphasizing their potential to provide unbiased information. Another plenary, led by Professor Diana Greene Foster, delved into the intersection of politics and healthcare, focusing on the recent changes to US abortion law. The emotional session highlighted the resilience of healthcare professionals in supporting women’s health issues, despite differing opinions.

Distinguished papers presented in the morning sessions covered … Read more

Key insights from social science research for antibiotic stewardship interventions

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By Christie Cabral, Senior Lecturer, Centre for Academic Primary Care , University of Bristol

As a social anthropologist, I’ve been investigating why antibiotics are overused for over a decade and using the insights gained to develop antibiotic stewardship interventions. For World Antimicrobial Resistance (AMR) Awareness Week, I am writing about three key insights from my research.

1. The role of ‘Explanatory Models’ for illness and treatment: the influence on consulting and prescribing behaviours

Explanatory models are the set of linked ideas or theories that we each have in our minds about an illness and the possible treatments. These inform what we do as a patient, deciding whether to consult, or as a clinician deciding whether to prescribe.

The (simplified) biomedical model for the infections is of two types: viral or bacterial. Antibiotics treat bacterial infections but are ineffective for viral infections. So, it’s simple, no one … Read more

Does increasing the Altmetric score increase citations for primary care research papers?

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Dr Alex Burrell

 

 

By Dr Alex Burrell, NIHR Academic Clinical Fellow in General Practice, Centre for Academic Primary Care, University of Bristol

Dr Alex Burrell has led a study exploring the relationship between Altmetric scores and citations in primary care research journals as part of his Editorial Fellowship at the British Journal of General Practice (BJGP) and BJGP Open.

The number of times a research article is cited has traditionally been used to assess its impact and quality. Altmetric score is an alternative measure of article impact which assesses the broader societal impact of articles and includes social media, blogs, and news mentions.

Number of citations, and other measures which are based on citation count, are still most often used by researchers and universities, and are tied to financial rewards. However, academic journals and authors increasingly use parts of the Altmetric score to share and promote research.

If Altmetric … Read more

My experience as an NIHR School for Primary Care Research intern: a pharmacy student’s perspective

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Loreta Valatka

 

 

by Loreta Valatka, Third Year Pharmacy Student, University of Bath

 

My internship experience

The Carry Naloxone Somerset project, led by Dr Jenny Scott, was the main focus of my 2023 research summer internship at the University of Bristol’s Centre for Academic Primary Care (CAPC). The aim of the project is to encourage people in Somerset who may experience or witness an overdose to carry naloxone – a first aid medicine that can be supplied without prescription to prevent an opioid overdose from being fatal.

Before the launch of the campaign, I analysed survey data to write a report about the possession and carriage of naloxone, as well as overdose experiences amongst Somerset Drug and Alcohol Service (SDAS) users. Post launch, I was responsible for follow-ups with the 23 pharmacies that had signed up so far. This was to ensure all participating members of the pharmacy teams … Read more