This article was originally published by the Elizabeth Blackwell Institute for Health Research. Reproduced here with kind permission.
The prevalence of antibiotic use in modern society is well established. Antibiotics have revolutionised medicine and how society sees – and deals with – disease. Along with concerns regarding the rise of antibiotic resistant bacteria, thought to be exacerbated by their over-use in many areas, there is a need to understand the history of their adoption and use, especially in primary care. Comprehending the many-tendrilled circumstances and behaviours that led to this point might help to inform future choices, and give some insight into future best practice.
Dr Barbara Caddick, Senior Research Associate at the Centre for Academic Primary Care (CAPC) at the University of Bristol, is well qualified for such an undertaking, with a PhD in History and extensive experience in research in primary care. Within CAPC she is a member of both the ‘infections and antibiotics’ research group and the ‘medicines and prescribing’ group.
Initially, Dr Caddick’s multidisciplinary research, was supported by ‘ideas exchange’ funding from the Brigstow Institute, which quickly led to a scoping projectentitled ‘Can the past inform the present? Exploring attitudes and approaches to the management of common infections’, was funded via the Elizabeth Blackwell Institute’s Medical Humanities strand. The project included visits to a variety of locations, including medical historical archives such as the Walgreen Boots Alliance in Nottingham – but as with so many research projects, the emergence of COVID-19 proved an enormous disruption.
“The project was intended to act as a scoping exercise to fund another, larger project. But as a result of the pandemic, I had to refocus toward remote work using online resources,” said Dr Caddick. “My planned visit to the Walgreens Boots Alliance archive was not possible; work to engage and recruit patient/public contributors born before 1950 was severely restricted. And some of the online collections I needed were also severely restricted or inaccessible due to staff furlough.”
New focus, new opportunities
Despite this, the shift online did identify other, novel opportunities: “As a result of the change in focus,” Dr Caddick continued, “I was able to identify the digitised archive of the British Journal of General Practice as worth investigating, and my research there directly informed a new project titled ‘Visualizing the past: Exploring data visualisation as a method to investigate the digitised archives of historical medical journals’, funded by the Jean Golding Institute seed-corn fund.”
As well as numerous abstracts in preparation from this, Dr Caddick has assembled an interdisciplinary team of researchers including primary care researchers, academic GPs and software specialists from Research IT to explore the archive and its implications further, and to further develop new links with researchers at the Alan Turing Institute for Data Science and Artificial Intelligence in London.
Old plans, revisited
Once COVID restrictions lifted, however, Dr Caddick was able to re-establish plans to visit the Walgreen Boots Alliance Archive, and development work with other public organisations.
“Through this I have developed links with a community craft club – organised and attended by seniors – and a care home,” she explained. “I also took advantage of an opportunity to work with the Black Country Living Museum, which formed the basis of a second successful application to the Elizabeth Blackwell Institute COVID-19 support scheme extension funding. I hope that this relationship will continue long term.”
Dr Caddick is currently strengthening her collaboration with the Black County Living Museum, alongside developing a relationship with the community group ‘Together in Penn Fields‘ (near Wolverhampton) to work towards new funding opportunities.
“I also made a successful bid to the GW4/British Academy Early Career Researcher Network South West Hub seed funding scheme,” Dr Caddick added. “This will fund four further archival scoping visits – two to the British Library, and one each to the Wellcome Library and the archive of the Royal College of General Practitioners. These will underpin the development of new research. I am now developing a larger programme of work focusing on the history of primary care, and the contribution that historical research can make to the field of present day primary care research and potentially to future clinical practice.”
In her capacity as Senior Research Associate (SRA) in Medicines and Prescribing in Primary Care in the Centre for Academic Primary Care (CAPC), Dr Caddick has contributed to projects focusing on online prescribing and patient experiences of sharing prescription medicine, as well as being appointed to additional SRA primary care dataset projects. Barbara is lead co-investigator for a collaborative study led jointly by Professor Geraldine Leydon, University of Southampton, and Professor Fiona Stevenson, University College London. The “Qualitative Data Preservation and Sharing” (Q-DaPS) study is funded by the National School for Primary Care to develop and design a prototype digital repository for qualitative health and social care research data.
“Through these roles I have been involved in research development and bid writing for much larger projects with external collaborators which have been successfully funded,” she said. “And I have been able to present my historical primary care work to a range of different audiences.”
Into the Crucible
Dr Caddick is now one of 30 researchers who have been selected to take part in the GW4 Alliance Crucible – an initiative undertaken by the GW4 Alliance of four research intensive UK universities, Bristol, Bath, Exeter and Cardiff. The Crucible programme is designed to enhance collaborative research leadership using hands-on training and coaching. This year’s theme is ‘Our data and digital world – opportunities for transformative interdisciplinarity, which explores the ethical conflict between data exploitation and fundamental human rights such as privacy and anonymity with the relentless societal encroaching of technology.
One in a Million: Primary care consultations archive