Category: Management of disease

How team science is helping to detect dangerous drugs and save lives

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By Dr Jenny Scott, Senior Lecturer, Centre for Academic Primary Care, University of Bristol

In 2019, while working at the University of Bath, I had a conversation with Professor Chris Pudney that would spark an idea that is now saving lives. We met at a research “sandpit” – an event designed to bring together researchers from different fields to explore new ideas. We started talking about the growing dangers faced by people who use drugs, especially in an unregulated and increasingly toxic drug market.

That conversation led to the formation of Team Harm Reduction – a group of scientists, clinicians, and researchers working together to tackle drug-related harm. By combining expertise in chemistry, artificial intelligence, mathematics, pharmacy, and intervention development, alongside my own experience in substance use services, we set out to create tools that could detect harmful substances quickly and accurately.

A crisis that

… Read more

Life-changing – how taking part in research helped me lose weight and enjoy life more

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Fred
Francis

 

 

 

 

 

Fred and Francis took part in the Game of Stones study, a National Institute for Health and Care Research (NIHR) funded clinical trial investigating the effectiveness of text messaging, with and without financial incentives, in helping men with obesity lose weight.

The study found that men who received text messages and a financial incentive of up to £400, if they met specific weight loss targets over a 12-month period, lost significantly more weight compared to the other two groups: men who received text messages only; and men who were put on a waiting list to receive text messages after 12 months.

To celebrate taking part in research as part of the NIHR Be Part of Research campaign, and to encourage others to do so, Fred and Francis share their stories about why they took part in the study and the impact it has had … Read more

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

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

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

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

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

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

Six years of researching mental health – what’s changed?

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Professor David Kessler, University of Bristol

 

 

by David Kessler, Professor of Primary Care, Centre for Academic Mental Health and Centre for Academic Primary Care, University of Bristol

In 2017 I wrote a blog for World Mental Health Day. I wrote about the increased societal openness about mental illness over my clinical lifetime, the impact of the widespread availability of talking therapies through IAPT (now renamed NHS Talking Therapies) and described some of the work we had been doing in Bristol and what we planned to do. I talked about research into treatment resistant depression and the threshold for starting antidepressant drugs. What’s happened since in our world, and have we made any progress?

It’s hard to escape the COVID pandemic, but it’s also hard to assess its impact on mental health. The COVID-19 Mental Disorders Collaborators concluded that throughout 2020 the pandemic led to a global increase of over 25% … Read more

Improving papilloedema diagnosis and referral

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by Dr Denize Atan, Associate Professor in Neuro-opthalmology, Neuroscience and Genetics, University of Bristol

Papilloedema is nerve swelling at the back of the eyes. It is caused by increased pressure inside the head and can be the first sign of a brain tumour or other serious health problems.

As half the people with a brain tumour have no symptoms, optometrists (trained eye care professionals who work at optician practices) may be the first to notice nerve swelling in someone during a routine eye test.

The importance of detecting papilloedema has been highlighted by recent high profile cases in the media.

The ‘Improving the Diagnostic accuracy of referrals for Papilloedema’ (DIPP) Study is funded by the National Institute for Health and Care Research (NIHR) to develop a set of guidelines and educational materials for optometrists and GPs that will help them to diagnose papilloedema more accurately … Read more