Category: Management of disease

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

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

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

Treatment decision-making in advanced kidney disease: an international collaborative workshop on future directions

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By Dr Lucy Selman, Associate Professor in Palliative and End of Life Care, Centre for Academic Primary Care, University of Bristol

On Thursday 8 June 2023, an expert meeting was held at the University of Bristol, on treatment decision-making in advanced kidney disease. The meeting brought together renal and palliative care clinicians and researchers specialising in the area from across the UK with colleagues from Harvard University and Brigham and Women’s Hospital, with two guests from Boston coming to Bristol to attend in person.

The aim of the event was to share research and clinical practice models related to treatment decision-making in advanced kidney disease – an area in which the partnering teams have complementary expertise.

The event was led by Dr Lucy Selman, Associate Professor of Palliative and End-of-Life Care at the University of Bristol in collaboration with Professor James Tulsky, Professor of Medicine at … Read more

Anyone can get long-term pain from shingles

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By Lorelei Hunt, Patient and Public Involvement Representative on the ATHENA Shingles Study, Centre for Academic Primary Care, University of Bristol

Five years ago, when I felt unwell with a pain on one side of my body, I assumed I had a virus. Only after a week, when a rash appeared in the same place, did I think that I might have shingles. I was in good health and never thought shingles was something that I was at risk of. But I now know that anyone can get it.

After getting chicken pox, the virus lurks in your nervous system and can reappear as shingles without warning at any time and the risk of this increases with age. The painful, blistering rash was bad enough, but I didn’t know that shingles can have a nasty after-effect, causing a type of nerve pain called post-herpetic neuralgia (PHN for … Read more

Championing a ‘People Era’ in heart failure research

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By Dr Alyson Huntley, Senior Research Fellow in Evidence Synthesis, Centre for Academic Primary Care, University of Bristol

World Heart Day on 29 September 2022 aims to inform people that cardiovascular disease, including heart failure and stroke, is the world’s leading cause of death, claiming 18.6 million lives each year. It also aims to highlight the actions that individuals can take to prevent and control heart disease. Alyson Huntley describes how researchers at the Centre for Academic Primary Care are refocusing priorities to ensure that the needs of people living with heart failure are at the centre of their work.

We aim to put people with heart failure at the centre of our research. A recent collaborative project with other universities highlighted the unmet needs of people living with heart failure. The priority setting process brought clinicians, patients and families/carers together on an equal footing to … Read more

Wakey! Evaluating the feasibility of a mental wellbeing app

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Dr Sophie Turnbull

 

 

By Sophie Turnbull, Senior Research Associate, Centre for Academic Primary Care, University of Bristol

I have an ongoing interest in how industry and academia can work together to produce really good evidence-led products that can be accessible for the target users, and have more longevity than those produced in purely academic settings.

From experience, when we produce digital interventions in our academic bubble, they are brilliantly researched, but often not maintained in the long-term, meaning they disappear soon after the research funding stops. Or we do not have enough budget to develop something that people are going to want to use.

While exploring how academia and industry can come together to reduce inequalities in access to good quality healthcare, I discovered ZINC. ZINC runs mission-led programmes with people from across disciplines to build commercial solutions to solve some of the most pressing societal issues. I … Read more