Involving people with advanced heart failure in setting the research agenda

Rachel Johnson

 

 

by Dr Rachel Johnson, GP and NIHR Clinical Researcher in Primary Health Care, Centre for Academic Primary Care, University of Bristol

Together with colleagues at the Universities of Bristol, Oxford, Birmingham, Cambridge and Lancaster, I recently completed a James Lind Alliance Priority Setting Partnership for advanced heart failure, funded by the NIHR School for Primary Care Research.

Priority setting partnerships (PSPs) are an established method for involving patients and the public in the first, crucial stage of research – deciding which research questions should be tackled by research studies. The results have just been published in BMJ Open Heart and include a list of the final top 10 priority research questions.

Briefly the process involved:

  • conducting a survey to elicit priority questions from a wide range of stakeholders, including patients, carers and clinicians
  • excluding questions that had already been addressed in the literature
  • ranking the
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Do web-based self-care interventions reduce health inequalities for people with chronic conditions?

 

 

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

Digital interventions have become increasingly popular due to their potential to increase access to healthcare for people with chronic conditions and reduce the burden on a stretched healthcare system.

This has been amplified during the COVID-19 crisis, where much face-to-face support has been reduced or is no longer available. However, there are concerns that digital health provision may exacerbate existing health inequalities.

Chronic or long-term conditions, such as diabetes, are estimated to account for 87% of deaths and have a significant impact on an individual’s quality of life. Even in high-income countries, people with lower socioeconomic status experience chronic illness more commonly and with greater severity than average for the rest of the population.

We also know that people with existing health conditions, in low paid or insecure work and … Read more

Why new guidance on domestic abuse for GPs is vital during COVID-19

 

 

by Dr Eszter Szilassy, Research Fellow, Centre for Academic Primary Care, University of Bristol

GPs and other primary health care professionals play a vital role in addressing domestic violence and abuse (DVA). This is especially true during the current coronavirus pandemic, when individuals and families are isolated from potential sources of help and support.

Home during lockdown may not be a safe place for those affected. In England, the National Domestic Abuse Helpline, run by Refuge, has seen a 50 per cent increase in calls compared to pre-COVID-19, along with a 400 per cent increase in web traffic.

We know that the pandemic is having a detrimental impact on the health and wellbeing of people affected by DVA and their children. Extensive periods of self-isolation and social distancing compounded by increasing uncertainty over jobs and financial security for families may be a dangerous and profoundly … Read more

Finding the best moisturiser for eczema – the impact research can have on everyday lives

Zoe Wilkins

 

 

by Zoe Wilkins, Trial Administrator, Centre for Academic Primary Care, University of Bristol

It’s safe to say that I knew little about eczema before working as an administrator on the Best Emollients for Eczema (BEE) trial and even less so about emollients, the different types of moisturiser used to treat the condition.

My own children occasionally suffered with very mild eczema; tiny patches here and there that would clear up with a couple of days of moisturisation. So, it was only after starting work on the trial that I began to understand the complexity of this condition. Some suffer seasonal ‘flare-ups’, for others year-round torment, which can be triggered by many different factors.

Although I knew that if you had eczema it was important to keep skin moisturised, I had not heard of the word ‘emollient’ before. Emollient is the medical word for moisturiser and comes in … Read more

Vaccinating children – why peace of mind should not be forgotten when it comes to funding

Gemma Lasseter

 

by Gemma Lasseter, Research Fellow, Centre for Academic Primary Care and NIHR Health Protection Research Unit in Evaluation of Interventions at the University of Bristol

In the UK, government policy on whether to fund new vaccines, or modify their availability, is based on advice from an independent scientific advisory group. This involves weighing up the benefits and costs, and then deciding whether a vaccine is value for money.

The idea is to find a balance between the cost of doing something (such as routinely vaccinating all children against a particular disease) and how much benefit you get from doing it (such as health gains by preventing disease and the associated economic savings).

Yet the current approach does not take into account many of the benefits that vaccinations offer and which set them apart from other health interventions. The fact that vaccinations are preventative rather than curative, for … Read more

What are the causes of unnecessary antibiotic prescribing?

 

 

By Christie Cabral, Research Fellow, Centre for Academic Primary Care, University of Bristol

Why do parents seeking evaluation, reassurance and information about their child’s cough end up with antibiotics from their GP? Research fellow Christie Cabral looks at the evidence.

GPs see a lot of children with respiratory tract infections (RTIs), usually presenting with a cough, high temperature or both. RTIs can be distressing and disruptive for children and parents but are mostly viral illnesses that will get better on their own: there is little that a GP can do to treat them.

However, many are prescribed unnecessary antibiotics that can lead to resistant bacteria. From our previous research, we know that parents often feel uncertain about the severity of an RTI and feel that it’s safer to consult a doctor.

They are usually seeking a medical evaluation, reassurance and information to help them understand and … Read more

Involving advanced heart failure patients in shaping research questions: A Priority Setting Partnership

 

by Dr Rachel Johnson, NIHR Clinical Lecturer in Primary Health Care, Centre for Academic Primary Care, University of Bristol and Anna King, NIHR Health Protection Research Unit in Evaluation of Interventions at the University of Bristol

 

Our Priority Setting Partnership (PSP) began as the idea of a group of doctors who have witnessed how difficult the experience of heart failure can be for patients and their families. Heart failure is one of the commonest causes of unplanned hospital admissions, and it can place a heavy burden on carers and families.

Our aim was to put the needs of patients, carers and health professionals at the heart of the research agenda. We followed the methods of the James Lind Alliance Heart (JLA), a not for profit organisation set up to ‘open up discussion between patients and clinicians to agree on priorities for future research.

The PSP … Read more

Male victims of domestic abuse face barriers to accessing support services – new study

 

 

by Dr Eszter Szilassy, Research Fellow, Centre for Academic Primary Care, University of Bristol

Men who experience domestic violence and abuse face significant barriers to getting help and access to specialist support services, our latest study shows.

Although the amount, severity and impact of domestic violence and abuse experienced by women is much higher than that experienced by men, men can also suffer significantly as a result of abuse from a partner, ex-partner or an adult family member.

An earlier study of 1,368 male patients in GP clinic waiting rooms in the UK found that more than one in four had experienced abusive behaviour from a partner or ex-partner. They were also between two and three times more likely to have symptoms of depression and anxiety.

The experiences of many men who are survivors of domestic violence and abuse are similar to those of women. Like … Read more

Public involvement in health research: what it’s like, what I’ve learned, and why it matters

 

 

Interview with Louise Ting, Member of the Centre for Academic Primary Care Patient and Public Involvement Steering Group

Louise Ting has been involved in service delivery and health research from a patient and public perspective for over six years. She has a passion for ensuring that patient and public involvement (PPI) is done properly and is meaningful both for researchers and for public contributors. Louise is a member of the PPI Steering Group at the Centre for Academic Primary Care, University of Bristol.

How did you find out about public involvement in research?

I first heard about public involvement when there was a large-scale commissioning exercise in Bristol for procuring the next set of mental health services in the city. They were asking people who had used services in the past to give their views and help assess the different bids by potential providers.

There were lots … Read more

Including the views and experiences of parents and children in a clinical trial: The Best Emollient for Eczema (BEE) Study

Dr Eileen Sutton

 

 

By Dr Eileen Sutton, Research Fellow and Trial Coordinator – BEE Study, Centre for Academic Primary Care, University of Bristol

Qualitative research in trials

Many clinical trials now include qualitative research methods – which can include interviews, focus groups, or observations – alongside clinical and survey data collection. These kinds of research methods can be used to help the design of trials or to help us understand what is going on when a treatment or service is delivered in a clinical trial. For example, we can interview research participants to find out more about how they have used or experienced a treatment, in much more detail than we could capture in a survey. Combining different research methods can help researchers to get a more complete picture.

Our research

Around 20% of children in the UK experience eczema, which is characterised by dry, itchy skin. Eczema can … Read more