by Dr Rupert Payne, Consultant Senior Lecturer in Primary Health Care, Centre for Academic Primary Care, University of Bristol
The COVID-19 pandemic has unsurprisingly been associated with a similar epidemic of social media misinformation. But there are also some genuine clinical issues of relevance to people with existing health conditions, who are known to be more vulnerable to the disease. One particular topic that has left patients and health professionals alike confused and alarmed is the suggestion that ACE inhibitor drugs may increase the dangers of COVID-19.
First introduced in the early 1980s, ACE (angiotensin-converting enzyme) inhibitors were initially used for the treatment of high blood pressure, but their role has grown over the years to include the management of heart failure, heart attacks, diabetes and kidney disease. Given that roughly one-fifth of the adult population in the UK has diagnosed hypertension, and other … Read more
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
by Dr Yvette Pyne, Academic Clinical Fellow, Centre for Academic Primary Care, University of Bristol
The breadth of conditions doctors are expected to manage continues to grow as people and society become ever more complex and it is in GP surgeries up and down the country where this is most starkly seen. The volume of work expected of GPs is taking its toll on individual doctors and the service as a whole.
My previous career designing and developing information technology (IT) systems gives me insight into the huge potential computers and machine learning have to help us in this increasingly challenging environment. Artificial Intelligence (AI) can enable us to provide the best evidence-based medicine to our patients while also freeing us from mundane administration to spend more time connecting with the human beings in front of us.
In the UK, Primary Care is already leading … Read more
by Dr Jason Sarfo-Annin, Honorary Research Fellow, Centre for Academic Primary Care, University of Bristol
Debate surrounding the future of general practice is usually rooted in the context of the primary care workforce, the introduction of new roles and developing practitioners with a new skill-mix.
Such solutions are rooted in the medical model of health. I share the Marmotian view that health care is just one dimension of improving individual and population health.
As GPs, we often consult with patients who cannot be helped by our services. We are also often unable to effectively signpost patients or help navigate them to services that can support them. Consequently, I believe the future involves working as part of a collaboration of services – delivered optimally by co-location. Provision of these services would be based on the geographical location of patients and include amenities already provided by local authorities … Read more
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
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
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.
Around 20% of children in the UK experience eczema, which is characterised by dry, itchy skin. Eczema can … Read more
By Dr Lucy Pocock, GP Career Progression Fellow, Centre for Academic Primary Care, University of Bristol
Dealing with death is part of the job description for all doctors. For those working in general practice, this often means planning ahead, with GPs encouraged to keep a register of patients thought to be in the last year of their life.
One reason for this is to identify which patients might benefit from palliative and supportive care – the kind of care which focuses on symptom control, rather than cure. At the moment, these registers appear to consist mainly of patients with cancer. Yet most people (72%) in England don’t actually die of cancer. So why aren’t other dying patients being registered?
To answer this question, it is helpful to think about how we die. As a GP, I can often predict, to some degree, a decline … Read more
by Dr Emma Anderson
Senior Research Associate
Centre for Academic Primary Care
As any parent knows, children get coughs, colds and ear infections all the time. Symptoms of these respiratory infections – including runny nose, cough and sore throat – can seem never-ending.
In the EEPRIS Study, led by Professor Alastair Hay from the University of Bristol’s Centre for Academic Primary Care, we recruited parents across Bristol to tell us about their children’s respiratory symptoms as they became ill. Gathering information in the community means we are able to find out more about common respiratory illnesses than when we study those who have decided to consult their GP. It also gives us a more accurate picture of how likely parents are to consult for these common illnesses, something which has been surprisingly unclear.
Two of our main findings were that:
- it takes up to three weeks for most
… Read more
By Dr Sarah Sullivan
Centre for Academic Primary Care
Psychosis is a serious and long-term mental illness. Unfortunately, for many sufferers the outcomes are poor. Many may relapse again after recovery, suffer long-term residual symptoms and have poor social functioning.
Primary care is an important part of the care pathway for patients with psychosis, so GPs need to be able to accurately identify those at high risk. The task is difficult because high-risk symptoms are frequently not specific to psychosis.
We also know that the greater the delay between someone’s first psychotic symptom and receiving specialist mental health treatment is associated with poorer outcomes. GPs play an important role in this, because most people are referred to mental health services by their GP.
In a study recently published in JAMA Network Open, we set out to find out if people had previously consulted their GP … Read more