Health Data Science: the next key development in patient-centred research will be data-led

 

 

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

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

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

Why GPs and patients need to talk more openly about death

 

 

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

After the trial: how a programme to improve the health care response to domestic violence and abuse fares in the real-world NHS

 

 

 

By Dr Natalia Lewis, Research Fellow, Centre for Academic Primary Care, University of Bristol

A new paper by researchers from the University of Bristol and NIHR CLAHRC North Thames highlights the post-trial journey of an evidence-based domestic violence and abuse (DVA) intervention to the NHS front-line, and the human and contextual factors that influence how its effect is sustained over time.

IRIS (Identification and Referral to Improve Safety) is a general-practice-based DVA training, support and referral programme. The programme develops DVA awareness and skills among general practice staff and provides a referral pathway to a named DVA advocate (IRIS advocate educator) based in a third sector agency. IRIS advocate educators provide IRIS training and ongoing support, consultancy to practice staff, and advocacy to referred patients.

Following a successful randomised controlled trial, IRIS has been implemented in over 30 local authorities in the UK. The trial … Read more

What’s normal in children’s respiratory infections? Bristol parents helped us find out

 

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

Why it’s important to pre-test patient-reported questionnaires

Insights from testing MYMOP and PEI

Dr Mairead Murphy

 

by Dr Mairead Murphy
Senior Research Associate
Centre for Academic Primary Care

In research studies, we use patient-reported questionnaires a lot to test if healthcare interventions work or not. Given that the correct completion of these questionnaires underpins our research conclusions, it’s important to know how patients interpret them.

We decided to look more closely at how people interpreted questionnaires. We asked people who had recently visited their GP to complete two commonly-used questionnaires in primary care and tell us their thought processes as they did this. The questionnaires we chose were:

  1. The patient enablement instrument (PEI): This questionnaire has six questions, all related to how “enabled” a patient feels following a GP consultation. It asks patient to rate their improvements in coping, understanding, self-help and other aspects of “enablement”.
  2. Measure Yourself Medical Outcomes Profile (MYMOP): This questionnaire measures symptoms, daily activities
Read more

Medicines have revolutionised treatment in the NHS – can this progress be sustained?

Dr Rupert Payne

 

by Dr Rupert Payne
Consultant Senior Lecturer in Primary Health Care
Centre for Academic Primary Care

The seventieth anniversary of the NHS has made me reflect on how proud I am to have contributed to its work for over the past twenty-odd years. Founded on 5 July 1948, the service continues to this day to operate to the same three core principles – meeting the needs of everyone, free at the point of delivery, and based on clinical need.

Aside from providing comprehensive, high-quality healthcare services to virtually the entire UK population, the other thing that the NHS is known for is the constant political bickering that carries on in the background, with criticisms about chronic under-funding and stealth privatisation. However, these are not new issues, with medicines an important reason for the challenges the NHS now faces.

In a response to concerns about rising costs, perhaps the first … Read more

Collaborative action planning is key to person-centred healthcare but how can we make it happen?

by Cindy Mann
Senior Research Associate
Centre for Academic Primary Care
@Jcindymann


Person-centred healthcare
is accepted as desirable on moral grounds and because it potentially leads to better health outcomes, greater efficiency and less waste. It means both involvement of individuals in their healthcare and individualisation of care.

The NHS has been chasing the goal of person-centred care planning for several years and there are many good examples of innovation. The ‘House of Care’ describes what it might mean in practice for people with long-term conditions. At its heart is personalised care planning, taking account of patients’ expressed needs and priorities. The national new models of care programme, involving 50 vanguard sites, is also pursuing this goal and recently reported on lessons learnt. Many of the vanguards have invested in health coaching and communication skills training for clinicians.

I recently worked on a large research project, The Read more