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

Children with eczema: the link to food allergies is not clear cut

By Dr Matthew Ridd, GP and Senior Lecturer in Primary Healthcare, Centre for Academic Primary Care, University of Bristol
and Dr Robert Boyle, Consultant Paediatric Allergist, Imperial College London

Around one in five children have eczema – and even mild cases can have a big impact on both the child and their family. For many, symptoms will come and go before they start primary school, but for others it can indicate the beginning of a genetic tendency to develop allergic conditions such as hay fever or asthma (or both).

We also know that children with eczema are more likely to develop food allergies, especially if the condition starts in the first few months of life and is severe. Often parents will make the allergy diagnosis themselves – at the sudden onset of vomiting, diarrhoea or rash after eating scrambled egg, for example.

This can be frightening, but … 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

Help us identify the unintended consequences of digital health tools in primary care

 

By Dr Jeremy Horwood, Senior Research Fellow, Centre for Academic Primary Care, University of Bristol and NIHR CLAHRC West, and Dr Andrew Turner, Senior Research Associate, NIHR CLAHRC West

Researchers from the DECODE study hosted a workshop late in 2018 to explore the unintended consequences of digital health tools used in primary care. The workshop was attended by members of the public, technology developers, GPs and key researchers in the field.

Digital health tools, such as health monitoring apps and online patient portals, are becoming commonplace, with NHS England supporting their use to improve patient access and care. But this increase in their use could lead to unintended consequences, both positive and negative. An understanding of these consequences is vital, so we can minimise the negative effects and harness the positive.

DECODE aims to improve how digital health tools are used in primary care by investigating … 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
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Is it possible to detect future risk of psychosis from a patient’s primary care consultation history?

 

 

By Dr Sarah Sullivan
Research Fellow
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

Domestic violence and abuse: ‘If we all work together, it will make a difference’

Guest blog by Medina Johnson (left), Chief Executive
and Lucy Downes (right), National Implementation Manager
IRIS Interventions

 

 

As we gear up for events and conversations to mark the 16 Days of Activism against Gender-based Violence, it’s timely to reflect on the importance of the healthcare response to gender-based violence. IRISi’s vision is a world in which gender-based violence is consistently recognised and addressed as a health issue.

Violence against women is a global health problem of epidemic proportions. Dr Margaret Chan, World Health Organization Director-General

The IRIS programme is our flagship intervention working with primary care to change and improve clinical practice and to provide patients affected by domestic abuse with access to specialist advice and support. It provides training and support to GPs, practice nurses and other primary care clinicians to help them identify and refer women with experience of domestic violence and abuse (DVA) to … 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