Past, Present and Future Research in the North Hub

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Past, Present and Future Research in the North Hub
Sarah Purdy GP and Consultant Senior
Lecturer University of Bristol
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Past
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Informing clinical management

• RCT comparing paracetamol and ibuprofen together
  with paracetamol or ibuprofen separately in
  children with fever
• Doctors, nurses and parents wishing to use
  medicines to treat young children unwell with
  fever should be advised to use ibuprofen first
  and that to maximise the time without fever over
  24 hours, two medicines are superior to either
  one.

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Informing lifestyle advice

• RCT of benefits of diet and exercise early in
  management of type 2 diabetes
• Increasing physical activity can act as a
  gateway behaviour positive effects in other
• behaviours

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Improving quality of consultations

• Enhancing the QUality of Information-sharing in
  Primary care for childhood respiratory tract
  infections
• To see whether use of the study booklet, in
  consultations for children presenting with cough,
  sore throat, otitis media, or urti, will result
  in a reduction in re-consultation during the
  first 2 weeks and a reduction in antibiotic
  prescribing.

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Working in partnership

• Epidemiological, multi-country, multi- centre,
  observational, cohort study to evaluate the
  incidence, clinical and economic burden of acute
  otitis media (AOM)
• Primary objective determine the incidence of AOM
  as diagnosed in children aged 0-6 years in
  several European countries
• GPs registered children and followed up one year
• 10 recruiting sites Bath, Cambridge and
  Newcastle regions
• UK successfully met target of 625 enrolled
• Study now in follow up stage

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Present.
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SMART II

• Self Management supported by Assistive,
  Rehabilitive and Telecare Technologies
• Qualitative study to identify technologies which
  can be used to help people with long-term
  conditions to self manage chronic pain
• Bath University
• Funded by Engineering, Physical Sciences Research
  Council
• Recruiting in BANES and Swindon

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• Physical activity as a treatment for depression
• Does physical activity, in addition to usual
  care, change the outcome in depression and alter
  the subsequent use of anti-depressant medication?
• RCT, economic evaluation and qualitative study
• Universities of Bristol Exeter
• Funded by NIHR HTA
• North Somerset, South Gloucestershire and Bristol

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Aspirin to Reduce Risk of Initial Vascular Events

• A randomised controlled trial of a low dose
  aspirin preparation in those at intermediate risk
  of cardiovascular disease (20-30)
• RCT 100mg aspirin v placebo to reduce
  cardiovascular event rate
• 12,000 patients across Europe and USA
• Recruiting men over 50, and women over 60 with gt3
  CVD risk factors
• Recruiting across North Hub

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COCO

• Tackling Childhood Obesity in Primary Care
• Feasibility of transferring the secondary care
  Care of Childhood Obesity (COCO) clinic model
  into primary care
• RCT of children 5 to 16 years randomised to
  secondary or primary care clinics
• University of Bristol and Bristol Royal Hospital
  for Children
• Funded by NIHR RfPB
• Recruiting in South Gloucestershire and Bristol

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HARPP

• Hospital Admission Risk Profile Project
• Aims to identify risk factors for unplanned
  hospital admission
• Case-control study of patients who have either
  been admitted to hospital (cases) or not
  (controls)
• Uses anonymised data from medical records
• University of Bristol
• Funded by MRC
• Recruiting across North Hub

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ASCENDA Study of Cardiovascular Events iN
Diabetes

• Does aspirin reduce risk of cardiovascular events
  in individuals with diabetes who do not already
  have occlusive arterial disease, and do benefits
  outweigh any potential hazards from bleeding?
• RCT of aspirin and/or omega-3 fatty acid v
  placebo
• University of Oxford
• Funded by BHF
• Recruiting across South West except Swindon

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Future..
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• Randomised Evaluation of Effectiveness and
  Acceptability of Computerised Therapy
• RCT of Beating the blues v Moodgym v usual
  care for depression
• Patients scoringgt10 on PHQ9
• South Gloucestershire, Glos and later Bristol
• David Kessler, University of Bristol

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ADEPT

• Alcohol detoxification in primary care
• Pilot RCT Chlordiazepoxide /-acamprosate
• Any patient requesting or requiring medication
  for alcohol detox
• Bristol and South Gloucestershire
• Anne Lingford Hughes, UOB

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DRN179 Lirainsulin study

• Liraglutide (agonist of glucagon-like peptide) is
  a once a day injection to increase insulin
  production in type 2 diabetes with less
  side-effects than Byetta (exenatide)
• This global study with Novo Nordisk is designed
  to test its effectiveness insulin in patients
  not reaching target HBA1c with metformin and
  sulfonylureas
• GPs invited to identify eligible subjects (fee
  300)
• Patients managed by research team at BRI
• Opened 11th March 09, 33 UK centres. 6 screened
  in UK so far. Aim for 10 patients in Bristol.
• Contact Dr Colin Dayan, Diabetes Dept, BRI

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There is a lot more going on..