The successful projects will join the 85 studies currently funded to date since the School's renewal in October 2015.
Developing and evaluating a measure of inappropriate polypharmacy in primary care: RAND appropriateness and CPRD epidemiological study
Rupert Payne (University of Bristol) with co-applicants Alastair Hay, Richard Morris and John MacLeod (Bristol), Tony Avery and Sarah Rodgers (Nottingham), Jenni Burt (Cambridge) and Stephen Campbell (Manchester).
Although polypharmacy is widely recognised as a major problem, there is currently no useful way to measure if polypharmacy is inappropriate. If this could be done, it would help doctors or pharmacists to identify patients receiving inappropriate polypharmacy, and improve patients’ medicines. Researchers propose to develop a measure of inappropriate polypharmacy that can be used in routine general practice. They will use the measure to quantify the extent of inappropriate polypharmacy in the UK population using a large electronic health record database. They are confident that this would help doctors and pharmacists to identify patients receiving inappropriate polypharmacy and improve patients' medicine. Read more.
Quantifying severity of chronic conditions in English Primary Care using the Clinical Practice Research Datalink
Evan Kontopantelis (Manchester) with co-applicants Chris Salisbury (Bristol), Christian Mallen and Carolyn Chew-Graham (Keele), David Reeves, Harm van Marwijk and Darren Ashcroft (Manchester), Nadeem Qureshi and Stephen Weng (Nottingham), Tim Holt and Rafael Perera (Oxford).
Despite full computerisation since the early 2000s, UK GP records do not grade disease severity or the burden of having multiple co-existing health conditions (comorbidity) – information that could be used to better understand and address patient needs. Researchers will develop the appropriate analytical methods, through a focus on type-2 diabetes (T2DM) and coronary heart disease (CHD), using Clinical Practice Research Datalink data, and to extend to future healthcare needs. They will evaluate how well a range of severity/comorbidity measures may be used for service planning. They will apply their models to ‘forecast’ needs for years 2020-2030 and consider the implications for service planning and policy. Read more.
Improving identification of familial hypercholesterolaemia in primary care using a new case ascertainment tool (FAMCAT).
Nadeem Qureshi (University of Nottingham) with co-applicants Kate Walters (UCL), Barbara Hanratty (Newcastle), Katherine Payne (Manchester), Stephen Weng, Joe Kai, Carol Coupland, Matthew Jones and Paul Leighton (Nottingham).
Familial Hypercholesterolaemia (FH) is a common inherited cause of raised cholesterol, affecting at least 120,000 people in the UK. However, over 80% of people with FH are still not identified. The risk of heart disease can be dramatically reduced by starting medicines to lower cholesterol levels. Currently it is recommended General Practitioners (GPs) identify possible FH by examining patients who have raised cholesterol and a family history of heart disease. Researchers have found this does not accurately identify all people with FH, and also causes unnecessary specialist referral for those without the condition.
Researchers propose to evaluate FAMCAT, a computer-based approach using GP computer records to identify people with Familial Hypercholesterolaemia. They will invite people identified by FAMCAT as having the highest possibility of FH, to have their diagnosis confirmed by a genetic test and, following assessment by their GP, referred to a specialist. Read more.
Developing clinically useful subgroups from urine samples reported as 'mixed growth' to guide primary care clinicians
Gail Hayward (Oxford) with co-applicants Chris Butler (Oxford), Michael Moore (Southampton), Alastair Hay (Bristol), Tom Fanshawe (Oxford).
One in ten women visit their GP each year with symptoms of a urine infection. The most common way to confirm a urine infection and decide on the best antibiotics is to grow the bacteria in a laboratory. However, up to a third will be contaminated meaning infection cannot be proven or ruled out. In this study, researchers will complement another study which is collecting 1191 urine samples from women contacting their GPs with symptoms of a urine infection. This study will increase the information about the patients by investigating whether the samples are 'contaminated', 'likely infected' or 'likely contaminated'. They will develop a better understanding of what a 'contaminated' urine sample means and researchers hope to help GPs make better antibiotic prescribing decisions for UTIs. Read more.
Optimising Treatment for Mild Systolic hypertension in the Elderly (OPTiMISE)
James Sheppard (Oxford), Jenni Burt (Cambridge), Mark Lown (Southampton), Rupert Payne (Bristol), Richard McManus (Oxford), Paul Little (Southampton), John Benson and Jonathan Mant (Cambridge), Richard Hobbs and Carl Heneghan (Oxford) and Sue Jowett, Emma Ogburn and Ly-Mee Yu (Keele).
Research has shown that reducing blood pressure with drug treatment is beneficial for patients in reducing the risk of heart attack and stroke. However, in older individuals, large reductions in blood pressure have been linked to an increased risk of falls which can lead to death. Researchers in this study will assess the safety of reducing the number of drugs prescribed to 540 older patients (>80 years) who have controlled blood pressure on treatment. They will compare the proportion of patients with safe blood pressure levels at follow-up in those randomly allocated to either reduction of medication or routine clinical care. Researchers will also conduct interviews with patients and doctors to try to better understand what motivates individuals to take blood pressure lowering medication in old age and how the potential side effects of treatment and effects on quality of life affect this motivation. Read more.
Feasibility study of Pelargonium sidoides root extract EPs®7630 (Kaloba®) for lower respiratory tract infection in adults
Michael Moore (Southampton) with co-applicants George Lewith and Paul Little (Southampton), Alastair Hay (Bristol), Merlin Willcox and Chris Butler (Oxford), Andrew Flower, Caroline Eyles, Lily Yao, Gareth Griffiths (Southampton) and Jennifer Bostock and Margaret Bell (Patient and Public participants).
It is important to avoid using antibiotics when they are not needed. Researchers will evaluate the feasibility of using pelargonium tablets or liquid in adults who visit their GP with an acute cough as their main symptom and where the GP thinks the symptoms are caused by an infection (bacterial or viral) but not pneumonia. They would like to understand the issues around herbal medicines for acute cough to inform a more definitive study to see if using pelargonium can reduce antibiotic consumption. Read more.