Designing health care for the people who need it
Professor Chris Salisbury’s 2018 RCGP James Mackenzie Lecture
News in 2018
Requests for emergency contraception could be an important sign of abuse
Women who experience domestic violence and abuse (DVA) are more than twice as likely to seek emergency contraception as other women, according to a study by National Institute for Health Research (NIHR)-funded researchers at the University of Bristol and Queen Mary University of London, suggesting that requests for emergency contraception could be an important sign of abuse.
New psychological intervention proves ‘life-changing’ for women experiencing domestic abuse
Training domestic violence and abuse (DVA) advocates to deliver psychological support to women experiencing DVA could significantly improve the health of those affected. In a randomised controlled trial led by researchers from the University of Bristol, women who received the intervention showed reduced symptoms of psychological distress, depression and post-traumatic stress compared to those who received just advocacy.
New study aims to reduce the use of oral antibiotics for ear infections in children
Middle ear infections, known medically as acute otitis media (AOM), are common painful infections in children, for which there are up to three million treatment episodes in England and Wales each year. They are often treated with antibiotics by mouth. However, these can cause side effects like rashes, diarrhoea and vomiting, and their over-use contributes to the growing global health threat of antibiotic resistance.
More adults are using complementary and alternative medicine in England but access is unequal, finds survey
Use of practitioner-led complementary and alternative medicine (CAM), such as acupuncture, massage, osteopathy and chiropractic treatment, rose from 12% of the population in 2005 to 16% of the population in 2015, according to a survey led by researchers at the University of Bristol’s Centre for Academic Primary Care. However, access to these treatments was unequal, with women, those who are better off and those in the south of England more likely to use CAM.
Popular drug combination for treatment resistant depression is not more effective than a single antidepressant in primary care
Psychiatrists and GPs increasingly combine mirtazapine with an SSRI (selective serotonin reuptake inhibitor) or SNRI (serotonin-noradenaline reuptake inhibitor) antidepressant for patients whose depression does not respond to a single antidepressant. A large clinical trial led by researchers at the Universities of Bristol, Exeter, Keele, Manchester and Hull York Medical School, and published in the British Medical Journal today, looked at the effectiveness of adding mirtazapine to an SSRI or SNRI in patients who remain depressed after at least six weeks of conventional (SSRI or SNRI) antidepressant treatment. They found that this combination was no more effective in improving depression than placebo and call on doctors to rethink its use.
Experts call for health system change to tackle the challenge of multimorbidity in the NHS
The number of people with multiple long-term conditions, known as multimorbidity, is rising internationally, putting increased pressure on health care systems, including the NHS. Researchers from the 3D Study – the largest ever trial of a person-centred approach to caring for patients with multimorbidity in primary care - at the Universities of Bristol, Dundee, Manchester and Glasgow, are hosting a conference today [Thursday 25 October] with the Royal College of General Practitioners to discuss the challenges facing general practice and how the health care system needs to respond.
New study will help GPs recognise the early stages of psychosis
GPs need to be able to recognise the early stages of a psychotic illness and quickly refer to specialist mental health services for treatment.
Risks of using algorithms to predict child abuse
In a letter published in The Guardian today, Professor Gene Feder, a GP and domestic violence and abuse research lead at the Centre for Academic Primary Care, has highlighted the risks of local authorities using algorithms to predict child abuse risk in social care.
Multimorbidity Conference: the challenge for primary care – 25 October 2018
The Centre for Academic Primary Care has joined with the Royal College of General Practitioners (RCGP) to deliver a conference on the challenges GPs face in providing care to patients with multiple long-term conditions.
Prescribing antibiotics for children with cough in general practice does not reduce the risk of hospitalisation
Doctors and nurses often prescribe antibiotics for children with cough and respiratory infection to avoid return visits, symptoms getting worse or hospitalisation. In a study published in the British Journal of General Practice today [Tuesday 11 September], researchers from the Universities of Bristol, Southampton, Oxford and Kings College London found little evidence that antibiotics reduce the risk of children with cough ending up in hospital, suggesting that this is an area in which unnecessary antibiotic prescribing could be reduced.
New study on the impact of digital health tools in primary care
A new study exploring the unexpected consequences of the use of digital health tools in primary care has been awarded funding by the National Institute for Health Research (NIHR) School for Primary Care Research. The research team from the Universities of Bristol, Oxford, Manchester, Warwick, University College London and the West of England Academic Health Science Network (AHSN) will use a variety of approaches and methods to understand the impact of these tools, which include online patient portals and health monitoring apps.
GP Journal Club re-launches on Twitter
GP Journal Club (#gpjc) is a popular monthly discussion group on Twitter for academics, students and professionals with an interest in primary care. The club is re-launching on Sunday 9 September at 19:30 (BST), with the first tweet chat on the topic of resilience in primary care.
New study will review support offered to sex assault victims
Researchers will speak to around 1,000 sexual assault victims to understand how the support they receive affects their long-term health and wellbeing.
Polycystic ovary syndrome linked to autism
Women with polycystic ovary syndrome (PCOS) are more likely than other women to have an autistic child, according to an analysis of NHS data carried out by a team at Cambridge University’s Autism Research Centre, although the risk remains very low. The research, co-authored by the Centre for Academic Primary Care's Dr Rupert Payne, is published today in the journal Translational Psychiatry.
Professor Gene Feder selected to co-lead vulnerable children and families theme in new NIHR Children and Family Policy Unit
Unit part of £65 million new NIHR investment in research to inform government decision-making
Gosport may have a negative impact on end-of-life care in general practice
Researchers from the University of Bristol have highlighted the potentially negative impact the deaths at Gosport War Memorial Hospital may have on end-of-life care delivered at home.
When are children and parents who have experienced domestic abuse ready to engage with child-centred support programmes?
Growing up in a household with domestic violence and abuse can affect children for the rest of their lives. Support programmes specifically aimed at children who have been exposed to abuse exist but determining how and when parents and children are ready to engage with them is challenging. A review, carried out by researchers at the University of Bristol together with NIHR CLAHRC West, NIHR CLAHRC East of England and the University of Central Lancashire, sheds light on some of these factors.
£1.7 million awarded to tackle domestic violence in low and middle-income countries
Professor Gene Feder at the University of Bristol’s Centre for Academic Primary Care has been awarded £1.7 million by the National Institute for Health Research to fund a Global Health Group for research into health systems responses to violence against women in Palestine, Brazil, Nepal and Sri Lanka.
Happy Birthday NHS!
As part of the #NHS70 celebrations, we're saying thank you to NHS staff and patients who help us do research to improve outcomes, treatment and service delivery in primary care. Together we're definitely better! Click on the image below to find out more.
Results of the largest ever multimorbidity trial in primary care challenge current thinking
In the largest ever trial of an intervention to treat people with multiple long-term conditions (multimorbidity) in primary care, researchers at the Universities of Bristol, Manchester, Dundee and Glasgow found that the patient-centred approach taken improved patients’ experience of their care but did not improve their health-related quality of life. This is a challenge to current thinking on which UK and international guidelines are based.
Dr Emma Le Roux appointed RCGP Clinical Champion for Dermatology
Dr Emma Le Roux, Senior Clinical Research Fellow at the University of Bristol’s Centre for Academic Primary Care, has been appointed Clinical Champion for Dermatology for the Royal College of General Practitioners (RCGP).
Increasing the duration of repeat prescriptions may save NHS money and improve care: policy briefing
PolicyBristol have published a briefing highlighting the policy implications of research into the clinical and cost-effectiveness of short versus long duration prescriptions for patients with chronic health conditions in England.
Patients to set agenda for heart failure research
People with advanced heart failure, their carers, families and friends are being asked to help set the priorities for future research into the condition.
Local real-time surveillance of infectious disease could improve antibiotic prescribing
Antimicrobial resistance is a significant threat to public health. Researchers from the University of Bristol’s Centre for Academic Primary Care and NIHR Health Protection Research Unit in Evaluation of Interventions have found promising evidence that local real-time surveillance of infectious disease, such as flu, could help GPs make better diagnostic and treatment decisions, reducing the amount of unnecessary antibiotic prescribing.
New study to help improve antibiotic prescribing in out-of-hours services
A multidisciplinary research team from the Universities of Bristol, Southampton, Oxford and University College London have been funded by the National Institute for Health Research (NIHR) School for Primary Care Research to undertake a study to explore antibiotic prescribing out of hours.
Improving how professionals can identify and support children experiencing domestic violence
New research has highlighted a lack of guidance for health and social care professionals who encounter children exposed to domestic violence.
MRC funding awarded for scoping study to assess innovative telecare service
Dr Ben Davies from the Centre for Academic Primary Care and Population Health Sciences at the University of Bristol has secured 'Proximity to Discovery' funding from the Medical Research Council (MRC) to support a scoping exercise to assess the impact of the Social Careline service in elderly and vulnerable communities.
New research shows that one of the most widely used treatments for childhood eczema is not helpful
The BATHE trial has found that pouring emollient additives into the bath do not add any benefit over standard management. Standard management of childhood eczema includes soap avoidance, leave-on emollients and corticosteroid ointments.
New study aims to better understand the role of food allergy testing in childhood eczema
GPs and researchers from the Universities of Bristol, Southampton and Nottingham have been funded by the National Institute for Health Research (NIHR) School for Primary Care Research to undertake a study to explore the role of food allergy testing in children with eczema.
Professor John Macleod wins large MRC grant for groundbreaking mental health research project
Professor John Macleod, Joint Head of the Centre for Academic Primary Care, has received £1.5 million as part of a large grant from the Medical Research Council (MRC) to develop a platform for conducting research into early years influences on mental health.
Buprenorphine may be a safer opioid substitute than methadone but only if treatment duration is longer, study suggests
The less commonly prescribed opioid substitute buprenorphine may be safer than methadone for problem opioid users, especially if used during the first month of treatment, according to a study by researchers from the University of Bristol, King’s College London, University of Manchester and Bristol Drugs Project, with implications for guidance on GP prescribing.
New questionnaire will help researchers measure the ‘burden’ of treatment for patients with multiple health problems in primary care
Patients with multiple health problems, known as multimorbidity, have many things to think about and do to take care of their health. Experts from the Centre of Academic Primary Care at the University of Bristol have developed a questionnaire to help researchers measure this treatment ‘burden’, so that they can understand the impact that interventions to improve care might have on patients’ daily lives.
NHS Health Checks: the importance of targeted approaches for male and BAME patients to improve equity in uptake
Patients are more likely to attend an NHS Health Check if they’re already at lower risk of stroke or heart attack, a University of Bristol evaluation has found. The patient groups most likely to respond to the standard invitation to attend a check are female, ‘white British’, older or from more affluent areas.
"Kidney age", not kidney disease
There should be a rethink in how doctors talk to some patients with reduced kidney health, replacing the term ‘chronic kidney disease’ (CKD) with different bands of kidney age, according to a group of experts writing in the Canadian Medical Association Journal.
New Primary Care Outcomes Questionnaire shown to be valuable for primary care research
The Primary Care Outcomes Questionnaire (PCOQ) developed by researchers at the University of Bristol's Centre for Academic Primary Care has been tested and found to be valid and responsive as an instrument for measuring patient-reported outcomes. The questionnaire has the potential to improve researchers’ ability to measure effectiveness of interventions and may also be useful to GPs for assessing the effectiveness of individual patient care.
Surgeries employing GPs with additional training in complementary medicine appear less likely to prescribe antibiotics
Use of complementary/alternative medicine may help reduce over-prescribing of antibiotics
Improving the response to domestic violence and abuse in sexual health clinics: research summary and podcast published
The findings of the joint NIHR CLAHRC West and North Thames study of the IRIS ADViSE pilot, which aimed to improve sexual health professionals’ response to women who have experienced domestic violence, are now available as a CLAHRC BITE and BMJ STI podcast.
Academics urge rethink on 28-day prescriptions for people with long-term conditions
The widely adopted practice of issuing 28-day rather than longer duration prescriptions for people with long-term conditions lacks a robust evidence base and should be reconsidered, according to a study published in the British Journal of General Practice today [Tuesday 13 March]. Related research shows that considerable savings could be made by the NHS switching to longer prescriptions.
Applications invited for ST3 Entry Academic Clinical Fellowships in Primary Care
Call for applications now open. Deadline: Monday, 19 March, 4pm