Success for CLAHRC researcher Meredith Hawking

Congratulations were in order for CLAHRC researcher Meredith Hawking after her poster won a prize at the 2018 Annual Scientific Meeting of the Society for Academic Primary Care at the Barbican Centre, London.

Meredith with her winning poster

The prestigious SAPC event brings together researchers and educators from the primary care community in the UK and around the world to showcase their latest studies.

Meredith is based at Queen Mary University of London and her PhD focuses on Investigating patients’ perspectives and adherence to anticoagulants for atrial fibrillation.

Atrial fibrillation is a heart condition affecting a million people in the UK that causes an irregular and often abnormally fast heart rate. AF is associated with 1 in 8 strokes (1 in 3 over 80 years). More than half these strokes could be averted by oral anticoagulants (OAC), but the proportion of patients receiving oral anticoagulants has improved by only 1.5% per year over the last 25 years and was only 50% in 2012.

Meredith’s poster- entitled Adherence to direct oral anticoagulants for non-valvular atrial fibrillation in real world settings: a systematic review and meta-analysis – outlines her work to explore how widespread nonadherenece to anticoagulants is.

Pulse checks in over 65s sees major improvements in the detection of atrial fibrillation

New CLAHRC research highlights a simple intervention that could improve detection of atrial fibrillation (AF) – a potentially dangerous heart condition affecting a million people in the UK and associated with 1 in 8 strokes (1 in 3 strokes among those aged over 80 years).

East London GP and CLAHRC researcher Dr John Robson led an investigation into the impact of regular pulse checks in general practice on AF detection among patients aged 65 and over. This work, published in the British Journal of General Practice, offers evidence that these checks – a cheap and straightforward intervention – rapidly improved the detection and prevalence of AF, meaning quicker access to treatment and reduced risk of stoke for those diagnosed.

The condition causes an irregular and often abnormally fast heart rate and is a leading cause of stroke – with strokes caused by underlying AF twice as likely to be fatal. AF is common in older people, but often shows no symptoms – meaning earlier detection and access to treatment means reduced risk of stroke and the health problems stroke victims have to live with afterwards.

Dr Robson and his team checked historical GP records to investigate the impact of a programme promoting pulse regularity checks across three groups of East London GP practices (or Clinical Commissioning Groups) –  City and Hackney, Newham, and Tower Hamlets.

An analysis of electronic primary care patient records before (2007–2012) and after (2012–2017) checks were introduced showed significant increases in AF detection.

Br J Gen Pract. 2018 Jun;68(671):e388-e393. doi: 10.3399/bjgp18X696605
Opportunistic pulse checks in primary care to improve recognition of atrial fibrillation: a retrospective analysis of electronic patient records.
Cole J, Torabi P, Dostal I, Homer K, Robson J

Top of the charts! Lancet paper on HIV testing most downloaded in 2017

The end of any year sees a number of “best of” charts published and research is no exception!

We’re delighted to report that a paper produced by the CLAHRC’s Dr Werner Leber and Professor Chris Griffiths and others is 2017’s most downloaded in The Lancet HIV. Dr Werner ‘s groundbreaking work represents the first time a model to explore the cost effectiveness of screening for HIV in primary care has been applied to the UK.

The work generated great media interest (below) and offers a model to measure cost-effectiveness for commissioners and providers of HIV care.

Read the paper:

Cost-effectiveness of screening for HIV in primary care: a health economics modelling analysis
Baggaley, Rebecca F et al.
The Lancet HIV , Volume 4 , Issue 10 , e465 – e474

http://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(17)30123-6/abstract 

Read the most downloaded list

Read a BITE sized summary of Werner’s work.

 

 

 

Prof Angela Harden

Angela Harden is a Professor of Community and Family Health. She is a social scientist with expertise in public health and evidence-informed policy and practice. She has conducted extensive research into the health of young people and the communities in which they live. Key themes in her research include sexual and reproductive health, mental health, health inequalities, the wider determinants of health and the evaluation of complex interventions. Angela has a keen interest in research synthesis, transfer and exchange. She is widely known for her methodological work integrating qualitative research into systematic reviews. Motivated by a desire to learn from the views and experiences of those targeted by public health interventions, this work has received international acclaim.
Before joining UEL Angela held research and teaching positions in a number of universities including the Institute of Education at the University of London, Kings College, and Middlesex University. In 2003 she was awarded a four year senior research fellowship by the Department of Health on the promotion of young people’s health. Her most recent post was as Associate Director of the Evidence for Policy and Practice Information and Co-ordinating Centre at the Social Science Research Unit, Institute of Education. Here she ran a number of large research projects as well as contributing to the design and delivery of a new MSc in Evidence Informed Policy and Practice. Between 2005 and 2008 she co-directed the Methods for Research Synthesis Node of the ESRC National Centre for Research Methods. Internationally, Angela is an active contributor to the Cochrane and Campbell collaborations. She is a co-convenor of the Cochrane Qualitative Methods Research Group and was a co-director of the Cochrane Health Promotion and Public Health Field until it became the Cochrane Public Health Review Group in 2008. She now serves on the methodological advisory board for this new research group.
As a newly appointed Professor of Community and Family Health, Angela’s remit is to develop a programme of research linked to improving the health of Newham. Working closely with colleagues in UEL, Newham University Hospital Trust and relevant external partners, she will focus on research with local relevance for improving health and reducing inequalities. Please click here for more details on this research programme.

Is screening for HIV in primary care cost-effective?

Our recently published research on the cost-effectiveness of screening for HIV in primary care has caused a great deal of interest and widespread media coverage.

We have produced a BITE sized summary of the paper with the headline findings and links to further information of interest.

The research, published in The Lancet HIV, represents the first time a model to explore the cost effectiveness of screening for HIV in primary care has been applied to the UK.

Our data provide the most reliable analyses to date and justify the investment needed to deliver HIV screening in primary care in the 74 localities considered to have high HIV prevalence – essentially most UK metropolitan areas.

Researcher and practicing GP Dr Werner Leber from Queen Mary University London said:
“We’ve shown that HIV screening in UK primary care is cost effective and potentially cost saving, which is contrary to widespread belief. This is an important finding given today’s austerity. Financial pressures, particularly within local authority’s public health budgets, mean that the costs of HIV testing are under intense scrutiny, and in some areas investment in testing has fallen.”

GP-based testing for HIV is cost-effective in areas of high prevalence and should be rolled out in 74 local authorities

New CLAHRC research published in The Lancet HIV has found that offering HIV testing to people on registration with a new GP in areas of high prevalence of the disease is cost-effective and will save lives.

Researchers based at the London School of Hygiene & Tropical Medicine and Queen Mary University of London (QMUL) carried out the study in areas with high prevalence of HIV – involving 86,000 people from 40 GP surgeries.

The promising results prompted CLAHRC researchers to call for a roll-out of HIV screening to all 74 high HIV prevalence local authorities in England (those with more than two diagnosed HIV infections per 1,000 adults).

HIV treatment is expensive, particularly when diagnosis is late. Early diagnosis means earlier intervention and treatment, saving the NHS money.

Building on earlier research from a trial in Hackney – a socioeconomically deprived inner London borough with an HIV prevalence rate of 8 per 1000 adults – the trial involved 40 general practices where they tested the effect of rapid fingerprick HIV testing as part of the standard health check during registration. They found it led to a four-fold higher HIV diagnosis rate.

Using a mathematical model that includes all the costs associated with HIV testing and treatment, the team now show that primary care HIV screening in high prevalence settings becomes cost-effective in 33 years (according to National Institute for Health and Care Excellence [NICE] criteria).

The CLAHRC North Thames study was carried out in partnership with NHS City and Hackney and involved University College London, Homerton University Hospital NHS Foundation Trust, University of Warwick, and University of British Columbia.

Dr Werner Leber from QMUL said: “We’ve shown that HIV screening in UK primary care is cost effective and potentially cost saving, which is contrary to widespread belief. This is an important finding given today’s austerity. Financial pressures, particularly within local authority’s public health budgets, mean that the costs of HIV testing are under intense scrutiny, and in some areas investment in testing has fallen.”

Read the full paper

Rebecca F Baggaley, Michael A Irvine, Werner Leber, Valentina Cambiano, Jose Figueroa, Heather McMullen, Jane Anderson, Andreia C Santos, Fern Terris-Prestholt, Alec Miners, T. Déirdre Hollingsworth, Chris J Griffiths.

Cost-effectiveness of screening for HIV in primary care: a health economics modelling analysis.

The Lancet HIV. DOI:10.1016/S2352-3018(17)30123-6

How to guide to establish NHS youth forums

Children and young people are a key population for everyone working in the NHS and Public Health. Involving them in commissioning and designing services makes for more appropriate care that’s more likely to be taken up by those who need it

Our ground-breaking diabetes project worked with young people impacted by the condition in east London – we trained young co-inquirers in research skills so they could run community engagement events and analyse feedback on how to improve local diabetes services.

Our work was integral in shaping new NHS “how to” guidance to help commissioners and providers think through and develop youth forums to support person-centred commissioning of children and young people in health and care services.

The ‘how to guide’ is a recipient of the NHS England’s Celebrating Participation in Healthcare grant award scheme and has been authored by the University of East London (UEL)