Addressing the polypharmacy challenge in working-age adults

Department Name:
Institute of Population Health Sciences, Barts & The London School of Medicine & Dentistry. Queen Mary University of London.

Supervisors names and email addresses:
1) Professor Deborah Swinglehurst d.swinglehurst@qmul.ac.uk
2) Dr Nina Fudge n.fudge@qmul.ac.uk
3) Professor Stephanie Taylor  s.j.c.taylor@qmul.ac.uk

Funding Status:
Directly Funded Project (UK and EU Students Only)
Stipend: £17,803

Application Deadline: 5 January 2020

Interview date: 28 January 2020

Duration:
3 years, full time

Project Description;

Multimorbidity (the presence of two or more ongoing medical conditions) and polypharmacy (the use of five or more medications concurrently) increasingly affects working-age people, especially in socially disadvantaged groups. Previous research has shown that although the prevalence of multimorbidity increases with age, the absolute number of people with multimorbidity is higher in adults aged under 65. Amongst people living in the most deprived areas, the onset of multimorbidity occurs 10 – 15 years earlier than in the most affluent areas.

The PhD student will join the APOLLO-MM team and this project will extend the interests of the ongoing APOLLO-MM study (www.polypharmacy.org.uk) to adults of working age.

The successful student will conduct an in-depth, longitudinal ethnographic study in which the focus is on observing the lives, experiences and ‘medicines work’ of patients living with multimorbidity in the community. The student will follow these patients over a period of 12-18 months, exploring the challenges they face, unpacking what self-management means in this context and considering how the ‘burden of treatment’ shapes their lives. The student will conduct ethnographic observations in patients’ homes and in other community and care settings. This will include accompanying patients to encounters with health and social care services to study their interactions with a wide range of agencies. We will import relevant social theory to analyse these in-depth case studies and inform the analysis and synthesis of a rich dataset.

The project will involve a range of qualitative research methods. It will include: literature review; observations in which detailed ethnographic field notes are taken; in-depth narrative interviews; semi-structured interviews; creative ethnographic methods (e.g. the development and deployment of ‘cultural probes’ to facilitate patients in depicting their lives).

Aside from academic outputs (the PhD thesis and related academic publications and presentations), the project lends itself to the development of creative professional and patient/public resources to support medicines optimisation in the care of patients with complex needs.

Project-specific skills and experience required:

Essential skills:
A good grasp of qualitative research methods and at least some experience of using qualitative methods (e.g. interviews)
Acceptance that this post necessarily involves travelling to research sites, fieldwork in homes and health settings, exposure to human subjects (who may be ill, confused or in distress) and working as a lone field researcher in unpredictable circumstances.

Desirable skills:
Experience of ethnographic and/or participatory forms of research

All candidates should hold a Master’s qualification (or complete their Master’s by September 2020) in an appropriate discipline and have a minimum of a 2:1 or equivalent in their first degree. Applicants should preferably have knowledge of the UK health and care system. All applicants are required to have excellent written and verbal communication skills. They should also be willing to work collaboratively in multi-disciplinary and multi-professional teams.

Enquiries email name and address:

Professor Deborah Swinglehurst d.swinglehurst@qmul.ac.uk

Training opportunities
PhD students will be entitled to the full range of PhD training opportunities at their host institution. In addition, all PhD students will benefit from the training provided by the NIHR ARC North Thames Academy (The Academy). The Academy brings together PhD students from across ARC North Thames, to create a community of students training in applied health research. The Academy works alongside each host institution’s graduate training programme to equip students with the skills needed to work at the interface of academia and health services.

Our doctoral programme focuses on practical aspects of applied health research, such as the skills required to undertake research in health care and public health settings, to engage patients and the public in research, and to navigate relevant ethical and research governance approval systems. In addition, we aim to provide students with an understanding of how their work fits into current NHS structures and applied public health research environments. PhD students will be expected to attend and present at scientific meetings aimed at disseminating the findings of ARC research.

Publication and wider dissemination:
It is expected that results of the PhD research will be publishable in good quality, peer-reviewed academic journals and communicated at conferences. The research would also be expected to generate outputs tailored to applied health research, public health practitioner, and policy-making audiences.

Eligibility
Candidates should hold a Master’s qualification in a relevant discipline (or complete their Master’s by September 2020) and have a minimum of a 2:1 or equivalent in their first degree. Applicants should preferably have knowledge of the UK health and care system. All applicants require excellent written and verbal communication skills and should be willing to work collaboratively in multi-disciplinary and multi-professional teams.
Due to funding restrictions, applicants must be UK/EU nationals. Please refer to UK Council for International Student Affairs (UKCISA) for the criteria.

How to apply
If you have queries about potential projects or would like to discuss these in more detail, please contact the appropriate supervisors by email. In case of any difficulties in making contact, please email ARC.academy@ucl.ac.uk 

Your application should consist of:

  • A CV (to include qualifications, work experience, publications, presentations and prizes) plus contact details of two academic referees (references will be taken up for all shortlisted candidates).
  • A personal statement (300 words) describing your suitability for the proposed project including how your research experience, skills and interests relate to the topic.
  • A 1-page proposal of how you would develop the PhD project that you are applying for.

Please send your application to ARC.academy@ucl.ac.uk