Innovation and Research in General Practice
Below are a few cutting-edge research topics that the College has supported in 2014:
Avoiding unnecessary hospital admissions for the elderly
There are increasing pressures on primary care to reduce emergency hospital admissions for the elderly. Currently there are three million people aged more than 80 years in the UK, this is projected to reach eight million by 2050. The largest percentage of hospital admissions comes from this age group and the majority of admissions are due to infection. The diagnosis of serious infection in the growing elderly population of the UK poses a challenge to General Practitioners. Dr Gail Hayward's research, 'Diagnosis of serious infection in elderly patients and the decision to admit: a qualitative interview study with UK GPs', will explore the process of arriving at a diagnosis of serious infection in elderly patients. Her work will describe the features that impact on the decision to admit elderly patients with suspected serious infection.
This work aims to support the development of health service interventions that support front line general practice to reduce avoidable admissions in this population. It is also likely that the work will stimulate future research assessing the key diagnostic markers of serious infection in the elderly.
Use of E Health records to support treatment and the management of acute ear infection in children
Electronic health care records provide a valuable tool for understanding and improving the diagnosis and treatment of a number of medical conditions. One such area of medicine is the support of patients with recurrent middle ear infection, Acute Otitis Media (AOM), which is one of the most common infections of childhood. There is little evidence to support care of these patients by general practice. Dr Mish Verkerk's research, 'Recurrent acute otitis media in UK children; current incidence, management and treatment effects: a longitudinal study of linked electronic health records', will aim to identify the proportion of UK children diagnosed with AOM that go on to develop recurrent AOM. Furthermore, the work will aim to understand how children with recurrent AOM are currently managed in the NHS.
This work will explore the effect of different management strategies on AOM recurrences in children. There is scant data on how NHS doctors currently treat recurrent AOM and how these treatment strategies affect outcomes of children suffering from this condition. The evidence from this work aims to support GPs, patients and parents in improving outcomes.
Using Assistive Technologies to support Dementia care
Caring for patients with dementia costs the (UK) economy a staggering £23 billion per year. This is predominately due to costs of institutional care; suggested ways of reducing these costs in the future include supporting people in their homes for as long as possible. Assistive Technologies (ATs) have the potential to help people with dementia live more independently and reduce care costs through delayed residential care admissions. Despite GPs being a key source of information for patients there is little research to date on GPs' knowledge and views of the role of ATs in dementia care. Dr Lisa Newtons will work on 'exploring General Practitioners' knowledge and attitudes to the role of assistive technologies in dementia care' aiming to discover GPs' level of knowledge around the range of, and role of, ATs in dementia care. Lisa will ask pertinent questions such as 'how will GPs use this technology to support dementia care?'
The outputs of this work will be used to support development of information leaflets on best practice use of ATs for GPs. Informing patients on the use of ATs in dementia care will contribute to existing information sources e.g. the RCGP dementia roadmap project.
GPs have consistently highlighted the need for further training in the diagnosis and management of dementia. At present there are no studies assessing GP trainees' current level of knowledge, skills and attitudes to dementia care.
Dementia remains a source of increasing health concern and social-care priority. It is one of the main causes of disability in later life and also presents multiple challenges for primary care. Dr Eugene Tang's research 'Dementia: Identifying Knowledge Gaps of Future General Practitioners' aims to highlight whether GPs of the future require further tailored training in dementia in order to help patients with dementia live well in the community.
Supporting Stroke Patients with medication adherence
Half of the patients who have experienced stroke are dependent on carers for everyday activities but the proportion of patients who need help with daily medication routines is unknown. The support stroke patients receive is, therefore, an increased issue for GPs, patients and carers. Evidence from medication adherence studies have so far concentrated on stroke survivors who are responsible for their own medication-taking, there is a need to understand and identify the best approaches to support patients and carers.
Dr Anna De Simoni's research 'Quantifying the support stroke survivors get with daily medication taking: a questionnaire survey' will aim to understand the type of support stroke patients receive with taking medications and if they feel more support is needed. The work aims to support development of interventions to support medication adherence and to support patients and carers.
Patients' experience of managing Chronic Kidney Disease
Being diagnosed with a long term medical condition presents patients with a number of challenges. Chronic kidney disease (CKD) is one such life-changing medical condition. Dr Sarah Tonkin Crine's research, 'A systematic review and meta-synthesis of patients' experiences of being diagnosed with, and managing chronic kidney disease', will aim to improve the current understanding of patients' perceptions and experiences of receiving a CKD diagnosis, and subsequent management of the condition. The research aims to identify improved strategies for explaining a new diagnosis of CKD to patients so that they can better understand and self manage the condition.
Inflammatory Marker Testing - best practice
Inflammatory markers can be helpful as part of the diagnostic workup for a number of medical conditions (e.g. polymyalgia), for monitoring of condition activity (e.g. rheumatoid arthritis) and for identifying the presence of infection. The use of inflammatory marker testing in general practice has increased over recent years. Much of the evidence for using inflammatory markers comes from research that has taken place in secondary care settings. There are regional variations in rates of testing in primary care, where there is a limited evidence and guidance for their use.
Dr Jessica Watson's research 'Inflammatory marker testing in primary care: a qualitative study' will explore the drivers for increased rates of inflammatory marker blood tests in general practice. This research aims to help identify how inflammatory markers can be optimised for use in general practice.
Improving patient care through their involvement in research
Patient involvement in decision making is an important feature of patients taking ownership of managing their own health. In her work as a GP and early career researcher, Dr Catherine Hyde, is exploring the process of shared decision making in prescribing analgesia for musculoskeletal pain. During the research, patients participate in systematic review. This is to ensure that the research is relevant to patients, their perspectives on prescribing are included and key factors that are important to patients are also included within the research.
Through this research grant 'Incorporating the patient perspective into exploring shared decision making in prescribing analgesia for musculoskeletal pain in primary care consultations: patient participation in systematic review with narrative synthesis' (awarded in early 2014) Catherine has found parity between both patient and GP opinions on pain management. Having progressed the work, Catherine found that patient involvement strengthened the research topic, and found significant factors that are not discussed in medical literature, e.g. the emotions felt during consultations. When completed, the aim is to disseminate the work to medical professionals and to patients to improve the patient experience of pain management.
More about the Scientific Foundation Board
The Scientific Foundation Board (SFB) was established in 1976 and is the College's charitable funding body that awards grants for research projects whose findings will be of direct relevance to the care of patients in a general practice setting. Any GP, primary health care professional or university-based researcher may apply for a grant for scientific research to be undertaken in the UK. These grants can kick-start the beginning of a distinguished research career and highlight the support from the College to research. The Board selects successful grant holders through assessment of applications against set criteria. Grants of up to £20000 can be awarded and grants up to £1000 can be awarded throughout the year through Chairman's action.
Funding opportunities are available here.