Patients and health professionals join research team to hear about early CHROMED study findings

chromedevent1Research participants along with their spouse or carer, and health professionals who took part in the CHROMED trial were invited to a feedback session on Wednesday 23rd March at the Petwood Hotel in Woodhall Spa to mark the end of the study and to hear about initial results from the trial.


chromedteamCHROMED (Clinical Trials for Elderly Patients with Multiple Diseases) is a European Commission (Framework 7) funded randomised control trial (RCT) which was conducted over three years in seven European countries. The study looked at the impact of telemonitoring equipment in the homes of older people (aged 60 years or over) with a chronic condition commonly known as COPD (Chronic Obstructive Pulmonary Disease) and an associated heart condition. The University of Lincoln and Lincolnshire Community Health Services NHS Trust (LCHS) collaborated closely on this study with partners in Liverpool, Italy, Spain, Sweden, Norway, Estonia, and Slovenia.

chromedevent2Dr Jo Middlemass, study research nurse, gave a presentation detailing the early results. In the feasibility (testing) phase a new breathing device (Resmon Pro) was shown to have identified a chest infection five days before it was treated. It was too early to present the results from the main study but Jo described the findings from interviews carried out with those participants who had the equipment in their homes. David Madeley (technician from Electronic Assistive Technology Service at LCHS) set up the equipment at the event to give everyone who wished to do so, and particularly those who were in the observation arm, an opportunity to try the equipment.

The event was positively received and culminated in a delicious afternoon tea!

By Dr Jo Middlemass

CaHRU team presents at SAPC Trent Regional Spring meeting

Zahid@NAPCRG2014_750Members of the CaHRU team attended the Society for Academic Primary Care Trent Regional Spring conference on Tuesday 15 March 2016 at College Court Conference Centre in Leicester. At the meeting were Drs. Zahid Asghar and Coral Sirdifield and PhD student Joseph Akanuwe (giving oral presentations), Dr Jo Middlemass and Jolien Vos (who led a workshop on multimorbidity), and Despina Laparidou, who gave a poster presentation. Prof Siriwardena was in attendance to support the team.

sapcleicester_coralThe Leicester Department of Primary Care and Diabetes Centre hosted the event on behalf of the Universities of Leicester, Nottingham, Sheffield and Lincoln, and as always it proved to be a worthwhile event with excellent keynote speakers and high quality presentations of research including from members of CaHRU. The opening keynote was given by Prof Maureen Baker, a Lincolnshire GP, who spoke on the ‘Future of General Practice’, describing the current problems of underfunding and poor morale and how general practice which deals with 90% of patient contacts with 9% of NHS funding can develop in future.

sapcleicester_joIn the multimorbidity workshop Jolien Vos presented her doctoral study on, ‘Care networks of older people with multimorbidity: social network analysis and qualitative study’ and led a discussion on patient vignettes derived from these. Jo Middlemass presented a European study, ‘Perceptions and experiences of telemonitoring in older patients with multimorbidity: a qualitative study’ and discussed implementation of remote monitoring technologies with delegates. They were joined by Steve Leven from Leicester who presented on the link between pay-for-performance with deprivation and multimorbidity.

sapcleicester_despinaDespina Laparidou gave a poster session on ‘Challenges for carers of people with dementia and their support needs from health and social care providers: a qualitative study’. After lunch, Prof Richard McManus, from Oxford presented his groundbreaking TASMINH studies on ‘Self-management of hypertension – can patients do it better?’ The answer, a qualified yes but with help from primary care practitioners, is a triumph for supported self-care.

sapcleicester_josephAt the final session Dr Zahid Asghar presented his work with Dr Jon Dixon (Sheffield University) and Prof Siriwardena on ambulance care for people with convulsions, ‘Exploratory cross-sectional study of factors associated with transport to hospital after suspected seizure’ and Joseph Akanuwe described his doctoral study, ‘Exploring patient and practitioner perspectives of QCancer use in primary care consultations’. The session was attended by Prof Carol Coupland from Nottingham University, one of the originators of QCancer.

CaHRU team attends CHROMED European trial meeting in Uppsala, Sweden

Dr Jo Middlemass, trial nurse, and Prof Niro Siriwardena who are members of the Clinical Trials for Elderly Patients with Multiple Diseases (CHROMED) (Funding by the European Commission’s 7th Framework Programme) attended the final investigator team meeting in Uppsala earlier this month (March 2016).

IMG_4175The study includes a consortium of seven European countries led by TESAN (Italy), Restech and including Del Politcnico Di Milano (Italy), University of Liverpool (UK), Tallina Tehnikaulikool (Estonia), Universitat De Barcelona (Spain), Uppsala Universitet (Sweden), Universitetssykehuset Nord-Norge (Norway), Bolnisnica Sezana Zavod (Slovenia), University of Lincoln, Lincolnshire Community Health Services NHS Trust.

The CHROMED study has been investigating the effectiveness and cost-effectiveness of a telemonitoring system for people with multiple chronic disease, specifically Chronic Obstructive Pulmonary Disease (COPD) and heart disease. The trial in Lincoln involved a feasibility study of five patients and a randomisation cohort of 32 patients aged 65 years and above in Lincolnshire. The monitoring equipment included a novel device for measuring lung function (using a technique called forced oscillation) and a wrist clinic measuring pulse, blood pressure, oxygen saturation, and temperature.

chromedThe study has already shown evidence that monitoring can detect patients’ worsening condition, even before symptoms are apparent. The study data have now been collected and are being analysed to see whether the monitoring system has improved patients’ outcomes, quality of life and healthcare costs.



Making it Happen – CaHRU attend 999 EMS Research Forum conference in Newcastle

Members of the CaHRU team together with colleagues from East Midlands Ambulance Service NHS Trust attended the 999 EMS Research Forum conference, ‘Making it happen: delivering research in pre-hospital care’ at the Assembly Rooms in Newcastle on 1 March 2016. The event was organised by the 999 EMS Forum in collaboration with North East Ambulance Service NHS Trust and Newcastle University.

IqbalEMS9991.3.16The conference was opened by Yvonne Ormston, Chief Executive of North East Ambulance Service and introduced by Prof Helen Snooks, Professor of Health Services Research at Swansea University and chair of the EMS 999 Research Forum. The opening keynote was given by Dr Simon Woods of Newcastle University on ‘Ethics and consent in pre-hospital research’. This was followed by a number of oral presentations from the highest scoring abstracts submitted to the conference. This included a presentation by Dr Mohammad Iqbal, research associate at East Midlands Ambulance Service NHS Trust and research fellow at CaHRU, who presented his doctoral study, ‘Non randomised control study of the effectiveness of a novel pain assessment tool for use by paramedics’. After the oral presentations there was a further keynote from Dr Chris Price of Newcastle University on ‘Delivering safe pre-hospital research: a stroke perspective’.

FionaEMS9991.3.16Poster sessions included a presentation from Fiona Togher, graduate research assistant at CaHRU on her doctoral research, ‘Refining questionnaire items in a Patient Reported Experience Measure (PREM) designed for users of NHS ambulance services: Question Appraisal Study’. The afternoon session included a workshop given by Prof Niro Siriwardena and Dr Adele Langlois supported by Dr Stephanie Armstrong, on ‘Ethics and consent in pre-hospital research’, which form part of the Network exploring Ethics of Ambulance Trials funded by the Wellcome Trust. The workshop was well attended and generated ideas on consent, confidentiality, and privacy in relation to ambulance trials as well as ideas on future research.

NEAT_team1.3.16The final keynote was given by Dutch researcher, and acute physician, Dr Prabath Nanayakkara on his ‘Research in the pre-hospital management of sepsis: opportunities and challenges’. The conference was closed by Prof Siriwardena, with prizes presented to the best research, best poster, research most likely to affect practice and best use of data, and thanks given to the organisers for an excellent and memorable event.

East Midlands Academic Health Science Network (EMAHSN) Patient and Public Involvement event

Viet-Hai Phung from CaHRU recently attended the East Midlands Academic Health Science Network Patient and Public Involvement (PPI) event at Nottingham’s Trent Vineyard on 24 February 2016. This provided an opportunity to share learning and best practice in PPI across the health and social care sectors. Viet-Hai, iscurrently undertaking a PhD focusing on the seldom-heard group of people recently arrived in England from EU accession countries, found the event thought-provoking.

Yvonne Coghill, who is Director of Workforce Race Equality Standard Implementation for NHS England, introduced the event. She used the Thomas Jefferson statement that: “There is nothing more unequal than the equal treatment vhp2of unequal people“, suggesting that it is equity, rather than equality, that the NHS should focus on. There then followed a keynote speech by Anu Singh, the Director of PPI and Insight at NHS England. She gave practical suggestions about how the NHS can use PPI meaningfully.

After the opening speeches, representatives from projects targeting seldom-heard groups (Roma, people with learning disabilities, young carers, minority ethnic groups with long-term conditions) talked about how they engaged with them. All four emphasised the importance of actively seeking out their target groups, as well as helping them to help themselves.

A masterclass on involving minority ethnic groups, run by Haseeb Ahmad and Jo Ryder from Leicester City Clinical Commissioning Group (CCG), provided suggestions on how to effectively involve minority ethnic groups, including taking time to establish and build relationships and making links with professionals on the ground, who may act as gatekeepers to other key community figures. After lunch, a session on running engagement events stressed the importance of clarity about the desired outcomes and that interactive methods, such as voting technology, can be effective at engaging participants.

At the close, EMAHSN announced that they have opened up funding of up to £1,500 each for up to 10 PPI groups to support their work in the East Midlands. There were plenty of practical ideas to consider when engaging, and building relationships, with these groups.

By Viet-Hai Phung