Tag Archives: general practice

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‘Tribulations and trials in primary care insomnia’ at BSS 2017

brighton_metropole This year’s British Sleep Society (BSS) conference, held in Brighton at the Hilton Metropole, featured an invited presentation from Prof Niro Siriwardena, director of CaHRU, entitled ‘Tribulations and trials in primary care insomnia’.

After a welcome to the conference by Professor Mary Morell, President of the BSS, the opening keynote was given by Professor Franco Cappuccio, from the University of Warwick on the topic of ‘Healthy sleep’. This was followed by the opening session of the conference on ‘Sleep and health’ chaired by Professor Graham Law, secretary of the BSS and a member of CaHRU. This session included three presentations. The first was on ‘Sleep and chronic pain: moving from association to causation?’ give by Dr John brighton_peopleMcBeth, Reader at the University of Manchester. He described the bidirectional relationship between chronic pain and sleep, with pain giving rise to insomnia and sleep disturbance exacerbating or even causing pain. Studies had shown that treating insomnia in people with chronic pain, for example due to fibromyalgia led to improvements in wellbeing and quality of life but no improvement in pain.

Prof Siriwardena next talked about how he had initially developed an interest in the problem of insomnia through initial research into use of sleeping tablets by general practitioners. ‘Tribulations and trials in primary care insomnia’ went on to describe the studies that showed that hypnotic drugs like benzodiazepines and z-drugs though often prescribed for insomnia did more harm than good, and that primary care trials of cognitive behavioural therapy for insomnia (CBT-I) showed positive effects. He went on to describe the work on the Resources for Effective Sleep Treatment (REST) project, a quality improvement project which successfully implemented CBT-I in general practice which led to reduced hypnotic prescribing in those practices. Because of the low uptake of CBT-I in primary care, there was increasing evidence that online or self-help CBT-I was effective with similar effect sizes to face-to-face individual or group therapy. Finally he presented the evidence on short behavioural therapies such as sleep restriction therapy including a forthcoming HTA funded trial led by Oxford University’s Simon Kyle and involving the Universities of Manchester (Peter Bower) and Lincoln (Niro Siriwardena).

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The final talk in the session was Dr Eleanor Scott, Senior Lecturer at Leeds University and Consultant Diabetologist at Leeds Teaching Hospitals, who spoke on Sleep and metabolic health, describing the relationship between insomnia and diabetes, obesity and cardiovascular disease. This was followed by Dr Jason Rihel,of University College London discussing his work on sleep in zebrafish and Dr Claire Sexton of Oxford University on her work on sleep related to dementia. Brighton was an excellent setting for a well-attended BSS conference.

By Niro Siriwardena

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Despina Laparidou presents Scaling up PINCER at ISQua 2017

IMG_0923Despina Laparidou, Research Assistant at CaHRU, together with Antony Chuter, a patient representative for Scaling Up PINCER (pharmacist-led information technology intervention for reducing clinically important errors) recently attended the International Society for Quality in Health Care (ISQua) Conference at the Queen Elizabeth II Conference Centre in London (1st – 4th October 2017) and presented the preliminary findings of the Scaling Up PINCER project, funded by the Health Foundation.

IMG_1639The Main Conference offered a combination of exciting plenaries, short oral presentations and longer themed sessions, while poster and e-poster presentations were also presented throughout the duration of the conference. One of the most interesting sessions was the “A Mile in My Shoes”. A Mile in My Shoes is an interactive shoe shop that invited delegates to “(literally) step into someone else’s shoes and embark on a mile-long physical, emotional and imaginative journey to see the world through their eyes”. The session involved listening to, while wearing their shoes at the same time, unique audio stories from people working within health and social care, sharing their experiences and showing the remarkable contribution and challenges faced by those working in, and using, our health and social care system.

IMG_1634Despina and Antony gave their presentation on the morning of Tuesday 3rd October during a session on “Health Foundation Improving Quality in Community Health Services” and was very well received by the audience. PINCER is a pharmacist-led information technology intervention for reducing clinically important errors in medication management in general practices and the study’s preliminary results show early indications of improvement in most of the study’s safety indicators for gastrointestinal bleed, stroke, heart failure and acute kidney injury, but not for the two asthma indicators. The session, chaired by Will Warburton from The Health Foundation, also showcased studies, such as the “Ophelia Project” on improving health literacy for vulnerable people in the community, and “Making Waves” on Promoting a positive experience for people with COPD.

The Conference came to an end with Wednesday’s plenary and the promise to meet again in 2018 for an even more exciting ISQua Conference in Malaysia!

By Despina Laparidou

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CaHRU students win top spots to present at SAPC Annual Scientific Meeting

sapcposterSeveral members of the Community and Health Research Unit have been selected for oral and elevator presentations at the forthcoming Society for Academic Primary Care Annual Scientific Meeting (SAPC ASM). This year’s conference will take place at the University of Warwick. The SAPC annual conference is the main international conference for primary care in the UK.

Dr Julie Pattinson will speak on her study, ‘Understanding reasons for variation by ethnicity in performance of general practice specialty trainees in the Membership of the Royal College of General Practitioners’ Applied Knowledge Test: cognitive interview study’.

Dr Zahid Asghar will also give an oral presentation on, ‘Performance of candidates with dyslexia in the Applied Knowledge Test for Membership of the Royal College of General Practitioners.’

An oral presentation will be given by Dr Murray Smith on the ‘Effect on hypnotic prescribing of a quality improvement collaborative for primary care of insomnia: a segmented regression analysis’.

CaHRU_logotypeDr Steph Armstrong will also speak at an elevator session on, ‘Ethical considerations in prehospital ambulance based research: an interview study of expert informants’, a study funded by the Wellcome Trust as part of the Network for exploring Ethics in Ambulance Trials (NEAT) project.

Michael Toze, will give an elevator pitch on his doctoral study, ‘Coming out in General Practice: the experience of older LGBT patients – his place ta the confernece was funded through the Best Oral Presentation Prize at the recent Trent Regional SAPC Conference hosted by CaHRU and the University of Lincoln.

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Finally, the abstract submitted by Joseph Akanuwe, research assistant and doctoral student at CaHRU, ‘Exploring Service User and practitioner perspectives of QCancer use in primary care consultations’ was among the top 10 highest scoring abstracts and will be eligible to be considered for the SAPC/North American Primary Care Research Group travel prize.

The whole team have done particularly well this year to be awarded oral and elevator pitches for all abstracts presented, but our doctoral students in particular have excelled.

By Niro Siriwardena

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Joseph Akanuwe presents doctoral research on cancer detection at early diagnosis research conference

JosephJoseph Akanuwe, research assistant at CaHRU, recently attended the Cancer Research UK’s Fourth Biennial Early Diagnosis Research Conference on 23rd and 24th February 2017 in London. Joseph whose abstract was selected for a poster presentation was awarded a bursary to attend the conference. As part of an Early Career Researcher programme, Joseph was also invited to make a PechaKucha (3 minute) oral presentation of his work on early detection of cancer risk in primary care using QCancer, a novel cancer risk assessment tool.

crukedApart from providing an opportunity for Joseph to explain his work to other researchers, policy makers and practitioners with interest in early diagnosis of cancer, the conference included a wide range of speakers from various fields, with a potential for making a significant difference to the field of early diagnosis research and a positive impact for patients. The conference materials including posters, papers/abstracts, conference photos and film will soon be available at the Cancer Research UK website.

Overall, the conference presented an opportunity to share, learn, network and understand the latest developments in early diagnosis research.

By Joseph Akanuwe

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University of Lincoln hosts Society of Academic Primary Care Trent Regional Conference

The Community and Health Research Unit and University of Lincoln hosted this year’s Trent Regional SAPC Spring sapc_lincoln1Conference at the Hilton Doubletree Hotel on Brayford Wharf in Lincoln. The conference included delegates from the Universities of Lincoln, Nottingham, Leicester and Sheffield and all over our region presenting and learning about the latest in primary care research and educational through orals, posters and workshops.

The conference keynote speakers were Chris Burton, Professor of Primary Care and Head of the Academic Unit of Primary Medical Care at the University of Sheffield, Aneez Esmail, Professor of General Practice at the University of Manchester and Navjoyt Ladher, clinical editor at The BMJ. The conference was chaired by Professor Niro Siriwardena, Professor of Primary and Prehospital Healthcare and opened by Professor Sara Owen, Pro Vice Chancellor and Head of the College of Social Science at the University of Lincoln. Prof Burton, new in post at Sheffield, gave the first keynote in place of Prof Nigel Mathers who was recovering from illness. Everyone wished Prof Mathers well for his convalescence and return to health.

Prof Owen’s opening talk focussed on the rapid development and expansion in science and health research and teaching at Lincoln. Chris Burton’s opening keynote focussed on ‘Complexity’, commonly used, misused and sapc_lincoln2misunderstood in healthcare and research. He described the mathematics of complexity as he had applied it in his research to issues such as frequent health service use and how these were described by ‘heavy-tailed’ or log-log distributions.

There followed a series of excellent morning oral presentations, workshops and posters. Before lunch, Prof Esmail gave another outstanding keynote, ‘The problem with patient safety – challenging orthodoxies’ He certainly did challenge the conventional approach to patient safety and described how conventional attempts to reduce harm, in particularly using a target-driven approach, could lead to poorer outcomes and how it was necessary, even important, to accept some risk for better outcomes.

After lunch and viewing of the excellent posters on display, we were treated to further oral presentations and another educational workshop. The meeting ended with our final keynote from Dr Navjoyt Ladher, clinical editor at the British sapc_lincoln3Medical Journal, who spoke eloquently about ‘Goldilocks medicine’ and the art of getting medicine right, particularly focussing on the harms of medicalisation and overtreatment. She went onto to talk about the editorial process at the BMJ, while encouraging primary care researchers to submit their studies to the journal.

The day ended with prizes awarded to the best poster, ‘Predictors of postpartum return to smoking: a systematic review’ by Sophie Orton, Tim Coleman, Tom Coleman-Haynes and Michael Ussher of Nottingham University, and the best oral presentation, which went to Michael Toze from CaHRU at the University of Lincoln for his doctoral research presentation, ‘Coming out in general practice: the experience of older LGBT patients’. Flowers, wine and a big vote of thanks went to Sue Bowler for her work organising the conference and making the day such a success, supported by the CaHRU team and members of staff from the other institutions involved.

By Niro Siriwardena