Research

ELECTRIC- Electrical Stimulation of the Tibial nerve in Residential and Care Homes

Dates: 1/7/17-30/6/20

Funder: National Institute for Health Research

Total Award to GCU: £1,224,993

Principal Investigator: Professor Jo Booth

GCU Co-investigators: Professor Suzanne Hagen, Professor Doreen McClurg, Professor Dawn Skelton, Dr Maggie Lawrence, Professor Helen Mason.

External Collaborators: Kings College London, University of Edinburgh, Leeds Beckett University, University of Hertfordshire, University of Aberdeen, Guy’s and St Thomas’ NHS Trust.

Project Website: ELECTRIC

 

Background

Urinary incontinence (UI) is highly prevalent in care home (CH) residents and associated with high personal, social, physical and economic burdens all of which are predicted to increase in line with changing demography. Incontinence is costly to CH providers, the NHS and individual older adults in monetary terms. UI is also personally distressing for older adults and research has shown incontinence impacts on dignity and quality of life, physical functioning, cognitive impairment, sleep disturbance, fractures, falls, hygiene and tissue viability problems and is a major cause of clinical depression and isolation. Despite this UI treatment options are limited and predominately rely on containment using expensive and undignified absorbent products. The trial evaluates a simple, non-invasive low cost option aimed at actively treating UI and reducing its impact on residents and care providers by comparing the effectiveness of transcutaneous posterior tibial nerve stimulation (TPTNS) with shame stimulation in 500 CH residents with UI.

Aim

To determine the clinical effectiveness of a programme of TPTNS stimulation to treat UI in care home residents and the associated costs and consequences.

Objectives

  1. To establish whether TPTNS is more effective in sham stimulation for reducing the volume of UI at 6, 12 and 18 weeks in older care home residents.
  2. To investigate mediating factors that impact on the effectiveness of TPTNS in a mixed method process evaluation involving fidelity, implementation support and qualitative components.
  3. To undertake economic evaluation of TPTNS in care homes assessing the costs of providing the programme and presenting them alongside the key primary and secondary outcomes in a cost consequence analysis.
  4. To explore in an interview study the experiences of TPTNS from the perspective of:
    • Care home residents
    • Family carers
    • Care home nurses, senior carers and managers
Feasibility and multi-centre clinical trial of gait rehabilitation in patients with recently diagnosed rheumatoid arthritis: the Gait Rehabilitation in Early Arthritis Trial (GREAT)

Dates: 01/10/17-30/9/2022

Funder: National Institute for Health Research - Health Technology Assessment (NIHR HTA)

Total Award to GCU: £1,836,461

Principal Investigator: Dr Gordon Hendry

GCU Co-investigators: Professor Martijn Steuljens, Professor Jim Woodburn, Dr Helen Mason (Yunus Centre)

External Collaborators: University of Glasgow, Keele University, Kings College London, University of Salford

Background

There are an estimated 645,000 individuals in the UK with rheumatoid arthritis (RA). During early post-diagnosis over half of RA patients report foot pain and swelling and walking related disability. Management of early RA is in the form of disease modifying anti-rheumatic drugs (DMARDs) and many patients report improvements in their symptoms. However self-reported walking disability 2 years post-diagnosis has been identified as the main predictor of persistent walking disability thereafter. This suggests that there may be a therapeutic window of opportunity to prevent persistent walking disability during the early stage following diagnosis in patients with foot and/or ankle RA. Research has shown that individuals with RA exhibit slow and unsteady gait patterns, are more sedentary, undertake reduced physical exercise and are less confident doing so for fear of pain or injury. Sedentary behaviour is associated with increase in body fat, elevated cardiovascular disease and the need for ongoing care. Thus long term walking disability and associated complications are likely to be costly to the NHS. Gait rehabilitation is a management strategy commonly used for improving independent walking capacity in neurological disorders by the implementation of repetitive walking tasks. However gait rehabilitation is not recommended in clinical guidelines or recommended as usual care for early RA. Thus a new gait rehabilitation intervention requires development and testing.

Aim

To undertake a three-phased study over five years to evaluate the addition of a gait rehabilitation programme as part of the care for individuals who have early RA affecting the foot and ankle.

Objectives

  1. Phase 1 – Development, evaluation and refinement of the new gait intervention in consultation with key stakeholders.
  2. Phase 2- Evaluation of trial participant recruitment and retention rates.
  3. Phase 3 – Compare the effectiveness of the new gait intervention plus usual care versus usual care alone for improving lower limb function
    • Compare cost-effectiveness of the addition of the new gait intervention to usual care versus usual care alone for improving lower limb function.
KNEEMO: Initial Training Network in Knee Osteoarthritis Research

Dates:29/2/14-28/4/2018

Funder: European Commission FP7

Total Award to GCU: £717,919

GCU Principal Investigator: Professor Martijn Steuljens, Professor Jim Woodburn

Co-investigators: Professor Joost Dekker, VU University Medical Centre; Professor Dieter Rosenbaum, University of Munster, Dr Jari Pallari, Peacocks Medical Group

External Collaborators: Aalborg University, Paracelus Medical University, Peacocks Medical Group, University of Munster, University of Southern Denmark, VU University Medical Centre Amsterdam, Xsens

Background

Knee osteoarthritis (KOA) is the most chronic musculoskeletal disorder and currently affects over 8 million people in the EU. Adverse biomechanics caused by ageing, obesity and sedentary lifestyle lie at the heart of the disease and there is no known cure. KNEEMO is the Initial Training Network (ITN) for knee osteoarthritis research funded through the European Commission’s which focuses on “targeted and tailored interventions for KOA,” focusing on the right patients for the right treatment at the right time.” KNEEMO training programme combines existing best practices from consortium members and is designed to equip researchers with skills and knowledge specific to the research field, generic research and complementary training.

Aim

To join up the European research effort in KOA in order to provide step change in the understanding and non-pharmacological management of the disease through early identification and personalised interventions.

Objectives

  1. To provide personalised biomechanical knee models.
  2. To enable the timely identification of patients at high risk of developing OA or with a poor initial prognosis.
  3. To design and evaluate new technology for biomechanical assessments.
  4. o develop personalised (targeted and tailored) interventions.
Investigating the cost and impact of Healthcare Associated Infection (HAI) to patients.

Dates:01/10/15-30/03/2019

Funder: NHS Health Protection Scotland

Total Award to GCU: £1,118,608

Chief Investigator: Professor Jacqui Reilly.

GCU Co-investigators: Dr Helen Mason (Yunus Centre)

External Collaborators: Professor Chris Robertson (University of Strathclyde), Professor Nick Graves (Queensland University of Technology)

GCU researchers funded by study:Sally Stewart (Research Project Manager), Dr Sarkis Manoukian (Research Fellow Yunus Centre), Lynne Haahr (Administrator/Data Manager)

Background

Healthcare associated infections (HAIs) or Nosocomial Infections (NI) are infection acquired as a result of an episode of healthcare. HAIs are distressing for patients, increase their length of stay and incur additional costs to both the patient and the healthcare system. Studies which assess the impact of HAI tend to focus on the impact on patients in terms of morbidity and mortality within hospital and the impact the HAI has on additional length of stay within acute care. Point prevalence surveys of HAI are undertaken every five years in Europe. In Scotland on any one day during 2016 one in every twenty-two patients in hospital had an active HAI. While prevalence is an effective measure of burden of disease and proportion of infection types and is an essential measure when planning resources, in order to develop a full picture of risk and impact an incidence survey is necessary to provide information on risk, aetiology and outcome of healthcare associated infection. In order to ensure that Infection Prevention and Control (IPC) programmes are targeted towards infection that have the highest impact on patient quality of life or greatest reduction in incidence or cost, robust surveillance and research is required.

Aim

This study will investigate the cost and impact of Healthcare Associated Infection (HAI) to patients, the health service and the wider community. This is in order to develop a model to allow policy makers to compare the cost effectiveness of Infection Prevention and Control measures in NHS Scotland. The model will support policy makers and clinical teams in building a patient centred, safe, effective and efficient service.

Objectives

The study will be undertaken over four phases of work:

  1. Incidence Survey which will determine the incidence and type of HAI in hospital.
  2. Case control Study which will estimate the impact of HAI on patient care in hospital.
  3. Longitudinal follow up of Case control study post discharge which will investigate the impact of HAI on patient care post discharge?
  4. Modelling which will develop a framework to support decision making for future investment in Infection Prevention and Control (IPC)?
Research to inform on blood borne viruses in Scotland as part of the Scottish Government’s Sexual Health and Blood Borne Virus Framework

Dates: 1/4/15-31/3/2020

Funder: NHS Health Protection Scotland

Total Award to GCU: £1,805,220

Chief Investigator: Professor Sharon Hutchinson

GCU Co-investigators: Professor David Goldberg (Health Protection Scotland/GCU)

External Collaborators: Health Protection Scotland

Background

The Scottish Government in collaboration with NHS boards and partners including HPS has developed a strategic framework setting outcome ambitions in relation to sexual health and blood borne viruses (BBV). The framework introduces new ways of working across policy areas including Sexual Health Strategy & Action Plan and Hepatitis C Action Plan for Scotland Phase II centre on best quality treatment and care is available to all when needed. This research using data collected from a variety of Scottish Government databases to will assess effectiveness of services to prevent, diagnose and treat BBV in particular Hepatitis C in the context that new therapies for the treatment of this infection become available.

Aim

To undertake research to inform the effectiveness of Blood Borne Virus (BBV) and sexual health services in Scotland using data collected as part of the Sexual Health and Blood Borne Virus Framework.

Objectives

  1. Lead on the analysis of data from Scotland’s Hepatitis C Clinical Database to address uptake of HEPC specialist services and antiviral therapy; the response to HEP C therapy according to treatment regime and setting and the extent of re-infection among people successfully treated for Hepatitis C.
  2. Lead on the analysis of data from Scotland’s Hepatitis C Clinical Database and other national databases to address liver and non-liver related morbidity and mortality among those diagnosed with and treated for Hepatitis C; development of decompensated cirrhosis and/or hepatocellular carcinoma among those diagnosed with Hepatitis C infection and their uptake of healthcare services prior to development of the condition.
  3. Lead on the analysis of data from Scotland’s Needle Exchange Initiative (NESI) to generate key monitoring data on and including prevalence and incidence of Hepatitis C virus among individuals who inject drugs in Scotland; prevalence and characteristics associated with Hepatitis B virus infection and HIV infection among people who inject drugs in Scotland.
  4. Advise on the analysis of data from Scotland’s Hepatitis B and Hepatitis C Diagnoses Database regarding the number and characteristics of people diagnosed with chronic and recently acquired Hepatitis C infection and those tested and diagnosed with Hepatitis C infection.
  5. Advise on the analysis of data from Scotland’s Sexual Health Information Systems (NASH)
  6. Develop a programme of research in collaboration with Health Protection Scotland and other stakeholders related to priority areas identified by Scottish Government’s Hepatitis C Treatment and Therapies Working Group.
  7. Explore and contribute to research on the epidemiology of alcohol and drugs in collaboration with HPS which relates to the Sexual Health and Blood Borne Virus Framework and develop links with key partners involved in evaluating Scotland’s alcohol and drugs strategies.