Research and Innovation Local grandmother with multiple sclerosis is helping researchers to prevent urine infections
Summer 2019
prevent UTIs. Ann was invited to take part in January 2018 and said: “I found out about the study through the MS nurse at Stoke Mandeville Hospital, who referred me to a researcher practitioner, Jamil Razzaque, who explained the study. The risk factor was minimal as the drug had already been tested and it was just a case of whether the drug suits people and does the trick. Unfortunately, losing control of the bladder is a very common part of MS, so I do suffer with UTIs. I was pleased to try and do something that would help with the UTIs and I haven’t had one since taking part.” Ann said of her decision to take part in the study: “I’ve had two or three UTIs and they do make you feel very ill all over your body. They’re almost undetectable until the last minute – you don’t realise you have one until you are poorly. They can be painful because you get a lot of burning and an uncomfortable tummy. They cause you to be ill in the rest of your body. I have to take enough pills as it is, so if this study keeps me from needing antibiotics, that would be great.”
Ann, a 75 year old, retired cake decorator with multiple sclerosis (MS) is taking part in the PReSUTINeB at Stoke Mandeville hospital. The study is looking into preventing urine infections in people with spinal conditions. Multiple sclerosis is a condition where the immune system mistakenly attacks a healthy part of the body such as the brain or spinal cord. Ann was diagnosed with MS in 1997 aged 54 and retired in 2003 as she began to frequently lose her balance and fall. MS can cause fatigue, difficulty walking and problems with balance and co-ordination. Spinal conditions cause a loss of bladder control, which often leads to urinary tract infections (UTIs). These occur when bacteria enters the bladder, urethra or kidneys and can lead to a burning sensation when urinating, incontinence, fever, headaches and nausea.
Mr Maurizio Belci, the study’s lead investigator, said: “Antibiotics, which are used to prevent and treat UTIs, are becoming less effective as the bacteria that cause these infections are becoming more resistant to them. The PReSUTINeB study is looking at immunotherapy treatment made from the bacteria E. coli, which is the most common cause of UTIs, to see if it can help prevent these infections.” The study is led by Buckinghamshire Healthcare NHS Trust with funding and support from the National Institute for Health Research (NIHR) and charity Stoke Mandeville Spinal Research, which funds research into spinal cord injuries. Contact James Cooper via email james.cooper9@nhs.net or call 01296 418140 for more information. Participating in health research helps develop new treatments, improve the NHS, public health and social care and save lives. Patients are encouraged to ask their doctor about research opportunities or search www.ukctg.nihr.ac.uk.
Patients on the study take oral vaccine tablets known as immunotherapy for three months to see if this can For further information about research opportunities at Bucks Healthcare NHS Trust please contact the Research and Innovation Department at Stoke Mandeville hospital on 01296 316065 or see the website at www.bhtresearchandinnovation.org You can also follow us on Facebook or Twitter @BHTResearch
LUSTRUM – Sexual Health study at BHT with recruitment at the Shaw & Brookside clinics This five-year programme of research aims to: improve the sexual health of heterosexual people and men who have sex with men (MSM) develop strategies to reduce the number of people who are unaware they have HIV (undiagnosed HIV) improve the care of people with bacterial sexually transmitted diseases (STIs) It’s focused on people at highest risk of STIs: young people and MSM. Why do this research? STIs are increasing and people under 25 and MSM are hardest hit. Chlamydia is the commonest infection and causes infertility in women. In MSM there are steep rises in HIV, syphilis, and gonorrhoea, which is becoming resistant to available antibiotics. This seems to be linked with increased use of digital media and socio-sexual” Apps which offer new ways for people from diverse backgrounds to meet up for sex. Key to preventing the spread of infection is to rapidly contact, test and manage sex partners of people with STIs and HIV. This is known as partner notification (PN). Current PN is not very effective. We have developed a promising new form of PN called Accelerated Partner Therapy (APT), which needs testing on a large scale. An adapted form could help improve PN for MSM. This could reduce bacterial STIs and also offer new ways of getting MSM tested for HIV - around 25% of MSM with HIV have never been HIV tested and are at high risk of transmitting HIV to sex partners. If we diagnose people with HIV early they can expect good health and normal lifespan. It could also highlight how best to use powerful new HIV prevention strategies. Contact Dr Jackie Sherrard, for information on 01296 566863, website https://www.lustrum.org.uk or Twitter @LUSTRUM_5
Research & Innovation 2018/19 Performance 2018/2019 has been and exciting year for Research and Innovation at BHT. We have grown in the number of research studies (199 studies open) that are open and the number of innovations we are supporting. We are growing in partnerships with universities and industry to increase opportunities for growth. In 2018/19 nearly 6000 patients consented to be part of research studies. In 2018/19, the team were recognised as one of the top three most satisfied work teams in the trust and the most engaged from the staff survey results. We really enjoy what we do. The graph shows the number of studies open in some of the specialties 2018-2019
92% of patients told us that research has been a positive experience. What they said;
“It provides a real hope to cure medical conditions” “It’s the only way to progress patient care” “It’s easy , everyone should do it” “I want to be part of improving the care we provide to our community” “Research in the NHS is for everyone and leads important change” “It might help my grandchildren” “It means the world to help other people” “It can lead to improvement in patient care”
Promoting Research for International Clinical Trials Day 2019
Recent Research Star Awards Dr Tahir Ali, Consultant in Intensive Care Medicine & Anesthesia Since critical care became research active Tahir (left) has constantly been looking for potentially eligible patients for both the Flo-Ela and STARRT-AKI studies. He has referred the majority of our recruited patients and has willingly completed all the extra paperwork required. He has also been extremely supportive explaining the complexities of the STARRT-AKI study to relatives and helping the Research team to gain fully informed consent at a difficult, stressful time.
Mandy Collins, Ophthalmic Imager Mandy (Centre) has been working with us on ophthalmic studies since 2014. Studies often require a named, certified photographer/imager to complete the study specific images and retinal photographs. These are usually required on all study patients at screening, then annually throughout the study and are in addition to standard patient care. The only member of staff we have that can do all of these tests is Mandy. She always manages to find time to see research patients, often during her allocated study leave or during her lunch break. She is an essential and highly valued member of the ophthalmology research team. Without her help we wouldn’t have been able to take on the complex studies that we are currently running.
STUDY RESULTS ☺ ☺ ☺ Prophylactic antibiotics halve the rate of infections after childbirth Results of the ANODE (prophylactic ANtibiotics for the prevention of infection following Operative DElivery) trial have been published in the Lancet journal. The study found that a single dose of antibiotic after assisted vaginal births can reduce the risk of infection by 56% up to six weeks after delivery, and reduce antibiotic use by 17%. One in five women experience an infective complication after operative vaginal birth, and according to the senior author of the study, Professor Marian Knight, prophylactic antibiotics can prevent over 7,000 of these infections annually in the UK. The results of the ANODE trial also have implications for healthcare resources: women who received preventive antibiotic were less likely to report visiting a GP, nurse, midwife or hospital outpatient department in relation to concerns about wound healing compared to those who received placebo. According to lead health economist, Associate Professor Oliver Rivero-Arias, this resulted in an average NHS cost saving of £52.60 per woman at six weeks. We’d like to thank all our patients who took part in this practice changing trial.
Innovation - Bringing Improvements for Vision Loss Patients Denise Voon is an Optometrist in the trust who works with the eye care team of doctors looking after patients with complicated cataracts and spectacle issues. Denise became interested in innovation after working with the research team on several research studies at Stoke Mandeville hospital. Her special interest is in low vision problems and the new technologies that might help people to manage them better. The low vision service sees patients for appointments lasting about 1 hour sorting out help with magnifiers and other tools. The innovative service that Denise is hoping to develop for Bucks patients will involve a “living lab” of mock home environments like a kitchen or living room which create a standard for measuring test results and testing out new gadgets. This will create uniform room layouts for patients and clinicians to compare new products in real world settings. BHT is working with several innovation design companies working on various product ideas to help people with problems like tunnel vision and SMART glasses. Denise is also talking to the Royal National Institute for the Blind (RNIB) about testing products before they’re approved for inclusion in their catalogue.
Are you interested in taking part in research?
METHYLPHENIDATE VERSUS PLACEBO FOR FATIGUE IN ADVANCED CANCER (MePFAC) Cancer-related fatigue is described as an overwhelming sense of tiredness or exhaustion which is unrelieved by rest and is associated with cancer or its treatment. It is a widespread problem in people with cancer at all stages of their illness, whether receiving treatment or not.
This research study is looking to recruit patients who are experiencing fatigue as a result of cancer treatment in order to see whether a drug (Methylphenidate) can reduce the fatigue experienced. Would you like to learn more about this study? If so please ask your doctor or nurse who will put you in touch with the research team or contact the study manager directly. Contact details Dr Faeqa Hami – Palliative Care Consultant Tel 01494 426314 Alice Ngumo - Cancer Research Lead Nurse Tel 01296 315908 The trial of Methylphenidate versus Placebo for fatigue in advanced cancer is funded by the National Institute of Health Research ( NIHR) Health Technology Assessment (HTA) Programme and is in partnership with University College London. MePFAC Participant recruitment poster v1 03-May-2017