NIHRDataInsights/HRCSData huggingface dataset:
Title: Enhanced Medication Summaries to reduce high risk prescribing in people with polypharmacy in primary care: a cluster randomised trial
Funder: Chief Scientist Office, Scotland

Abstract: Minimising the risks associated with polypharmacy is an important challenge for health services internationally. NHS Scotland has created national polypharmacy guidance and made polypharmacy reviews part of the GP contract. However, the guidance is 50 pages long and difficult to use. The aim of this project is to draw on the national guidance to develop an individual patient enhanced medication summary which clearly identifies potentially inappropriate prescribing to support polypharmacy reviews, and evaluate whether it improves prescribing quality and safety. We will initially work with NHS colleagues to collaboratively develop the enhanced medication summary and implement it in the NHS Ayrshire and Arran primary care information system, then evaluate its effect in a cluster-randomised trial in all A&A practices, with a parallel process evaluation to understand how GPs used it in practice. If effective, the enhanced medication summary could be implemented across Scotland, improving care for a highly vulnerable patient group.


Research activity codes: 8.5 RESOURCES AND INFRASTRUCTURE (HEALTH SERVICES)
Health categories: GENERIC HEALTH RELEVANCE
Title: Improving physical activity levels of older people living in care homes
Funder: Chief Scientist Office, Scotland

Abstract: Physical activity (PA) is important to the maintenance of good health in older people. Older people living in care homes do not engage in PA, and this increases their risk of further deterioration of health and hence hospital admission. Care homes, residents and their staff will take part in this project to find reasons why care home residents do not participate in PA and to identify ways to increase PA. There will be four stages to this project: examining the existing evidence, observing how existing care home routines influence residents’ PA, developing interventions, and feeding back these interventions to relevant care home staff to obtain their views on the feasibility of these. Potential interventions will then be ready for future testing to see if they improves health, quality of life, and reduce unplanned hospital admission for this vulnerable group of patients.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: GENERIC HEALTH RELEVANCE
Title: Putting research methodology into practice: producing useful evidence about trial recruitment strategies for trial designers and recruiters (Non Committee)
Funder: Chief Scientist Office, Scotland

Abstract: This study will find out what sort of evidence researchers need to design effective trial recruitment strategies and how that evidence should be presented to them. This will make it easier for researchers to design evidence-based recruitment strategies and highlight what sort of evidence future research should provide. Randomised trials are central to evidence-based health but how we design and run them is far from evidence-based. Many design and process decisions are made without evidence to support them, either because evidence does not exist, or because it is not available in a useful form. The problem is nowhere better illustrated than trial recruitment, where evidence of benefit exists for just a handful of techniques. How this evidence is presented takes no account of what users actually need when designing their recruitment strategies. Consequently recruitment is considered the number one problem in trial methods research.


Research activity codes: 8.4 RESEARCH DESIGN AND METHODOLOGIES (HEALTH SERVICES)
Health categories: GENERIC HEALTH RELEVANCE
Title: Feasibility, acceptability and nature of video consultation via the internet in general practice
Funder: Chief Scientist Office, Scotland

Abstract: The increasing popularity of video-over-internet programs such as Skype have led to calls from governments and service planners for secure versions of these technologies to be adopted in general practice. Many conditions, for example follow-up of depression and long-term condition reviews do not require ‘hands-on’ examination but, as visual examination remains important, still require practice attendance. Video-consulting may reduce this requirement and improve access for people who work, are housebound or geographically isolated. Despite this, very few practices have attempted video-consulting, partly due to technical challenges and workload concerns.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE
Title: Novel psychoactive substance (NPS) injecting in Scotland: in depth study of injecting practices, risk behaviours, health implications and service utilisation
Funder: Chief Scientist Office, Scotland

Abstract: Injection of new psychoactive substances (NPS) is increasing in Scotland, from <1% of active injectors in 2008 (3/2071) to 10% (227/2213) in 2015/16 according to data gathered in the national Needle Exchange Surveillance Initiative (NESI) Scotland survey. In some areas, this figure reaches 29%. The latest NESI survey (data not yet published) also found the prevalence of hepatitis C to be higher amongst those who mainly inject NPS (62%) than amongst mainly heroin injectors (55%). Other health harms associated with NPS use have been found to include: accidents and injuries, mental health impairment, stroke and myocardial infarction1. However, there is a dearth of research in Scotland on most aspects of NPS injecting pathways, risk behaviours and health consequences. This proposed study will conduct in-depth interviews with NPS injectors in Scotland to establish the circumstances and consequences of NPS injecting and to help inform appropriate treatment approaches.


Research activity codes: 2.2 FACTORS RELATING TO PHYSICAL ENVIRONMENT
Health categories: GENERIC HEALTH RELEVANCE
Title: Developing theory based behaviour change interventions to minimise drop-out on randomised trials
Funder: Chief Scientist Office, Scotland

Abstract: This research aims to find new ways to minimise the damaging consequences of people dropping out of clinical trials. Clinical trials compare medical treatments to find out which work best. The number of people needed in a trial is worked out in advance to make sure the trial is big enough so that it produces a sound scientific conclusion. If a lot of people drop-out of the trial before it is finished, the trial conclusions may become unreliable or unusable. This research will interview people who have dropped out of trials to explore what led to drop-out. Interviews will especially focus on peoples’ behaviour (what they did and why). We will then develop and test new ways to help people stay in trials targeting the specific barriers people have identified. Reducing drop-out will directly lead to more reliable evidence being available to the health service to improve patient care.


Research activity codes: 8.4 RESEARCH DESIGN AND METHODOLOGIES (HEALTH SERVICES)
Health categories: GENERIC HEALTH RELEVANCE
Title: Developing and evaluating an economic and ethico-legal framework for priority setting in health and social care
Funder: Chief Scientist Office, Scotland

Abstract: Health and Social Care Integration Partnerships (HSCPs), created in Scotland, are collaborations between the NHS and local authorities, with third-sector representation. HSCPs make joint decisions about budgets for primary, community, social and some acute hospital care; thirty-one HSCPs manage approximately £8billion of resources. Decisions about how to allocate resources fairly and efficiently are very difficult, particularly with limited health care resources. There are many competing claims on budgets that could benefit different groups of patients. Frameworks to aid such decisions have been developed separately within disciplines and have never been evaluated. This research is leading-edge; developing the first framework for making difficult decisions that integrates economics, decision-analysis, ethics and law. Uniquely, we will implement and test the framework in two HSCPs to establish barriers and facilitators to its use, but also assess, relative to all other HSCPs, what difference it makes to priority setting processes in practice and to evidence-based shifts in balance of care.


Research activity codes: 8.2 HEALTH AND WELFARE ECONOMICS
Health categories: GENERIC HEALTH RELEVANCE
Title: Slowing the flow of zero day admissions to hospital: data linkage to inform priorities for future intervention along paediatric referral pathways
Funder: Chief Scientist Office, Scotland

Abstract: Zero day hospital admissions (i.e. being admitted and discharged on the same day) are becoming more common in children. Some zero day admissions may be safely avoided. We do not know how to ‘slow the flow’ of zero day admissions. For example we do not know whether doctors in emergency departments, general practice surgeries or out-of-hours facilities are sending children to hospital in equal proportions or whether the majority of zero day admissions come from one of these ‘stream’. Our research will answer the questions (1) “within the ‘flow’ are there identifiable ‘streams’ of zero day admissions which could be slowed?” (2) “what are the implications to general practice of slowing the flow of zero day admissions?” and (3) “which of these ‘streams’ is the most important to slow down first?”. To answer the first two questions we will link details of every hospital admission between 2015 and 2017 to other routinely collected NHS data. To answer the third question we will work in partnership with children, families and NHS professionals to prioritise the next steps to develop intervention(s). This study will give information which will be essential to developing interventions to safely reduce paediatric hospital admissions.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE
Title: Feasibility of an intervention co-supporting children and fathers in health behaviour change and maintenance following fathers' participation in Football Fans in Training: FFITer families
Funder: Chief Scientist Office, Scotland

Abstract: Reducing inactivity, poor diet and obesity in adults and children is difficult. These behaviours are influenced by several factors, including family circumstances. Efforts to improve family health usually focus on mothers, not fathers, even though men are more often overweight and less likely to take part in weight loss or healthy living programs. We developed a successful weight loss/healthy living program (Football Fans in Training, FFIT) for men, delivered by coaches in football clubs. FFIT is popular and helps men make positive changes to their weight and lifestyles. Our studies have shown that these changes can be long-lasting in some men (we have followed men who have done FFIT up to 3.5 years after signing up). FFIT is being delivered at professional football clubs throughout Scotland, and in England and Germany. After research with FFIT participants and family members, and following demand from participants, clubs and Scottish Government, we have developed a 4-week extension to FFIT (‘FFITer Families’) which aims to: encourage children (and families) to adopt healthy lifestyles; promote positive parent-child communication about diet, physical activity and wellbeing; and improve long term weight loss and positive behaviour changes in men. This study examines how FFITer Families can be improved.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING
Health categories: GENERIC HEALTH RELEVANCE
Title: Derivation of a hospital episode frailty index from electronic patient records: understanding the role of frailty in health outcomes for olderpatients in Scotland
Funder: Chief Scientist Office, Scotland

Abstract: A great success of modern healthcare is an ageing population. While many adults live their later years in good health, some lose the strength and physical reserves required to live independent, healthy lives. These individuals are living with frailty and benefit from specialist care by geriatric medicine teams when in hospital. This has been shown to improve the chance of retaining independence after discharge. However, identifying these patients in a busy hospital is difficult. Despite this, many markers of frailty are routinely recorded by doctors and nurses, for example difficulty managing tasks at home or memory problems. These markers are called ‘health deficits’, which tend to increase with age, although at different rates between individuals depending on general health. A frailty index is a tool that summarises these health deficits into a score. In this research study, we plan to design and test a unique frailty index. This will use information already collected by hospital staff from patients who were admitted to three Scottish hospitals. This information will be anonymous and kept confidential. We will then compare these frailty scores to important outcomes, such as the chance of a patient being readmitted to hospital or dying after being discharged. We hope to show that such a frailty index could be used by hospitals to identify current patients at higher risk, in whom extra support and assessment may be beneficial. We also know that an increasing number of the frailest patients are admitted to hospital many times as they approach the end of their lives. By knowing their frailty index scores we may identify higher risk patients who deteriorate between hospital stays. This research will allow us to test whether data from hospital records could help target better care to frail older people in the future.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: GENERIC HEALTH RELEVANCE
Title: Partnership in continous manufacturing for nano-based drug products
Funder: Department for the Economy, Northern Ireland

Abstract: The aim of this project is to establish and deliver new end to end continous manufacturing capabilities for poorly soluble micron and nanosized action pharmaceutical ingrediens (APIs)that will transform the global supply chain of medicines by developing techniques capable of (1) making nano-particulate active pharmaceutical ingredients and (2) retaining their desirable nano properties throughout the entire manufacturing chain.


Research activity codes: 5.1 PHARMACEUTICALS
Health categories: GENERIC HEALTH RELEVANCE
Title: Capability, health and travel behaviour of older people
Funder: Department for Transport

Abstract: The research investigated the prevalence of, and relationships between, five different facets of ‘health’ that have the potential to impact on travel - health conditions, impairments, difficulties with daily activities, mobility aid use and self-rated health, before assessing the interplay between these characteristics and travel behaviour. The UK has an ageing population, meaning the travel needs of this group are becoming increasingly important. Used in conjunction with projections about age and health, the information generated by this project will enable the Department to identify where difficulties with transport are likely to be most prevalent for the older population in the future and where the development of policy and infrastructure should be focused.


Research activity codes: 1.2 PSYCHOLOGICAL AND SOCIOECONOMIC PROCESSES;8.3 POLICY, ETHICS AND RESEARCH GOVERNANCE
Health categories: GENERIC HEALTH RELEVANCE
Title: Proactive Health Care of Older People in Care Homes (PEACH) study
Funder: Dunhill Medical Trust

Abstract: 432,000 older people live in UK care homes, where healthcare is unstructured and allows unacceptable variation in quality. Local projects delivering structured and planned (proactive) healthcare have improved outcomes but have not been sustained or implemented widely. This study will consider how to implement abd sustain proactive healthcare in care homes through: region-wide Quality Improvement (QI) to deliver proactive healthcare to care home residents (WP1), process evaluation of the QI programme and resulting changes to healthcare (WP2), measuring changes in Health-Related Quality of Life during the QI programme (WP3), costing health service use and using this with WP3 data to consider cost-benefit (WP4) and analysing records of hospital, GP and ambulance attendances to measure impact on health service use (WP5). On conclusion we will be able to describe why and how other regions can implement similar improvements to deliver change at pace and scale.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE
Title: Development of a validated model to predict how the centralisation of emergency medical services will affect the health of older patients
Funder: Dunhill Medical Trust

Abstract: Unscheduled hospital admissions for older people are increasing in real and relative terms at a time when healthcare policy favours centralization of emergency care provision. It is unclear whether older patients with multiple co-morbidities will uniformly benefit from redirection to larger centres further away from traditional local settings. To inform decisions by planners and providers, we will develop a multi-state outcome prediction model for emergency hospital attendances by older persons post-centralisation by utilising NHS data sources to estimate the probabilities of moving between pre-admission state, new institutionalisation, re-admission and death at 28 days. Sensitivity analysis will consider age, gender, ethnicity, diagnostic category, co-morbidities, travel time and deprivation. We will validate the model against the impact observed for older persons over 12 months before and (following award of an additional year of funding) 24 months after a regional emergency care centralisation case study and report changes in case-mix, procedures and length of stay for the total population and matched groups


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE
Title: Forgotten lives: hidden deaths. People with learning disabilitie living in generic long term care settings
Funder: Dunhill Medical Trust

Abstract: This study will obtain data on the end-of-life care of older people with LD living in generic care settings in England and Wales. This group is likely to represent the oldest of the older people with LD. Such settings will be the final residence for a significant proportion of this ageing LD population. It is estimated that 25% of deaths of people with LD in all care settings take place in long term settings for older people. This figure is higher than might be expected and indicates that, towards the end of their lives, older people with LD move into generic care settings. Little is known about this population. The high proportion of people with LD who die whilst resident in such settings warrants focused research. This study aims to examine the quality of end-of-life care and to compare with comparator groups of people in the same settings without LD.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES;7.1 INDIVIDUAL CARE NEEDS
Health categories: GENERIC HEALTH RELEVANCE
Title: Gender identity and ageing: investigating dignified and inclusive health and social care for older trans people in Wales
Funder: Dunhill Medical Trust

Abstract: Very little is known about trans people’s health and social care needs in later life or about diversity within this community. The importance of engaging with the trans community is a central pillar of this research and community engagement occurs at a number of stages across the project. The main objective is to ascertain the extent to which current health and social care provision is person-centred, inclusive and anti-discriminatory. Data collection comprises life history interviews with older trans people (N≤25) and a survey with said professionals (N≤250). Informed by findings, four workshops with professionals and key trans stakeholders will then take place, with the aim of developing good practice guidelines. Multiple pathways will be used to disseminate the information, including, for example, digital stories and a lay report. Data gathered will be used to produce web-based learning materials for health and social care services and will be made available through the research website.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS;8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE
Title: Validation of an older persons prehospital early warning score (VOPPES)
Funder: Dunhill Medical Trust

Abstract: Identification of the critically ill older person can be challenging due to the physiology of ageing and comorbidities. Early warning scores based on patient observations were developed to identify patient deterioration in hospital, however, it is unknown whether such scores are predictors of outcome in unselected out of hospital patients over the age of 65 years. Specific Aims: To determine whether a prehospital National Early Warning Score (NEWS) in patients over the age of 65 years is a predictor of outcome, namely in-hospital mortality within 24 hours or 30 days or ICU admission within two days


Research activity codes: 4.2 EVALUATION OF MARKERS AND TECHNOLOGIES
Health categories: GENERIC HEALTH RELEVANCE
Title: INTERpreting epigenetic signatures in STudies of Early Life Adversity (InterStELA)
Funder: Economic and Social Research Council

Abstract: Early life adversity can have a significant and lasting effect on social, developmental, and health outcomes; various markers of early life adversity such as low socio-economic position (SEP); parental death, illness or divorce; separation from parents; parental mental health or addiction; lack of warmth and affection of parent-child relationships; residential instability, and physical, emotional and sexual abuse are associated with lower educational attainment, income and economic participation, as well as with adverse health behaviours and poorer mental and physical health outcomes. Reducing or potentially eliminating the harmful effects of early adversity is crucial for combating inequalities. There is a large body of evidence documenting and describing the long-term consequences of early life adversity, but the pathways and mechanisms through which they occur remain uncertain. In order for early life adversity to influence later outcomes, biological systems must be affected. Epigenetics is a potential molecular mechanism linking early life adversity with later outcomes. DNA methylation is one type of epigenetic change. It is a chemical change to our DNA that influences the extent to which our genes are expressed. DNA methylation can respond to environmental factors in early life, which means it may be very useful to study early life adversity. Animal models have shown links between early life stress and altered methylation patterns, and more recently evidence from human studies has shown that low SEP and abuse are associated with differences in methylation patterns. The aim of this project is to create a network of researchers working on the relationship between early life adversity and DNA methylation. Bringing together a team of social and biological researchers will enable the researchers to share data and expertise in order to drive the field forwards and speed up progress. The researchers will use existing high-quality data from studies where people have been followed across the life course in order to better understand how early life adversity affects changes in DNA methylation and whether there are other factors that alter these relationships. In addition to carrying out specific research projects in this area, network members will meet at a series of workshops, in which the results from research will be discussed and future projects will be planned.


Research activity codes: 2.1 BIOLOGICAL AND ENDOGENOUS FACTORS;2.3 PSYCHOLOGICAL, SOCIAL AND ECONOMIC FACTORS
Health categories: GENERIC HEALTH RELEVANCE