NIHRDataInsights/HRCSData huggingface dataset:
Title: Geodemographic factors associated with deliberate self harm and death by suicide: a within and between neighbourhoods analysis
Funder: Health and Social Care Research and Development Division (HSC R&D) of Public Health Agency, Northern Ireland

Abstract: Objective To determine which individual and community characteristics are associated with suicide and deliberate self-harm. Is this behaviour grouped by geodemographic clusters, and if so, what are the features of these clusters? Analysis will examine the differential qualities within and between neighbourhoods, after adjusting for individual-level risk factors. Design - The study will utilize a Multilevel modelling approach to analyse suicidal behaviour, exploring the potential associations between neighbourhood factors and suicidality. The analysis will examine the area effects and trends over time within and across small geographically defined areas, and across Northern Ireland as a whole. Participants - This study will analyse data on all deaths reported as suicides over the past 15 years within Northern Ireland. In addition, the analysis will also incorporate data on presenting cases of self harm from the hospitals in the Western Health and Social Care Trust over the past two years. Main Outcome Measures - The study will determine the standardised incidence ratios for suicidality, by age, sex and location. Location will be defined through configurations of census output areas. Definition of area will be defined by the characteristics of neighbourhoods. The analysis will be formulated within a multilevel structural equation modelling framework, which will enable the properties of the count variable to be considered, while explicitly allowing for a test of effect sizes at case, time and location level.


Research activity codes: 2.4 SURVEILLANCE AND DISTRIBUTION
Health categories: GENERIC HEALTH RELEVANCE
Title: Opportunity-Led Research Proposal: REVIVE Study
Funder: Health and Social Care Research and Development Division (HSC R&D) of Public Health Agency, Northern Ireland

Abstract: BACKGROUND: Survivors of critical illness, even after the acute illness has resolved, have markedly reduced physical function and health related quality of life. There is an urgent need to improve the outcome of these patients. AIM: To investigate whether a 6 week exercise programme improves physical function in patients discharged from hospital following critical illness compared to standard care. The objectives are: a) To investigate whether a 6 week exercise programme improves physical function, quality of life, exercise capacity, anxiety and depression and self efficacy to exercise in patients discharged from hospital following critical illness; b) To determine the feasibility (safety, practicality and acceptability) of providing a 6 week exercise programme for patients discharged from hospital following critical illness; c) To explore patients' perceptions of the benefits of the 6 week exercise programme; d) To examine medium term (6 months) effects of the exercise programme; and e) To evaluate the cost-effectiveness of the exercise programme. METHODS: A prospective phase II randomised controlled trial of exercise versus standard care following critical illness will be used to investgate whether physical function and health related quality of life is improved for patients discharged from hospital following critical illness. Blinded outcome assessment will be conducted following hospital discharge at baseine, post exercise porgramme, and after 6 months. Semin-structured interviews will be used to explore patients' perceptions of the benefits and acceptability of the exercise programme. Practicality and acceptability of the exercise programme will be determined by recording information relating to e.g. recruitment and retention, transport, safety, exercise sessions completed and reasons for non compliane. Data relating to all health care contacts will also be recorded. BENEFITS: This study will determine whether physical function and health related quality of life in patients who are discharged from hospital following critical illness is improved by a 6 week programme of exercise. If effective, this study will improve outcomes that are meaningful to patients and their family, and inform the design of a future phase 3 clinical trial of exercise following recovery from critical illness.


Research activity codes: 6.7 PHYSICAL
Health categories: GENERIC HEALTH RELEVANCE
Title: Informing decisions on investment to reduce health inequalities in Scotland
Funder: Chief Scientist Office (Scotland)

Abstract: Tackling health inequalities is afforded a high priority in Scotland, but efforts to meet this challenge are undermined by a paucity of information regarding the effectiveness of interventions in practice. This project seeks to augment an existing suite of practical tools that model the delivery costs and impact of various interventions, and to exploit the resultant research resource to answer key questions about strategies for reducing health inequalities. An investigation of the feasibility of reaching deprived population groups or specifically targeting such groups will be conducted to inform tool development. Results from the tools will form the basis of comparisons between interventions in terms of their impact on health inequalities, including a broad comparison between downstream individual interventions and upstream universal approaches. Overall this work will provide national and local decision-makers with practical tools and interpreted research findings that will inform decisions about investing in interventions to reduce health inequalities


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES;8.2 HEALTH AND WELFARE ECONOMICS
Health categories: GENERIC HEALTH RELEVANCE
Title: Effective Feedback to Improve Primary Care Prescribing Safety (EFIPPS): a randomised controlled trial using ePrescribing data
Funder: Chief Scientist Office (Scotland)

Abstract: Improving quality and safety is a central priority for NHS Scotland. The development of unique patient-level prescribing datasets held by ISD has created new opportunities for measuring and feeding back prescribing safety data to General Practices to drive improvement. This study will draw on psychological theory to design two formats of prescribing safety data feedback for General Practices, paralleling the two main ways in which graphical quality data is now used in NHS Scotland improvement work. These will be tested in a randomised controlled trial compared to a simple educational intervention. The study will both develop methods for designing and implementing routine prescribing data feedback, and provide knowledge that will inform decisions about how best to use new clinical datasets to improve the quality and safety of care in NHS Scotland and more widely.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES;8.4 RESEARCH DESIGN AND METHODOLOGIES (HEALTH SERVICES)
Health categories: GENERIC HEALTH RELEVANCE
Title: Preventing early unplanned hospital readmission following critical illness
Funder: Chief Scientist Office (Scotland)

Abstract: Although 70-80% of patients are discharged home after an ICU admission, they subsequently suffer high levels of physical and psychological morbidity, and disability. We recently found that 23% of ICU survivors required emergency hospital readmission within 90 days, and experienced excess mortality and 62% greater hospital resource use over 12 months compared to other hospitalised patients. We propose two parallel approaches to address this issue. First we will use national data to generate risk prediction models for early readmission for use prior to discharge, and report standardised risk of readmission to benchmark health board readmission rates. Second, a staged approach including pre-study research findings, literature review, interviews with individual patients and carers, and focus groups will be used to generate an evidence-based taxonomy to understand reasons for readmission and their relative importance. Our outputs will inform novel interventions and a structure to use early readmission as a novel quality indicator.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES;7.3 MANAGEMENT AND DECISION MAKING
Health categories: GENERIC HEALTH RELEVANCE
Title: Establishing QALY weights for end of life
Funder: Chief Scientist Office (Scotland)

Abstract: There is conflicting evidence of public preferences for end of life treatments and very limited evidence in relation to public preferences for end of life treatments to improve quality of life compared with life extension. There is also very little evidence on the relative value of QALYs when end of life treatments are compared with other conditions. NICE and SMC conduct assessment on end of life technologies using different criteria e.g. NICE permit a higher cost effectiveness threshold to be applied for life extending treatments. The purpose of this study is to develop a survey to provide more definitive evidence of societal preferences in relation to the relative value of QALYs gained at the end of life and the relative value of improvements in quality of life compared with life extension at the end of life.


Research activity codes: 7.2 END OF LIFE CARE
Health categories: GENERIC HEALTH RELEVANCE
Title: Making clinical trials more relevant: improving and validating the PRECIS tool for matching trial design decisions to trial purpose.
Funder: Chief Scientist Office (Scotland)

Abstract: Many clinical trials have designs that make it hard for patients and health professionals to use the results because the applicability (external validity) of the trial is low. PRECIS is a tool that helps trialists to think carefully about the impact their design decisions have on others’ ability to use trial results. Many research groups have found PRECIS useful but they have highlighted problems, particularly that its inter-rater reliability is not clear and that it needs a scoring system. This proposal will improve and validate a new version of PRECIS. We will then use the new tool to compare the internal validity of, and effect estimates from, a set of matched trials, some taking an explanatory approach, others more pragmatic. Compromised internal validity is often put forward as an argument against pragmatic designs but there is no empirical evidence for or against this. We will provide this empirical evidence.


Research activity codes: 6.9 RESOURCES AND INFRASTRUCTURE (TREATMENT EVALUATION);8.4 RESEARCH DESIGN AND METHODOLOGIES (HEALTH SERVICES)
Health categories: GENERIC HEALTH RELEVANCE
Title: Identification and Characterisation of the High Risk Surgical Population in Scotland
Funder: Chief Scientist Office (Scotland)

Abstract: Identifying patients at greatest risk of death or major complications in the postoperative period is relevant to clinicians, healthcare funders and patients. Data from North America suggest complications following surgery are associated with long-term mortality. Differences in utilisation of intensive care services may explain the disparity seen in surgical outcomes between the UK and other developed nations. Whole country data for intensive care utilisation and short- and long-term outcomes after high risk surgery have not been reported previously. We are in a unique position in Scotland to do this through linking data from the national Scottish intensive care database to the Scottish hospital discharge database and death register. We will extract data on diagnostic information, detailed physiological data from ICU, long-term outcomes, data on hospital readmissions and demographics including social deprivation. These data will allow construction of a detailed model allowing identification of high risk groups and will inform the design and powering of future studies.


Research activity codes: 7.3 MANAGEMENT AND DECISION MAKING
Health categories: GENERIC HEALTH RELEVANCE
Title: Scottish Health and Ethnicity Linkage Study (SHELS): examining inequalities in allmortality, all-hospitalisation, infectious and parasitic diseases, injury and poisoning, and bowel screening.
Funder: Chief Scientist Office (Scotland)

Abstract: The Scottish Health and Ethnicity Linkage Study (SHELS) has linked Scotland's health databases to the 2001 Census creating potential multi-ethnic retrospective cohort studies on 4.65 million people. This project will examine ethnic inequalities in a) allmortality; b) all-hospitalisation, length of stay and readmission; c) mortality/hospitalisations for infectious and parasitic diseases and incidence/prevalence for TB, HIV, and hepatitis C and B; d) mortality/hospitalisation for injuries and poisonings; and e) participation in and outcome of the Scottish Bowel Screening Programme 2) further develop, test and refine methods, particularly by using primary care data and socioeconomic variables;. The new work will contribute substantially to ethnicity and health research, and the project will provide valuable data that NHS Scotland can use to address the needs of minority ethnic groups and demonstrate compliance with legislation and NHS policy. SHELS is preparing to be a platform for larger scale nationally and internationally funded work.


Research activity codes: 2.4 SURVEILLANCE AND DISTRIBUTION
Health categories: GENERIC HEALTH RELEVANCE
Title: Can a football-based weight management/physical activity/healthy living programme be adapted for delivery in secure institutional settings to support at-risk groups in positive, sustainable behavioural change?
Funder: Chief Scientist Office (Scotland)

Abstract: Obesity and physical inactivity are major public health problems Football Fans in Training (FFIT) has successfully used the draw of Scottish Premier League clubs to engage overweight/obese men (a hard-to-reach group) in weight loss and physical activity. However, external constraints mean some men cannot attend club-based weekly programme sessions. The project aims to explore the potential of adapting FFIT for delivery to two such populations (prisoners/patients and shift workers) at secure institutions. A 2-phase, mixed-methods programme development/pilot evaluation. Phase 1 uses scoping reviews to identify effective components of weight/physical activity/dietary interventions for these populations, and focus groups/interviews to explore the views of participants and staff delivering prototype interventions, which will also be observed. The Phase 1 findings will inform development of separate Phase 2 interventions for prisoners/patients and shift workers. Before-and-after process evaluations will examine their potential to deliver sustained behavioural and physical/mental health changes to the target populations.


Research activity codes: 5.7 PHYSICAL
Health categories: GENERIC HEALTH RELEVANCE
Title: Avoidable Scottish Hospitalisations (ASH)
Funder: Chief Scientist Office (Scotland)

Abstract: Potentially Preventable Hospitalisations (PPH) (also termed hospitalisations for ‘ambulatory care sensitive conditions’) are those that could potentially be prevented by timely and effective disease management within primary care. The concept of PPHs was originally developed in the USA but has been adopted widely by international health systems as an indicator of the quality of primary care. PPHs are also increasingly used within Scotland as NHS performance indicators. However, key questions remain about the validity of these measures. The aim of the project is to test the robustness of PPHs as indicators of the quality of primary care in Scotland and where appropriate to propose methods for refining PPH measures so that they might be better used to set targets for and monitor health system performance. Using practice level data, we will explore relationships between quality and access of primary care services, hospital admissions for PPH diagnoses, and factors that confound and mediate these relationships


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES;8.3 POLICY, ETHICS AND RESEARCH GOVERNANCE
Health categories: GENERIC HEALTH RELEVANCE
Title: Use and misuse of opioid prescribing across Scotland – rates, quality, variations and explanations
Funder: Chief Scientist Office (Scotland)

Abstract: This study aims to describe opioid prescription rates across Scotland, explore indicators of appropriate/inappropriate prescribing in chronic non-malignant pain, and seek indicators of the level of problem use, and factors associated with variations in these. With Information Services Division of NHS Scotland, and Health Informatics Centre, Dundee University, we will link all opioid prescribing data over the last 10 years to routine NHS, demographic and Generation Scotland (GS) data. We will explore factors (individual, practice-based) associated with prescribing rates. Based on British Pain Society guidelines, we will identify good prescribing and factors associated with this. We will also identify indicators of problem use (eg escalating doses, co-prescribing, multiple GPs) and factors associated with these. Using GS data, we will relate prescribing to diagnosis/severity of chronic pain, and the presence of associated clinical factors. Multi-level modelling will quantify the respective roles of individual, practice-based and local policy-based influences on opioid prescribing.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE
Title: Multiple Symptoms Study 2. A feasibility study to manualise, teach and demonstrate the delivery of the Symptoms Clinic intervention.
Funder: Chief Scientist Office (Scotland)

Abstract: Physical Symptoms which cannot be explained by disease, so-called Medically Unexplained Symptoms (MUS), account for at least 15% of GP consultations and 30- 50% of referrals to specialists. Evidence indicates that patients with persistent or recurring MUS are poorly served by health services which seek to diagnose and treat diseases, not manage symptoms We have developed and pilot-tested the Symptoms Clinic, a GP with Special Interest (GPwSI) intervention for patients with multiple MUS. The Symptoms Clinic implements a consultation model (Recognition, Explanation, Activation, Learning) centred on explanation of symptoms in terms of understandable physiological mechanisms which invite adaptation, rather than as psychosomatic markers of distress. We now wish to test whether the intervention can be taught to other GPs and reliably delivered by them. This study represents a stage in the process of complex intervention 2 development; it bridges the gap between early theory-based development and readiness for a full effectiveness trial.


Research activity codes: 7.3 MANAGEMENT AND DECISION MAKING
Health categories: GENERIC HEALTH RELEVANCE
Title: Developing a UK taxonomy and framework for facilitating health policy deliberations on maximising secondary uses of healthcare data: a mixed methods study
Funder: Chief Scientist Office (Scotland)

Abstract: Background: The move from paper to electronic health record systems is proving both challenging and expensive. The substantial UK investments in recent years were predicated on the assumption that eHealth systems would be cost saving through increasing the efficiency of care provision, but this has been challenged by our work and that of others. This suggests that major benefits associated with investments in eHealth are most likely to arise from innovative secondary uses of digitised data. Aims: To create a taxonomy and framework to inform Scottish/UK policy making on the range of secondary uses to which digitised health records can be subjected. Methods: Phased work, involving: 1) scoping the literature for examples of innovative secondary uses of data; 2) in-depth discussion with experts to identify additional CSO Grant Application Form – version November 2012 2 examples, and understand barriers/facilitators to enabling secure reuse of data; and 3) integrating these strands of work to develop a framework for policymakers.


Research activity codes: 8.3 POLICY, ETHICS AND RESEARCH GOVERNANCE
Health categories: GENERIC HEALTH RELEVANCE
Title: An exploratory study of the acceptability and perceived value of electronic multi-compartment medication devices to inform a subsequent RCT of their effect on medication adherence.
Funder: Chief Scientist Office (Scotland)

Abstract: Poor adherence to medication is a major cause of morbidity and hospital admission for people with long-term conditions. People fail to adhere to treatments for many reasons, including failure of memory. In such scenarios, one solution is to use multi-compartment medication devices (MMDs). MMDs vary in form from refillable boxes to sophisticated electronic web-linked devices which alert patients when to take medicines and warn patients/carers if medication has not been taken or taken inappropriately. Such devices are now widely available and being promoted to patients and carers, but their efficacy has not been tested rigorously, such as in a randomised controlled trial. However, there are many challenges to running such a trial including: participant inclusion criteria, choice of the technology, acceptability of the intervention to patients, pharmacists and GPs, the choice of outcome measures, and ability to recruit participants. We propose an exploratory study of these issues.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: GENERIC HEALTH RELEVANCE
Title: Cascading knowledge about end of life care at home: the development and piloting of a training programme for those who help carers and a carer resource pack
Funder: Marie Curie

Abstract: Caregivers of patients approaching the end of life assume a great responsibility in ensuring that their relative or friend has appropriate care, often carrying out many aspects of care themselves. They often experience substantial difficulties; not least because the experience is likely to be unknown territory. This study seeks to provide an innovative means of addressing these issues by the development and piloting of a training programme for volunteers (who may include experienced or bereaved carers) as well as carer support workers, to enable them to cascade their learning to unpaid carers providing end of life care at home and to whom they provide mentorship and support. An associated resource pack will be developed for carers to enable reflection on their needs and access to relevant information judged as helpful by experienced carers (research partners: see below). The aims of the project are thus: • To develop and pilot a training programme for volunteers and support workers who help carers providing home based end of life care. The programme will use the domains of an evidence based carer support need assessment tool (CSNAT) as a framework. • To develop a resource pack for carers, (including the CSNAT tool) to enable them to identify and prioritise areas of need and facilitate discussion in each individual case of what support is most appropriate. We will draw on lessons learnt from development of a ‘peer’ education training programme in advance care planning for volunteers, published in 2011 by the National End of Life Care Programme and the National Council for Palliative Care. In addition, we will draw on our previous research relating to the Carer Support Need Assessment Tool for end of life practice at home (CSNAT), using the 14 items or ‘domains’ in the tool to structure the training programme. In addition, we will make the CSNAT available as a carer held tool in the associated carer resource pack. We will conduct the study in the Carers Federation Ltd, in East Midlands. We will work with bereaved carer ‘research partners’ in the project. The project will last for two years and include four phases of work: 1. Development of core resource pack for carers; training needs analysis among volunteers and support workers; 2. Development of the training programme for volunteers and support workers 3. Piloting of the training programme 4. Revision of the training programme; publishing training programme and resource pack; dissemination


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS;7.2 END OF LIFE CARE
Health categories: GENERIC HEALTH RELEVANCE