The Old School

The Practice is currently involved in the following Research Trials:

 

EARLY ARTHRITIS - There is accumulating evidence for the need to identify patients with rheumatoid arthritis (RA) early. Damage occurs early and early treatment is effective. Clearly there is a need to improve ways of identifying these patients. It is recognised that patients with RA often have non-specific musculoskeletal complaints in the months or years prior to development of RA (unpublished observations). Family members of patients with RA are also at greater risk of developing RA. Given we know that earlier identification of patients enables earlier treatment and this leads to better long-term outcomes, we need a method of identifying patients at the pre-clinical stage of disease.

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HEAT- (Helicobacter Eradication Aspirin Trial) is a large simple double-blind placebo controlled outcomes study of Helicobacter pylori (H. pylori) eradication to prevent ulcer bleeding in aspirin users. This trial is funded by the National Institute of Health Research Health Technology Assessment (NIHR HTA) Programme. Aspirin use is widespread and increasing in elderly patients. The main hazard is gastrointestinal bleeding, which may be increasing because of increasing aspirin use. This trial is based on evidence that peptic ulcer bleeding in aspirin users occurs predominantly in H. pylori positive people. Patients will be identified by their GPs, and then asked to attend an appointment with a Nurse to consent to the trial and take a H. pylori breath test. Those with a positive result will be randomised to receive a one week course of either eradication treatment or placebo. No follow-up visits are required, but instead information will be extracted from the patients' electronic medical record using the MI Quest search tool.

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PANDA – What are the indicators for prescribing AntiDepressAnts that will lead to a clinical benefit? Each year, millions of people visit their General Practitioner (GP) with depression and are given medication called antidepressants. However, doctors are still not certain when some people with depression might benefit from antidepressants or whether they would get better without. So there is a concern that some people might be prescribed antidepressants when it is not really necessary. We want to test the hypothesis that the severity and duration of depressive symptoms predict the response to antidepressants. If this is confirmed it could then be used to generate much more specific guidance about when antidepressants are likely to be of benefit. The aim of the PANDA randomised controlled trial is to investigate the severity and duration of depressive symptoms that are associated with a clinically important response to SSRI antidepressants in people with depression. We will carry out a randomised controlled trial comparing sertraline to placebo in individuals with depression whom the patient and their GP are unsure whether an SSRI is indicated.

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REACT – this is an online study to compare the effectiveness of a Relatives Education And Coping Toolkit (REACT) with an online Resource Directory. Half the people in the study will receive the REACT toolkit, and half will receive the Resource Directory. REACT is a free online toolkit for relatives (or close friends) of people with psychosis or bipolar disorder. It contains lots of information, strategies to manage common problems and stories from other relatives about their experiences. Through the site you can also contact a REACT Supporter who is a trained relative who can provide additional support. There is also an online forum (REACT Group) where you can talk directly with other relatives using the site. We are looking for relatives or close friends of people with psychosis or bipolar disorder to take part. We would like to invite you take part if the following applies to you: Aged 16 and over, A relative or close friend of someone with psychosis or bipolar disorder, Living in the UK, A good knowledge of written and spoken English language, Regular access to a computer which is connected to internet, Willing to engage with online support for distress linked to your supporting role.

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TIME - Treatment In Morning versus Evening Study. Patients traditionally take their blood pressure lowering tablets in the morning and blood pressure is traditionally measured at some time during the working day. Most of the current evidence that shows the benefits to patients of reducing their blood pressure comes from studies where tablets were taken in the morning and BP was measured in the daytime.  In recent years, special monitors that can measure blood pressure throughout the day and the night have been developed. Results from studies using these monitors have suggested that night time blood pressure might be a better measurement of the benefits of blood pressure lowering. In addition, tablets taken at night lower night-time blood pressure more than tablets taken in the morning. The big question is, would night time dosing be better (or worse) than morning dosing in preventing the bad things associated with high blood pressure (such as strokes and heart attacks)? The present study will try to answer this question. To do this we are asking patients who take medicines for high blood pressure to take part in a study that will compare morning dosing (some time between 6am and 10am) with night-time dosing (some time between 8pm and midnight). For further information refer to-  https://www.timestudy.co.uk