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Update on Current Vascular Research

This update highlights the ongoing vascular research at the University Hospital of South Manchester and the University of Manchester. Under the leadership of Professor Christi Deaton, the research focuses on major health issues like heart disease, diabetes, stroke, and kidney disease. The CLAHRC initiative aims to transform research into improved healthcare practices, addressing the needs of diverse populations and emphasizing patient self-management. Collaborative efforts strive to enhance the quality of care through innovative, nurse-led strategies and evidence-based approaches.

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Update on Current Vascular Research

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  1. Update on Current Vascular Research Christi Deaton Professor of Nursing University Hospital of South Manchester NHS FT School of Nursing, Midwifery & Social Work The University of Manchester

  2. Vascular Research • Broad area of research • Heart disease • Diabetes • Stroke • Kidney disease • Focus on: • CLAHRC (implementation) • Examples of nurse-led cardiovascular research

  3. Greater Manchester CLAHRC • Collaborations for Leadership in Applied Health Research and Care • Innovative programme from NIHR • The NIHR CLAHRC for Greater Manchester is a collaboration of Greater Manchester NHS Trusts and the University of Manchester • Conduct high quality health services research • Ensure knowledge gained from the research is translated into improved health care in the NHS “Knowledge Transformation”

  4. Greater Manchester Why CLAHRCs? • Aim to provide high quality research and apply it! • Addressing Cooksey’s second translational gap • Major problem in the health service re “know how” • Evaluative component

  5. CLAHRC in UK • Nine approved CLAHRCs in England • Manchester, Birmingham, Leeds/York, Leicester, Exeter/Peninsula, London-Imperial, Sheffield, Nottingham, Cambridge. • Each receives £10 million over 5 years from the NIHR alongside £10 million in ‘matched funds’ • Began in October 2008

  6. NIHR CLAHRC • Director Bonnie Sibbald • Deputy Director Ruth Boaden • Vascular disease focus • Major health problem in GM • Expertise in the University • Stroke, Kidney, Heart, Diabetes • Aims to improve the quality of care and the health of citizens suffering from these conditions

  7. Greater Manchester The WISE Approach WISE: Whole-system Informing Self-management Engagement

  8. People with Long Term ConditionsResearch Theme 1. Anne Rogers, Carolyn Chew-Graham • Develop new information resources to support patient self-management in diabetes, kidney and heart disease. • Adapt these resources to the needs of people living in poverty. • Assess cost and effectiveness through randomised controlled trials.

  9. Health Care PractitionersResearch Theme 2. Linda Gask, Christine Bundy & Chris Dickens • Develop better approach to the management of depression in patientswith diabetes and heart disease. • Adapt this approach to meet the needs of people from ethnic minority groups. • Assess cost and effectiveness through randomised controlled trials.

  10. Health Care ServicesResearch Theme 3. Kinta Beaver • Develop patient-led access to specialist care for people with diabetes and kidney disease. • Adapt these to the needs of people from ethnic minority groups. • Assess cost and effectiveness through randomised controlled trials.

  11. Health Information SystemsResearch Theme 4. Iain Buchan • Use existing NHS information systems to- • Map clinical care pathways • Measure inequalities • Develop simulation models to assess impacts of planned interventions on cost and quality of care.

  12. CLAHRC Implementation • Stroke – Pippa Tyrrell (Salford) • Diabetes – Martin Gibson (Salford) • Chronic Kidney Disease – Donal O’Donoghue/Janet Hegarty (Salford) • Heart Disease – Christi Deaton (UHSM/UoM)

  13. Academic Partners

  14. Model for Improvement and Promoting Action on Research • Implementation in Health Services” (PARiHS) framework * Implementation Strategy Evidence-based framework* for change • Agree the goals of change • Determine how attainment of these goals will be measured • Identify what changes should be made to attain the goals • Implement change using Plan-Do-Study-Act cycles • Sustain and spread the change

  15. Implement Research Theme output

  16. Stroke Implementation of national stroke strategy • Work with emergency services to ensure people with acute symptoms are triaged without delay to specialist stroke centres • Develop patient-centred management plans to support people through the sequelae of stroke / TIA, and prevent future vascular injury and death.

  17. Greater Manchester Diabetes Improve access and quality of care • Nurse-led call centre management with regular proactive telephone advice • Nurse-led specialist ambulatory care clinic for people with hypertension and hyperlipidemia.

  18. Chronic Kidney Disease Improve general practice management • Local adaptation of national clinical guidelines, including referral protocols to specialist care • Training for nurses and GPs in chronic kidney disease management • Educational outreach by hospital specialists

  19. Heart Disease Improve access and quality of care • Decrease stroke risk in AF through early diagnosis (pulse checks) and anti-coagulation management • Improve MDT management of chronic heart failure (CHF) • Optimal doses ACEI/ARB and BB • Discharge planning and follow-up

  20. Implementation Sites

  21. Patient and Public Engagement • Research themes • Patient consultation and participation • Implementation themes • Patient consultation through new/existing patient engagement networks • Governance • Patient representation on Steering Group • Wider engagement • Public dissemination of findings • Public debate/scrutiny:- use of NHS information resources for research

  22. Step Change Implementation • Large-scale sustained knowledge transfer between University and NHS. • Increased capacity in the NHS to plan and implement evidence-based changes to service delivery • Inputting into commissioning

  23. Other Vascular Research….

  24. Examples of Nurse-Led Research in Cardiovascular • Predictors of Impaired health related QoL in patients receiving thrombolysis or primary PCI • Linda McGowan, Chris Dickens, Heather Iles-Smith, Cat Rogers, F. Fath-Ordoubadi • 6 Month Interim Findings • Winner of best poster abstract at 9th Annual Spring Meeting on Cardiovascular Nursing, Dublin, April 2009 (presented by Cat Rogers) • Council on Cardiovascular Nursing and Allied Professions (CCNAP) of the European Society of Cardiology

  25. Doctoral Student Research • An investigation of the role of anxiety and depression on representation rates post Primary PCI for STEMI • Heather Iles-Smith • The impact of anxiety on health status and quality of life of patients with heart failure • Katherine Easton

  26. Doctoral Student Research • The relationship between self-care and health related QoL in adult patients with dilated cardiomyopathy • Maria Kaprana • An investigation into the factors that facilitate early help-seeking behaviour for CHD related conditions among Chinese Elders in NW England • Zhenmi Liu

  27. Conclusions • Number of ongoing and developing projects • Opportunities for research development and involvement connected to the CLAHRC programme and other studies

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