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Addressing the polypharmacy challenge in working-age adults


Project Description

Multimorbidity (the presence of two or more ongoing medical conditions) and polypharmacy (the use of five or more medications concurrently) increasingly affects working-age people, especially in socially disadvantaged groups. Previous research has shown that although the prevalence of multimorbidity increases with age, the absolute number of people with multimorbidity is higher in adults aged under 65. Amongst people living in the most deprived areas, the onset of multimorbidity occurs 10 – 15 years earlier than in the most affluent areas.
The PhD student will join the APOLLO-MM team and this project will extend the interests of the ongoing APOLLO-MM study (www.polypharmacy.org.uk) to adults of working age.

The successful student will conduct an in-depth, mixed-method, longitudinal ethnographic research study in which the focus is on observing the lives, experiences and ‘medicines work’ of patients (n = 12 – 14) living with multimorbidity in the community. The student will follow the lives of these patients over a period of 12-18 months, exploring the challenges they face, unpacking what ‘self-management’ means in this context and considering how the ‘burden of treatment’ impacts on adults of working age. The student will conduct ethnographic observations in patients’ homes and in other community and care settings. This will include accompanying patients to encounters with health and social care services to study their interactions with a wide range of agencies. We will import relevant social theory to analyse these in-depth case studies and inform the analysis and synthesis of a rich dataset.

The project is ethnographic in orientation and will involve a range of qualitative research methods. It will include: literature review; observations in which detailed ethnographic field notes are taken; in-depth narrative interviews; semi-structured interviews; creative ethnographic methods (e.g. the development and deployment of ‘cultural probes’ to facilitate patients in depicting their lives).
Aside from academic outputs (the PhD thesis and related academic publications and presentations) the project lends itself to the development of creative professional and patient/public resources to support medicines optimisation in the care of patients with complex needs.

All candidates should hold a Master’s qualification (or complete their Master’s by September 2019) in an appropriate discipline and have a minimum of a 2:1 or equivalent in their first degree. Applicants should preferably have knowledge of the UK health and care system. All applicants are required to have excellent written and verbal communication skills. They should also be willing to work collaboratively in multi-disciplinary and multi-professional teams.

Project-specific skills and experience required

Essential skills:
A good grasp of qualitative research methods and at least some experience of using qualitative methods (e.g. interviews)
Acceptance that this post necessarily involves travelling to research sites (SE England), fieldwork in homes and health settings, exposure to human subjects (who may be ill, confused or in distress) and working as a lone field researcher in unpredictable circumstances
Desirable skills:
Experience of ethnographic and/or participatory forms of research
Fluency in Bengali / Sylheti

Contact

For general enquiries, please email:
For project specific queries, please contact Prof Deborah Swinglehurst: or Dr Nina Fudge:

Applications

For applications and other information please visit our main NIHR CLAHRC North Thames funded PhD studentships page: https://www.findaphd.com/phds/program/nihr-clahrc-north-thames-funded-phd-studentships/?i274p2695

CLAHRC Research Area: Multimorbidity

Funding Notes

Start date: 01/10/19
Duration: 3 years, full time
Stipend: £17,803
Institution: QMUL

How good is research at Queen Mary University of London in Public Health, Health Services and Primary Care?

FTE Category A staff submitted: 20.61

Research output data provided by the Research Excellence Framework (REF)

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