(BRC) Development of digital tool measuring exposure and impact of medications in patients with musculoskeletal conditions


   Faculty of Biology, Medicine and Health

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  Dr Meghna Jani, Dr Pauline Whelan, Dr J McBeth  No more applications being accepted  Competition Funded PhD Project (Students Worldwide)

About the Project

Prescription drugs are an integral component of healthcare worldwide. People diagnosed with chronic conditions often require optimal drug therapy to achieve the best clinical outcomes and health-related quality of life. Whilst research studies using electronic health records and clinical trials provide information on what medicines have been prescribed, only the patient themselves can report if they have administered the medication, at what dose and interval. For medications associated with a high risk of harms, several interactions and often used ‘as required’ by the patient, measuring medication exposure directly from patients is especially important from a medication safety perspective. In conditions such as rheumatoid arthritis where drug doses are often escalated or tapered, development of such a tool has the potential to support future digital interventions and self-management.

An example of one class of such medications are opioids that are prescribed for pain across several conditions and available over the counter. People living with rheumatic and musculoskeletal diseases (RMDs) are frequently prescribed opioids to manage pain. Our previous work evaluating 841,047 UK patients found that there is a high frequency of long-term opioid use across several RMDs (up to 1 in 3 fibromyalgia patients; 1 in 4 rheumatoid arthritis patients, in those starting opioids). These medicines are often prone to divergence (e.g., taking a partner’s medication to help with pain symptoms), however it is not possible to quantify this from traditional data sources. Opioids often are used in combination with each other; however, our previous PPIE work has revealed patients are often unaware of what dose thresholds may be associated with serious harms. Biologic drugs are another example of medicines prescribed across several inflammatory conditions. A digital tool to measure patient reported medication exposure would help support the patient with drug tapering and adherence to such high-cost drugs.

The aim of the PhD will be to co-design and test a digital prototype that will allow patients to self-report specific medications they are taking, at what dose and frequency, longitudinally. The prototype will be designed such that it could support future digital interventions, population health research, patient self-management and adherence assessment alongside clinical care.

Objectives:

1.   Perform a systematic review evaluating available mobile health applications/ digital devices that capture medication exposure longitudinally

2.   Lead focus groups with patients and clinicians to ascertain priorities, barriers/ facilitators to engagement prior to designing the tool

3.   Co-design a digital prototype with patients

4.   Mixed methods evaluation of the digital prototype to assess usability and acceptability 

https://www.research.manchester.ac.uk/portal/meghna.jani.html

https://research.manchester.ac.uk/en/persons/pauline.whelan

https://research.manchester.ac.uk/en/persons/john.mcbeth

Others:

Centre for Epidemiology Versus Arthritis: http://www.cfe.manchester.ac.uk/

Division of Informatics, Imaging & Data Sciences: https://www.research.manchester.ac.uk/portal/en/facultiesandschools/division-of-informatics-imaging--data-sciences(3508b831-4d64-4f79-8790-a50df943742c).html

Before you Apply 

Applicants must make direct contact with the primary supervisor before applying to discuss their interest in the project. It is your responsibility to make arrangements to meet with potential supervisors, prior to submitting a formal online application.  

How to Apply 

To be considered for this project you MUST submit a formal online application form - full details on how to apply can be found on the BRC website https://www.bmh.manchester.ac.uk/study/research/funded-programmes/manchester-brc-phd-studentships/ 

Your application form must be accompanied by a number of supporting documents by the advertised deadlines. Without all the required documents submitted at the time of application, your application will not be processed and we cannot accept responsibility for late or missed deadlines. Incomplete applications will not be considered. If you have any queries regarding making an application please contact our admissions team  FBMH.doctoralacademy.[Email Address Removed]  

Equality, Diversity and Inclusion  

Equality, diversity and inclusion is fundamental to the success of The University of Manchester, and is at the heart of all of our activities. The full Equality, diversity and inclusion statement can be found on the website https://www.bmh.manchester.ac.uk/study/research/apply/equality-diversity-inclusion/  

Computer Science (8) Mathematics (25) Medicine (26)

Funding Notes

This studentship covers tuition fees and stipend and is open to both the UK and international applicants. We are able to offer a limited number of studentships to applicants outside the UK. Therefore, full studentships will only be awarded to exceptional quality candidates, due to the competitive nature of this scheme.

References

1) Huang YT, Jenkins DA, Peek N, Dixon WG, Jani M. High frequency of long-term opioid use among patients with rheumatic and musculoskeletal diseases initiating opioids for the first time. Ann Rheum Dis. 2023 Aug;82(8):1116-1117.
2) Jani M, Birlie Yimer B, Sheppard T, Lunt M, Dixon WG. Time trends and prescribing patterns of opioid drugs in UK primary care patients with non-cancer pain: A retrospective cohort study. PLoS Med. 2020 Oct 15;17(10):e1003270.
3) Lewis S, Ainsworth J, Sanders C, Stockton-Powdrell C, Machin M, Whelan P, et al. Smartphone-Enhanced Symptom Management In Psychosis: Open, Randomized Controlled Trial. J Med Internet Res. 2020 Aug 13;22(8):e17019.
4) Bucci S, Varese F, Quayle E, Cartwright K, Machin M, Whelan P et al. A Digital Intervention to Improve Mental Health and Interpersonal Resilience in Young People Who Have Experienced Technology-Assisted Sexual Abuse: Protocol for a Nonrandomized Feasibility Clinical Trial and Nested Qualitative Study. JMIR Res Protoc. 2023 Mar 21:12:e40539.
5) Wildman MJ, O’Cathain A, Hind D, Maguire C, Arden MA, Hutchings M, Bradley J, Walters SJ, Whelan P, Ainsworth J et al. An intervention to support adherence to inhaled medication in adults with cystic fibrosis: the ACtiF research programme including RCT. Southampton (UK): NIHR Journals Library; 2021 Oct. Programme Grants for Applied Research.
6) McBeth J, Dixon WG, Moore SM, Hellman B, James B et al. Sleep Disturbance and Quality of Life in Rheumatoid Arthritis: Prospective mHealth Study. J Med Internet Res. 2022 Apr 22;24(4):e32825.
7) Gandrup J, Selby DA, van der Veer SN, Mcbeth J, Dixon WG. Using patient-reported data from a smartphone app to capture and characterize real-time patient-reported flares in rheumatoid arthritis. Rheumatol Adv Pract. 2022 Mar 16;6(1):rkac021.doi: 10.1093/rap/rkac021
8) Ali SM, Lee RR, McBeth J, James B, McAlister S, Chiarotto A, Dixon WG, van der Veer SN. Exploring the Cross-cultural Acceptability of Digital Tools for Pain Self-reporting: Qualitative Study. JMIR Hum Factors. 2023 Feb 8:10:e42177. doi: 10.2196/42177.
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