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Identifying and quantifying the relative importance that patients attach to the outcomes of safe prescribing in primary care


   Faculty of Biology, Medicine and Health

  ,  Applications accepted all year round  Self-Funded PhD Students Only

About the Project

There are over 1.8 million serious prescribing errors in English general practices each year and hazardous prescribing is associated with substantial healthcare costs, reduced quality of life and increased risk of mortality.

This PhD is part of a research programme focusing on quantifying the economic impact of interventions to reduce hazardous prescribing in primary care, quantified by cost to achieve changes in quality-adjusted life-years (QALYs). Focussing on health status alone is likely to underestimate the value of interventions to patients and decision-makers.

Recent qualitative work suggests that what people consider important in safety extended beyond health status and included preventability and trust. Similarly, factors such as improving public trust and confidence influence local and national decision-makers when implementing services. Another component that may be important to patients is the concept of process utility, such as how the information about potential harms is communicated.

The aim of this PhD is to explore the relative importance to patients of safe prescribing, capturing health status, non-health benefits and process utility. This PhD will use stated preference methods (discrete choice experiments (DCEs) or best-worst scaling experiments (BWS)) to quantify the stated preferences of patients for the relative order of importance of different consequences possible when a medicine is prescribed more safely as a result of a general practice-based intervention.

This PhD will be based in the Manchester Centre for Health Economics (MCHE), School of Health Sciences. The supervisory team will include Rachel Elliott and Katherine Payne. Professor Elliott is an expert in the economics of safety and Professor Payne has expertise in in stated preference methodology.

The PhD student will be expected to:

· Carry out a literature review and critique of the published evidence

· Complete a qualitative interview-based study to develop the preference experiment.

· Design, execute and present analysis of a preference experiment.

Entry Requirements

Candidates are expected to hold (or be about to obtain) a minimum upper second class honours degree (or equivalent) in a related area/subject. Candidates with previous laboratory experience are particularly encouraged to apply.

How To Apply

For information on how to apply for this project, please visit the Faculty of Biology, Medicine and Health Doctoral Academy website (https://www.bmh.manchester.ac.uk/study/research/apply/). Informal enquiries may be made directly to the primary supervisor. On the online application form select PhD Health Economics.

For international students, we also offer a unique 4 year PhD programme that gives you the opportunity to undertake an accredited Teaching Certificate whilst carrying out an independent research project across a range of biological, medical and health sciences.

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/”


Funding Notes

Applications are invited from self-funded students. This project has a Band 2 fee. Details of our different fee bands can be found on our website View Website

References

1. Elliott RA, et al. Cost effectiveness of a pharmacist-led IT-based intervention with simple feedback in reducing rates of clinically important errors in medicines management in general practices (PINCER) Pharmacoeconomics 2014; 32:573-590. DOI: 10.1007/s40273-014-0148-8
2. Elliott RA, Camacho E, Jankovic D, Sculpher MJ, Faria R. Economic analysis of the prevalence and clinical and economic burden of medication error in England. BMJ Quality & Safety. 2021;30:96-105. dx.doi.org/10.1136/bmjqs-2019-010206
3. Rhodes, P., et al., Sensemaking and the co-production of safety: a qualitative study of primary medical care patients. Sociology of Health & Illness, 2016. 38(2): p. 270-285. 4. Payne K.Vass C, Wright SJ, Burton M & Payne K. Scale Heterogeneity in Healthcare Discrete Choice Experiments: A Primer The Patient 2018 DOI: 10.1007/s40271-017-0282-4
5. Dalal G, Wright SJ, Vass CM, Davison NJ, Vander Stichele G, Smith CH, Griffiths CEM, Payne K. Patient preferences for stratified medicine in psoriasis: a discrete choice experiment. British Journal of Dermatology 2021; 185(5):978-987

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