The successful candidate will be able to select one topic:
a) Adverse events associated with analgesic medication in adults aged 85 years and older: an electronic healthcare record study
Many older people have pain and there are different ways to help with this pain. Exercising or physiotherapy can help, however people aged 80 years and older (‘the oldest old’) cannot always take exercise or get to their physiotherapy appointments. Therefore, taking painkillers is sometimes the only option. Painkillers can have side effects (or harms) and the oldest old often have other health problems and take different medications as treatments which can worsen harms associated with painkillers. This project will consider opioids, including codeine and morphine. A large database of anonymous healthcare information from primary care will be used to thoroughly assess the harms of real-life opioid use in the oldest old. The study results will enable doctors to identify which patients are most at risk of harms from opioid use and help the safe prescribing and monitoring of opioids in the oldest old.
Informal enquiries: Milica Bucknall: [Email Address Removed]
b) Illness perceptions and outcomes in people living with gout
Gout affects 1 in 40 people and is mainly treated in primary care. What people think about their illness (illness perception) can affect how they manage their illness. It can also change over time. The overall aim of this PhD is to find out how illness perceptions affects gout. The student will perform a systematic review to find out what is known about gout illness perceptions already. They will then use data from a questionnaire study sent to people with gout at different points in time over five years. The questionnaire included questions about illness perception at each time-point. The student will use the information from the study to find out how illness perception affects things like gout flares, gout treatment, or other things (e.g. pain, quality of life). The student will then compare what they found in the UK study with other studies in New Zealand and Sweden.
Informal enquiries: Lorraine Watson: [Email Address Removed]
c) Evidence-informed self-management among older adults with musculoskeletal pain and comorbidities in underserved communities: A PhD in knowledge mobilisation
In the UK, over three million people aged 65 years and over live with joint pain along with other long-term conditions including depression and anxiety. Furthermore, health inequalities exist between older adults of different ethnicities, socio-economic groups, and geographies, leading to the need to adopt an intersectional lens for improving the health and well-being of older adults with self-management.
This PhD will focus on how best to support older adults (65yrs and over) with long-term joint pain and other long-term conditions to use current best-evidence to self-manage and to enhance their wellbeing and quality of life. The PhD is in three parts. Firstly, a stakeholder group will meet to discuss important aspects (eg community and social networks) to refine the focus of the PhD. The student will then undertake an ethnography inquiry to: (i) understand what influences how older people self-manage in communities, (ii) understand communities’ knowledge and experiences of health information and (iii) how knowledge is shared in community settings. Using these findings the student will coproduce with stakeholders, methods to facilitate the use of evidence-based information among older adults in community settings.
Informal enquiries: Opeyemi Babatunde: [Email Address Removed]
d) The impact of primary care clinical risk prediction tools on management to prevent new morbidity
Risk prediction rules are becoming increasingly recommended to identify patients at high risk of health events (such as heart attack), but it is not clear how much they are used in primary care or whether they lead to better care for high-risk patients. In the first part of the study, the student will summarise evidence from published research studies to determine:
i) how often risk prediction tools are used in primary care
ii) whether using these tools leads to more patients being offered suitable advice/ treatment
iii) whether such treatment options are mostly offered to patients at highest risk,
iv) whether using these tools reduces the number of patients suffering from future health events.
The second part of the PhD may take a qualitative, quantitative or mixed methods approach, and include interviews with GPs on their attitudes to, and use of, prediction tools, and/or analysis of primary care data to investigate further the use of these tools and their impact.
The student will work with an advisory group to agree which risk prediction tools to include in the review, to discuss and interpret findings, and formulate recommendations to increase optimal tool use.
Informal enquiries: Kelvin Jordan: [Email Address Removed]
e) Using Big Data to Understand Healthcare Utilisation by Patients with Fibromyalgia in English Primary Care
Fibromyalgia is a common long-term condition that is thought to result from abnormal levels of certain chemicals in the body’s nerves. People with fibromyalgia can experience many different symptoms. This means they often use many different healthcare services, undergo many tests for their symptoms with normal results, and are treated with lots of ineffective pain medicines. This can be frustrating and an ineffective use of limited healthcare resources. Understanding how to reduce excessive healthcare use in patients with fibromyalgia is important. Part 1 of this PhD will systematically look at all published studies examining healthcare use in people with fibromyalgia to see its overall levels, if it varies across countries, if it is changing over time, and if there are features that patients have that associate with high levels of healthcare use. Part 2 will look at a big dataset of anonymised medical records from across England to see if there are groups of people with fibromyalgia that have very high levels of healthcare service use over time. Part 3 will look in the Clinical Practice Research Datalink to see if treatment with an anti-depressant called “Duloxetine”, which has been shown to help pain in people with fibromyalgia, reduces how often they use healthcare services.
Informal enquiries: Ian Scott: [Email Address Removed]
Extended project descriptions/apply button can be found here: https://www.keele.ac.uk/study/postgraduateresearch/studentships/primarycaresciencesphdopportunities/
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