Exeter Collaboration for Primary Care (APEx) seminars – summer 2015

Posted by jchoules

22 July 2015

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The summer term of monthly APEx seminars has come to an end with our usual mix of an external speaker, an internal speaker and a joint one with two ‘junior’ researchers giving shorter seminars within the hour. These were all presented by the organiser of this series, Professor Jose M Valderas, Professor of Health Services & Policy Research, University of Exeter Medical School (UEMS).

We started the series in April with several of the  UNTEST team (part of PenCLAHRC[i]) giving presentations,  led  by Professor Chris Hyde and Dr Bijay Vaidya talking on “Ordering of thyroid function tests in primary care – is six-fold variation too much and should we do anything about it?” The team shared the findings of various investigations and considered the nature of any further research on how to reduce variation in routine test ordering with a view to taking this forward in the South West if there is support.

We followed this up in May with a seminar by Professor Chris Dickens, APEx member and Head of the Primary Care Mental Health Group, UEMS,  speaking on “The challenges of integrating primary care for people with physical and psychological health problems”. He told his audience that there have been many calls for the integration of physical and psychological primary healthcare to improve patient outcomes. Chris presented his research conducted with colleagues in the Practitioner theme of the Greater Manchester CLAHRC, which aimed to develop and evaluate a collaborative care intervention for people with coronary heart disease and diabetes. Chris also discussed whether full integration of physical and psychological healthcare is possible or even desirable on a large scale in primary care, or whether we should settle for care that is coordinated rather than integrated.

The third seminar in June was given by two local UEMS researchers:The first was Sarah Bailey who works within APEx’s Primary Care Diagnostics Group, headed up by Professor Willie Hamilton. Sarah was presenting her research work (also her PhD work) on “Thrombocytosis: an important marker of cancer in primary care?”. Sarah presented work from this prospective cohort study which aimed to investigate, in patients with raised platelet count in primary care, what is the risk of cancer, and which cancers are diagnosed? The study used electronic primary care records from the UK Clinical Practice Research Datalink (CPRD) database. 40,000 patients aged > 40 years with a platelet count of over 400,000/µl were included in the main cohort, alongside an age and sex matched comparison cohort of 10,000 patients with normal platelet counts. The results of this study will be of use in a primary care setting, for practitioners receiving a blood count unexpectedly showing thrombocytosis. Further analyses with these data will examine the level of raised platelets at which further investigation for cancer is warranted, with a view to developing an automatic alert on laboratory results showing thrombocytosis.

The second part of the slot was given by Dr Lindsey Anderson who works in APEx’s Cardiovascular Risk and Assessment Group, led by Professor Rod Taylor. She talked about the work involved in Cochrane reviews in a talk entitled “Cochrane cardiac rehabilitation reviews – working with Cochrane: lessons learned”. She provided an overview of the current portfolio of Cochrane reviews in the area of cardiac rehabilitation, and the plans for maintaining and updating this portfolio. Lindsey also highlighted some of the benefits and pitfalls of working with the global Cochrane collaboration.

The next series starts on 17 September with Professor Chris Salisbury from the Academic Unit of General Practice, University of Bristol, speaking on “Multimorbidity: designing health care for the people who use it”. For further details.

[i] The National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South West Peninsula

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