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80c8b1b5-2419-49ee-b01f-71cd4ac37e9f ARC Wessex programme of research on Medicines Optimisation (MODIFY SPiDeR STOP-DEM) For further information please see the links below MODIFY : The development and iMplementation Of a multidisciplinary medication review and Deprescribing Intervention among Frail older people in primarY care SPiDeR Social Prescribers In Deprescribing Role STOP-DEM : Development of a structured deprescribing intervention for people with dementia or mild cognitive impairment in primary care

aeb3153c-5d74-4046-b64a-afed7e369f76 Understanding the Networks, Effects and Teams involved in Community Alternatives to ACute Hospitalisation for Older People in Hampshire and Isle of Wight Region – CAtCH-NET Chief Investigator: Dr Natalie Cox, NIHR Academic Clinical Lecturer Geriatric Medicine, Academic Geriatric Medicine, Faculty of Medicine, University of Southampton Team: Dr Stephen Lim, Principal Clinical Research Fellow, Academic Geriatric Medicine, Faculty of Medicine, University of Southampton & Honorary Consultant Geriatrician University Hospital Southampton NHS FT Dr Sara McKelvie, NIHR Clinical Lecturer Primary Care Research, Primary Care Research Centre, Faculty of Medicine, University of Southampton Dr Carole Fogg, Senior Research Fellow, School of Health Sciences, University of Southampton Start: 1 October 2024 End: 31 March 2026 Partners: Hampshire and Isle of Wight NHS Healthcare Foundation Trust, Isle of Wight NHS Trust, Portsmouth Hospitals University NHS Trust, University Hospital Southampton NHS Foundation Trust, University of Southampton Background Many older people within Hampshire and Isle of Wight (HIOW) live with several health conditions. These may suddenly worsen, requiring rapid assistance from healthcare professionals. Often it is best to provide this in the person’s own home, so urgent community-based services have expanded. Despite this, many older people attend hospital within HIOW. Some are discharged within 24 hours, indicating they too might be better managed at home. Therefore, increasing home support is a priority. To achieve this, we need to understand how urgent care services for older people are currently working. Aim To understand current use of urgent care services for older people in HIOW ICS, alongside factors that promote or hinder provision. Objectives 1. To establish the priorities of key stakeholders. 2. To describe the attributes of older people who are discharged within 24 hours from hospitals, who are seen by specialist teams for older people early in their arrival. 3. To explore experiences of healthcare professionals and patients regarding urgent care services for older people. 4. To learn the type and amount of data routinely collected within urgent community-based care services for older people within HIOW and whether we can link this together, to understand care pathways older people may experience. Design We will initially conduct workshops to engage and discuss with key people who commission and plan healthcare, to identify the key regional priorities within the scope of the project. We will use routinely collected information from the hospitals with urgent specialist services for older people and perform statistics to describe the service use and the types of patients supported by them. Working together with data analysts, we will scope out and report on the types of data collected by community services. We will interview healthcare staff who refer into, or work within, the urgent services and patients who have used them. We will analyse the transcripts to give an account of their experiences of the services. Patients and public Members of the public have advised on the initial study outline and will be members of the study group. They will give input on study materials and interview questions and aid in interpreting results, as well as guiding the best ways to share our findings for a public audience. Dissemination Our results will describe the older people aided by urgent community-based services and those attending hospital who might be managed at home. It will describe factors that promote or hinder support at home. We will share findings within the region, topublicisethe healthcare work in urgent care for older people. This will improve knowledge and aid in service design and delivery.

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Pharmacological And Non-Pharmacological treatment of ADHD in Pre-schoolers: a systematic review and network meta-analysis: the PANPAP study Lead applicant: Professor Samuele Cortese Co-applicants: Andrea Cipriani, Corentin Gosling, Luis Farhat, Cinzia Del Giovane Background: Children with Attention-Deficit/Hyperactivity Disorder (ADHD) have problems with attention and need to move more than most children. About 5% of school-aged children and 2% of pre-schoolers have ADHD, respectively. This translates into almost 10,000 pre-schoolers with ADHD in the South West England area. Interventions for ADHD include pharmacological and non-pharmacological treatments. When not treated, ADHD entails a significant burden to society, estimated at more than £20,000 per year. Therefore, it is important to detect and treat ADHD in the early years to prevent the negative consequences of ADHD later in life. Experts and ADHD support groups agree that the NHS does not meet the needs of pre-schoolers with ADHD. Currently, there are either long waiting lists or no services for pre-schoolers with ADHD in the NHS. To provide the best care for pre-schoolers with ADHD, we need to make sure that the NHS offers treatments that work well and are safe. In 2018, the National Institute for Health and Care Excellence (NICE) recommended mainly non-pharmacological interventions (behavioral interventions) for the treatment of pre-schoolers with ADHD. Back then, there was a paucity of studies on other non-pharamcological interventions and on medications for ADHD in pre-schoolers. Since 2018, there has been an increasing number of studies on other types of interventions (e.g., family-based interventions and diet) and on medications. There has also been an increasing trend in some countries (e.g., USA) to use medications for pre-schoolers with ADHD. Therefore, we need to understand which is the best intervention for pre-schoolers with ADHD. Aim: To compare the efficacy and safety of pharmacological and non-pharmacological interventions for ADHD in pre-schoolers. Methods: We will not do a new study, which would be very expensive. Rather, we will use a new type of research, called “network meta-analysis”. This approach uses data from available studies to compare different types of treatments even when they have not been compared directly in the individual available studies. Therefore, we will first systematically search for published and unpublished studies of any pharmacological or non-pharmacological treatment for pre-schoolers with ADHD. We will then combine the information from these studies with a state-of-the-art statistical approach. We will finally assess the quality of the studies included in the analysis and the strength of the evidence that we will generate. We are well known experts in this type of research. The study will be conducted at the University of Southampton, in collaboration with international researchers, including a statistician with renowned expertise in this type of analysis. Impact: The findings of our research are expected to inform future regional, national and international guidelines on the treatment of ADHD in pre-schoolers. As such, our results will be disseminated to local commissioners and policy makers, NICE, and international guidelines groups such as the European ADHD Guidelines Group. We will also disseminate our findings to associations of families with children with ADHD in the Wessex area, at the national (for example, National Attention Deficit Disorder Information and Support Service, ADDISS), and international level (ADHD Europe). Read all Mental Health Hub projects

b369496b-453f-489e-9d44-7a954ac3f6d7 COMPLETED: Symptoms, Trajectory, Inequalities and Management: Understanding Long-COVID to Address and Transform Existing Integrated Care Pathways (STIMULATE) This project is part of a national consortium Contact: Professor Nisreen Alwan MBE , University of Southampton Currently in England, there are 90 specialist Post Covid services in which assessment and treatment of Long Covid, and other complications of COVID-19, are informed by NICE guidelines and growing expertise in the field. However, there is evidence that access to such clinics and related care pathways, the nature of those pathways, and patient experience, varies. Research is required to inform diagnosis, care, public health strategies, policy planning, resource allocation and budgeting. It is likewise essential to define the usual care pathway in Post Covid services, and to understand patient presentation, and the effectiveness and cost of care. The STIMULATE-ICP consortium includes: University College London Hospitals NHS Trust, University College London, University of Central Lancashire, LongCovidSOS, UK Doctors #Longcovid , Royal College of General Practitioners, University of Liverpool, Liverpool University Hospitals Foundation Trust, Perspectum, Living With, University of Hull, Hull University Teaching Hospitals Trust, University of York, University of Leicester, University of Exeter, University of Southampton, University of Sussex, Alliance Medical, GE Healthcare, Olink, Francis Crick Institute, NIHR Applied Research Collaboration South West Peninsula, NIHR Applied Research Collaboration East Midlands, NIHR Applied Research Collaboration North Thames, NIHR Applied Research Collaboration Yorkshire and Humber, NIHR Applied Research Collaboration North West Coast, British Heart Foundation Data Science Centre, BHF Data Science Centre, Health Data Research UK, Office of National Statistics, Royal Devon and Exeter NHS Trust, as well as NIHR Clinical Research Network support. Plain English Summary of findings: 23 interviews were completed with people with probable Long Covid We found… There was a lack of awareness of Long Covid, its symptoms and the support available for people with Long Covid An assumed lack of awareness of Long Covid within healthcare People with Long Covid symptoms experienced doubt and uncertainty about the cause of their symptoms Experiences of stigma and discrimination were commonly experienced by people with probable Long Covid. This included experiences of age and gender discrimination, experiences of being dismissed, unsympathetic attitudes and social exclusion. People with probable Long Covid reported feeling embarrassment, feeling tainted and/or different to others because of their Long Covid symptoms. In addition, they expected disbelief and/or judgement from others because of Long Covid People with Long Covid were sometimes reluctant to seek care due to worries surrounding possible investigations and medications, or worries about symptoms being wholly attributed to mental health conditions. There were also concerns about burdening the NHS. The nature of Long Covid symptoms made accessing care difficult. Long Covid symptoms can often come and go or fluctuate, and sometimes one symptom may be more prominent than others. This can mean some symptoms can be overlooked by patients and healthcare professionals. Experiences of people with Long Covid are also constitute epistemic injustice, or inequality surrounding creating, interpreting and conveying knowledge. This is due to the lack of awareness and knowledge of Long Covid both in the community and within healthcare. What we did Research findings from this study and the NIHR funded HICOVE study have been translated into an easily-usable webtool. This tool aims to encourage people with probable Long Covid who have not yet sought help and support from the NHS or other services to do so. It covers topics of self-doubt, stigma and effects on mental health as well as offering resources, tips, and advice on next steps. This tool is primarily aimed at people who may have Long Covid but are not currently accessing care but may also be helpful to those who are. It is also aimed at healthcare professionals, social prescribers, as well as community organisations to raise awareness about the difficulties and stigma people, particularly those from disadvantaged backgrounds, may face when considering reaching out for a consultation or community support. The webtool is available here: Supporting Long Covid Care ( long-covid-care.org.uk ) Where next? We are working on disseminating the Supporting Long Covid Care webtool as widely as possible. We will create an offline version of the tool so this is accessible to people who are not ‘online’. We will also include translations of this into community languages. This will be available to download from the website and from community organisations. We are also looking at ways to evaluate the webtool. See our news article

Checklist, webinar and resources Project Outputs Buy-in and Engagement Fit with Health and Social Care Systems Alignment with Health and Social Care Priorities Outcomes and Impact Adoption and Spread Checklist, webinar and resources Quick links: The ARC Wessex Implementation Team have developed a process to assess the implementation factors of ARC projects outputs. Our Implementation Checklist assesses how far research teams have considered implementation and enables us to determine the level of input we need to provide to support the implementation process. The checklist comprises six domains representing key elements in the process leading to implementation. Within each domain there are a set of statements addressing different aspects of this process and the conditions required for implementation. In addition, there are several questions which are intended as prompts to help make the assessment. To complete the checklist, think about your project and consider each statement within the domain and its accompanying question(s). Decide if you agree or disagree with the statement by placing a tick in the relevant column. You should also think about the evidence you have to support your response and details of this should be provided in the last column. If you have questions about the checklist email, please send these to arcwessex@soton.ac.uk addressed to the “Implementation Team” Complete the evaluation survey implementation checklist Implementation Checklist The ARC Wessex Implementation Team have developed a process to assess the implementation factors of ARC projects outputs. Our Implementation Checklist assesses how far research teams have considered implementation and enables us to determine the level of input we need to provide to support the implementation process. The checklist comprises six domains representing key elements in the process leading to implementation. Within each domain there are a set of statements addressing different aspects of this process and the conditions required for implementation. In addition, there are several questions which are intended as prompts to help make the assessment. To complete the checklist, think about your project and consider each statement within the domain and its accompanying question(s). Decide if you agree or disagree with the statement by placing a tick in the relevant column. You should also think about the evidence you have to support your response and details of this should be provided in the last column. If you have questions about the checklist email, please send these to arcwessex@soton.ac.uk addressed to the “Implementation Team” Download implementation checklist Learn more about implementation checklist Download implementation checklist Download the poster Introduction to Implementation - Dr David Kryl (video) Virtual workshop recorded in October 2020 (video) Use the Web-based Implementation Toolkit Video gallery Video gallery Implementation resources Bitesize guides to Implementation Bitesize guides to Implementation Play Video Play Video 10:12 Implementation Bitesize session 1- Dr David Kryl Implementation bitesize 1 - An introduction to Implementation by Dr David Kryl (10 minutes) Play Video Play Video 15:29 Implementation presentation Session 2 Dr Michelle Myall Implementation bitesize 2 - Implementation Science and Frameworks by Dr Michelle Myall Play Video Play Video 09:51 Implementation bitesize 3 - Checklist by Cindy Brooks Implementation bitesize 3 - Checklist by Cindy Brooks (10 minutes) Play Video Play Video 13:48 Implementation Bite size 4 Q & A.mp4 The ARC Wessex Implementation team answers your questions Implementation Checklist Play Video Play Video 10:54 Introduction to Implementation - Dr David Kryl Introduction to Implementation - Dr David Kryl (video) Play Video Play Video 01:15:22 Virtual workshop recorded in October 2020 Virtual workshop recorded in October 2020 (video) Summer Series 2021 Summer series 2021 Play Video Play Video 19:54 Summer Series Session 1: Study Outputs, Buy in & Engagement Cindy Brooks and Dr Michelle Myall explain Implementation in a series of summer sessions Live Q & A session Thursday 7th October 12.00pm Play Video Play Video 15:31 Summer Series Session 2: Fit and alignment with health and social care systems & priorities Summer Series Session 2: Fit and alignment with health and social care systems & priorities by Dr Michelle Myall and Cindy Brooks Play Video Play Video 11:12 Summer Series Session 3: Outcomes and Impact and Adoption and Spread Cindy Brooks and Dr Michelle Myall explain Implementation in a series of summer sessions Live Q & A session Thursday 7th October 12.00pm

dcda912e-45e2-47ca-a777-aad1c26161d1 ADOPTED PROJECT: Supported remote rehabilitation post Covid-19 COMPLETED: Development, deployment, and evaluation of a digitally enabled rehabilitation programme Chief Investigator: Professor Elizabeth Murray – University College London, Dr Henry Goodfellow – University College London Institute of Epidemiology & Health Care Project Team Members: Dr Katherine Bradbury – University Of Southampton, Dr Stuart Linke – Camden & Islington NHS Foundation Trust, Mr Chris Robson – University College London, Professor Fiona Stevenson – University College London Institute of Epidemiology & Health Care, Dr Manuel Gomes – University College London Institute of Epidemiology & Health Care, Dr Fiona Hamilton – University College London Institute of Epidemiology & Health Care, Professor Ann Blandford – University College London, Professor John Hurst – University College London, Professor Delmiro Fernandez- Reyes – University College London, Professor William Henley – University of Exeter Medical School, Dr Melissa Heightman – University College London Hospitals NHS Foundation Trust, Dr Paul Pfeffer – Barts Health NHS Trust, Dr William Ricketts – Barts Health NHS Trust, Ms Hannah Hylton – Barts Health NHS, Trust Dr Richa Singh – Barts Health NHS Trust, Ms Julia Bindman – Patient and Public Involvement contributor based in England. Publication: October 2025 - D esign and deployment of digital health interventions to reduce the risk of the digital divide and to inform development of the living with COVID recovery: a systematic scoping review Organisations Involved: Living With, NHS England, various NHS trusts, AHSN Wessex, UCL Partners. Start Date: 1st October 2020 End Date: 30th September 2023 Background: Covid-19 had affected nearly 300,000 patients in the UK by 6/7/20. Many remain symptomatic with breathlessness, fatigue, and anxiety for weeks or months. These symptoms can be improved with rehabilitation, but traditional, face-to-face models of service delivery will struggle to cope with these large numbersof patients. A digital approach is likely to be needed, but there are numerous challenges with this approach, including failures of implementation; anxieties around the digital divide/health inequalities; and concerns around low engagement with such programmes. Aim: To refine, deploy and evaluate a digitally- mediated, remote, supported rehabilitation programme for patients affected by Covid-19.Methods: We will combine research methods common to engineering and computer science (focused on developing a product that is safe, stable and meets user requirements) with those familiar to biomedical and health service researchers (focused on effectiveness and population impact). Thus, we will apply the Medical Research Council (MRC) Framework for development and evaluation of complex interventions (Phases 1, 2 and 4) Publications Experiences of user-centred design with agile development for clinically supported self-management of Long Covid Trajectories of functional limitations, health-related quality of life and societal costs in individuals with Long COVID: a population based longitudinal cohort study Additional funding The work from this project led to an additional Grant from NIHR SPCR Do community-based digital health inclusion programmes contribute to tackling health inequalities in disadvantaged population groups?

9381b390-9efb-4b71-9879-2371689f041c ADOPTED PROJECT: EnablExercise in Crohns: A qualitativE study to uNderstAnd the Barriers and faciLitators to physical activity and Exercise IN children and adolescents with CROHN’S disease ADOPTED PROJECT: EnablExercise in Crohns: A qualitativE study to uNderstAnd the Barriers and faciLitators to physical activity and Exercise IN children and adolescents with CROHN’S disease Principal Investigator: Dr Zoe Saynor Co Applicants : Dr Nadeem Afzal , Dr Christopher Roberts , Professor Kelly Mackintosh , Dr Danielle Lambrick , Professor James Faulkner , Mr William Freer (PPI Contributor) Partners: University of Portsmouth, University Hospital Southampton NHS Foundation Trust, Swansea University, University of Winchester, For Crohns (charity), Guts UK (Charity) Duration : 12 Months Background: We know that people with inflammatory bowel disease (IBD), of which one of the main forms is Crohns, are at a high-risk of not meeting the physical activity recommendations for health, due to a combination of bowel and general physical symptoms (e.g. abdominal pain, diarrhoea and fatigue). Additionally, there are currently no physical activity and exercise guidelines for young people with IBD – making it difficult to advise what people should be doing. Researchers within our team have been monitoring the effects of COVID-19 and associated lockdowns on physical activity and mental health on a global scale, and saw negative impacts in both people with long-term conditions and in the wider population. However, there is currently no data to tell us how young people with e.g. Crohns have been impacted during this time. in our centre, we are seeing an increasing number of people with Crohns transitioning from paediatric to adult care with metabolic syndrome and we anticipate this will rise in response to the COVID-19 pandemic. Objectives: Assess the barriers to, and facilitators of, physical activity and exercise participation in young people with Crohns disease. Additionally, comparing their views to their parents/guardians and clinicians. Design and Methods: The proposed research will be a qualitative cross-sectional study consisting of individual semi-structured interviews with the three participant groups (in clinic for young people; videoconference for parents/guardians and clinicians). The interview schedule will be co-developed with people living with Crohns. Information from the interview will be digitally recorded, transcribed verbatim and thematically analysed. For the young people with Crohns involved in the study, we are interested in documenting their disease activity and nutritional/growth status at the time of interview so will use the Paediatric Crohns Disease Activity Index (PCDAI) to determine remission, mild activity, or moderate-to-severe activity and growth ‘weight height and BMI’ Z-scores for this. Clinical and Scientific Impact: Physical activity is important for both mental and physical health and is particularly important in people with a long-term condition. This work will provide important understanding of the views and experiences of young people with Crohns, their parents/guardians and clinicians surrounding physical activity and exercise. The findings from this qualitative study will provide insight as to why young people with Crohns may not undertake physical activity and exercise and will help inform the design and delivery of future appropriate physical activity and exercise programmes for this population. This information would complement our ongoing research (The ACTIVE-IBD Study), and will inform future funding applications to develop, evaluate and implement educational and interventional resources to increase the physical activity and exercise undertaken by young people living with Crohns. This funding award will help expedite our journey to the end goal of improving this provision and, ultimately, the quality of lives of people with Crohns

a0531f94-b063-4041-908b-5830a10b5f66 ADOPTED: Community pharmacy alcohol-related liver disease risk identification and linkage to care through development of a complex intervention (CIP-LINC) Prinicpal Investigator: Dr Alexander Smith Start Date: 16 February 2023 End Date: 31 March 2025 Background Liver scarring (known as cirrhosis) is a frequent and ever more common reason for dying in the United Kingdom (UK). The most common cause of liver scarring in the UK is alcohol. Death from liver scarring can be prevented if liver disease is found at an early stage. This can be hard because many people with liver scarring do not look or feel unwell until they develop liver failure. At this stage it is too late to prevent complications. Alcohol-related liver disease can be found earlier by assessing for it in people who drink too much alcohol. This is advised in national guidelines. Local pharmacists are one of the most accessible health professionals. There are over 12000 local pharmacies in England. Lots of these pharmacies are in areas where more people have alcohol problems. Local pharmacists are able to identify people who drink too much alcohol and provide them support to drink less. However, it is not known if local pharmacists can get these people assessed for alcohol-related liver disease. This study looks at how this could be done with the aim of creating a Toolkit to make it happen.

Dr Preeti Dhuria (University of Southampton) and Professor Christina Vogel (The Centre for Food Policy, City St George’s, University of London) discuss how weak enforcement lets retailers bypass UK obesity regulations < Back Chocolate at the checkout Weak enforcement of obesity regulations is undermining public health Dr Preeti Dhuria (University of Southampton) and Professor Christina Vogel (The Centre for Food Policy, City St George’s, University of London) discuss how weak enforcement lets retailers bypass UK obesity regulations It’s far too easy to choose unhealthy options in retail stores in the UK. This isn’t just a personal challenge for citizens, it’s a public health crisis. The places we shop shape our food choices and quite frankly, the odds are stacked against us in selecting healthy food. There is a growing momentum for strong policies to rein in the aggressive promotion of unhealthy foods, and that’s a positive step. In fact, the UK government introduced a ban on placing unhealthy foods at checkouts, aisle-ends and store entrances in 2022. But you wouldn’t necessarily know it as a shopper. Our research shows there is a significant lack of resources for adequate enforcement. This situation means we still see chocolate at checkouts in some stores and alcohol at the aisle-ends in others because stores are either breaking the rules or using loopholes to continue making money at the expense of the country’s health. Regulating the food retail environment is an important part of the solution to lower levels of obesity but weak enforcement can undermine health goals. The Food (Promotion and Placement) Regulations 2021 are designed to limit the promotion of unhealthy foods in most retail stores and online equivalents in England. When 22 local government officers were asked about their approach to enforcement before the regulations came into effect, the clear narrative was that these regulations would not be robustly enforced because of a lack of staff and training. Our research showed the key obstacles to enforcing these regulations include: Staffing Constraints : There is limited capacity within local authority enforcement teams to enforce these regulations. Their scarce resources are used for immediate threats to life like knife crime rather than assessing breaches, issuing notices and processing fines for these anti-obesity regulations. Inadequate financial support: Funding constraints further hinder enforcement because only £281k in funding has been allocated across the 317 local authorities in England to support these enforcement tasks, leading to inconsistencies across regions. Minimal training: Enforcement officers are likely to rely on personal judgment and experience due to limited training and guidance on how to interpret the definitions in the regulations, leading to significant variations in the interpretation and enforcement of the rules across regions. Despite the regulations’ long-term health goals, it is clear that they are ranked as a low priority and the process of issuing infringement notices is cumbersome. This situation is leading to patchy enforcement, and businesses not being held accountable uniformly. The processes for reporting breaches are also unclear meaning even action by the public is usually difficult. A freedom of information request covering a three-month period showed that no improvement notices had been issued despite instances of non-compliance being observed. A Call for Stronger Enforcement Our research outlines actions at the national and local levels that could help to improve the level of enforcement being undertaken. National-level actions Provide adequate and dedicated funding to local authorities to recruit and allocate staff specifically for compliance assessment of these regulations. Provide centralised training and detailed guidelines for enforcement officers to ensure consistency and build confidence among enforcement teams. Streamline compliance assessments by requiring manufacturers to disclose nutrient profile scores for their products and retailers to provide key details, such as store square footage and employee count, to their local authorities. Local-level actions Instigate linkages within local authorities by supporting cross departmental activity between trading standards, environmental health and public health officers to make enforcement efficient. Raise regulations’ priority by incorporating into joint strategic needs assessment within local authorities to increase buy-ins from councillors and Directors of Public Health. Lack of enforcement compromises impact Investing in enforcement is essential to securing regulation compliance and achieving the level playing field that food businesses and public health advocates called for. Early enforcement ensures that businesses fully understand their obligations, comply with the rules, and help build a precedent for healthier retail environments. Proactive enforcement sends a clear message- the regulations are here to stay, and compliance is non-negotiable. But local authorities cannot achieve strong compliance without adequate funding and the right tools. A lack of enforcement risks being misinterpreted as a sign of regulatory failure and withdrawal of the regulations. This outcome would be detrimental to the health of British children and families. Here are a few instances recently where our research team have spotted non-compliance but do not know how to effectively report the instances, and even approaching the store manager has not led to an immediate removal of products from restricted areas. To truly make an impact, future food policies must incorporate robust enforcement strategies and dedicated funding from the outset to maximise the regulations’ impact and safeguard public health. Previous Next

4eb65901-c241-410c-86cb-3a42cbe62229 The feasibility and acceptability of a collaborative deprescribing intervention to reduce anticholinergic burden among hospitalised older patients. Digital Anticholinergic Reduction Tool (DART) Chief Investigator: Dr Kinda Ibrahim Associate Professor, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton Team: Dr Stephen Lim, Principal Clinical Research Fellow, Honorary Consultant Geriatrician, Academic Geriatric Medicine, University Hospital Southampton. Dr Eloise Radcliffe, Senior Research Fellow, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton Dr Emily Smith, Research Fellow, Pharmacy, University Hospital Southampton Dr Cathrine McKenzie, Pharmacy and Critical Care, University Hospital Southampton Mr Andrew Bates, Critical Care Nurse, Research Manager and NIHR Clinical Doctoral Research Fellow, University Hospital Southampton. Dr Andy Fox, Consultant Pharmacist Medicines Safety, University Hospital Southampton, Southampton General Hospital Dr Sara Mckelvie, Clinical lecturer, School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton. Mr Edward Hewertson, Geriatric consultant, Medicine for Older People, University Hospital Southampton, Southampton, General Hospital Prof Tracey Sach, Professor in Health Economics, Faculty of Medicine, University of Southampton Mrs Sarah Bennett, Medicine for Older People Lead Pharmacist, Pharmacy Department, University Hospital Southampton, Southampton General Hospital Mr Kenny Fraser, co-founder of TRISCRIBE. Mrs Pam Holloway and Mr Neil Wilson (Patient representatives) Start: 1 October 2024 Duration: 31 March 2026 Partners: University Hospital Southampton NHS Foundation Trust, Triscribe Limited, Health Innovation Wessex. Why this research is important? It is estimated that over one third of all older adults are prescribed medication which are known to have “anticholinergic” side effects. These anticholinergic side effects can include an increased risk of falls, delirium, and memory problems. People who have a high number of anticholinergic medications have an increased risk of these side effects. This can be measured as their anticholinergic burden (ACB). Several tools have been developed to assess the ACB score, by checking a person’s medication list, with the aim of reducing these medications where possible (deprescribing). The study aim The project team worked with a company to design an online tool which can calculate the total ACB score for patients using their electronic medication list. It can also list the individual anticholinergic medications contributing to that score. Patients with high ACB score will be highlighted to healthcare staff including pharmacists, nurses, and doctors. In this project, we plan to understand how this tool can be used by clinicians in older persons wards to reduce the number of anticholinergic medications prescribed where appropriate. Our approach Working with doctors and pharmacists in one large hospital, we agreed how the tool should be used. First, pharmacists with check weekly using the digital tool how many patients have high ACB scores. Then they would highlight in patients’ medical notes the list of medications with high anticholinergic effects using a sticker note. The doctor looking after the patient then sees the note which would prompt him/her to either stop the drug, reduce the dose or switch to a safer drug. We will test this intervention among 50 patients admitted to older people wards. We will collect information before and after receiving the intervention including number and type of medications prescribed, quality of life, and cognition. We will also talk to staff and patients to understand their views about the intervention, any challenges, and how to improve the process. Involving patients and public Two patient and public contributors have been actively involved in developing this research proposal. They represent an older person with comorbidity and polypharmacy and a carer, and both have lived experience of managing polypharmacy following hospital admission. They will continue to provide input on study procedures and materials and contribute to plans for sharing the findings. Sharing the study findings We will share the findings with public, health professionals, researchers and policymakers through plain English summaries, social media, policy briefing documents, scientific papers, conferences and other meetings.

663cd08e-9825-45c9-8e1b-c94d485206ee COMPLETED SOCIAL CARE: Building capacity in social care through co-produced research and a research learning partnership between University of Portsmouth and Portsmouth City Council Background Social care is facing many challenges and, in a time where staff are stretched and resources are low, research can feel like a luxury rather than part of daily activities. Yet research is crucial for improving practice and finding innovative ways to overcome challenges. To increase capacity in social care research, academia and social care need to work together to understand each other and co-produce a programme that will fit with the workplace demands of social care and focuses on issues that hold meaning and value to those we are seeking to engage. The work that we co-produce will therefore lead to tangible practice change and/or a strengthening of the evidence for existing practice. The University of Portsmouth (UoP) and Portsmouth City Council (PCC) do not currently have a research learning partnership established, however our civic partnership agreement provides a strong impetus to build a learning partnership that will inspire, engage, and provide professional development for social care professionals in research, whilst providing academics with direct experience of co-producing research in complex public service contexts. Through this project we aim to develop such a research learning partnership. Contributors: Amy Drahota, Reader in Health & Social Care Evidence & Evaluation, University of Portsmouth Carole Fogg, Senior Research Fellow, University of Southampton Patricia Gilbert, Lecturer (Sociology), University of Portsmouth Patryk Jadzinski, Senior Lecturer (Paramedics), University of Portsmouth Gail Mann, Research Development Lead, Portsmouth City Council Nils Niederstrasser, Senior Lecturer (Psychology), University of Portsmouth Lucy Porteous, Senior Lecturer (Social Work), University of Portsmouth Clare Rachwal, Deputy Head of Service, Adult Social Care, Portsmouth City Council Jenny Roddis, Associate Head (Research & Innovation), University of Portsmouth Sharon Smith, Principal Social Worker, Adult Social Care, Portsmouth City Council Annabel Tremlett, Senior Lecturer (Social Work), University of Portsmouth Aims and Objectives Our overall aim is to build research capacity in social care through establishing a research learning partnership between the University of Portsmouth (UoP) and Portsmouth City Council (PCC) adult social care team, the public and other key partners, and develop co-produced research relevant to PCC social care practice and national issues. We will achieve this via the following four objectives: A. To establish a research learning partnership for social care between UoP and PCC which will provide learning opportunities for both partners and their associated stakeholders around the development, design, and delivery of research. B. To identify and prioritise research topics for development for further grant funding opportunities, within social care and also in collaboration with other health and care delivery partners. C. To undertake preliminary research activities (e.g. a systematic review, public involvement activities, and potential data gathering) on a prioritised topic in adult social care, which will underpin a funding application for further primary research. D. To develop guidance on increasing capacity in social care research via co-production in collaboration with wider ARC Wessex social care research partnerships. Research Plan / Methods We will begin this project with a three-month exploratory process with social care teams, that will be about relationship-building and working together to devise a programme of activities that will meet the needs of social care, establish what a learning partnership would look like, and how this will fit with the expertise of academics. We envisage that we will co-develop some activities that centre around relevant topic(s) of importance to social care, and that the academics can support based on their expertise. Our focus will be adult social care, to tie in with the School of Health & Care Professions’ thematic strength in older adults, PCC’s adult social care team, and the ‘ageing and dementia’ research area of ARC Wessex. The project will involve a researcher-in-residence, employed by UoP but embedded within PCC, to work alongside adult social workers and build a culture of joint research across the organisations. We will be seeking to integrate research into current processes, for example through senior social worker team meetings and practice support forums that would be happening anyway. Throughout the project we will be seeking to establish a legacy of ongoing work and practice, through the development of funding applications for future projects and the development of a community of practice that will outlive the duration of the funding, nurture an affinity for research, and help demonstrate the value of research to social care. Summary of findings This project had four strands: 1: Growing a research culture and working together We helped six people at Portsmouth City Council (PCC) to become research active or develop their research skills; four were awarded ‘Visiting Researcher’ status at the university, and two were social workers employed on the joint social work project as research assistants. Of the four visiting researchers: One social worker received mentorship to undertake their own small research project; One Mental Health Practitioner developed their research ideas, and applied for research funding; Two individuals independently completed a research project and were supported to develop their analysis and findings through collaboration with University researchers. All individuals are pursuing further research and supporting each other. 2: Joint social work project A research question was developed through discussions and shadowing within adult social work teams at PCC. This led to a review of the evidence on how and why different features of collaborative working may impact the outcomes of older adults receiving services. We found 28 relevant studies that helped develop three theories on collaborative working. The theories relate to: how multidisciplinary team meetings are managed; how staff can learn from each other and feel safe to speak out; how new solutions for older adults can arise when staff feel safe to speak out. These theories can be used to develop recommendations and new interventions to improve how social workers can work with other professionals to provide the best care for older adults. 3: Research learning programme A 6-part seminar series, Research Skills in Social Care , was delivered in-person for colleagues at PCC and online for wider audiences. The series gave an overview of the six stages of conducting a literature review to grow research knowledge and encourage discussions. Team members also gave seminars on their research projects through the Applied Research Collaboration Wessex online seminar series. 4: Reflecting on what we have learnt about growing research The process of growing research has been rewarding and challenging. Success has come from mentorship and individual relationships where trust and rapport are developed, and confidence is built at a steady pace. Arranging rooms and technology in a different organisation for the seminar series was difficult, however the in-person nature of the seminars was beneficial for sparking informal conversations and removing barriers between research and practice, presenting an “accessible” face. What we did with this Knowledge The knowledge from the joint research project is being shared with the wider adult social work team to inform team development. Additionally, we are working the Health Determinants Research Collaboration (HDRC) at Portsmouth City Council to establish how the activities to grow research can be expanded to other areas of the city council and local authorities wider afield. We are working together to develop a report for publication and continue to work with the adult social work team to grow research. Where next? • A funding application has been submitted by an Approved Mental Health Professional to conduct a literature review around racial disparities in coercive mental health treatment •A social worker is planning small research project evidencing the need for a larger autism/neurodivergence support service for adults •Further collaboration with Health Determinants Research Collaboration initiative •Discussing development of interventions based on the findings of the joint research project. This will form the basis of a future funding proposal. Koren Luddington – Visiting Researcher & Social Worker “I was matched with a mentor from the University, who was empathic and reassuring of my self-doubts. She made me feel as though all questions were valid and she was able to provide explanations that felt personalised and relevant to my field of work” Taken from Koren’s blog post on NIHR ARC Wessex Supporting capacity building in this project has been really eye opening - throughout this project I have met incredible, passionate people that are doing everything they can to provide support. There is such a wealth of knowledge and innovation happening in Adult Social Care, and it’s up to us in research to support and encourage that. Dr Leah Fullegar Leah.Fullegar@port.ac.uk