Professor Alastair Hay reflects on the achievements of the Respiratory Infections Health Integration Team (HIT) during 2013-14.
Every winter health care services are overwhelmed by patients with respiratory tract infections (RTIs). Children play a key role in respiratory infection transmission, with enormous cost implications for societies and healthcare systems worldwide. Prescribing rates for antibiotics in primary care settings are high, with considerable uncertainty regarding which patients are most likely to benefit. Higher use of antibiotics in primary care is associated with greater levels of bacterial resistance. This creates a vicious cycle of increasing patient demand, increasing antibiotic use and reducing antibiotic effectiveness. The Respiratory Infections HIT (RuBICoN) aims to reduce the burden of respiratory infections on both the NHS and the community.
We now have an active Patient & Public Involvement (PPI) group that informs our grant applications and provides guidance on the patient information we are producing. We are working with commissioners and health educators so that Bristol-based research evidence informs interventions and helps parents make better decisions about when and where to consult the NHS if their children become ill.
We have led changes to the bronchiectasis HOT clinic at North Bristol Trust, allowing patients to make direct contact with the clinic when they are unwell. This gives more rapid access to specialist care, which we hope will result in faster, more appropriate care and reduce hospital admissions.
The team has submitted a grant application to the National Institute of Health Research (NIHR) to evaluate the clinical and cost effectiveness of analgesic ear drops as an alternative to antibiotics in acute otitis media, a common respiratory infection of children that can case ear pain. We’ve also prepared an outline NIHR Programme Grant for Applied Research application to conduct a community based prospective cohort study to investigate the socio-demographic, clinical and microbiological determinants of primary care utilisation for children with RTIs and to develop an intervention to improve parental use of primary care.
We have mapped the educational provision around infection prevention and control within the NHS locally. The next steps are to identify gaps and provide educational sessions to raise the profile of these issues in the partner organisations. And finally, we have expanded our links with industry partners and are looking, with them, to develop or evaluate near patient microbiological testing. This will facilitate rapid diagnostics in those individuals in which a swift diagnosis can assist in deciding the treatment options.