Paul Little
MBBS, BA, MD, DLSHTM, MRCP, FRCGP, FMedSci
- Primary position:
- Professor of Primary Care Research
Background
Professor Little was the first GP to be awarded a Wellcome HSR training fellowship (for research on health promotion), and the first to be awarded an MRC Clinician Scientist Fellowship (for research on common self-limiting illness), and in addition current major areas of research are in enabling behaviour change both for health professionals and also in empowering patients.
Qualifications
BA Physiology, Oxford (1981)
MBBS, London (1984)
MRCP, London (1989)
MD, London (1992)
MRCGP, London (1992)
DLSHTM, London (1995)
MSc, LSHTM (1995)
FRCGP, London (2000)
FMedSci, London (2010)
Appointments held
Wellcome HSR Fellow, University of Southampton (1993-1997)
MRC Clinician Scientist, University of Southamptont (1998-2003)
Current Post: Professor of Primary Care Research.
Aldermoor Health Centre, Southampton University commenced 1/2/2003
Publications
The University of Southampton's electronic library (e-prints)
Article
Monograph
Research
Research Interests
Two main areas of interest: health promotion and the management of common self-limiting illnesses. These topics link evidence about effectiveness with the effect of management of patient beliefs and behaviour, better understanding the importance of the patient centred approach to the consultation.
Health promotion
Back Pain
ATEAM trial
This was an MRC funded trial of the Alexander Technique (a technique to improve and modify poor postural and body ‘use’ habits) and exercise prescription by GPs for back pain (the ATEAM trial). It demonstrated significant benefits for pain and function in the longer term.
ASPEN trial
Following the ATEAM trial EME have now funded this study to investigate the mechanisms of Alexander Technique and the mechanism of recovery in back pain with both physiotherapy and the Alexander Technique.
ARC Fellowship (Lisa Roberts)
I am co-investigator and mentor for this project which aims to understand communication in physiotherapy consultations and will then develop and pilot and intervention to modify consultation behaviour.
Internet based behaviour support
A major focus of interest is in developing internet based behavioural support for a range of conditions:
Obesity (the HTA funded POWeR trial)
Hypertension (SMILE trial, funded by the National School for Primary Care Research)
Infection transmission (The MRC PRIMIT trial)
Irritable bowel syndrome (NIHR funded, lead by Hazel Everitt)
Eczema (NIHR funded, lead by Miriam Santer)
The management of common infections
UTIS study
Following our work in trialling antibiotic prescribing strategies in several respiratory infections we have also recently completed a study to develop clinical scoring algorithm for urinary tract infections leading to a trial of different management approaches.
GRACE
We have been funded to lead two major trials as part of a large European Union Network of Excellence project (GRACE) for Lower respiratory tract infection – which is the commonest acute condition managed in primary care.
RCT of amoxicillin: this trial which is coming to a close has randomized 2061 individuals in 12 Networks across Europe and the results are likely to dominate the management of lower respiratory tract infection (LRTI) in primary care for some time.
GRACE INTRO
The second GRACE trial developed from another EU project we share (CHAMP), and has developed and tailored web based communication training packages for health professionals in 6 EU countries. Currently we have randomized 246 practices across Europe and recruited more than 4000 patients in this trial - which will assess whether an internet based behavioural intervention to modify communication in the consultation can modify health professional antibiotic prescribing for LRTI.
DESCARTE
This is a large prognostic cohort study in acute sore throat (more than 13000 patients have been recruited) funded by the MRC.
PRISM
This is an HTA funded study to develop and perform a randomized trial (which has recruited more than 1500 patients) of strategies for using rapid tests and clinical scores for sore throat.
PRIMIT
The MRC have funded us to develop and trial an infection control website requiring complex intervention development.
Internet Dr
An MRC studentship was used to develop web based self help advice using the MRC Framework for the development of complex interventions.
NIHR PRIME Programme grant
This supports several studies on the management of acute and recurrent infections:
SNIFS: nasal irrigation and steam for recurrent sinusitis.
TASTE: probiotics and xylitol for recurrent sore throat
3C’s study (Cough Complication Cohort): a large prospective cohort similar to DESCARTE but for LRTI
Internet Dr trial (following the development referred to above).
Academic unit: Primary Care & Population Sciences
Research project
BREATHE (Breathing Retraining for Asthma Trial of Home Exercise)
Although effective medicinal treatment exists for asthma, many people continue to have distressing symptoms and impaired quality of life. People with asthma have expressed interest in non-drug asthma treatments, particularly in breathing exercises. Several recent studies have shown benefits from a short course of breathing exercises taught by a respiratory physiotherapist for people with asthma who remained symptomatic despite usual treatment. We believe that many NHS patients could potentially benefit from these exercises, but unfortunately, there is currently not enough access to suitable trained physiotherapists able to provide such a service. We propose to provide the same breathing training programme that we have previously shown to be effective when taught 'face-to-face' by a physiotherapist in the form of a DVD, or internet download. Patients will use this in their own home at times convenient to them, in addition to their standard treatment (e.g. with inhalers). We will find out whether this type of instruction is better than the 'usual care' that is currently provided, and whether it is as good as the 'face to face' physiotherapist instruction (which is more expensive and less convenient for patients).
Responsibilities
Undergraduate teaching
Responsibility for critical appraisal paper in MBBS finals.
Clinical teaching for MBBS.
Postgraduate student and research fellow supervision
I supervise 3 PhD students, 3 Academic Clinical Fellows, and mentor 2 senior postdoctoral awards and a Clinical Research Fellow.
I also do regular teaching at GP workshops and clinical postgraduate meetings.
Divisional responsibilities
Member of Management team for Primary Care and Population Sciences Division.
National and International Responsibilities
Head of Southampton primary care group for National Primary Care HODs group and also for the National School for Primary Care Research.
GP representative on EME Board.
Member of main panel of NIHR Programme Board and chair of sub-panel.
Member of REF panel for primary care.
Teaching responsibilities
Clinical Teaching in Primary care for undergraduates.
Lecturing on research methods (critical appraisal and the development of complex interventions).
Supervision of Post-graduates and research fellows.
Post-graduate teaching for clinicians.
Contact
Professor Paul Little
Primary Medical Care
Aldermoor Health Centre
Aldermoor Close
Southampton
SO16 5ST
Room Number: AHC/