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The University of Southampton
Medicine

Research Group: Primary Care Research Centre

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Primary Care Research Centre - high quality community based research including antibiotics, cancer, communication, mental health, supporting self-management and integrative health care.

This group page highlights our research focus, our projects and staffing.

To view more in-depth information about the Primary Care Research Centre please visit our website.

 

Primary Care Research
Primary Care Research
Improving the health of the population
Improving the health of the population
Early Career Research
Early Career Research

Research focus

The Primary Care Research Centre offers a broad spectrum of expertise in both methodologies and topic areas. We doubled in size between the 2008 Research Assessment Exercise and the 2014 Research Excellence Framework assessment, in which 87% of our research was rated as ‘internationally excellent’ or ‘world-leading’. In the Public Health, Health Services, and Primary Care unit of assessment, we were ranked 3rd highest for the quality of our research outputs out of 32 institutions.

Since 2008 the Primary Care Research Centre has built on our existing strengths in acute infections, mental health problems, and complementary medicine. We continue to develop new directions for our antibiotic research – in particular research into lower and upper respiratory tract infections including influenza, as well as urinary tract infections. Our strategy has been to enhance diagnostic clarity and self-care, better understand prognosis, minimise the medicalization of self-limiting illness and reduce the risk of antibiotic resistance through more targeted use of antibiotics.

Other research focuses on mental health research particularly in the areas of assessment and management of common mental health problems (e.g. delineating distress from depression and anxiety, monitoring depression, and developing algorithms for antidepressant use). Our research showed that GP performance indicators for the assessment of severity of depression at diagnosis and follow-up were associated with better targeted treatments and referrals.

We also continue to develop large robust trials of non-pharmacological approaches to chronic disease management (e.g. MBSR, CBT-based guided self-help) to extend web-based interventions to population settings (e.g. for obesity in Teeside); to different platforms (such as mobile phones); and to other common conditions (e.g. back pain, asthma, and distress). The Centre has worked in developing and evaluating web-based interventions promoting lifestyle change (e.g. for obesity, hypertension) and self-management of common conditions (e.g. dizziness, chronic fatigue syndrome, hypertension, irritable bowel syndrome (IBS), childhood eczema, and distress, funded from the NIHR Research for Patient Benefit (RfPB), HTA, and SPCR programmes. Having piloted effective websites, large MRC- and HTA-funded trials are underway for infection transmission, obesity and IBS.

Key achievements

Following landmark trials developing open pragmatic trial methodology for prescribing strategies in sore throat, otitis media and acute cough, we developed and trialled clinical prediction rules, dipstick ‘rules’ and delayed prescription for urinary tract infection (UTI), demonstrating modest reduction in antibiotic use was possible.

A high profile trial demonstrated the limited impact of both antibiotics and nasal steroids for rhino-sinusitis.

The largest placebo-controlled trial to date in acute chest infections demonstrated that when pneumonia is not suspected clinically, antibiotics provide little benefit for acute lower-respiratory-tract infection in primary care, both overall and in patients aged 60 years or more, and cause slight harms.

We showed that the inclusion of GP performance indicators for the assessment of severity of depression at diagnosis and follow-up was associated with better targeted treatments and referrals, in multi-practice observational studies

The analysis of GPRD data (from 170 practices over 13 years) showing that the rise in antidepressant prescribing is due to increases in the proportion of patients on long-term medication rather than any increase in the rate of diagnosis of incident depression, and pointing to the need to research longer term prescribing in primary care as well as the initial decision to prescribe.

In another study, acupuncture was evaluated for managing osteoarthritic pain, and contributed to individual patient data meta-analysis of acupuncture for chronic back pain, showing it is effective and a reasonable referral option. Significant differences between true and sham acupuncture indicated that acupuncture is more than a placebo. However, the differences are modest, suggesting that other factors besides needling contribute to its effects.

Our research addresses the feasibility of early identification of alcoholic liver disease in primary care and intervention based on feedback of liver disease risk, and have British Liver Trust funding for a new feasibility study for more extensive identification of liver risk using fibrosis markers in primary care.

We are are building on a successful web-based behavioural intervention for obesity, developing an integrated obesity and alcohol intervention for those at risk of cirrhosis due to the combined effects of alcohol and fatty liver, linking with the NIHR Nutrition BRC.

Collaborations and enterprise

For more information on patient and public involvement in our research, and on our research collaborations, please view our Primary Care theme pages here.

We are working on the development of an algorithm to inform clinical decision-making about starting antidepressants in primary care, through an NIHR PGAR-funded cohort and trial with UCL, Bristol, York and Liverpool.

We have evaluated the Alexander Technique (AT) for chronic/recurrent back pain in the MRC-funded ATEAM) study and the NIHR EME-funded ASPEN study. Having demonstrated that AT is cost-effective, we are evaluating the additive effect of physiotherapy and exploring recovery mechanisms.

The Centre has evaluated risk stratification of liver disease risk using non-invasive markers. We have set up a cross-Faculty research group (the Wessex Alcohol Research Centre) with strong patient and public involvement (PPI).

We lead the multicentre SPCR-funded CANDID lung and colorectal cancer cohort and ATAFUTI trial of alternative treatments for adult female UTIs and are key collaborators in the SPCR BARACK-D trial of aldosterone receptor antagonism in chronic kidney disease; DUTY cohort of diagnosis of UTI in children and TARGET cohort on childhood respiratory infection prognosis.

Working with us

Opportunities to work or study with us will appear here.

Undergraduate teaching
Undergraduate teaching
List of related projects to Primary Care Research Centre
Related ProjectsStatus
HATRIC - Herbal Alternative Treatment (Pelargonium) for lower Respiratory tract Infections with Cough in adultsActive
BREATHE4T (Breathing REtraining for Asthma Trial of Home Exercises for Teenagers) Active
Empathica: Expectation Management for Patients in Primary Care: Developing and Feasibility Testing a New Digital Intervention for PractitionersActive
ACTIB - Assessing Cognitive behavioural Therapy in Irritable Bowel SyndromeActive
4S Sore Throat Study (Scores and Swabs to Self-assess Sore Throats)Active
Healthy Paths - Exploring primary care patients’ experience of an internet intervention ‘Healthy Paths’ for emotional distress Active
ROSE - Rosa canina fruit (rosehip) for OsteoarthritiS: a cochrane rEviewActive
A digital behaviour change intervention to help reduce the spread of the COVID-19 outbreak: A rapid co-design, implementation and evaluation project. (GERMDEFENCE)Active
Chinese Herbal medicine to aid AnTibiotic use reduction in exacerbation of Chronic Obstructive Pulmonary Disease (CHAT COPD)Active
MOMA Investigating the feasibility of a mobile mindfulness-based digital intervention for patients with asthmaActive
Retrospective Survey of Prevention, Treatment, Occurrence and Outcomes of Covid-19 in the community (RTO-Covid-19)Active
RECON - Reducing and preventing Cognitive impairment iN older age groups (the RECON programme)Active
Reducing common infections in usual practice for recurrent respiratory tract infections: The RECUR ProgrammeActive
DEFINE: Development and evaluation of a FeNO-guided asthma management intervention in primary careActive
CANDID Cancer Diagnosis Decision RulesActive
CERAbTc-19 (Clinical Evaluation of Rapid Antibody Test for Covid-19)Active
Qualitative study on community pharmacists’ perspectives of recommending herbal medicine in acute infectionsActive
Antidepressants for Insomnia: Cochrane systematic reviewActive
OPEN: Out of Hours Prescribing: Enhancing CommunicationActive
Antenatal Couples’ Counselling in Uganda (ACCU)Active
HaRI: Harnessing resources from the internet to maximise outcomes from GP consultations: A qualitative StudyActive
ORCHID 2 - Standardised Chinese Herbal Medicine for Menstrual Irregularity in Polycystic Ovary Syndrome: Nominal Group Technique and Prospective Observational StudyActive
STREAM - Screen and TREAt for MalnutritionActive
SNIFSII - Saline Nasal Irrigation For acute Sinusitis IIActive
ECO - Eczema Care OnlineActive
CELLULITIS - Experiences of cellulitis and views about causation and preventionActive
COVID-19 virtual hospital Prognostic study (COVPRO)Active
CERrnaTc-19 (Clinical Evaluation of Rapid RNA Test for Covid-19)Active
ALICE Antivirals for influenza like illness - an RCT of clinical and cost effectiveness in primary careActive
D-fRUTI - D-mannose for recurrent UTI Active
MACRO - Defining best management for adults with chronic rhinosinusitisActive
Patient-reported outcome measures for monitoring primary care patients with depression: PROMDEP randomised controlled trial.Active
The Atlantis study: Amitriptyline at Low-dose and Titrated for Irritable Bowel Syndrome as Second-line Treatment: A Double-blind Placebo-controlled TrialActive
Quantifying the association between COVID-19, ethnicity and mortality: A cohort study protocolActive
ARTIC PCActive
PRINCESS - Probiotics to reduce infections in care home residents, the PRINCESS trialActive
CLASP Cancer: Life Affirming Survivorship support in Primary careActive
Family Planning: Fact or Fiction?Active
ATTACK: Aspirin to target arterial events in Chronic Kidney DiseaseActive
ANTidepressants to prevent reLapse in dEpRession (ANTLER) Active
Supporting self-management of low back pain with an internet intervention in primary care: A randomised controlled trial of clinical and cost-effectiveness (SupportBack 2)Active
CEDAR the children's ear pain studyActive
REDUCE (REviewing long term anti-Depressant Use by Careful monitoring in Everyday practice)Active
OPTIMISE - OPtimising Treatment for MIld Systolic hypertension in the ElderlyDormant
BATHE Bath additives in the treatment of childhood eczemaDormant
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