Case Study: HDRUK North

Transforming care for older people through health data research

LIDA is a key partner in the recently successful Health Data Research UK North (HDRUK North) award – a £3.4M innovative data initiative in the North of England, focusing on transforming care for older people living with frailty using routine health data.

HDR UK North is an innovative data initiative in the north of England that will benefit patients across the UK and help address some of the most challenging health issues facing patients and the NHS. In a major partnership spanning the Universities of Leeds, Liverpool, Lancaster, Manchester, Newcastle and Sheffield, the initiative aims to improve the care and services for patients by supporting the better use of data and analytical tools. One of the major challenges for the partnership is addressing the issue of frailty, an area of unmet clinical and social care need that affects 10% of people aged over 65, rising to 25-50% of people aged over 85 years. Frailty accounts for £15 billion of expenditure in the UK and is likely to have a growing impact due to the ageing UK population.

LIDA is a key partner in the University of Leeds team, which includes cross-disciplinary expertise spanning data science, biostatistics, geriatric medicine, primary care, pharmacy, and health psychology. The University of Leeds team is led by Andy Clegg, Professor of Geriatric Medicine at the Academic Unit of Ageing and Stroke Research (AUASR).

The team is co-leading a project with colleagues at the University of Liverpool to improve warnings to GPs about medicines that can be dangerous or harmful for frail older people. The project focuses on ‘anticholinergic’ medications used to treat bladder, bowel and mood problems in older people. Common side effects of these medications include confusion and falls that often lead to hospital admission. The team plan to develop a score using data from patients’ health records to predict if anticholinergic medications are likely to increase harm. This score will run in a computer-based system designed with pharmacists and doctors to help them review patients’ medicines and reduce harm from anticholinergic medications.

The score will be developed using information routinely collected by GPs. Anonymous records, with names and addresses removed, from 180,000 older people living in Bradford will be used to see how well the score predicts being admitted to hospital with confusion (delirium) or a fall. The team will use similar data from Wales and Merseyside to see if they get consistent results.

The team will also develop guidance for GPs and pharmacists on how they should use the score to improve prescribing for older people, and then test it out in GP surgeries to see if it reduces risky AC prescriptions, before offering it for national use. The overall aim of the project is to improve medicines safety for older people with frailty, increase quality of life for older people, reduce delirium and falls, and save NHS and social care costs.

Additional projects in the partnership will initially focus on improving monitoring of residents in care homes to detect deterioration, and optimising prescribing of antibiotics, thereby reducing the potential for antimicrobial resistance.

15 organisations from across the North are involved in HDRUK North, which will be co-ordinated by a team of researchers from the University of Liverpool led by Professor Sir Munir Pirmohamed, the David Weatherall Chair of Medicine, NHS Chair of Pharmacogenetics at the University of Liverpool, Director of the MRC Centre for Drug Safety Science and Wolfson Centre for Personalised Medicine. HDRUK North will form part of HDRUK’s network of research sites and hubs, which bring together world-class research and innovation expertise, a track record in using health data to derive new knowledge and scientific discovery and enable the responsible use of data to speed up benefits to patients and the population.

Professor Andrew Clegg

Associate Director, HDRUK North

 

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