Department of Academic Geriatric Medicine
We are specialist doctors trained in diagnosing and managing conditions relating to older people. We work to translate innovative research findings into improving health and healthcare for people in later life. Academic geriatric medicine training at the Royal Devon University Healthcare NHS Foundation Trust benefit from an award-winning training programme, and a productive research team working across the key areas affecting older adults, namely Stroke, Frailty, Dementia & Delirium and polypharmacy.
Additionally, we have close links with the department of metabolic medicine, performing work specifically in diabetes in frailty, including leading the modification of national guidelines, and the department of genetics where three of our members are contributing to a large project exploring the genetics of multi-morbidity. Finally the use of large databases has allowed a real world evidence to be produced exploring how older adults, not ordinarily engaged in clinical trials, benefit (or otherwise) from modern medicine. This big data approach is led by Dr Jane Masoli, one of our previous academic fellows, who we subsequently supported through PhD, Clinical Lectureship and currently as an NIHR Intermediate Fellow.
Finally, the pandemic has highlighted the need for researchers with an expertise in multi-morbidity. As such Prof Sheridan has become a national influencer in vaccination researcher, whilst Prof Strain has become an (inter)national research lead in the area of long Covid, contributing to the UK, Canadian and American Guidelines for the management. All of this research keeps the patient and their carer at the heart, and we have regular engagement with our patient and participant leads.
Current trials
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Full list of currently funded trails
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Grants with Departmental Lead Applicants
Allan as CI, (Butchart & Strain as Co-Is) Development and testing of an intervention to improve Recovery after an episode of Delirium. NIHR 2020 Hope Operationalising NHS England’s Frailty Plan: now what? Implications of a “frailty” diagnosis for older people James Stroke Audit Machine Learning (SAMueL). NIHR Health and Social Care Delivery Programme - NIHR134326;over 2 years (Co-Lead applicant) Logan 2016-2019 for NIHR Clinical Doctoral Research Fellowship ICA-CDRF- 2015-01-044, ISRCTN Number, 15412695 Strain The role of SGLT-2 co-transporter inhibitors on metabolite utilisation in people with type 2 diabetes Astra Zeneca Pharmaceuticals. 2018 Strain Individualising care for frail older adults with diabetes in institutional care. Novo Nordisk research Foundation. 2017 Strain Genetics of Long COVID; MRC UKRI. 2020 Masoli Development and Skills Enhancement Award, NIHR. 2020;
Grants with Departmental Co-Applicants
Allan, Masoli & Strain Genetic Evaluation of Multimorbidity towards INdividualisation of Interventions (GEMINI). MRC/NIHR Allan The clinical, social and cost effectiveness of a decision support tool to optimise community-based tailored management of sleep (TIMES) for people living with dementia or mild cognitive impairment and sleep disturbance TIMES -TaIlored ManagEment of Sleep. NIHR Programme Grant Allan Identifying and mitigating the individual and dyadic impact of COVID-19 and life under physical distancing on people with dementia and carers (INCLUDE). ESRC (2020-2021). Allan Combination treatment for dementia with Lewy Bodies and Parkinson's disease dementia. NIHR HTA Programme 18/189 (2021-2025). Allan & Strain GEMINI Genetic Evaluation of Multimorbidity towards INdividualisation of Interventions Medical Research Council (2020-2021) Masoli VirAl Load In covid-19 Disease (VALID) study; Animal Free Research UK. 2020 Masoli Understanding Measurement of Postural Hypotension in Primary Care (UMPH); NIHR School for Primary Care Research Masoli Thresholds Used for Detecting postural hypotension (THUD) feasibility; Northcott Devon Medical Foundation Hope NIHR Research Capability Funding via South West Ambulance Service Foundation Trust (SWASFT), Role – co-applicant, falls focus groups and pilot project Hope South West Ambulance Service Foundation Trust (SWASFT), Older Persons’ Research Support Grant, James Optimising Implementation of Ischaemic Stroke Thrombectomy (OPTIMIST) NIHR Programme Grant for Applied Research – NIHR202361 over 5 years (co-applicant and theme co-lead) James Acute Bundle of Care for IntraCerebral Haemorrhage (ABC-ICH): Evaluation of the North of England Scale-up. The Stroke Association; over 2 years (co-applicant) James Enhancing and disseminating the outputs of the Promoting Effective and Rapid Stroke Care (PEARS) NIHR PgfAR Programme Grant and facilitating thrombectomy implementation in England. NIHR Programme Development Grant - NIHR 201692; over 18 months (co-applicant) James Use of simulation and machine learning to identify key levers for maximising the disability benefit of intravenous thrombolysis in acute stroke pathways. NIHR Health Services & Delivery Research Programme; over 2 years (co-applicant) James OPTIMAS: OPtimal TIMing of Anticoagulation after AF-associated acute ischaemic Stroke: a randomised controlled trial. British Heart Foundation (Clinical Study CS/17/6/33361); over 5 years (co-applicant) James Modelling the optimal provision of thrombectomy for acute ischaemic stroke in England. The Stroke Association; over 6 months (co-applicant) Logan Development and Evaluation of a Training Package to support the Remote Assessment and Management of People with Movement Impairment and Disability UK RI-NIHR, MRC, COVID-19: MR/V021060/1 (with University of Plymouth, Faculty of Health); Strain Symptoms, Trajectory, Inequalities and Management: Understanding Long-COVID to Address and Transform Existing Integrated Care Pathways. NIHR. 2021. Strain The use of the anti-viral Remdesivir for the treatment of long COVID. Gilead Pharmaceuticals |
Getting involved
The Patient and Carer Voice is embedded in all of our research. We have run focus groups at concept of studies to ensure feasibility, included at least two patient representatives in the trial management groups of our studies and include them in reporting of our trials, and one study with a stroke survivor as a co-applicant (SAMueL-2).
Specific examples of this include the ProMOTE study which had two patient representatives in the trial. The patients were involved in the study design, production of the patient information sheets, and reporting of the results through stroke support groups. We have regular meetings with the Exmouth Stroke survivor group to follow up results and consider research questions that they pose.
The long COVID research is being fully co-produced with two patient support groups: LongCovidSOS and LongCovid Kids. Strain has produced two manuscripts with these groups, one of which is in press and the second has been published.
The dementia and delirium trials being led by Prof Louise Allan are being fully co-developed with people who have lived experience of Delirium. They are included in the trial management group and have been involved in the design of the intervention.
You can find out more here.
More information
Geriatric medicine is by nature a multidisciplinary specialty. We already have one nurse consultant (Debbie Cheeseman) and one AHP consultant (Angie Logan PhD) given equal standing within the department. They are represented as co-applicants, local Principal investigators and co-authors in our publication list.
We are in the process of further developing allied healthcare professionals. Suzy Hope’s work with the South West Ambulance Service has produced a Research Support grant in order to produce PPI Falls focus groups and pilot a project to inform a future larger scale NIHR grant application. Suzy has also worked with and supported an ambulance clinician to successfully achieve an NIHR & Health Education England Transitional Award.
We have successfully been awarded two PhD Fellowships to support radiographers working in validating new ways of assessing osteoporosis, and exploring the underlying cause of impaired bone quality in older adults with diabetes. These are being co-supervised between Strain and Prof Karen Knapp in the department of medical imaging.
Further support has been afforded two dieticians and an occupational therapist in applying for PCA Fellowships and project grants. These have, as yet, been unsuccessful, but we plan to continue supporting these allied healthcare professionals in further improved submissions.