Otago studies supported by Health Research Council

Wednesday 11 May 2016

Otago studies supported by Health Research Council

Health Research Council ‘Emerging Researcher First Grants’ have been won by two up-and-coming University of Otago, Christchurch researchers.

The grants, announced today, aim to support the career development of some of New Zealand’s best and brightest health researchers.

Dr Claire Heppenstall of the Department of Medicine receives $145,459 for a project focused on taking rest home residents off unnecessary medicines, while Dr Pippa Scott of the Department of Pathology gains $149,982 to investigate transmission of infectious bacteria between cattle and people in rural communities.

The HRC has also announced seven Feasibility Study recipients, four of whom are Otago researchers. These grants cover a range of topics including the feasibility of:

• Safely using beta blockers in patients with chronic obstructive pulmonary disease

• Using smart e-cigarettes to study smokers’ patterns of e-cigarette and tobacco use

• A trial of free prescriptions for people with many health problems who use a large number of medicines

• Using isotopic analysis as an objective measure of New Zealanders’ sugar intake

Otago’s HRC Emerging Researcher First Grant recipients for 2016

Emerging Researcher First Grants

Dr Claire Heppenstall (Department of Medicine, Christchurch)

Utilising a prognostic indicator to guide deprescribing in Aged Residential Care

$145,459

Older people living in Aged Residential Care (ARC) are often prescribed multiple medications. Many of these are to prevent future illness, not to treat symptoms. Polypharmacy has been associated with poorer health outcomes and quality of life. In older people with short life-expectancy many of these medications are no longer necessary. However General Practitioners find it difficult to stop medications. This study proposes the use of a scale to identify people with limited life-expectancy, and to feed this information back to GPs together with medications prompts. We hope this will empower GPs to stop unnecessary medications. This study will assess the feasibility of this intervention, and whether it reduces numbers of medications prescribed and outcomes for this vulnerable population.

Dr Pippa Scott

Zoonotic disease transmission in New Zealand rural communities

$149,982

Around 60% of microorganisms causing human disease are passed between animals and humans (“zoonotic” pathogens). Changing farming practices in New Zealand are creating conditions promoting pathogen transfer between species. This project aims to identify interventions to control transmission to humans. Two zoonotic bacteria will be examined: Shiga-toxin producing Escherichia coli (STEC) and Staphylococcus aureus. STEC causes severe diarrhoea, while S. aureus causes serious skin and bloodstream infections. Data will be collected in a dairy-farming community about the frequency of STEC and S. aureus in cattle and humans, and about how humans interact with cattle and the environment. Data will be included a mathematical model simulating transmission of bacteria within and between species. Intervention effects will be tested in the model. Identifying effective interventions will reduce the STEC disease burden, particularly in young rural New Zealanders, and reduce transfer of antibiotic resistant S. aureus to humans, maintaining treatment options for infections.

Feasibility Studies

Associate Professor Bob Hancox (Department of Preventive and Social Medicine)

Beta-blockers in COPD: Feasibility of an RCT in stable patients

$149,908

Beta-blocker treatment is known to improve survival from cardiac diseases. Unfortunately, beta-blockers are usually avoided in patients with chronic obstructive pulmonary disease (COPD) because of concerns that they may make airflow obstruction worse. Therefore patients with COPD are often deprived of the benefits of beta-blockers even though they have a very high risk of cardiac problems. Recent evidence suggests that beta-blockers may be safe and effective in lung disease but there have been no clinical studies to confirm this. This feasibility study will assess the safety and tolerability of metoprolol, a cardio-selective beta-blocker, in patients with COPD to determine whether a randomised controlled trial of beta-blockers should be conducted. The randomised study will provide a definitive answer on whether beta-blockers are safe and effective in patients with chronic obstructive pulmonary disease. It has the potential to transform treatment of COPD and widen the indications for beta-blocker treatment.

Professor Janet Hoek (Department of Marketing)

Feasibility Assessment of a Smart E-cigarette

$149,750

Uptake of electronic cigarettes (EC) has escalated in recent years. While some regard EC as a game-changing innovation that will radically increase smoking cessation, others believe EC allow smokers to manage smokefree restrictions, promote dual use, and put at risk decades of tobacco control achievements. Smart EC allow usage data to be collected passively and provide unprecedented insights into how EC use evolves. Using a smart EC and active collection of smoked tobacco use via a smartphone app, we will examine whether dual use is a transitional or sustained behaviour that supports continued smoking. This feasibility study tests the acceptability of the smart e-cigarette among EC users of differing devices, and explores compliance with an app-based ecological momentary assessment collecting smoked tobacco use data over a two month period. The full study examines whether EC support smoking cessation and tests their potential to help achieve New Zealand’s smokefree 2025 goal. Further information:http://hrc.govt.nz/news-and-publications/news-media#trial-to-investigate-how-e-cigs-affect-smoking

Professor Pauline Norris (School of Pharmacy)

Randomised controlled trial of prescription charges: feasibility study

$150,000

Prescription charges in New Zealand are low but can still prevent some people picking up prescription medicines they need. We plan to do an experiment where we recruit a group of people, who have many health problems, use a large number of medicines, struggle to pay for prescriptions, and are likely to need more hospital care if they do not take their medicines. We will divide the group in half, pay prescription charges for one group, and compare the groups in their use of health services, to see whether free prescriptions make a difference. This feasibility study will allow us to work out which groups of people to involve, how many we will need to include to be sure our results are correct, how to find these people, which outcomes to look at, how best to provide free prescriptions and find organisations to contribute funding to the study.

Dr Lisa Te Morenga (Department of Human Nutrition)

Validation of a dietary intake biomarker for free sugars intake

$149,998

Although it is generally accepted that intake of sugars should be limited the food industry continues to lobby against governmental strategies to limit intakes claiming the evidence that sugar is harmful is inconsistent and unconvincing. Thus public health researchers must continue to examine the relationship between sugar and disease. However measuring sugar intakes accurately is problematic because people tend to underestimate their consumption and thus the effect of sugars on health in population studies such as the Dunedin Study may be obscured. Recent preliminary US research has shown that carbon stable isotope ratios (13C) could be used as an objective measure of sugar intake. We aim to investigate whether this method is valid for the NZ population, which consumes different types of sugars. If 13C can reliably predict sugar consumption in New Zealanders we will be able to examine the relationship between sugar and disease in the Dunedin Study.

ENDS

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