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Adolescents (and their families) in the UK and around the world are now better able to cope with chronic pain because of the unique work carried out at the University of Bath Centre for Pain Research (BCPR), directed by Professor Christopher Eccleston.
The BCPR produced the first multidimensional `one-stop' tool to assess the impact of pain on children's lives, which has now been adopted in at least 12 countries. Pioneering treatments from Bath have influenced therapeutic approaches worldwide.
The Bath team also manage the evidence base for chronic pain, giving access through the Cochrane Library, advising internationally on clinical service development and improvement.
A high quality clinical trial, systematic reviews and meta-analyses performed by a team at Brunel University have directly informed key international clinical practice guidelines, policies and on the management of low back pain and neuropathic pain and have been cited by users (NHS Trusts: Addenbrookes) in response to such guidelines. In this way our research is directly informing clinical practice.
The Pain Research Group (PRG) is a research team within the Centre for Health and Social Care Research (CHSCR). The PRG's research programme in chronic pain management encompasses a range of robust methodological approaches to achieve better patient outcomes with local, national and international impact. The PRG has adopted a dual approach to investigating the treatment of chronic pain, incorporating psychological factors with the application of neuromodulation techniques. This has led to significant improvements in patient outcomes and patient satisfaction surveys demonstrate excellent, positive results. The research has had significant influence on clinical practice at national level, underpinning recommendations for best practice issued by the British Pain Society in relation to spinal cord stimulation and intrathecal drug therapy. It has also contributed to NICE's clinical guidelines on the implementation of spinal cord stimulation and influenced clinical decision making through the NHS evidence database. At an international level, our research has contributed to three sets of guidelines issued by the Polyanalgesic Consensus Conference: inflammatory mass, intrathecal drug therapy for chronic pain and recommendations for reducing mortality and morbidity of intrathecal drug therapy. The reduction of morbidity and mortality in intrathecal drug therapy is of particular significance as the reduction of harm and unnecessary complications in healthcare is of high concern to healthcare organisations worldwide.
Work by Fonagy and Roth at UCL to establish a firm evidence base for psychological therapies has had a profound impact on the delivery of services across the UK. This evidence was used to establish the Improving Access to Psychological Therapies programme. Building on the original research, Roth and Pilling developed a series of competence frameworks which have been used to train thousands of additional therapists to deliver the programme. More than a million patients have now benefitted from the programme, which, along with the clear impacts on individual wellbeing, has also been recognised as having significant economic gains, in terms of NHS savings, reduced welfare spending, and increased return to the workforce.
The Glasgow Composite Measure Pain Scale (CMPS) has provided the first validated pain questionnaire for the rapid assessment of acute pain in dogs in surgical and clinical settings. Developed by the University of Glasgow School of Veterinary Medicine, the scale aids clinical decisions on appropriate pain relief intervention and has been freely downloaded by over 3,000 clinical users since its launch in 2008. In addition, it has been used extensively by veterinary healthcare companies to successfully obtain regulatory approval for analgesic drugs and in marketing support materials. The University of Glasgow researchers have been instrumental in developing international pain guidelines with the World Small Animal Veterinary Association, which represent more than 180,000 veterinarians worldwide, and has thereby promoted awareness of pain management in companion animals.
Eating disorders (anorexia nervosa, bulimia nervosa and related conditions) are common, often chronic and disabling, and sometimes fatal. Christopher Fairburn and colleagues have engaged in long-term research into the nature and treatment of eating disorders. The impacts are: (1) developing the standard measurement tools for eating disorders; (2) devising the leading and most effective evidence-based therapy for bulimia nervosa (`CBT-BN'); (3) showing that a modified form of the treatment is effective for all eating disorders (`CBT-E'); (4) developing an effective and popular self-help version. These treatments allow, for the first time, a significant chance of complete and sustained recovery from an eating disorder. The treatments are recommended by NICE and international guidelines, and are being disseminated worldwide.
Depression is a major public health problem producing substantial decrements in health and well-being, with 15% lifetime prevalence, affecting 350 million people worldwide. The Mood Disorders Centre (MDC) has improved treatment for depression by (i) understanding psychological mechanisms underpinning depression; (ii) translating this into innovative treatments and prevention interventions, evaluated in clinical trials; (iii) improving dissemination, delivery, and access to treatments. This research has improved patient care and quality of life, influenced national policy (NICE Depression Guidelines), informed national service and training provision (Improving Access to Psychological Therapies IAPT programme, with 680,000 people completing treatment 2008-2011) and achieved international impact on clinical practice.
Around 28% of people worldwide will experience a sleep disorder at some point in their lives. Cognitive behavioural therapy (CBT) is an optimal treatment of choice for sleep disorders, but access to treatment is limited by the low number of expert CBT practitioners, resulting in long waiting times for CBT. University of Glasgow Sleep Centre research led to the development of an online CBT course (`Sleepio'), which has been sold online since 2010, and since September 2012 has been sold online by The Boots Company Plc. (Boots). Sleepio has been included in the NHS Health Apps Library and selected for integration with two of the best-selling fitness monitors. University of Glasgow expertise also underpinned `Sleep Matters', a year-long campaign by the UK Mental Health Foundation (MHF) which generated 300 media articles with a combined circulation of 145 million, raising awareness of and widening access to treatment for sleep disorders.
Newcastle University research has changed policy and practice relating to the provision of pain relief to rodents and rabbits. This has impacted on up to 35 million animals worldwide during the REF period. Having established the under-use of analgesics in laboratory rodents, Newcastle researchers developed objective pain scoring systems. These established that analgesics should be administered to rodents and rabbits, and that the efficacy of this treatment should be assessed objectively. The research resulted in changes to policy statements, institutional policies (both academic and industrial) and individual research worker practices in the USA, Canada, Australia, Europe and the UK. This has produced clear benefits to the welfare of animals used in biomedical research, helps to satisfy public concerns that animals used in research should experience the minimum pain and distress, and improves scientific outcomes of research, since pain is an uncontrolled experimental variable, that can adversely affect study results.
Statistical research has played a leading role in the creation of two pain measurement tools for dogs and a welfare tool for farm animals. The Glasgow Composite Measure Pain Scale (CMPS) was the first validated, multidimensional tool for assessing acute pain in domestic animals in surgical and clinical settings, leading to improved treatment. The tool is based on a statistical model and is unique in providing an intervention threshold for pain relief. Since its launch in 2008, it has been downloaded by over 3,000 users from both veterinary practice and industry and it has been used by several companies for regulatory approval of novel analgesics. A second pain measurement tool (GUVQuest) was developed for chronic pain in dogs, enabling its impact on quality of life to be assessed. This tool is suitable for animal owners and is being exploited commercially in web-based form. A welfare tool for pigs has also been developed using the same statistical principles and work is underway on the development of similar tools for cows and cats.