Summary of the impact

King's College London researchers identified that the failure to supervise daily dosing of methadone for heroin addicts was associated with a high annual number of methadone-related deaths. Their research on newly-introduced supervised dosing showed major benefit from this policy initiative with greatly reduced levels of methadone overdose deaths per daily dispensed dose in the UK. Based on this research, guidelines from the National Treatment Agency and Department of Health now include clear direction for initial supervised consumption to prevent or greatly reduce methadone overdose deaths. Recent estimates suggest that the introduction of supervised methadone dosing has saved more than 2,600 lives in the UK.

Summary of the impact

King's College London (KCL) researchers developed cognitive behaviour therapy for psychosis (CBTp), which is now a National Institute for Health and Care Excellence-recommended psychological intervention. CBTp is now part of routine NHS treatment and an estimated 25,000 patients in England and Wales receive it annually. Implementation of CBTp has been steered by KCL researchers' involvement with the Government's Increasing Access to Psychological Therapies — Severe Mental Illness initiative. The KCL model for CBTp has been used to develop clinics in Australia and the US and information on this therapy is disseminated via a KCL-led website.

Summary of the impact

The use of a formulary to influence prescribing practice is common, with almost all hospitals possessing one that attempts to provide advice on the safe, effective and economic use of medicines. The Maudsley Prescribing Guidelines to Psychiatry steps beyond the function of a mere formulary and provides evidence-based guidance on the use of psychotropic medicines that influences prescribing on both a national and international basis. Now in its 11^th Edition and translated into nine languages, much of the evidence in The Guidelines is generated by King's College London research. Additionally, this research is used in other guidelines, in clinical handbooks and in prescribing practices around the world.

Summary of the impact

King's College London researchers have had a major widespread impact on medical care for people with dementia. They have demonstrated the limited benefit and considerable harm done by the use of antipsychotics in dementia patients. Their follow-on campaigning and policy work brought this major health issue to the forefront of the political agenda and led them to work with the Department of Health to create a best practice guide, now widely used nationally and internationally. In addition, they have worked with the BMJ to develop an e- learning package for General Practitioners. The combined impact of this work has made a major contribution to a 60% reduction in the use of antipsychotic drugs in people with dementia in the UK and major changes in practice internationally, preventing 1000's of unnecessary deaths.

Summary of the impact

King's College London (KCL) researchers contributed to the discovery that increased C fibre nerve activity in the bladder is a major cause of overactive bladder (OAB) syndrome. Based on this insight, KCL researcher Professor Dasgupta, a surgical urologist at Guy's Hospital, and his team pioneered a new surgical technique for micro-injecting Botulinum Toxin-A (BTX-A) directly into the bladder to suppress C fibres and improve bladder control. The KCL team then conducted the world's first successful clinical trials into the minimally invasive injection of BTX-A n OAB patients. These trials received significant international media coverage. This cost-effective OAB therapy is now licensed by the EU and FDA, is recommended in national and international guidelines, and has significantly improved the treatment of a common health problem.

Summary of the impact

King's College London (KCL) researchers discovered that heroin overdose is a common and accidental occurrence which is usually witnessed. Risk of fatal overdose on prison release is exceptionally high with 1 in 200 dying of an overdose within four weeks. KCL researchers proposed and tested the acceptability of prior provision of take-home emergency supplies of the heroin antidote naloxone. KCL research created the stimulus for a national training project for families and carers to administer naloxone and as a result, lives are now being saved. KCL research had a substantial impact on national and international policy and service delivery with take-home naloxone programs introduced around the world. KCL researchers lead the first trial to assess the effectiveness of naloxone for prisoners on release.

Summary of the impact

Myeloproliferative neoplasms (MPN) are a group of blood disorders that affect more than 9,000 people in the UK every year. King's College London (KCL) research on the biology, diagnosis and treatment of MPN has had the following significant impacts:

• International criteria for diagnosing MPN were revised to incorporate testing for specific mutations.
• The treatment of patients with two specific types of MPN, essential thrombocythaemia and myelofibrosis, has changed and been incorporated into national and international guidelines. Changes to treatment of essential thrombocythaemia are saving the NHS an estimated £20 million/year while the first specific therapy for myelofibrosis - a drug called ruxolitinib — has been introduced and is benefitting patients.
• International guidelines for the management of pregnant women with MPN have been changed based on KCL research.

Summary of the impact

In the last two decades researchers at King's College London (KCL) have revolutionized the management of benign surgical salivary disease (obstruction and tumours). Understanding the pathophysiology of the salivary glands has translated into a complete change of treatment away from traditional gland removal to minimally invasive gland preserving management. In obstructive disease >90% of stones can be released and <3% of glands removed. Similarly most parotid tumours can be removed safely by extracapsular dissection preserving the gland and significantly reducing risk of facial nerve injury. In children, >80% of childhood ranulas now can be treated without sublingual gland removal. KCL's Dental Institute has become a UK referral centre for minimally invasive salivary procedures and the procedures are now used worldwide.

Summary of the impact

Researchers at King's College London (KCL) have established new surgical interventions, including coronectomy, to prevent nerve injuries resulting from wisdom teeth extraction, the most common surgery on the NHS and worldwide. These interventions have been adopted worldwide, for instance coronectomy is now a billable procedure in the US, and are also incorporated into a number of guidelines, for example those by the Royal College of Surgeons and the British Dental association. The KCL team have developed a website aimed at providing information for those with trigeminal nerve injuries, which they can gain both through online content and by directly emailing the specialist team.

Summary of the impact

Trachoma, caused by ocular infection with Chlamydia trachomatis, is the leading infectious cause of blindness. Research by Professors David Mabey and Robin Bailey, LSHTM, has shown that a single oral dose of azithromycin is an effective, feasible mass treatment and could eliminate trachoma from affected communities. As a result, the manufacturer Pfizer agreed to donate azithromycin to trachoma control programmes for as long as necessary and WHO established an Alliance for the Global Elimination of Blinding Trachoma by 2020. Since 2008, 205m azithromycin doses have been donated, and WHO elimination targets have been achieved in nine countries.