Unique research project aims to improve heart failure patient outcomes

It is hoped that the project will ultimately lead to lower death rates and readmissions to hospital.

Heart failure is responsible for approximately five per cent of medical admissions and the hospital readmission rate within three months of discharge has been estimated as being as high as 50 per cent.

The project has been tracking the management of heart failure patients through the transition phase from leaving hospital to managing medicines at home, and identifying the strengths and weaknesses of current systems.

The research team has been working with patients across the healthcare economy in Leeds, Hull, Calderdale, Kirklees and East Lancashire.

ISCOMAT (Improving the Safety and Continuity of Medicines Management at care Transitions), funded by NIHR Programme Grants for Applied Research, studies medicines management for patients with heart failure across a range of health organisations involved in their care when they are discharged from hospital.

It is unique in being the first pharmacy-led, experience-based project co-designed with patients and staff working together to improve care.

Patients and staff have worked together to decide priorities for improving services and have jointly designed ideas for a Medicines at Transitions Toolkit (MATT). This included creating a ‘trigger’ video, recording patients talking about their experiences of leaving hospital and how they managed their medicines at home. It has played a key role in helping to design the toolkits about to be tested for feasibility.

The project is a multidisciplinary research collaboration between University of Bradford, University of Leeds and Bradford Teaching Hospitals NHS Foundation Trust involving patients, NHS staff, and the NIHR Clinical Research Network.

Professor Alison Blenkinsopp of the University of Bradford, and joint chief investigator, said: “The use of patient experience and joint design with them on this scale is unusual and this is the first time it has been used for the development of interventions for clinical trial. Placing patients at the centre of service improvement has been invaluable in helping us to design the toolkit, which bridges the gaps in current systems and transitions.”

Dr Peter Gardner, of the School of Psychology at the University of Leeds and the other joint investigator, said: “One of the key factors in the project is to identify and take account of best practice in the management of medicines.

“It is important to learn from the positive experiences of staff and patients in addition to the difficulties that they face.”

The feasibility study will take place during the remainder of 2017 with patients across Leeds, Bradford and Hull to establish the optimum implementation process for the MATT, assess its usability and acceptability, identify key facilitators and barriers to implementation, and test data collection methods.

It will then go forward to clinical trial in 2018 across 42 NHS trusts, with key measures being rates of death, readmission and the appropriate prescription of medicines after discharge.