My research aims to improve the effectiveness of tests and treatments for people with long-term, progressive conditions, particularly diabetes, and to improve the way that treatments are targeted at those people most likely to benefit through appropriate monitoring of the condition. My research programme includes two main strands:
1. What are the best ways to monitor disease progression and treatment?
Monitoring of biological and physiological markers can be used to guide clinical practice. For example, changes in blood glucose, HbA1c and renal function are all used to change treatment. In collaboration with colleagues we are carrying out a series of studies to look at the best way to use these tests. Using information about accuracy of measurement and underlying rates of change of disease markers obtained from large randomised trials and clinical databases, the studies will provide data about the relative effectiveness of different monitoring strategies that will inform clinical practice and health policy. (Funded by grants from the NIHR Health Technology Commissioning Board, NIHR School of Primary Care Research and NHS Diabetes).
2. Which interventions will improve health for people with long-term progressive conditions?
As Director of the Primary-Care Clinical Trials Unit I am involved in a range of studies that involve developing and evaluating interventions for use in a primary care setting. These include systematic reviews to compare different drug treatments or care-pathways for insulin treatment in type 2 diabetes; clinical trials of blood glucose self-monitoring in non-insulin treated patients, interventions to help people take medication regularly and mobile-phone based telehealth systems to help monitor diabetes. (Funded by grants from the NIHR Health Technology Commissioning Board, the UK Medical Research Council, the NIHR School of Primary Care Research and the NIHR Oxford Biomedical Research Centre).