Identifying gambling problems in primary care
Principal investigator: Sean Cowlishaw

Studies suggests growing numbers of people are gambling in the UK, and also experiencing problems with gambling (e.g., debt, relationship breakdown). These problems are over-represented in primary care, and it may be that GPs should have a role in helping change behaviour and reducing the hazards from gambling. However, in contrast with other risk behaviours, such as excessive drinking, there is limited awareness of gambling and harms associated with it are usually unrecognised.

This project will increase awareness of gambling problems in general practice, and examine the need for initiatives to identify and address these issues in primary care. It involves an exploratory study of gambling problems in general practices.

“This funding will help understand how primary care could be involved with reducing the harms from gambling,” said Dr Cowlishaw. “General practice may be the only setting in which many people with problems will seek health-care services. As such, these visits may provide critical opportunities to identify and help people at the early stages of their problems, and before they suffer lasting damage to mental health and family relationships.”

VOICES study (ViOlence: Impact on Children Evidence Synthesis)
Principal investigators: Alison Gregory and Ali Heawood

The VOICES study will explore the impact on children of exposure to domestic violence and abuse (DVA) using systematic review and secondary analysis of qualitative evidence. This research is important because 14% of children will be exposed to DVA at some point during their childhoods and, even if they are not the direct target, they often experience major physical and psychological health consequences.

“In VOICES, we will draw together data from the viewpoints of children, non-abusing parents and ‘concerned others’ (adult relatives and friends) in order to give a picture of how children are affected by DVA and the needs that could potentially be addressed by doctors and other professionals working in primary care,” said Dr Gregory. “The findings from this research will hopefully feed into the NICE guidance around the health service response to DVA, so that clinicians feel better equipped in their response to patients who have been exposed to domestic violence.”

Can continuity of primary care decrease unscheduled secondary care use?
Principal investigator: Richard Morris

This project will investigate the potential role of continuity of primary care on unscheduled secondary care. It will use data from the Clinical Practice Research Datalink (CPRD) which contains current data on anonymised patient records within several hundred general practices across England. The CPRD is linked with Hospital Episode Statistics (HES) data in England, and we will investigate patients in CPRD who could be linked by their NHS number to HES data which would show emergency hospital admissions in the financial years 2012-4.

“The purpose of this project will be to investigate the suitability of the data to address the hypothesis that continuity of care in primary care can reduce unplanned secondary care,” said Prof Morris. “We will request from CPRD a dataset of up to 10,000 patients, aged over 65. If the data do seem suitable, we will seek further funding to carry out an analysis on the full CPRD dataset which consists of over 2 million patients.”