Celebrating a double century – NUH hits recruitment milestones to help older patients
Research team members are celebrating a double century of recruitment into two innovative clinical trials aimed at improving post operative care for vulnerable older patients.
Both the POP-I and WHITE-10 studies have marked the randomisation of 100 participants, thanks to the recruitment efforts of the clinical research team at NUH, who are working alongside colleagues at the University of Nottingham to deliver these studies.
As well as generating evidence which will change practice to help older people who need urgent surgery, especially after hip fractures – often the cause of a health crisis for these elderly patients – both studies should help improve their quality of life in future.
The aim is to reduce distress for patients and their families, encourage them to become mobile as soon as possible after surgery, and return to their normal lives in familiar surroundings.
POP-I (Perioperative Iron and EPO Intervention Study) is an NIHR (National Institute for Health and Care Research) funded multi-centre trial looking at the effectiveness of a commonly used treatment - intravenous iron - for anaemia after hip fracture and emergency abdominal surgery in older people.
Although the trial has not yet concluded, the results should influence practice at national and international level, improving the way older patients are cared for in future.
Professor Iain Moppett, professor of Anaesthesia & Perioperative Medicine and Honorary Consultant Anaesthetist at Nottingham University Hospitals, chief investigator for the POP-I study, praised the “huge achievement” of the NUH team in recruiting into this trial.
“Recruiting older patients into clinical research can be challenging and needs to be handled sensitively,” said Professor Moppett, who was recently awarded an OBE in the King’s Birthday Honours for his work to improve care given to patients before, during and after surgical procedures.
“These results are testament to the skills of the team in Research & Innovation working alongside our PI.”
Becoming involved in POP-I makes a positive impact on patients and their loved ones, even before the trial closes. This is because one measure of trial’s success examines how many of these patients survive surgery for the serious traumas they experience and how many can return home afterwards.
“Our ultimate aim is for patients to make a full recovery, regain their independence and restart their lives in familiar surroundings after surgery – that is hugely important,” added Professor Moppett.
Professor Moppett wrote to Anthony May, CEO of Nottingham University Hospitals, to praise the Trauma & Orthopaedic Research Team, in particular Emma Connor and Charlotte Bentley who have led the studies locally over several years achieving “steady, high-level recruitment” when NUH hit the century of recruitment landmark.
Adam Pedley, trial manager at the University of Nottingham’s Clinical Trials Unit, wrote a message of thanks to the clinical research team in Research and Innovation.
“Behind every one of those 100 numbers is a conversation with an older patient and their family, often at a difficult moment after major emergency surgery, and a team willing to have that conversation carefully and well,” he said.
“Screening, consenting and randomising in this population is not easy, and the fact that you have done it 100 times over speaks volumes about the research team, the theatre and ward staff who support you, and your PI.”
Meanwhile, WHITE-10 is another trial in perioperative medicine, where NUH has also played a major role in driving recruitment.
The trial, led by researchers in Oxford, looks at whether a drug called Lidocaine – which is administered intravenously during their operation - can reduce the delirium many older patients experience after surgery.
Lidocaine is a widely used anaesthetic and nerve blocker. If the trial proves successful, this will become a new indication for the medicine.
Around a quarter of patients who have a hip fracture experience an episode of delirium after their surgery. Delirium is a condition where the patient loses awareness of themselves and their environment, having difficulty in thinking clearly. For relatives and friends, as well as the patient, this is highly disturbing.
Due to the age of the patients and need for specialist care, recruitment into the WHITE-10 trial also needs to be sensitively handled and NUH has been the second highest recruiter since the trial opened late in 2021.