UOA 3: Allied Health Professions, Dentistry, Nursing and Pharmacy

Staff conducting research: Professor Peter Thomas, Dr Sarah Thomas, Dr Andy Pulman, Dr Sarah Collard, Dr Huseyin Dogan, Dr Nan Jiang

Pharmaceutical interventions to treat fatigue in people with Multiple Sclerosis (MS) are not always effective and, although cognitive behavioural therapy has proved helpful for other conditions, there was a lack of evidence supporting its use for managing MS fatigue. BU researchers confirmed the evidence gap in psychological treatments for MS fatigue.

The team worked with Poole Hospital to develop FACETS (Fatigue: Applying Cognitive behavioural and Energy effectiveness Techniques to LifeStyle) - a group-based fatigue management programme, designed to be easily implemented in clinical practice.

The MS Society supported digital delivery of the programme and the national roll-out of FACETS via a one-day facilitator training course developed by the research team, which has so far trained more than 300 healthcare professionals in the UK. 

Nearly 14,000 people with multiple sclerosis in the UK have participated in FACETS programmes, and the programme has also been delivered or adapted for use worldwide. The CEO of the MS Society said: “Our feedback from people with MS has shown the positive impact that the FACETS programme has on their lives, making a real difference.”

Staff conducting research: Professor Rob Middleton, Professor Tom Wainwright, Louise Burgess, Tikki Immins

Enhanced Recovery After Surgery (ERAS) is an evidence-based approach to help people recover more quickly after major surgery. Since 2010, BU research has been instrumental in the application of ERAS within orthopaedics across the UK and internationally.

BU researchers conducted the first systematic review examining patient experience of ERAS in hip and knee replacements, which confirmed that patient satisfaction was high and patient outcomes were improved.

They have also sought to optimise elements of the pathway known to directly affect patient experience, such as pre-operative education. 

They have worked with clinicians and government officials around the world to decrease costs for hospitals by reducing the average length of hospital stay through ERAS programmes, whilst improving patient outcomes. This has included work with health district boards in New Zealand and working with the Scottish government on implementing a national programme of ERAS approaches.

Staff conducting research: Professor Ian Swain, Dr Jon Cobb, Professor Tom Wainwright, Professor Robert Middleton, Professor Paul Taylor, Choukri Mecheraoui

Electrical stimulation is a method of controlling muscles using an external device, following neurological disease such as stroke or musculoskeletal problems. When used to provide a specific function, such as walking or hand grasp, it is known as functional electrical stimulation (FES). 

Professor Swain’s research using an electrical stimulation device demonstrated significant advantages over traditional physiotherapy to rehabilitate patients after a stroke.

Professor Swain has steered a collaboration between BU, Salisbury NHS Foundation Trust and Odstock Medical Limited (OML), after taking the lead in patenting the first Odstock Dropped Foot Stimulator and helping establish OML. The clinical service has since expanded to include the treatment of people with multiple sclerosis (MS), spinal cord injury and Parkinson’s disease.

The findings from the partnership have helped develop the National Clinical FES Centre in Salisbury, the largest clinical service in the world, and provided equipment for other FES centres across the UK.

The FES devices developed with BU research input have radically improved people’s lives, increasing their functional ability and their participation in society.

Staff conducting research: Professor Robert Middleton, Professor Tom Wainwright, Louise Burgess, Shayan Bahadori, Dr James Gavin, Tikki Immins

Venous thromboembolism (or Deep Vein Thrombosis - DVT) is the leading cause of preventable deaths in hospital. Research by Professor Robert Middleton and Professor Tom Wainwright has informed the development of Firstkind Ltd.’s gekoTM medical device and was critical in obtaining National Institute for Health and Care Excellence (NICE) and Food and Drug Administration (FDA) approval for the device in the UK and USA respectively.

Their research not only demonstrated its use to prevent DVTs, but led to the optimisation of the device settings, and expanded its clinical indications for use, to include the reduction of oedema (swelling). This fundamental role in the development of the gekoTM has led to sales in 14 countries and adoption in the National Health Service (NHS) during the COVID-19 pandemic.

Staff conducting research: Professor Roger Baker, Professor Peter Thomas, Dr Sarah Thomas

In the late 1970s, Professor Baker began to see a connection between physical symptoms and the way earlier stressful events were emotionally processed. 

Together with a project team and clinicians, Professor Baker began the development of the Emotional Processing Scale (EPS) in 2000. Research findings indicated that nearly every psychological disorder they studied revealed significant difficulties with emotional processing. 

The EPS was published in 2015 and is used as a tool to diagnose and treat people with a variety of physical, behavioural and emotional pathologies. It has been employed by clinicians and in teaching, such as by Dorset Healthcare University NHS Foundation Trust and the Open University.

The EPS has been translated into 19 languages and been used by therapists, psychologists and teachers in France, Poland and Italy, while Professor Baker’s three self-help books based on the research have sold more than 90,000 copies worldwide.

Staff conducting research: Professor Jane Murphy, Dr Joanne Holmes, Cindy Brooks, Dr Nirmal Aryal

Malnutrition affects 1,300,000 (or 1 in 10) older adults living in the community, with far-reaching health consequences, an increased need for healthcare and higher rates of mortality. Research undertaken by Professor Murphy identified the need for new practical approaches to screening and tools that would allow for early intervention to prevent malnutrition.

BU researchers worked with the Patients Association to help test and refine their Nutrition Checklist, which has been used by councils and NHS Trusts throughout the UK to screen vulnerable populations. It became a vital tool for diagnosing malnutrition in the community during the Covid-19 pandemic.

As well as identifying new ways of screening, Professor Murphy developed new interventions to reduce the risk of malnutrition in vulnerable groups, such as people with dementia, who are particularly at risk due to reduced appetite, difficulties associated with eating, and swallowing problems.

Key aspects of BU research were embedded in the National Dementia Training Standards Framework. Findings also led to the development of a training toolkit to deliver person-centred nutritional care for people with dementia and a guide for family carers.