92 The Pharmaceutical Journal

Articles

17 July 2010 (Vol 285) www.pjonline.com

Research networks are key and theyoffer a central role for pharmacists For this article, Beth Allen, research manager at the Royal Pharmaceutical Society,looked at the roles of clinical research networks, which form part of the NationalInstitute for Health Research’s infrastructure, and found examples of pharmacists’who work within them

The National Institute for Health Research(NIHR) was established in April 2006 toimprove the health and wealth of the nationthrough research by means of the creation of ahealth research system that supportsoutstanding individuals working in world-classfacilities, conducting leading-edge research,focused on the needs of patients and thepublic. The NIHR’s key work strands areoutlined in the diagram opposite.

Those actively engaged in research will befamiliar with the NIHR as a research fundingorganisation. However, there is also a nation-wide research infrastructure that presentsopportunities for all pharmacists in all sectorsto engage in multidisciplinary research toimprove and advance healthcare delivery forthe benefit of patients and the public.

The infrastructure ismade up of clinicalresearch networks,clinical research facilitiesand centres and aresearch design service.This article focuses onthe roles of the clinicalresearch networks withsupporting examples ofpharmacy engagementand the opportunitiestherein.

Research networksThe NIHR topic-specificand comprehensiveclinical researchnetworks ensure that allNHS patients andclinicians can share thebenefits of participating inclinical research through workingwith partners and funders, includingindustry.

These clinical research networks supporthigh-quality clinical trials. However, they alsosupport other well designed health researchstudies throughout England, and promotepatient and public involvement in healthresearch.

Topic specific clinical research networksThere are six topic specific clinical researchnetworks:

• National Cancer Research Network — 40local research networks across the UK

• Dementias and Neurodegenerative DiseasesResearch Network — seven local researchnetworks across England

• Diabetes Research Network — eight localresearch networks in England

• Medicines for Children Research Network— six local research networks in England(see “Medicines for children” Panel, left)

• Mental Health Research Network — eightlocal research hubs in England (see “Mentalhealth” Panel, right)

• Stroke Research Network — eight localresearch networks in England

Comprehensive local research networks All other diseases and areas of need arecovered by the comprehensive clinicalresearch network (CCRN) across England,with 25 comprehensive local research

networks (CLRNs) covering the wholecountry. CLRNs are the primary vehicle forproviding infrastructure to support studyinvolvement. They encourage participation ina range of high quality studies in the NIHRportfolio and provide research personnel andfacilities to support recruitment.

A forthcoming article in ThePharmaceutical Journal will spotlight the workof CLRNs and the ways in which pharmacistscan and are engaging in multidisciplinaryresearch, with a particular focus oncommunity pharmacy.

Primary care research networksPrimary care research networks (PCRNs) arededicated to expanding clinical research inprimary care, where most patient contacttakes place. A primary aim of a PCRNis to facilitate recruitment into appropriatelocal NIHR portfolio studies requiring thesupport of GPs and other primary carecommunity staff (see “Primary care event”Panel, right).

The networks bring a wide range ofprimary care health professionals together andpromote high quality research, informed bythe views of patients and their carers. Primarycare has particular responsibility for areassuch as disease prevention, health promotion,screening and early diagnosis, as well as themanagement of long-term conditions, such asarthritis and heart disease.

The UK Clinical Research Network(UKCRN) Co-ordinating Centre oversees the

MEDICINES FOR CHILDREN

The Medicines for Children Research Networkwas created to improve the co-ordination,speed and quality of randomised controlledtrials and other studies of medicines intendedfor use in children and adolescents. ThePharmacy and Pharmacology Clinical StudiesGroup is one of 13 specialist groups thatsupport the MCRN both in providing expertiseto NIHR portfolio studies and in research prioritysetting.

The focus of the group is formulation,pharmacokinetics and pharmacogenomics. Thispharmacy expertise (particularly formulationscience and the need for dosing accuracy) atthe beginning of such studies involving childrenis vital to ensure reliability and validity ofoutcomes.

I have been involved in Department ofHealth research initiatives since I was awardeda Public Health Career Scientist Award in 2002.Establishing the Centre for Paediatric PharmacyResearch, also in 2002, provided theknowledge and expertise required by the NIHRwhen these clinical research networks were firstestablished. Our early involvement as experts inmedicines has ensured that pharmacy isleading in this important multidisciplinary clinicalresearch area.

Ian Wong, chairman of the Pharmacy andPharmacology Clinical Studies Group, MCRNNIHR, and Associate Director of London andSouth East MCRN Local Research Network

Key work strands of the National Institute for Health Research

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PRIMARY CARE EVENT

The Primary Care Research Network for GreaterLondon (PCRN-GL) is hosting a pan-Londonengagement event for pharmacists interested inresearch on 21 July 2010 at the RoyalPharmaceutical Society’s headquarters. This ispart of its commitment to increase the numberof primary care healthcare professionals inLondon willing to facilitate the flow ofparticipants into high quality clinical studies onthe NIHR portfolio. This event will help PCRN-GL to identify

pharmacists in London with an interest inresearch, or those who are already researchactive.In putting together this event the PCRN-GL

has discovered high levels of enthusiasmamong the pharmacy community. A key outputof the event will be equipping the PCRN-GL tobetter understand what pharmacist interests areand how the PCRN-GL and other NIHRorganisations can support them. The event willoffer pharmacists an insight into the networkand how it currently works with study teamsand primary care practitioners to recruitLondoners into high quality NIHR researchstudies.There will be speakers from research study

teams who have worked with pharmacists inthe delivery of previous research. There will bean open session and an opportunity forpharmacists to put questions to researchersand network staff. The PCRN-GL believes thatthis event will complement other pharmacyinitiatives across London.

Claire Pentecost, senior research officer,PCRN-GL

COLLABORATION

The NIHR Collaboration for Leadership inApplied Health research and Care for NorthWest London currently has five partneringorganisations across eight sites undertaking amedicines management project.These are all being project managed or led

by nine pharmacists working closely with aconsultant lead who co-ordinates activity andshares learning within a multidisciplinary team.The projects involved are: “Medication

reconciliation and telephone support atdischarge”; “Medication reconciliation atdischarge”; “Improving medications in theelderly — developing a STOPP trigger tool kit toavoid inappropriate use of medications in theelderly”; “Improving antibiotic prescribing”; and“Embedding the five rights ofmedication management: a systems andeducation approach”.Other projects, such as “Community

acquired pneumonia” and “Chronic obstructivepulmonary disease discharge care bundles”have also relied heavily on pharmacist supportin a number of ways, for example, support inthe “front-line” and patient training (COPDinhaler use), systems change (four hourantibiotics delivery for community acquiredpneumonia and improving local antibioticguidelines).The pharmacists involved form part of the

CLARHC’s “Collaborative learning and delivery”events, which aim to enable the application ofimprovement and research methodology toother aspects of practice.

Jackie Valentine, programme lead for acutecare, NIHR CLAHRC for North West London

MENTAL HEALTH

The Mental Health Research Network ismanaged by a partnership between the Instituteof Psychiatry, King’s College London, and theUniversity of Manchester.Historically, mental health research has

generally been under-resourced and lacked co-ordination. The MHRN aims to provide theinfrastructure to support research, link this withpractice to improve the quality of treatment andcare, identify research priorities and developresearch capacity. The MHRN consists of acentral co-ordinating executive managementteam and eight regional hubs. David Taylor,chief pharmacist, South London and MaudsleyNHS Foundation Trust and professor ofpharmacology, King’s College London, ispharmacy lead for the whole of the MHRN andsits on the central executive representingpharmacy issues. Each regional hub has apharmacy lead linked with the central executivevia Professor Taylor. The role of hub leads includes working with

pharmacists within the hub to streamline theirinvolvement in studies adopted by the MHRN,identifying clinicians interested in research anddeveloping future research projects. One of thekey aspects of the role is advising on thefeasibility of studies, especially pharmaceuticalindustry studies.In mental health supply, services are

commonly not provided in-house, but via anacute trust or a community pharmacy and thehub lead may need to liaise acrossorganisations during study set-up. Ian Maidment, pharmacy lead, MHRN South

London and South East hub

The Pharmaceutical Journal 93

Research networks

(Vol 285) 17 July 2010www.pjonline.com

work of all the networks for the NIHR,including the CCRN . Similar networks are in place in Northern Ireland, Scotland and Wales.

CLARHCsNine collaborations for leadership in appliedhealth research and care (CLARHCs)have been established across the UK througha competitive bidding process. Their purposeis to undertake high-quality applied healthresearch focused on the needs of patients andto support the translation of research evidenceinto practice in the NHS. They do not sit

under the umbrella of the UKCRNCoordinating Centre but are collaborativepartnerships between a university and thesurrounding NHS organisations. Their aim isto create and embed approaches to researchand its dissemination that are specificallydesigned to take account of the way thathealth care is increasingly delivered acrosssectors and a wide geographical area (see“Collaboration” Panel, below)

ConclusionWhat all the CRNs have in common is thedesire to bring together researchers,practitioners, policymakers and members ofthe public: there are opportunities forpharmacists across all sectors and at variouscareer stages to bring their unique knowledgeand expertise to multidisciplinary research.

However, the examples given in the Panelsare by no means exhaustive, and pursuing anacademic/research career is certainly not theonly reason to get involved, as the personaland professional benefits are wider reaching,for example: enhanced job satisfaction; pursuitof an interest in a specific aspect of practice;opportunities for career development orchange; greater multidisciplinary working andnetworking; developing a local leadership role

(and skills); opportunities for mentoring(mentor and mentee); training and groundingin research (theory and practice); creation ofopportunities for collaborative andpartnership working; contribution tocontinuing professional developemnt; andpositive outcomes for patients and the public.

To begin to explore the ways in which youmight get involved you can approach thenetwork leads directly to find out what ishappening in your local area. Maps for all thenetworks and the leads in each region areavailable on the NIHR website atwww.nihr.ac.uk/infrastructure.

Alternatively, approach your local practiceforum research lead to facilitate localpharmacy engagement with these networks.This will assist the integration of LPFs intothe local healthcare community and ensurepharmacy practice research does not sit inisolation from the wider healthcare team orusers of pharmacy services.

The Royal Pharmaceutical Soceiety’sscience and research team would also like toencourage pharmacists to share theirexperiences of working with the NIHR. If youhave an experience you wish to share, pleasego to the new S&R network on the RPSwebsite at www.rpharms.com.

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