Tag Archives: drugs

Commercial clinical trials : How do we get health professionals interested?

(This is a guest post by Gemma Borland on behalf of the Heart of England Hub of the Mental Health Research Network)

drugs etc

Do your patient’s receive the best possible treatment? How do you know?

Every day in clinical practice medications are used, but do you know how these medications have been developed and would you want to be involved when the products of the future are being tested?
Pharmaceutical companies sponsor clinical trials to research new medications.  Potentially, these trials may lead to the  development of  more effective drugs.

The importance of this research cannot be underestimated, finding medications with fewer side effects, which are easier to take, impact less on someone’s life and manage someone’s condition better, can improve a service user’s quality of life dramatically. The need to continually strive towards the best treatments available in the NHS is paramount.

Equally important is the need for new medications to be tested in the NHS and on the UK’s patient populations.

Clinical research studies

Since I became involved in setting up clinical research studies 5 years ago, I have worked with dedicated clinicians and nurses, passionate about the importance of commercial research having seen the benefits that access to cutting edge treatments can bring to their patients. However, there is a real need to increase commercial trial activity within the NHS.

Industry trials are often seen as complex, with onerous Sponsor requirements and a lack of understanding as to what the work entails. For Health Professionals who have not yet been involved in commercial clinical trials, the work can seem a daunting avenue to pursue. This is the challenge facing the Mental Health Research Network, a national initiative to support mental health clinical research in the NHS.  We need to identify how we get individuals involved in commercial research and look at the issues which may prevent people working on commercial trials.

Mental Health research Network

The Heart of England Hub of the Mental Health Research Network is currently piloting a project to develop and run a mentoring programme, tailored at supporting nurses, clinicians and other professionals, working on commercial studies for the first time. The programme will provide an experienced mentor with whom study teams can access for advice and guidance whilst working on a commercial trial, as well as training and information to help people better understand commercial trial work.

With this additional support, we are hoping to expand the number of clinicians, nurses and other health professionals working on commercial studies in the Midlands, with the ultimate goal of increasing the number of commercial trials running across the region.

We want your comments, i.e. what are your opinions on commercial clinicial trials, would you get involved? If not, why not?

http://www.mhrn.info/
For further information on the mentoring programme contact : gemmaborland@nhs.net

Medication errors

DSC_0007

I was just reading a report from the National Patient Safety Agency entitled ‘Safety in Doses’ (See link below). This report gives a review of medication errors reported to them during 2007.  The majority of these involve general medical settings although 9% of them (6551) happened within mental health services. Luckily, 96% of all incidents are not serious, in that nobody got hurt – however there were 100 cases of death and severe harm.

In mental health and learning disabilities settings the most common problems are caused by omission of anti-convulsant medications, generally, omission of medications is a serious problem. Incidents involving methadone and clozapine were also frequently seen. A big problem is found in the interface between primary and secondary care settings. Given the complexity of modern mental health care provision the number of such interfaces and the potential for confusion is greatly increased.

I can remember a couple of incidents from practice in which medication was administered incorrectly. Fortunately neither case caused any harm to anyone but I will never forget the feeling of absolute horror when I realised what had happened.

General Views Of The UK's Major HospitalsLess fortunate were the patients being cared for by these Nurses practising at Heartlands Hospital in Birmingham – I can remember reading about this truly dreadful incident.  It is very easy to understand the anger felt by the widow of of one of the patients killed.

How many of us can say that we have never made a mistake when working with drugs?

Those of you who are a little older will remember the ‘drugs assessment’ that every student nurse had to pass. This involved studying the contents of a drug trolley, learning the nature and purpose of every drug as well as it’s usual dosage and most common side effects. It was a tough test to pass!

I just wonder if we need something like this now?

I guess a lot of people will say that nurses are often working in stressful situations, there isn’t always the level of staffing & resources needed to do things as well as we would like. I certainly don’t think that all errors are down to nurses lacking knowledge.

What others think? Do you as qualified staff feel that students are as well prepared as they ought to be? – what about students, are you ready to take responsibility for administering medication? Also, if there are errors being made then why do you think this happens?

I would really love to hear from people.

Link to National Patient Safety Agency report

Photo at top of blog from Flickr creative commons by Charles Williams (click on picture)

PS On an unrelated note I had an email from the RCN asking that I draw your attention to the RCN election website – there are two links below for your attention

www.rcn.org.uk/generalelection

http://www.facebook.com/pages/Nursing-counts/268071293877?v=wall

A losing battle?

British Royal marine with captured Opium - from Flickr commons - see also below

I was just reading this story from the BBC about a suggestion that the Scottish cannabis crop (worth an estimated £100 million) may now be bigger than the Scottish vegetable crop.

This comes in the same week that we had the story about the sacked Government drugs adviser. As usual then, plenty of stories about drugs.

Just ask a CPN

Of course, if I wanted stories about drugs then I would need to go no further than my own students in practice or my clinical colleagues. Any of these people would be able to reel off hair raising stories about drugs in the communities around us – often we hear about the effects of these substances and their widespread availability (ok, far more often we hear about legal drugs i.e. alcohol)

Not so long back a local CPN told me that in their particular area they may as well stop asking ‘do you take drugs of any sort’ – in favour of asking ‘what do you take?’  When I was last a CPN it was pretty obvious that in some parts of town it was probably more convenient to buy Crack Cocaine or Cannabis than it was to buy, say – five portions of fruit & veg a day!

Crime

How much crime is all of this promoting?

A litle example – Not so long back my daughter was in Church with her Nan – whilst the service was in progress she noticed a man going around collecting unattended handbags. As soon as he had gathered enough he ran from the church. ‘Money for drugs’ was the assumption of the (mainly elderly) theft victims – it may not have been, but would you bet against them being right?

As well as a great deal of petty crime there is a colossal amount of organised crime – both here as well as in poorer countries. There is a suggestion that Mexico is close to buckling under the strain of fighting the drugs war as well as other Latin American nations (See link) (also this)

How many members of our armed forces have been killed or injured in Afghanistan by weapons and explosives partly funded by illegal drugs?

What do you think?

I can’t help thinking that eventually we are going to have to face the fact that the we need to look at this – where is the war on drugs heading? – are we just here to pick up the pieces?

I don’t have the answers of course but I wonder, what would you as Mental Health Nurses do?

Is my assessment over pessimistic? – or are the streets of our major cities awash with illegal drugs?

Do you think that we need more of the same – or some degree of legalised supply of drugs?

I think that Mental Health nurses are ideally placed to comment given our knowledge of what is going on.

Get back with your comments if you get a minute – feel free to do so anonymously if you want.

NB Photo at top of post from Flickr commons also on Helmandblog

(See also)

Time article ‘Drugs in Portugal’