Reena Ravikumar – DREAMS Trial

Dexamethasone versus standard treatment for postoperative nausea and vomiting in gastrointestinal surgery: randomised controlled trial – Based at the Institute of Applied Health Research, University of Birmingham

Overview:

BDRF awarded the DREAMS Trial £130,000 to run a pilot study in 2011, testing whether doses of a drug called Dexamethasone could help prevent people suffering nausea and vomiting after bowel surgery.

Hugely successful, this pilot led on to a much larger trial that is re-writing surgical guidelines on an international scale. Published in the British Medical Journal, its findings have massive benefits for patients and healthcare services through shorter hospital stays, reduced costs and a better experience for patients. Thanks to DREAMS, surgery on the bowel is a less daunting experience, and patients will recover and get back to their everyday lives more quickly.

Professor Dion Morton, who headed up the work, said of the study: “We are extremely grateful to BDRF, whose funding got this work off the ground. Their support has enabled us to make a big step forward in improving care for patients who need bowel surgery, which wouldn’t have been possible otherwise. The changes to routine clinical practice resulting from this study are being adopted nationally and have already been taken up into international guidance, enabling more patients to recover in comfort and get home more quickly”

Further information:

Publication in the British Medical Journal

Kat Oakland – Lower Gastrointestinal Bleeding Audit.

A UK-wide comparative audit of acute lower gastrointestinal bleeding (LGIB) and the use of blood transfusions in hospital treatment, to improve outcomes (including a lower death rate) for patients – Based at Oxford University Hospitals NHS Foundation Trust & NHS Blood & Transplant

Overview:

This work was a nation-wide audit of care pathways for patients suffering acute gastrointestinal bleeding, aiming to develop gold standard care guidelines within the NHS.

LGIB is a relatively common reason for emergency admission to hospital, and has become more so in reason years. BDRF Researchers conducted the largest ever audit of the patient journey within the NHS, to discover which centres get the best results and how. The ultimate goal was to develop a gold standard care pathway for all.

143 UK Hospitals provided data on over 2,500 patients. Hospitals were given their individual results to see how they compared nationally.

The results were also presented to the scientific community in Edinburgh, Barcelona, Milan, Vienna and Orlando.

Guidelines describing best practice for all hospitals across the UK are currently being drawn up. Hospitals will be able to use these to design a gold standard service which hitherto did not exist.

Further information:

Publication in the BMJ’s GUT Journal

Publication in the Lancet Gastroenterology and Hepatology journal

Matt Lee & Adele Sayers – NASBO (National Audit of Small Bowel Obstruction)

A UK-wide audit, designed and delivered entirely by Junior Doctors – led by South Yorkshire Surgical Research Group

Overview:

Small Bowel Obstruction is among the most common reasons for emergency visits to hospital in the UK. It is extremely painful and distressing, leading to untold misery for patients and their families. Worse than this, 13% of patients affected will die within 90 days, yet at present, there are no UK-wide guidelines for NHS treatment.

Our innovative study, the biggest of its kind ever conducted in this area of UK medicine, aimed to identify the best way to look after patients arriving in hospital with SBO. This is the first and most important step to setting NHS guidelines for their care.

Designed, led & implemented by surgical Trainees, NASBO is a revolutionary research project that is now garnering attention throughout the UK and beyond. Data was collected on the care of over 2,500 patients at 126 Hospitals from all parts of the UK. The results are being used to draw up best practice guidelines and will be fully released in December 2017.

Further information:

Publication in the BMJ

NASBO Launch and Full Report BDRF News item

Kathryn Gill – UK Multi-centre trial of transcutaneous posterior tibial nerve stimulation in patients with faecal incontinence- using a novel device.

A trial of new, non-invasive technology to treat faecal incontinence – Based at Sandwell and West Birmingham Hospitals NHS Trust 

Overview

Faecal incontinence affects 1 in 10 of the population. It’s often caused by injuries caused during childbirth for women, and aging in both men and women.

This trial looked at a new device; a patch that is fitted instead of an internal box, thus avoiding the need for surgery . The study was based on how long the treatment lasted and measured whether a four hour approach or a 1 hr approach had better results. Patients were given bowel diaries to record their results and to assess their quality of life.

The trial proved that it is worth investigating further and that the four hour approach had better results than the one hour. While larger scale trials are needed to definitively prove the benefits, this method could reduce the number of hospital visits needed for patients, improve their quality of life and save money for the NHS.

Further information:

Final report from the project team