Study 1

Study leads: Prof David Hewson & Nicky Poulain

The third of the five priorities of the BLMK ICS is ‘Age Well’, which involves offering proactive interventions to enable older people to stay healthy and independent as long as possible. Two age-related conditions that can make ageing well difficult to achieve are frailty and sarcopenia.

Current NHS policy requires all GP practices to screen for frailty using the electronic Frailty Index (eFI). The eFI uses data from electronic health records to stratify older people by frailty level into fit/robust, mildly frail, moderately frail, or severely frail. However, at present, the NHS does not screen for sarcopenia, nor offer any intervention for the condition.

Although the Healthy Ageing Programme (HAP), has been effective in improving strength, physical function, and fear of falling, a limitation of the programme to date has been the low uptake in certain groups of people, including those from ethnic minorities. This programme focuses on improving the uptake of the HAP using feedback and guidance from participant and patient involvement (PPI) groups. In addition, a qualitative study, involving people who decline the offer to participate in the HAP, will be conducted to find out what changes could be made to the programme to encourage them to participate.

This programme is organised in three Work Packages (WPs):

• WP1: Development of a tablet-based screening tool for sarcopenia used in GP practices.
• WP2: Qualitative study to identify barriers and facilitators for older people in the BLMK ICS to take part in physical activity
• WP3: Evaluation of interventions for older people with sarcopenia and frailty

Study 2

Study leads: Dr Erica Cook, Prof Gurch Randhawa, Dr Yannis Pappas & Dr Chirag Bakhai

The unprecedented COVID-19 pandemic has resulted in the rapid adoption of remote (telephone/video ) appointments in the NHS, particularly across primary care. There is some concern that this change may exacerbate existing health inequalities, particularly among the most vulnerable in society. Therefore, this research programme seeks to examine the barriers and facilitators that influence access to primary care for patients of different ages, socio-economic and ethnic communities, with aims to facilitate an improved understanding of how multi-model primary care can be successfully delivered and implemented to support the wider population.

Study 3

Study leads: Dr Erica Cook, Prof Gurch Randhawa, Dr Yannis Pappas & Harjinder Singh

Non-adherence is common, critical, and costly. Around 70% of non-adherence is unintentional and is under-researched. Adherence delivers patient benefit through improved health outcomes. Automated medication reminders (AMR) offer an innovative, safe, and effective approach to improving adherence shown to offer substantial patient benefit and cost savings. We plan to recruit pharmacies across Luton, Bedfordshire and Milton Keynes to pre-fill and deliver this intervention to patients aged 65+ years who are prescribed at least two medications. We will examine the impact of AMRs on adherence, quality of life and health service use. A mixed methods process evaluation will assess the uptake and engagement of AMRs, intervention delivery and fidelity, and mechanisms of action and contextual influences that impact a) engagement, b) delivery, c) experiences and d) outcomes.

Study 4

Study leads: Dr Shuby Puthussery, Dr Pei-Ching Tseng, Dr. Sanhita Chakrabarti, Emma Brown and Tara Pauley