Care and prevent: skin infections and kidney disease
Research type
Research Study
Full title
Promoting skin and soft tissue infection care and preventing AA amyloidosis renal failure among people who inject drugs in the United Kingdom: A mixed methods multi-phase study.
IRAS ID
218143
Contact name
Magdalena Harris
Contact email
Sponsor organisation
London School of Hygiene and Tropical Medicine
Clinicaltrials.gov Identifier
12021, LSHTM Ethics reference
Duration of Study in the UK
4 years, 0 months, 0 days
Research summary
Background
Skin and soft tissue infections (SSTIs) are a significant, yet under-researched, cause of illness and death among people who inject drugs (PWID). Approximately 10% of PWID in the UK are hospitalised each year for SSTI-related complications. Most hospitalisations are avoidable; due to delays in primary care access. SSTI care for PWID costs the NHS around £77 million per year.AA-amyloidosis, a serious complication of chronic SSTIs, causes renal failure and premature death. Median survival from diagnosis is 19 months for UK PWID. Disease progression can be arrested with early diagnosis, effective SSTI treatment and injecting cessation. AA-amyloidosis can be screened for, but this simple urinalysis test is not currently implemented in drug treatment services.
Aim
To explore the facilitators and barriers to SSTI prevention, self-care and treatment access among PWID and to test the feasibility of implementing screening and referral to treatment for AA-amyloidosis in UK Drug Treatment Services.Methods
The project employs a mixed-method multi-phase design, involving five interlinked phases: Phase 1) Determining the evidence base: systematic review of the literature on SSTI interventions for PWID. Phase 2) Feasibility study of AA-amyloidosis screening and treatment referral in drug treatment services: researcher-administered survey; urinalysis for proteinuria; referral to specialist services; peer accompaniment to diagnostic appointment. Sample n=400 PWID. Phase 3) Qualitative investigation of barriers and facilitators to the AA-amyloidosis care pathway: in-depth interviews and observations before, at the time of and 3-4 months after specialist referral. Sample n=15-20. Phase 4) Qualitative exploration of factors informing SSTI protection and risk: in-depth interviews with a matched sample of PWID with and without SSTI. Sample n=45-50. Phase 5) Dissemination events and resource development.Outcomes
Outcomes include: educational resources; recommendations for SSTI interventions & AA amyloidosis screening; potential development of a national AA-amyloidosis risk screening study supported by Public Health England (outcome dependent).REC name
London - London Bridge Research Ethics Committee
REC reference
17/LO/0872
Date of REC Opinion
19 Jun 2017
REC opinion
Further Information Favourable Opinion