Introduction
Hi there, my name is Leonie
Brinkmann. I am a German pharmacist and started my PhD at the University of
Manchester about two years ago. I work in the field of health economics. Health
economics is a branch of economics that tries to evaluate health care services
or new medications from an economic perspective without neglecting the value of
health. This combines a medical background knowledge, data analysis and
statistics. I myself, for example, focus on patient safety. Using big data sets of electronic health
records I try to identify specific patients with medication errors to see how
many of the medication errors lead to harm for the patient.

In Depth…
I am a pharmacist by background and
did my undergraduate at the University of Heidelberg. Pharmacy is a great
subject that combines biology, chemistry, physiology and pharmacology. I was
always interested in medicines and diseases, but I cannot see blood. So
studying medicine was off the table, but pharmacy happened to be the prefect
trade off!
I enjoyed my
undergraduate a lot, but it included long hours in the laboratory. Lab work was
never something I enjoyed. I found it rather boring… But luckily as pharmacist
you have loads of other opportunities in community pharmacies, industry,
hospital or research.
I was very lucky to get a job as
clinical pharmacist in a hospital. My main objective was to increase patient
safety on the wards. I had a great time going from ward to ward, identifying
patients with medication errors, and telling the doctors or nurses off that
made the error. It always felt a bit
like being the safety police of the hospital.
But at some point I felt like I
wanted to study again, I wanted to learn something new and be challenged a bit
more. That’s when I decided to do a PhD. I found a great project that took the
work I was doing in the hospital on a small scale to another level. Before I
was looking through the patient’s health records by hand, now I am evaluating a
computer programme that automatically screens all electronic health records of
a patient and identifies medication errors. The pharmacists does not need to
screen each patient, but can focus on how to communicate medication errors to
the responsible doctor.
The burden of
medication errors is estimated to be about £89.1 million per year for the NHS.
This highlights how important it is for the NHS to invest in programmes that
aim to reduce medication errors. But
unfortunately, the NHS does not have endless money to fund great ideas like
this. That’s where health economics becomes interesting, because we can show
the value of money of the new computer programme. To do so I am using
electronic health records from GP-practices and hospitals to investigate the
relationship between medication errors, patient harm and costs. Quantifying the
burden of medication errors enables us to estimate the true value for money of
the computer programme. Results on the value for money of such programmes aims
to aid decision making by policy makers on
whether to fund such programmes or not.
So if you like numbers, you are not
scared of statistics and you want to make the NHS a bit safer, this is the
perfect opportunity for you!

Going Further…
Learn more about Pharmacy https://www.bmh.manchester.ac.uk/study/pharmacy/
Little introduction video to understand what health
economics is about (only 3 minutes) https://www.youtube.com/watch?v=bUay9DV__G0
Learn more about what we do as health economists in our
newsletter http://research.bmh.manchester.ac.uk/healtheconomics/MCHENewsletter/
What are electronic health records that I use in my PhD
project https://www.ehealthireland.ie/Strategic-Programmes/Electronic-Health-Record-EHR-/
Why are health records important for research?
https://www.youtube.com/watch?v=GNbe3-d3KdQ
by YPU Admin on April 2, 2015,
. Tags:
antipsychotics, cycling, delusions, depression, exercise, gym, hallucinations, healthy, manchester, medication, medicine, mentalhealth, MHLS, NHS, paranoia, postgrad, psychosis, Research, rowing, running, schizophrenia, training, and treatment
Introduction
My name is Joe and I’ve just begun the 2nd year
of my PhD in Medicine. I am researching how we can use physical exercise to
improve people’s mental health. Specifically, I work with young people (from 18
years onwards), who are experiencing serious mental health problems for the
first time in their lives – a condition which is referred to as “First Episode
Psychosis”. I am investigating whether specially designed physical exercise
routines can help people with First Episode Psychosis to feel healthier; in the
body, and also in the mind.

In Depth
What is First Episode Psychosis
First Episode Psychosis is the first 5 years of any
‘psychotic disorder’, such as Schizophrenia. This affects around 1 in 100
people, and most often starts around the age of 18. The most recognisable
symptoms of first-episode psychosis are hearing voices, seeing things which
other people cannot see (hallucinations), delusional beliefs and paranoia.
Along with these, there are often less obvious symptoms of people severely
lacking in motivation, feeling depressed, withdrawing from society and becoming
reclusive.
Current Treatment
The most common treatment for first-episode psychosis is
antipsychotic medications: There are tablets that sufferers can take which
greatly reduce the symptoms of hearing voices, delusions etc. However, people
taking these tablets often relapse within a few years, or need higher and
higher doses overtime for them to remain effective. Furthermore, antipsychotics
do not help with the symptoms of social withdrawal and inability to feel
motivated. Unfortunately, it is these unseen symptoms which can really prevent
people from living a happy and fulfilling life.
What do I Investigate?
I am investigating whether we can use physical exercise for
first-episode psychosis, as an extra treatment for all the different types of
symptoms so that they need fewer medications and feel better overall in life.
To do this, people with first-episode psychosis are sent to me from their
mental health service. I design them a special exercise routine and then take
them to the gym twice-per-week for 10 weeks to train with them. In the exercise
sessions, we do running, rowing and cycling to work on their fitness, and also
weight training to work on the muscles. Past research has shown that these
sorts of training can make people feel better, happier and more motivated –
even in normal healthy people. It has never been tried for First Episode
Psychosis (even though these are the people who may need it most!).
To see if it has worked, we score peoples’ mental health
using a psychiatric interview before they start the 10 weeks of training, and
then score them again after the 10 weeks to check if they have improved. I also
look at peoples’ physical health, fitness, social life and brain functioning, as
exercise is known to be able to help with these things too. If proven
effective, exercise may eventually become part of NHS treatment programs for
first-episode psychosis, and be available to any young person who is in need of
treatment, like a new form of therapy!

Going Further
If you want to know more about first-episode psychosis in
general, such as what causes it, what it does, here is a great place to start: http://www.camh.ca/en/hospital/health_information/a_z_mental_health_and_addiction_information/psychosis/first_episode_psychosis_information_guide/Pages/first_episode_psychosis_information_guide.aspx
For more information about my specific experiment, you can
find the full details of the clinical trial here: http://www.controlled-trials.com/ISRCTN09150095/
If you’re interested in which physical exercise can improve
mental health, this article goes through many different ways in which it may do
this:
http://www.huffingtonpost.com/2013/03/27/mental-health-benefits-exercise_n_2956099.html