Clinical trials are essential to develop innovative and revolutionary medical research. Graeme Hetherington takes a look at some of the work carried out at hospitals in the region.

THANKFULLY, the outlook for people with many health conditions including cancer and heart disease is generally much better than it was twenty, or even ten, years ago and this is largely down to medical research.

We tend to think of medical research being done in laboratories in universities, or within multi-national pharmaceutical companies. Whilst this is true, it’s also the case that vital research is taking place on our doorsteps, led by the research team at County Durham and Darlington NHS Foundation Trust.

On top of this, CDDFT is currently working with South and North Tees Hospitals to create a research alliance, the Durham Tees Valley Research Alliance, the first of its kind in the country. This will bring together the specialties of all three organisations and increase the opportunities for patients with a wider range of conditions to be offered the latest treatments and procedures.

Dr James Limb, director of research and innovation, explains: “Clinical and other trials often only recruit a specific number of patients so we have to be alert so as not to miss out on these opportunities.

"By their very nature clinical trials are also very controlled so we have to make sure we meet all the criteria. This means identifying suitable patients, so we work very closely with clinical teams across the trust to identify and communicate with those who might benefit, making them aware of what’s involved – such as what treatments could be offered, what the trial will involve, and how long the trial will last.

"The public perception of clinical trials tends to associate them with testing drugs but we get involved with trials looking at all aspects of healthcare – such as procedures such as scans and endoscopies which play a vital role in diagnosing illness and helping develop treatment plans. Sometimes all the patient has to do is give us permission to share relevant information about their care, but other trials can involve much more.

"Our relationship with clinical colleagues is fantastic; they’re totally on board because they know what a difference being involved in a trial can make for their patients. We have a dedicated team of research nurses who liaise with patients, clinical teams and the organisation running the trial.

“This focused approach means we’ve established a reputation for being a reliable research partner. In fact, we have recruited the first patient to international trials. On more than one occasion we’ve even recruited the first ten patients. This is an achievement we’re very proud of as there is often a lot of groundwork to be done even before recruitment."

Last year the Trust was involved in 95 clinical trials across 25 specialties, and 2,068 patients were recruited. Some current trials include the Big Baby, Add-Aspirin and Senior-Rita trials.

Tarn Nozedar, research manager says: "Big Baby aims to find out if labour should be started a little earlier for women with babies who appear to be bigger than expected for their dates. We want to find out if doing this could prevent problems for women or babies during birth and we’re working with pregnant ladies in our maternity units at University Hospital of North Durham and Darlington Memorial Hospital. The results of this trial will help obstetricians and midwives decide on the best way to care for women with bigger babies.

“The international Add-Aspirin study which is looking at whether taking aspirin regularly after treatment for early stage cancers that have not spread widely, stops or delays the cancer coming back. This study will compare groups of people who take aspirin and those who take placebo tablets.

"Some studies have suggested that people who regularly take aspirin may be less likely to be diagnosed with cancer than those who don’t take aspirin. Also, in studies testing the beneficial effect of aspirin on heart disease, aspirin appeared to reduce the number of people who developed cancer, and if people did develop cancer, it appeared to be less likely to spread.

"The British Heart Foundation Senior-Rita trial is concentrating on heart disease, which is the biggest killer in the UK. The trial aims to help determine which of the many advances in treatments for diseases linked to heart arteries, are beneficial for patients over the age of 75. Previous studies have suggested that this group of patients, particularly those who are frail, may be less likely to receive some treatments such as coronary angioplasty, a procedure that clears blockages in the heart arteries using a balloon and a stent. This is due to fears the procedure may cause them more harm. We’re hoping our research will help determine appropriate treatment pathways for this group of patients so they can benefit from them.”