Have you ever seen a patient with dementia and wished there was more you could offer them? This is an experience familiar to most clinicians working with people with memory problems.
Cognitive and memory clinics serve an important purpose for patients experiencing symptoms of cognitive impairment and their loved ones. A timely diagnosis, instigation and monitoring of treatment with medication, social and psychological support, carer support and signposting to relevant agencies are important to patients and their families. Management of behavioural and psychological symptoms of dementia (BPSD) is also hugely valued. However, it can be frustrating to discuss with patients that we are currently unable to offer any disease modifying treatments, or that for cases where the diagnosis is unclear, we don’t have a diagnostic biomarker available in clinical practice to aid our investigations.
This situation will only change through research!
As clinicians we have first-hand experience of seeing and assessing patients with cognitive impairment. We are ideally placed to encourage our patients to get involved in research, and to get involved in research ourselves! We are also equipped with a unique set of clinical skills to support and deliver research programmes.
Taking part in dementia research as a clinician has many benefits to both you and your patients:
- Gives you as a clinician a sense of hope and allows your consultations with patients to be better informed and more hopeful. There is increasing evidence that clinicians and services that are research active deliver higher quality care and have better patient outcomes
- Enhances your diagnostic skills
- Improves your knowledge of new methods/therapies that may soon come to clinic
- Helps you understand the scientific basis of the disease
- Provides intellectual stimulation
- Offers additional career prospects in clinical research programmes
- Gives you the opportunity to network with colleagues with similar experiences and interests
- Allows you to really make a difference in delivering successful studies and improving outcomes for your patients
- Is enjoyable, facilitates opportunities for networking and attending educational events
- Being research active is a metric for the Memory Services National Accreditation Programme.
How can clinicians get involved in research?
There are several different ways that this can be done:
Clinical research is simply not possible without patients and their loved ones taking part. As clinicians, it is important that we make our patients aware of the opportunities available to take part in research. You can:
- Find out, and keep up to date, with research happening locally. Find out how to refer patients to your local memory research centre, talk to your patients about taking part in research and offer to refer them.
- Encourage your patients to sign up to Join Dementia Research to allow them to have the opportunity to take part in dementia studies
The NIHR has a clinical research network (CRN) which supports patients, the public, and health and care organisations across England to participate in high-quality research, advancing knowledge and improving care. The CRN is comprised of 15 Local Clinical Research Networks (LCRN) who coordinate and support the delivery of high-quality research both by geography and therapy area.
One of the 30 specialty therapy areas identified by the CRN is ‘Dementias and Neurodegeneration’ (DeNDRoN)
Contacting your local CRN’s lead for Dementia is a great place to start in registering your interest in taking part in dementia research as a clinician. Studies adopted to the NIHR portfolio include a range of both drug and non-drug trials, and new studies are added regularly.
We have collated a list of contact details for the Dementia lead in each LCRN (correct as of 22nd March 2021). They would be delighted to hear from you!
- The NIHR runs various online and classroom based training courses, such as Good Clinical Practice and Principal Investigator training through the ‘NIHR learn’ platform. This is a good way of getting started with clinical research.
If you have completed your clinical training, many LCRNs run ‘green shoots’ schemes to support consultants and other qualified healthcare professionals to become principal investigators. Contact your LCRN for more details locally.
Remember, you do not need to hold a PhD or harbour ambitions to become a clinical academic to take part in research activity within the NHS! Many core and higher trainees in geriatrics, neurology and psychiatry find their ‘special interest’ sessions to be a useful time to gain some experience of working in dementia research.
For doctors, there are opportunities nationwide in clinical training to take formal time to take part in research activity:
Academic Foundation Programmes
The academic foundation programme includes the same curriculum and outcomes as the standard foundation programme. However, it also includes a period of research during the second year (FY2), which can either be a four-month block or day-release.
Academic Clinical Fellow Programmes
The academic clinical fellowship combines core specialty training with academic work. 25% of the time is spent on academic work and 75% on clinical.
The academic work can be arranged in different ways, for example via one three-month block each of the three years, or up to two days a week.
Time Out of Programme for Research
Once you have entered a speciality training scheme, it is possible to apply for time ‘Out of Programme for research’ (OOPR)
There are many funders who advertise specific fellowships for clinicians wishing to complete PhD programmes, for example:
- Alzheimer’s Research UK offers Clinical Research Training Fellowships:
- Alzheimer’s society offers ‘Clinician and Healthcare Professionals training fellowships’
- The NIHR run Clinical Doctoral Research Fellowships
- The Wellcome Trust offers PhD Training fellowships for clinicians
Further advice on how to secure funding for a PhD programme can be found here:
These posts are for clinicians who hold a PhD or MD or equivalent and who are in their third year of specialty training of higher. They provide a 50:50 split between academic work and clinical training
Senior Academic Posts
You can apply for senior academic posts once you have finished your specialist training and have been awarded your Certificate of Completion of Training (CCT), or after 5 years of post-doctorate clinical experience for other health care professionals.
For non-medical healthcare professionals
HEE/NIHR Integrated Clinical Academic Programme
The Health Education England (HEE) and National Institute for Health Research (NIHR) Integrated Clinical Academic (ICA) Programme provides research training awards for healthcare professionals, excluding doctors and dentists, who wish to develop careers that combine clinical research and research leadership with continued clinical practice and professional development.
For medical or non medical healthcare professionals
NIHR Clinical Research Network (CRN) Research Fellows (one year)
These posts are offered by local CRNs and are designed to nurture a cohort of research capable clinicians and build future capacity in the NHS whilst supporting and developing recruitment to NIHR portfolio studies. They are open to post-graduates training in medicine, nursing or the allied health professions. Half of the funding is provided by the CRN with the other half from partnering NHS trusts.
The NIHR offers multiple services which can help support you to set up your own research study:
- Research Design Service (RDS)
The RDS offers high quality, responsive, specialist advice and support on research design and methodology, to researchers making funding applications for submission to our research programmes and national, peer-reviewed funding competitions for applied health or social care research.
- Study Support Service
The Study Support Service helps researchers and the life sciences industry plan, set up and deliver high quality research to time and target in both the NHS and the wider health and social care environment, across England.
We hope this article has given you a taste of the multiple ways in which clinicians can get involved in research in dementia. Our experience is that working in dementia research as clinicians can be fulfilling, fascinating and fun, and we hope that you will consider how you might get involved too.