Cardiovascular disease in the context of multiple long-term conditions and frailty

Using hospital data to improve treatment of older people with cardiovascular disease

Rehabilitation

Summary

We are developing a research pipeline for using anonymised routine hospital data from an electronic patient record system (EPIC) to test its feasibility in the study of cardiovascular frailty and rehabilitation.

What are we doing?

Cardiovascular disease is the most common disease as people age, but existing clinical guidelines are based on research that do not include representative older people with multiple long-term conditions or frailty. This research will harness the hospital data to understand secondary care prescribing in cardiovascular disease by frailty and co-morbidity, and the association with important adverse outcomes including falls, fractures and loss of independence.

We hope to:

1. Support the curation and generation of a reproducible and maintainable data pipeline in EPIC (~600,000)
2. Perform exploratory analysis using anonymised EPIC data to test feasibility of using this data to understand factors related to adherence to specific cardiovascular clinical guidelines in older age: hypertension, heart failure and anticoagulation in atrial fibrillation, and factors associated with adverse events including falls, fractures, hospitalisation and loss of independence.

How are we doing it?

Our research benefits from a strong co-applicant team across the university and NHS, with input from clinician researchers in primary and secondary care and with expertise in health data science, ageing, cardiovascular health and prescribing.

The pipeline will be developed and analysed by postdoctoral researchers in collaboration with software engineering specialists. Analysis will use fully anonymised data to ascertain prescribing, healthcare measures and outcomes of interest.

What happens next?

We will begin to establish the EPIC pipeline to support collaborative research across the UK. We hope to use the pilot analysis to develop an external grant application on cardiovascular frailty and rehabilitation.

BRC Colleagues

Dr John Dennis, Senior Research Fellow
Dr Joao Delgado, Lecturer in Epidemiology and Public Health

Other Collaborators

Professor Rupert Payne, Professor of Primary Care and Clinical Pharmacology
Dr Andrew McGovern, Honorary Academic Clinical Fellow and Specialist Registrar in Diabetes, Endocrinology and Internal Medicine

People involved

Dr Nick Kennedy

Senior Investigator Fellow