Description of the goods or services required
The Health Technology Assessment Programme is accepting stage 1 applications to their commissioned workstream for this primary research topic:
19/30 Strategies in older people's care settings to prevent infection
The aim of the HTA Programme is to ensure that high quality research information on the effectiveness, costs and broader impact of health technology is produced in the most efficient way for those who use, manage, provide care in or develop policy for the NHS. Topics for research are identified and prioritised to meet the needs of the NHS. Health technology assessment forms a substantial portfolio of work within the National Institute for Health Research and each year about fifty new studies are commissioned to help answer questions of direct importance to the NHS. The studies include both primary research and evidence synthesis.
This is a brief of broader scope from which the programme is interested in potentially funding more than one proposal.
Infectious diseases are a major cause of illness in the UK. Long term care facilities and day care for older people are settings where preventing the spread of infection is particularly important. We are interested in proposals for the evaluation of the effectiveness and cost-effectiveness of strategies that aim to prevent infection in older people’s care settings which target either individual infections, particular types of infection (bacterial/viral/fungal/parasitic), and/or infection generally. Settings of interest include long term care facilities (residential care and nursed care) and any day care settings where older people gather but excludes acute hospital settings.
Examples of topics of interest include but are not limited to: awareness raising, information and advice for the patient group and/or for staff, staff-led strategies, strategies designed to support behavioural change or organisational culture change, strategies or technologies to prevent infection generally or for specific infections. Important outcomes should include reduced infection and recurrence and reduced use of health care resources (e.g. GP visits, hospital admission).
Applicants should clearly define and justify the choice of strategy and its individual components to prevent infection, choice of older people’s care setting, study design and outcome measures. Applicants should demonstrate how the choice of strategy aligns with national and/or local policy and practice and with literature to reduce antimicrobial resistance (AMR), if appropriate. Primary research, including randomised and observational studies, and evidence syntheses will be considered. Developmental studies are not included within the scope of this call. We are looking for studies of strategies with a sufficient prior evidence base which show promise to positively impact the translational pathway to potentially change clinical practice.
Older people are particularly vulnerable to infection, often as a result of chronic conditions, and there is increased risk of infection in settings where people live or come together. Preventing infection demands a comprehensive, concerted effort to implement strategies that contain a combination of interventions to address people’s behaviour relating to infection prevention. This is a complex problem that requires whole systems approaches.
Associated with the infections suffered by older people, are concerns about the levels and appropriateness of the prescribing of antimicrobials. Inappropriate use of antimicrobials is leading to an increase in resistance, making these agents less effective and contributing to infections that are hard to treat.
Infection prevention relating specifically to older people’s care settings has featured in the Chief Medical Officer’s report 2011/12. Other policy and guidance documents that have emphasised the requirement for improvements in infection prevention and control and better antimicrobial stewardship across the UK include the Department of Health and Social Care’s five year strategy 2013-2018. Recent NICE guidance (NG63) has drawn attention to the lack of research evaluating interventions in older people’s care settings to prevent infection. Therefore, we wish to commission research into the effectiveness and cost-effectiveness of such strategies taking into account ongoing initiatives in this field.