The COVID-19 pandemic has highlighted the need to invest in care home research infrastructure

Gordon, Adam L.; Rick, Caroline; Juszczak, Ed; Montgomery, Alan; Howard, Rob; Guthrie, Bruce; Lim, Wei Shen; Shenkin, Susan; Leighton, Paul; Bath, Philip M; Ball, Jonathan; Gage, Heather; Glover, Matthew; Godfrey, Maureen; Hewitt, Jonathan; Jaki, Thomas; Lasserson, Dan; Logan, Pip; Passmore, Peter; Quinlan, Philip; Royal, Simon; Tate, Val

Abstract

The COVID-19 pandemic resulted in catastrophic levels of morbidity and mortality for care home residents. Despite this, research platforms for COVID-19 in care homes arrived late in the pandemic compared with other care settings. The Prophylactic Therapy in Care Homes Trial (PROTECT-CH) was established to provide a platform to deliver multi-centre cluster-randomized clinical trials of investigational medicinal products for COVID-19 prophylaxis in UK care homes. Commencing set-up in January 2021, this involved the design and development of novel infrastructure for contracting and recruitment, remote consent, staff training, research insurance, eligibility screening, prescribing, dispensing and adverse event reporting; such infrastructure being previously absent. By the time this infrastructure was in place, the widespread uptake of vaccination in care homes had changed the epidemiology of COVID-19 rendering the trial unfeasible. While some of the resources developed through PROTECT-CH will enable the future establishment of care home platform research, the near absence of care home trial infrastructure and nationally linked databases involving the care home sector will continue to significantly hamper progress. These issues are replicated in most other countries. Beyond COVID-19, there are many other research questions that require addressing to provide better care to people living in care homes. PROTECT-CH has exposed a clear need for research funders to invest in, and legislate for, an effective care home research infrastructure as part of national pandemic preparedness planning. Doing so would also invigorate care home research in the interim, leading to improved healthcare delivery specific to those living in this sector.

Citation

Gordon, A. L., Rick, C., Juszczak, E., Montgomery, A., Howard, R., Guthrie, B., Lim, W. S., Shenkin, S., Leighton, P., Bath, P. M., Ball, J., Gage, H., Glover, M., Godfrey, M., Hewitt, J., Jaki, T., Lasserson, D., Logan, P., Passmore, P., Quinlan, P., …Tate, V. (2022). The COVID-19 pandemic has highlighted the need to invest in care home research infrastructure. Age and Ageing, 51(3), Article afac052. https://doi.org/10.1093/ageing/afac052

• Journal Article Type: Article
• Acceptance Date: Jan 19, 2022
• Online Publication Date: Feb 17, 2022
• Publication Date: Mar 1, 2022
• Deposit Date: Jan 20, 2022
• Publicly Available Date: Feb 18, 2023
• Journal: Age and Ageing
• Print ISSN: 0002-0729
• Electronic ISSN: 1468-2834
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 51
• Issue: 3
• Article Number: afac052
• DOI: https://doi.org/10.1093/ageing/afac052
• Keywords: Geriatrics and Gerontology; Aging; General Medicine
• Public URL: https://nottingham-repository.worktribe.com/output/7280554
• Publisher URL: https://academic.oup.com/ageing/article/51/3/afac052/6529173
• Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in Age and Ageing following peer review. The version of record Adam L Gordon, Caroline Rick, Ed Juszczak, Alan Montgomery, Rob Howard, Bruce Guthrie, Wei Shen Lim, Susan Shenkin, Paul Leighton, Philip M Bath, the PROTECT-CH Triallists, The COVID-19 pandemic has highlighted the need to invest in care home research infrastructure, Age and Ageing, Volume 51, Issue 3, March 2022, afac052, is available online at: https://doi.org/10.1093/ageing/afac052