New HRB awards for School of Medicine researchers to address health challenges

Posted on: 31 May 2023

Four academic clinicians in the School of Medicine have been announced by the Health Research Board (HRB) as recipients of the major awards, which support researchers and research teams to conduct high-quality definitive intervention trials and feasibility studies.

The four awardees will investigate improved care and treatment pathways for significant health challenges including: multimorbidity (Professor Susan Smith) hypertension (Professor Martina Hennessy and Dr Cormac Kennedy) Work and Cancer (Professor Deirdre Connolly), and cocaine use disorder (Dr John Kelly).

Congratulating the new awardees, Dean of Research at Trinity, Professor Sinead Ryan, said:

“I warmly congratulate all the researchers who have received funding under this programme. These awards will support research teams to harness our collective expertise for the greater good, and make crucial interventions in improving care and treatment for a variety of health challenges facing our society.”

According to HRB Chief Executive, Dr Mairéad O'Driscoll:

“We are proud to announce the latest round of funding in the HRB’s DIFA scheme. It is the only public funding source for investigator-led clinical trials in Ireland. Not only will DIFA enhance our country’s reputation as a location for high quality clinical trials, but it will also help to realise the HRB’s ambition of a people-centred Irish healthcare system where access to clinical trials is routine to standard care.”

DIFA 2023 Project details: 

1. Professor Susan Smith, Professor of General Practice, Discipline of Public Health & Primary Care

Project title: Medicines and SocIal Prescribing to aDdress pAtient priorities in multimorbidity (MIDAS): A multi-arm (definitive) cluster randomized trial in Irish general practice

Multimorbidity – living with 2 or more chronic conditions - is recognised as a key challenge facing patients and health systems and requires cost-effective interventions that improve health outcomes for patients. Researchers have already conducted two separate pilot trials, one supporting GPs to manage polypharmacy (the simultaneous use of multiple medicines) in patients with multimorbidity and the second, providing link workers to deliver social prescribing for patients with multimorbidity. Social prescribing connects people to activities, groups and services in their community to meet the practical, social and emotional needs that affect their health and well-being. Both interventions have the capacity to be integrated into Ireland’s new Chronic Disease Management Programme.

Professor Smith said: 

“This award provides an opportunity to evaluate much needed interventions to support the management of people living with multiple long term conditions in Ireland in order to improve their health outcomes and experience of care.”

2. Professor Martina Hennessy, Assoc Professor Consultant, Medical Education, Trinity College Dublin & Director of Wellcome HRB-Clinical Research Facility, St. James’s Hospital and Dr. Cormac Kennedy, Clinical Senior Lecturer, Trinity College Dublin & Associate Director, Wellcome-HRB Clinical Research Facility at St James's Hospital.

 Project title:  Semaglutide for people with obesity and resistant hypertension trial (SUPPORT): a pilot randomised, double blind, parallel group, multicentre trial.

Hypertension (high blood pressure) is the leading risk factor for morbidity and mortality globally, yet its management remains inadequate. Resistant hypertension (RH) refers to patients with uncontrolled blood pressure (BP) on at least three anti-hypertensive agents, including a diuretic. Patients with RH are more likely to have obesity and cardiovascular disease. Treatment of RH is problematic and necessitates new approaches. The Semaglutide Treatment Effect for People with obesity trials provide evidence of the positive effect of semaglutide on body weight and BP. The research question the team asked is whether a weight-centric approach, using semaglutide, for patients with obesity and RH, but without diabetes, results in a clinically meaningful reduction in BP versus standard care.

A pilot randomised, double blind, parallel group, multicentre trial will be performed to inform an international, multicentre definite study.

This initial study will inform how a larger trial can be best planned and run. Ultimately, this work will help us to understand whether weight lowering medicines can be used to improve difficult to control blood pressure, health and well-being. 

Professor Hennessy said: 

“Re-visiting the treatment of resistant hypertension through the lens of obesity marks a new approach to treating this complex chronic disease.”

3. Professor Deirdre Connolly, Discipline of Occupational Therapy

 Project title: Investigating the effectiveness of Work and Cancer for women with breast cancer.

Over half of women diagnosed with breast cancer in Ireland are below the age of 64 years. Although cancer treatment is very successful, and women are now living longer with cancer, many women have persistent symptoms that interfere with their ability to return to work.

Going back to work is an important milestone in recovery from cancer. However up to 40% of women do not go back to work because of physical and psychological difficulties that interfere with their ability to meet the demands of their work. These include fatigue, ‘chemo-brain’, pain, and distress.

Collaborating with women with breast cancer and healthcare providers, Deirdre’s team designed a unique online programme, Work and Cancer, that gives women with breast cancer, strategies to manage post-treatment difficulties and information on their work entitlements and supports.

Women who took part in a pilot study of Work and Cancer told the team that it increased their confidence to communicate their work-related needs to their employers and gave them strategies to manage post-treatment symptoms. They said the programme was “powerful”, “invaluable”, “very comprehensive” and “supportive”. One woman told is “there’s a lot written about work and cancer but there’s nothing that pulls it into a one-stop package like this”.

No similar programme is available for cancer survivors nationally or internationally. This is the first programme specifically designed to prepare people with cancer to successfully return to work.

Work is an important part of peoples’ daily routine. It provides financial security, socialisation, a sense of identity and has societal benefits. People with cancer often consider return to work as an important milestone in their recovery from cancer and a sign of returning to ‘normal life’. It is therefore important that services are provided to support cancer survivors to negotiate what is often a very difficult process.

This funding will enable Deirdre and her team to test the effectiveness of Work and Cancer with a larger group of women with breast cancer and to evaluate the cost effectiveness of the Work and Cancer programme. If we find thatWork and Cancer is effective in supporting women with breast cancer to return to work, we hope it will be available as routine cancer survivorship care in Ireland.

Professor Connolly said: 

“Returning to work is very important for cancer survivors. This funding allows us to test a unique service that will help them to achieve this goal.”

4. Dr John R. Kelly, Consultant Psychiatrist & Clinical Senior Lecturer 

Project title: POSITRON - PsilOcybin with pSychologIcal supporT foR cOcaiNe - A pilot feasibility trial of psilocybin therapy for cocaine use disorder

Cocaine use disorder has a detrimental impact on the individual, their families and on society. It is a pattern of cocaine use leading to clinically significant impairment or distress. 

Psilocybin (a psychoactive substance) therapy - a synergistic combination of pharmacology and psychological support - is emerging as a multi-modal treatment paradigm that is showing therapeutic benefits for addiction disorders, such as alcohol and tobacco addiction.

Psilocybin activates cortical 5-HT2A receptors, induces transient alterations of brain connectivity, and promotes synaptogenesis ( the formation of synapses between neurons in the nervous system) and neural plasticity. It is not yet known whether psilocybin therapy will play a therapeutic role in cocaine use disorder.

John’s team envisages that this pilot feasibility study will provide the necessary preliminary data to pave the way for a larger clinical trial to assess if psilocybin with psychological support will promote cocaine abstinence, reduce craving, and reduce rates of relapse in treatment seeking adults with cocaine use disorder.

Dr Kelly said: 

“Cocaine remains the highest presentation for treatment of adults in Ireland. This award provides a much needed opportunity to develop a comprehensive treatment strategy to help people recover.”

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