My research focuses on the role of lifestyle on liver disease, specifically non-alcoholic fatty liver disease. Specifically, I have been working on administering a very low calorie diet (approx. 800kcals per day) to patients with advanced NAFLD. I have also designed an exercise programme targeting patients on the waiting list for liver transplantation. In my spare time, I am a practising aerial artist and contortionist.
The research is entitled ‘Lifestyle as therapy in Liver Disease’. The research has had two parts; the first looked at physical activity and how that could be made into an intervention for people awaiting liver implants. We co-created the intervention with the patients, which was a home-based exercise programme. The second part is looking at a Very Low Calorie Diet (VLCD), 800 calories a day for 8-12 weeks, in patients with advanced NAFLD. This is a feasibility study as this has never been trialled with patients with this condition before.
September 2018 – Newcastle University Directors day: poster presentation.
September 2018 – BASL 2018: poster presentation.
November 2019, Assessing the feasibility and acceptability of Changing Health for the management of prediabetes: protocol for a pilot study of a digital behavioural intervention, Pilot and Feasibility Studies, Vol. 5, page 139.
I chose to work with Non-Alcoholic Fatty Liver Disease (NAFLD) within the ageing unit because it’s a fairly new disease that actually effects a third of people in the UK. Unfortunately, the majority of people are not aware that NAFLD exists, or even that they have the disease, until it’s progressed with serious consequences. Research in this area is important to increase the awareness of the disease as it also comes with a lot of co-morbidities, like metabolic and cardiovascular issues. I am interested in bridging the gap between patients and public awareness and the science behind the disease.
I studied Biomedical Sciences at undergraduate level at Newcastle University then followed that with a Masters that looked at physical activity and cardiovascular health. My Masters got me interested in a lifestyle approach to chronic disease; how lifestyle interventions work and fit into research. I have found this area fascinating which has led me to the research I am carrying out now for my PhD.
Our main recruitment approach was to target patients from two hepatology clinics. We firstly made sure we had the support of the consultants of these clinics, and that they were fully aware of the inclusion and exclusion criteria. We then made sure either myself or my supervisor were present at the clinics. This was so we were able to explain the study and answer any questions immediately after the consultant had recommended the research to them. During this initial meeting we talked the patients through the intervention and sent them away with an information sheet and a fact sheet. They were encouraged to speak to their friends and family about the study and get in touch within a week if they were interested in taking part. An important factor was that they felt it was recommended by their consultant, and therefore good for their health. Having a meeting immediately after their consultant appointment was very useful as this gave a personalised approach, and we could gauge interest straight away. The patients chose the method of communication that suited them best. It was great to see that everyone we approached got back in touch with us. Overall, we approached 40-42 patients and recruited 30 of these onto the study. We also found our drop-out rate was much lower than expected, especially for such an intense study where patients were asked to come in to the clinic every 2 weeks. I think a big factor in this was that we kept the lines of communication open, and the patients always felt they could contact us throughout the study which made them feel comfortable.
A key factor to consider when recruiting patients is encouraging them to have time to think about it with their friends and family. Our patients all found that their family support was very important. We gave patients options to bring family or friends with them to the initial meeting and throughout the study. Making patients aware it was ok if they dropped out and that they were not contracted made them feel better about enrolling in the study, as it took away the fear of having to commit from the outset. Speaking to patient’s face to face right at the start is also important as it makes the experience more personalised. Although information sheets and fact sheets are written in lay terms, they can still be intimidating for people. Face to face contact makes it easier for patients to connect the study to a person, and makes them more willing to ask questions and get involved. Having a consultant or medical professional backing the study, and being the first person to mention it to the patient has really helped. Patients felt the study was recommended to them, and felt accountable to the consultant who first mentioned it to them. I know that a motivator for a lot of them when going back to see their consultant 6 months/ 1 year later and being able to show them their improvement with their NAFLD.
It’s been brilliant- there have been two main positives for me. There has been a community feel, which is nice knowing there is always someone to reach out to. I have peers who feel quite isolated, whereas I have been aware from the outset that I am part of this community. It’s also been really useful as I have received support for topics such as writing papers and getting your research out there. I feel proud that my research is affiliated with NIHR.
Knowing people within the liver theme has been really useful as there has been a lot of crossover with other liver diseases; it has been great that I can tap into other experts within the theme. NAFLD also comes with many co-morbidities; it is great having the infrastructure in place so that I can get advice from experts even across themes for areas I am not so familiar with.
I love how small the city is but at the same time it has everything you need. You can go from the monument and walk 20 minutes and get to Ouseburn or Quayside. In a car you can get to the coast in 20 minutes. It’s quite a young student city which is nice as there is always lots going on.