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Case study: Alastair Duncan on his south London AHP research career

Read about Alastair's research career.

We are putting Allied Health Professionals (AHPs) working in research in the spotlight as part of a Pan-London National Institute for Health and Care Research Clinical Research Network (CRN) campaign, which includes CRN North Thames, CRN South London, CRN North West London and CRN Kent, Surrey and Sussex. This month, we spoke to Alastair Duncan, a Consultant Dietitian at Guy’s and St Thomas’ NHS Foundation Trust and lecturer in Nutritional Sciences at King’s College London (KCL).

How did you first get involved in research?

I have worked as a dietitian specialising in HIV care for over 25 years. Antiretroviral drug trials have been central to HIV care, and as part of the multidisciplinary team, I have always raised awareness of trials recruiting patients. In 1999, we became aware of unusual metabolic side effects beginning to affect people living with HIV. As part of a team, I participated in a series of cross-sectional studies to explore which factors might be associated with these side effects.

What has been the highlight of your research career so far?

The biggest highlight was being awarded an NIHR clinical doctoral research fellowship. I had become aware of more and more patients attending my HIV outpatient clinic diagnosed with type 2 diabetes, who did not appear to have the usual contributing factors. They were younger and lighter than most newly diagnosed with type 2 diabetes. At that time, some of the commonly used medicines could not be taken with antiretrovirals, so patients were asking me to help control their blood glucose levels through diet and exercise alone. The NIHR research fellowship allowed me to spend three years as a principal investigator of a portfolio of studies exploring why so many people living with HIV were developing diabetes and what could be done to reduce diabetes risk. I’m delighted to let you know that most risk factors driving diabetes in people living with HIV are modifiable, and I showed that despite the effects of HIV and antiretrovirals, diet and exercise can mitigate this increased diabetes risk.

What skills do you think are needed for a career in research?

You will need training in the methodologies you will use in your research. For example, for the portfolio of studies within my NIHR research fellowship, I had to refresh my seriously rusty lab and statistics skills and learn new qualitative research techniques. I loved improving my skills in those areas. All researchers need effective time management skills to make the best use of quieter times and cope with busy periods.

Why do you believe research is important?

I will answer this question with two questions. How can we improve the quality of care for our patients without research? And when we are puzzled by something new or different in our clinical practice, what else but research can solve the problem?

What are your plans and ambitions for the future?

Within my role as a clinical academic, I hope to focus on four areas:

  • Support other clinical researchers to develop their projects.
  • Explore how best to support older people living with obesity who want to lose weight without this worsening frailty.
  • Work with patients living with HIV to understand how best to support them as they get older and begin to experience multiple health conditions.
  • Support KCL postgraduate students to develop their research skills and experience.

Is there anything else you'd like to add?

Following my NIHR research fellowship, funded by awards from the British HIV Association, I conducted in-depth research interviews exploring how to support people living with HIV as they grow older. It is a privilege to work with patients in this way, exploring the details of their lives and health experiences in a way that time constraints of clinical practice prevent. I recommend other researchers develop their skills in conducting interviews and focus groups and, wherever possible, embed qualitative methodology within their research projects.

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