Case study: Research is like a recipe, it has key ingredients"

How did you first get involved in research?

My research journey started out of curiosity. As a critical care pharmacist, evidence-based medicine is at the heart of what we practise, however, working in a dynamic environment such as intensive care, I often found myself questioning how I know therapy X is any better than therapy Y for indication Z when clinicians around me are undecided in their practices. Naturally, this curiosity cultivated a mindset that would often critique studies, discuss current papers with colleagues and look for gaps in literature. Little did I know at the time but in the world of research this is known as equipoise.

My first exposure to research came following heavy investment by the critical care department at Barking Havering and Redbridge University Hospitals NHS Trust (BHRUT) in appointing their first lead consultant for research in anaesthesia and critical care. Complimented by a set of research nurses the idea was to create an infrastructure that would foster a culture of research within the department. At the time, our research lead had started evaluating a study called STARRT-AKI for our centre to be part of. As a critical care pharmacist with a specialist interest in continuous renal replacement therapy I was invited to review the protocol. Finishing the read, I knew I wanted to be a part of the study delivery team. GCP and informed consent training ensued very quickly and my first role in research as a Co-Investigator on the STAART-AKI study.

This was a trial comparing early initiation of dialysis against delayed dialysis for critically ill patients in the ICU for acute kidney injury.

Being directly involved in research now meant I was a part of the group of healthcare professionals that were trying to address those gaps in literature. Following the successful delivery of STAART-AKI, the critical care and pharmacy department supported the addition of research to my job plan which now means I have research embedded as part of my clinical role.

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

Delivering the Beta-Lactam InfusioN Group (BLING) III study in our ICUs as a Principal Investigator has been a big highlight for me. This was a randomised controlled trial comparing continuous beta-lactam infusion with intermittent dosing in critically ill patients. The trial design was a perfect fit for an early-career research pharmacist and to think it nearly did not happen. Our team were a few days away from getting the green light to run BLING III before the national lockdown occurred in 2020. We waited over 18 months before enrolling our first patient into the study.
Recently I also presented at our trust’s Research and Innovation Symposium 2023 and shared my experiences of being the first pharmacist Principal Investigator at BHRUT.

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

It’s like a recipe and I think the following five ingredients are key:

Patience: A single research project (even short ones) take long periods of time to design, be implemented, analysed and for the results to be published. Studies go through numerous changes, amendments so patience is key.

Organisation: Your organisational skills will be tested frequently. Each study is unique and will have its own timelines, nuances, and niceties for delivery, not to mention data processing in a variety of media formats. Working logically and methodically ensures the protocol is adhered to and will put you in good stead to juggle multiple studies simultaneously. Surrounding yourself with a strong support network will also make this easier.

Concentration: Research studies are accompanied by comprehensive protocols, and you will often find yourself sitting, reading, and concentrating for a prolonged period. With practice anyone can do it, but initially this can be difficult, especially for a clinical pharmacist who is more used to being busy on his feet attending ward rounds.

Comprehension: The ability to take vast amounts of information from multiple sources and evaluate it to inform your decision making is an important skill set. With experience, this will allow you to visualize how the study will run in your particular clinical area, stakeholders you will need to engage and any potential blockers or risks to the research project.

Passionate about patient care: Working together for our patients is a core value embodied by the NHS and being in a position to offer access to a study stands true to that value. The offer of hope in many cases a clinical trial brings carries with it the possibility of change and a future of better outcomes for the patients we care for.

Why do you believe research is important?

Research is the safest way to test new techniques, services, interventions and treatments in a safe and controlled manner within the boundaries of a study protocol. It generates evidence that drives forward better practices in our care for patients. It is shown that trusts that are research active deliver better quality of care for patients than trusts who do not participate in research. Research also provides a platform to reach the underserved communities. Serving such a diverse population at BHRUT, we recognise recruiting under-represented groups to studies will provide the results of tomorrow that are reflective of the populations we serve.

What are your plans and ambitions for the future?

My experience has taught me if you are passionate about something, you’re going to be great at delivering it. So, with that spirit I look forward to developing my own research interests in the near future; aspire to design a study as a sponsor and developing a pharmacist-led research footprint at the NIHR CRN level.

Research-active pharmacists make up a small proportion of practicing pharmacists in the UK and I hope my story will inspire a future generation of budding pharmacists to take on the mantle of research alongside their clinical roles.