Date: 17 May 2018
A semi-retired registrar has encouraged others to take part in NHS research after a trial of a heart monitor on her smartphone helped her change her lifestyle to prevent palpitations.
Josephine Baldock of Charvil, Reading, reduced her hours at work and started exercising more after a portable heart monitor she was given for the study led her to conclude stress was the cause of her palpitations.
Ms Baldock spoke ahead of Sunday’s International Clinical Trials Day (20 May), an annual drive to encourage the public to take part in health research.
The 65-year-old was offered a chance to take part in the IPED study while she visited the Royal Berkshire Hospital for palpitations in July 2017.
The Investigation of Palpitations in the Emergency Department (IPED) study looked at whether a credit card-sized device connected to a smartphone app to record an electrocardiogram (ECG) - a test to check the heart's rhythm and electrical activity - can be used to diagnose people with palpitations.
Palpitations are heartbeats that suddenly become more noticeable and can be caused by medications, heart conditions and emotional triggers such as stress.
They are usually harmless, however patients should see a doctor if they last a long time or get worse, as they could be a result of more serious heart problems.
The study was run through 10 NHS trusts across the UK and funded by the National Institute for Health Research (NIHR), Chest Heart and Stroke Scotland and the British Heart Foundation.
The mother-of-two said: “I was very anxious because it happened on a Sunday morning while I was in bed, just waking up. I wasn’t doing anything exertive at all. I waited for half an hour, and then it happened again.
“I just got up and thought something wasn’t quite right so I came straight into casualty at the Royal Berks.
“When they ran the tests on me, they asked if someone from cardiology could come and speak to me because there was something they were doing research-wise.
“I wanted to take part in research because I’d never experienced anything like that before. I thought if that helps to find out what it is, then it’s crazy not to.”
Patients visiting the ED at the Royal Berkshire Hospital with palpitations were asked if they wanted to take part and were given an envelope which had an equal chance of containing the device or a letter telling them they would receive standard care. Both groups were asked to keep a record of their symptoms for comparison. Standard care usually involves an ECG, blood test and being advised to make a GP appointment.
Those with the device were told to press two sensors on it with the index and middle fingers of both hands for 30 seconds when they experienced palpitations. The device was connected to an app via bluetooth to record their ECG, which was automatically emailed to the research team at NHS Lothian, who gave the results to patients’ local research teams.
Local teams notified patients and their GPs of the results and advised them to book an appointment if the palpitations required further investigation.
Ms Baldock returned to the Royal Berkshire Hospital for a heart scan after two weeks. It revealed no abnormalities and she realised stress was causing her palpitations.
She decided to change her hours to part-time at her registrar job at Reading Borough Council. She has since been ice skating, cycling and has bought a rowing machine.
She said: “My job was quite sedentary, it was in an office and pressurised at times. We all know what stress can cause. I wasn’t aware of it, that was the scary thing.
“I swapped my life sat in an office to a different lifestyle. There’s a reason when you’re in your 60s that you should really think about how much you work. If you haven’t got your health, even if you’ve got all the money in the world, it doesn’t really matter.
“I used to exercise maybe once or twice a week because I didn’t have the time before when I was working full-time. I have made changes, and it’s all down to that Sunday morning.”
After three months, patients on the IPED study were contacted by phone about their health. Those with the device were asked to return it in a pre-paid envelope.
Ms Baldock, who completed the study in October 2017, said: “I could look back to a certain day and think about why I felt stressed or why I had palpitations, so I could see a pattern forming. I saw it unfolding. Research was extremely helpful and I would recommend for anyone to do it.”
The IPED study closed in January after recruiting 243 participants, with 58 patients recruited by Royal Berkshire NHS Foundation Trust, which runs the Royal Berkshire Hospital.
Dr Liza Keating, the study’s principal investigator at Royal Berkshire NHS Foundation Trust, said: “The device used in IPED can help patients because it is possible that any abnormality can be detected earlier than might be the case without using it. This can also help save the NHS time and money by reducing the number of appointments patients book at their GP practice or the ED.
“On the whole the patients have been very keen to take part in the study. In fact because this is a randomised study half of the patients have been disappointed not to have been offered the device.
“We hope that this research will benefit patients by helping us decide the best way to treat people with palpitations in the future.”
International Clinical Trials Day is held every 20 May to celebrate the anniversary of the first clinical trial by James Lind in 1747 into the causes of scurvy on board the HMS Salisbury.
Participating in health research helps develop new treatments, improve the NHS and save lives. Patients are encouraged to ask their doctor about research opportunities and view trials seeking volunteers at The UK Clinical Trials Gateway at www.ukctg.nihr.ac.uk.