Research at the University of Aberdeen into the cost effectiveness of kidney dialysis therapy, the treatment of groin hernias, and the major causes of kidney failure, has been given an £825,000 boost by the European Union’s BIOMED Programme.
Dialysis Study
Dr Alison MacLeod, a Reader in the Department of Medicine and Therapeutics, together with Dr Izhar Khan, consultant nephrologist, and Professor Cam Donaldson, of the Health Economics Research Unit, has been awarded £350,000 to investigate the cost effectiveness of dialysis therapy for kidney failure throughout Europe.
The three-year Eurodice study (European Dialysis and Cost Effectiveness) will compare the resource use and policies in 10 centres throughout Europe, including Tirana, Albania; Tallinn, Estonia; Nantes, France, Heidelberg, Germany; Thessaloniki, Greece; Debrecen, Hungary; Nijmegen, The Netherlands; St Petersburg, Russia; Dundee and Aberdeen.
Dr MacLeod said: “Patients whose kidneys fail require life-saving treatment with dialysis or with a kidney transplant. Although dialysis is now very advanced, allowing more patients to be treated successfully, it is also very expensive. It is essential, therefore, to ensure that resources are used as effectively as possible.
“The project will be co-ordinated by a team of clinicians and health economists from Aberdeen and we aim to find the optimum mix of resources, taking into account the very different social structures of these countries, that will provide the best care for dialysis patients in Europe.”
Hernia Surgery
A second award of £245,000 has been awarded to Professor Adrian Grant, Director of the University’s Health Services Research Unit. Prof Grant will lead a European-wide research project, involving 45 centres in 18 countries, to assess two revolutionary techniques developed to improve the surgical repair of groin hernias. The aim is to define a European approach for their introduction into health care services by the end of the year 2000.
The first development is a ‘tension free technique’ which involves placing a small synthetic mesh over the weakness in the abdominal wall instead of darning the area. The procedure has advantages. It is easily performed under local anaesthetic, the patient experiences less pain and can go home and return to work sooner. Surgeons claim that complication rates are low and that few people suffer a recurrence of their hernia, resulting in reduced National Health costs.
The second development has been the use of keyhole (laparoscopic) surgery during which the surgeon operates through a small incision while watching progress on a TV monitor via a laparoscope. The operator uses long instruments pushed through the incision to insert a synthetic mesh over the area. This is similar to the tension-free techniques, but does not involve opening the abdomen. Patients recover faster, experience less pain and go home within 24 hours in most cases. However, with this technique, occasional serious complications have been reported and, until recently, the risk of recurrence was unknown. The aim of the project is to clarify these issues.
Prof Grant said: “The surgical repair of groin hernias is the most frequently performed operation in general surgery. Relatively modest improvements in either clinical outcomes or cost would therefore have significant medical and economic impact.”
Kidney Research
A third grant of £230,000 has gone to Professor Andrew Rees, Regius Professor of Medicine, to develop a co-ordinated research programme into understanding the processes responsible for progressive kidney scarring, a major cause of kidney failure. More than 250,000 people throughout Europe are being treated by dialysis and renal transplantation as a result of chronic kidney failure. The human and economic burden is already enormous and the number of patients requiring treatment is increasing by 10-15% per year.
Research laboratories throughout Europe will be involved in the study. They will apply the latest methods in molecular and cell biology, as well as the most recent clinical basic research to study the control of inflammation and scarring of the kidney. The information gained will provide the foundation for new treatments and will also provide better ways of measuring disease activity.
Professor Graeme Catto, Dean of the Faculty of Medicine and Medical Sciences, said: “These awards demonstrate that our research drive has percolated into the heart of the Europe. With three substantial awards, we have truly won the jackpot this time.”