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Together with the University of Liverpool and Liverpool Women’s NHS Foundation Trust, Alder Hey has a strong focus on the development of new medicines for children and babies and on optimising the use of drugs in everyday practice.
Our research focuses on a number of themes, including drug development and early phase studies in children and babies, paediatric pharmacovigilance, drug safety and paediatric drug formulation.
Medicines research in paediatrics is an important component of the Integrated Research Strategy for Child Health and a key contributor to the Liverpool Health Partners Clinical Academic Programme in Drugs.
The theme is supported by major institutions, units and infrastructure awards:
Theme Lead Professor Matthew Peak: Matthew.Peak@alderhey.nhs.uk
Leads for Paediatric Medicines Research Unit Dr Mark Turner: Mark.Turner@liv.ac.uk Professor Tony Nunn: A.J.Nunn@liv.ac.uk Professor Matthew Peak: Matthew.Peak@alderhey.nhs.uk
Clinical Director of NIHR Alder Hey Clinical Research Facility Professor Michael Beresford: M.W.Beresford@liv.ac.uk
Director of Pharmacy Mo Azar: Mo.Azar@alderhey.nhs.uk
Senior Research Pharmacist Jenny Bellis: Jennifer.Bellis@alderhey.nhs.uk
Senior Lecturer in Paediatric Clinical Pharmacology Dr Dan Hawcutt: d.hawcutt@liverpool.ac.uk
GRiP Leads Dr Mark Turner: Mark.Turner@liv.ac.uk Professor Tony Nunn: A.J.Nunn@liv.ac.uk
GRiP Research Pharmacist Jennifer Duncan: Jennifer.Duncan@alderhey.nhs.uk
Lead for Antimicrobial Pharmacodynamics and Therapeutics Professor William Hope: William.Hope@liv.ac.uk
Recent regulatory requirements mean that clinical trials most take place with children to test the safety and effectiveness of new medicines. However there remains a lack of age appropriate formulations of medicines which means that healthcare professionals are often required to manipulate dosage forms for adults so that a medicine can be given to a child or baby.
The NIHR funded Manipulation of Drugs in Children (MODRIC) study investigated how medicine dosage is manipulated for paediatric use. This study led to the production of national guidance for healthcare professionals to minimise risk.
Researchers at Alder Hey Children’s Hospital, University of Liverpool, University of Central Lancashire and University College London have developed a tool that will raise awareness of potential side effects from medicines.
Medicines play a vital part in treating and preventing disease in adults and children. The aim is always to develop medicines that have no side effects (or adverse drug reactions as they are also called) but the reality is that all medicines can potentially cause unwanted effects in some people. Medicines affect people differently, especially children due to the changes that take place as they grow and develop. When healthcare professionals prescribe a medicine, they weigh up the benefits of the medicine against any potential risk.
Previous research at Alder Hey found that three out of every 100 children admitted to hospital experience a reaction from a medicine taken at home. Most of these reactions were not severe and resolved soon after the medicine was stopped. However, 22% may have been avoidable, including side effects such as diarrhoea with antibiotics, constipation with medicines given to relieve pain and vomiting related to chemotherapy.
Around one in six children experienced at least one side effect from a medicine while in hospital, which is similar to findings in adults. More than half of the reactions seen in children in hospital were due to medicines used in general anaesthesia and for the treatment of pain after surgery. The five most common side effects were nausea and/or vomiting, itching, constipation, diarrhoea and sleepiness.
The use of technology (such as Electronic Prescribing), changing guidelines, educating patients and or/their parents on their medicines and raising awareness amongst healthcare professionals are some of the possible factors that may help. Advances in pharmacogenetics may represent the ultimate method of avoidability. Pharmacogenetics aims to optimise the use of medicines, by targeting medicines to patient’s individual genes. This is called ‘personalised medicine’.
In the UK, the Medicines and Healthcare Products Regulatory Agency (MHRA) monitors the safety of medicines. If information indicates that the risk regarding a medicine has changed since it was authorised, regulatory bodies can take action. Health care professionals, patients and carers are encouraged to report side effects to the MHRA using the yellow card scheme. This can even be done now, using the Yellow Card App, helping to make medicines safer for children (and adults).
Being a teenager can be a stressful and busy time as it is, but for Dylan he has taken on the added task of being part of a significant research study at Alder Hey examining Diabetes.
Dylan’s older brother Jake has Type 1 Diabetes which developed when the immune system destroys the insulin producing cells in his pancreas. Insulin is a hormone which helps glucose to travel to the cells to be used as fuel. Without this hormone the glucose builds up in the blood. It's a lifelong condition and, if untreated, it can cause very serious health problems.
A screening for antibodies showed that Dylan was prone to also develop Diabetes in the future. The test revealed he had four out of the five antibodies which are present in someone with the condition.
Four years ago, Dylan made the decision to be involved with a piece of research at Alder Hey. For the past two years, Dylan has been taking a new form of oral medication as part of the trial. Only the trial company are aware if this is either oral insulin or a placebo.
Dylan says: “It’s important for people to know how vital research is. Learning about conditions and new medication could help many children with their Diabetes and other conditions. I’m proud that by taking part in the study at Alder Hey, I’m playing a part in finding out more for a future generation.”
The study hopes to show that oral insulin will be able to prevent or slow down the onset of Diabetes thereby presenting the pancreatic function for longer.
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