Multimorbidity and Pregnancy: Determinants, Clusters, Consequences and Trajectories (MuM-PreDiCT)
Lead Research Organisation:
University of Birmingham
Department Name: Institute of Applied Health Research
Abstract
What is the problem?
One in five pregnant women have two or more active long-term health conditions. These can be both physical conditions (like diabetes or raised blood pressure), and mental health conditions (such as depression or anxiety). Often women also have to take several medications to manage their different health needs. Having two or more health conditions is also becoming increasingly common in pregnant women as women are increasingly older when they start having a family and as obesity and mental health conditions are on the rise in general.
We don't really understand what the consequences are of multiple health conditions or medications for mothers and babies. This can make pregnancy, healthcare and managing medications more complicated. Without deeper understanding of the problem, women with several long-term health conditions may not have the best and safest experience of care before, during and after pregnancy because services have not been designed with their health needs in mind.
What will we do?
Our research is divided into five work packages. The first work package will examine how health conditions accumulate over time and identify what makes a woman more at risk of developing two or more long-term health conditions before pregnancy.
The second work package will explore women's experiences of care during pregnancy, birth and after birth. We will work together with families and health professionals to establish how care could be improved.
The third work package will look further at how having two or more long-term health conditions may affect pregnant women and their children. We will do this in three ways: we will identify outcomes that women, health professionals and researchers feel should be reported in research; we will examine how often women experience pregnancy complications; and we will explore how frequently women and their children develop additional long-term ill health.
In the fourth work package we will describe how medications are prescribed. We will investigate how taking combinations of medication may affect pregnant women and their babies.
In our fifth work package, we will build a prediction model to help identify how likely a previously healthy pregnant woman will develop multiple long-term conditions after pregnancy. We can do this by using health information collected during or just after pregnancy. This is because we know that some complications in pregnancy may be a warning sign of future illnesses.
What will our research achieve?
We will help women and their healthcare professionals make informed decisions about their care and medication use by providing accessible information on risk. For example, the risks associated with pregnancy; the risks associated with combinations of medications during pregnancy; and the future risk of developing long-term health conditions after a pregnancy complication.
Our work will also identify important time points to intervene and ways to prevent pregnancy complications or developing future long-term health conditions. This will reduce the health burden for women, partners, carers and reduce avoidable healthcare and economic cost in the long run for society. Working together with women and healthcare professionals, we will produce recommendations on how to plan and design services that meet the needs of women and their families before, during and after pregnancy.
One in five pregnant women have two or more active long-term health conditions. These can be both physical conditions (like diabetes or raised blood pressure), and mental health conditions (such as depression or anxiety). Often women also have to take several medications to manage their different health needs. Having two or more health conditions is also becoming increasingly common in pregnant women as women are increasingly older when they start having a family and as obesity and mental health conditions are on the rise in general.
We don't really understand what the consequences are of multiple health conditions or medications for mothers and babies. This can make pregnancy, healthcare and managing medications more complicated. Without deeper understanding of the problem, women with several long-term health conditions may not have the best and safest experience of care before, during and after pregnancy because services have not been designed with their health needs in mind.
What will we do?
Our research is divided into five work packages. The first work package will examine how health conditions accumulate over time and identify what makes a woman more at risk of developing two or more long-term health conditions before pregnancy.
The second work package will explore women's experiences of care during pregnancy, birth and after birth. We will work together with families and health professionals to establish how care could be improved.
The third work package will look further at how having two or more long-term health conditions may affect pregnant women and their children. We will do this in three ways: we will identify outcomes that women, health professionals and researchers feel should be reported in research; we will examine how often women experience pregnancy complications; and we will explore how frequently women and their children develop additional long-term ill health.
In the fourth work package we will describe how medications are prescribed. We will investigate how taking combinations of medication may affect pregnant women and their babies.
In our fifth work package, we will build a prediction model to help identify how likely a previously healthy pregnant woman will develop multiple long-term conditions after pregnancy. We can do this by using health information collected during or just after pregnancy. This is because we know that some complications in pregnancy may be a warning sign of future illnesses.
What will our research achieve?
We will help women and their healthcare professionals make informed decisions about their care and medication use by providing accessible information on risk. For example, the risks associated with pregnancy; the risks associated with combinations of medications during pregnancy; and the future risk of developing long-term health conditions after a pregnancy complication.
Our work will also identify important time points to intervene and ways to prevent pregnancy complications or developing future long-term health conditions. This will reduce the health burden for women, partners, carers and reduce avoidable healthcare and economic cost in the long run for society. Working together with women and healthcare professionals, we will produce recommendations on how to plan and design services that meet the needs of women and their families before, during and after pregnancy.
Technical Summary
Our vision is to characterise and understand the determinants and consequences of pre-existing multimorbidity (MM) in pregnant women; and to predict and prevent MM and its adverse consequences in women and their offspring.
We will use electronic health records and birth cohort data from across the four UK nations and European registries of congenital anomaly. We have already harmonised most of the definitions of variables and linkage algorithms to ensure comparable methods across the datasets.
We have described the epidemiology of pre-existing MM in pregnant women. We will characterise MM clusters and trajectories. We will investigate if MM clusters and trajectories differ by parity, age, ethnicity, social-deprivation and lifestyle factors. Identifying the determinants of MM clusters and trajectories will enable development of preventive interventions and strategies to reduce inequalities.
To improve maternity services, we will interview pregnant women with MM, their carers and health professionals to understand current service provision and their limitations. We will then hold workshops to co-design care pathways for pregnant women with MM.
We will then study how maternal MM affects the outcomes of pregnancy, mothers and offspring. Initially we will use established consensus methods to develop a core outcome set for research of pregnant women with MM. Then we will determine the rates of these outcomes based on maternal MM status and then based on prescription combinations received. Findings will help women make informed decisions about their pregnancy, inform maternity care planning and improve safe prescribing during pregnancy.
Our previous work has demonstrated that pregnancy complications are associated with development of future morbidities after pregnancy. Using this information and other covariates we will develop and validate prediction models to inform prevention and early detection of multiple long-term conditions postpartum.
We will use electronic health records and birth cohort data from across the four UK nations and European registries of congenital anomaly. We have already harmonised most of the definitions of variables and linkage algorithms to ensure comparable methods across the datasets.
We have described the epidemiology of pre-existing MM in pregnant women. We will characterise MM clusters and trajectories. We will investigate if MM clusters and trajectories differ by parity, age, ethnicity, social-deprivation and lifestyle factors. Identifying the determinants of MM clusters and trajectories will enable development of preventive interventions and strategies to reduce inequalities.
To improve maternity services, we will interview pregnant women with MM, their carers and health professionals to understand current service provision and their limitations. We will then hold workshops to co-design care pathways for pregnant women with MM.
We will then study how maternal MM affects the outcomes of pregnancy, mothers and offspring. Initially we will use established consensus methods to develop a core outcome set for research of pregnant women with MM. Then we will determine the rates of these outcomes based on maternal MM status and then based on prescription combinations received. Findings will help women make informed decisions about their pregnancy, inform maternity care planning and improve safe prescribing during pregnancy.
Our previous work has demonstrated that pregnancy complications are associated with development of future morbidities after pregnancy. Using this information and other covariates we will develop and validate prediction models to inform prevention and early detection of multiple long-term conditions postpartum.
Organisations
- University of Birmingham (Lead Research Organisation)
- National Institute for Health Research (Co-funder)
- Bradford Institute for Health Research (BIHR) (Collaboration)
- Maastricht University (UM) (Collaboration)
- University of Toulouse (Collaboration)
- University College London (Collaboration)
- University of Manchester (Collaboration)
- ULSTER UNIVERSITY (Collaboration)
- Cegedim (Collaboration)
- St George’s Hospital (Collaboration)
- Guy's and St Thomas' NHS Foundation Trust (Collaboration)
- UNIVERSITY OF DUNDEE (Collaboration)
Publications

Anand A
(2023)
Prevalence of polypharmacy in pregnancy: a systematic review.
in BMJ open

Azcoaga-Lorenzo A
(2023)
Maternal multimorbidity and preterm birth in Scotland: an observational record-linkage study.
in BMC medicine

Black M
(2023)
England's preconception health report: convenient and valuable data.
in BJOG : an international journal of obstetrics and gynaecology

Charles Gadd
(2022)
mmVAE: multimorbidity clustering using Relaxed Bernoulli ß-Variational Autoencoders
in Machine Learning for Health


Hanley S
(2024)
Lost in the System: Responsibilisation and Burden for Women With Multiple Long-Term Health Conditions During Pregnancy
in Health Expectations

K Phillips
(2023)
Prevalence of polypharmacy in pregnancy: a systematic review
in BMJ open

Lee S
(2021)
Epidemiology of pre-existing multimorbidity in pregnant women in the UK in 2018: a cross-sectional study
in The Lancet
Description | BHF Data Science Centre PhD Studentship in Cardiovascular data Science |
Amount | £176 (GBP) |
Organisation | British Heart Foundation (BHF) |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 08/2021 |
End | 09/2025 |
Description | Investigating the implementation of a platform for electronic health record (EHR) automated clinical epidemiology into an NHS trust maternity division. |
Amount | £93,531 (GBP) |
Organisation | Shrewsbury and Telford Hospital NHS Trust |
Sector | Public |
Country | United Kingdom |
Start | 02/2022 |
End | 12/2023 |
Description | MILLENIA: MultIpLe Long-tErm conditions in pregnancy aNd experiences of mIdwifery cAre - a mixed methods study |
Amount | £358,759 (GBP) |
Organisation | HEE/NIHR Integrated Clinical Academic Programme |
Sector | Public |
Country | United Kingdom |
Start | 04/2024 |
End | 04/2027 |
Description | MIREDA (Mother and Infant Research Electronic Data Analysis) Partnership |
Amount | £1,236,698 (GBP) |
Funding ID | MR/X02055X/1 |
Organisation | Medical Research Council (MRC) |
Sector | Public |
Country | United Kingdom |
Start | 06/2023 |
End | 06/2026 |
Description | MLTC-M Community of Practice in ECR training on best practice patient and public involvement with diverse populations |
Amount | £49,838 (GBP) |
Funding ID | MR/X004341/1 |
Organisation | Medical Research Council (MRC) |
Sector | Public |
Country | United Kingdom |
Start | 06/2022 |
End | 01/2024 |
Description | MuM-PreDiCT Clinical Research Fellow |
Amount | £72,000 (GBP) |
Organisation | Medical Research Council (MRC) |
Sector | Public |
Country | United Kingdom |
Start | 08/2021 |
End | 02/2023 |
Description | PhD in Applied Health Research, Clinical Research Fellow, |
Amount | £80,000 (GBP) |
Organisation | Medical Research Council (MRC) |
Sector | Public |
Country | United Kingdom |
Start | 07/2022 |
End | 08/2024 |
Description | Planning mode of birth in routine antenatal care - development of a decision-aid (Plan-A) |
Amount | £974 (GBP) |
Organisation | National Institute for Health Research |
Sector | Public |
Country | United Kingdom |
Start | 09/2022 |
End | 03/2025 |
Description | The HDRUK/Turing Wellcome PhD Programme in Health Data Science |
Amount | £6,005,246 (GBP) |
Funding ID | 218529/Z/19/Z |
Organisation | Wellcome Trust |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 06/2020 |
End | 06/2028 |
Description | Using big data to optimise preconception health among women with mental illness |
Amount | £110 (GBP) |
Organisation | National Institute for Health Research |
Sector | Public |
Country | United Kingdom |
Start | 01/2023 |
End | 03/2024 |
Description | impRoving testing for cardiometabolic diseases in women with previous gestational diabetes: an exemplar study on implementation and evaluation of a novel dAta-DrIven rANdomised clinical Trial platform in primary care (RADIANT) |
Amount | £345,885 (GBP) |
Organisation | National Institute for Health Research |
Sector | Public |
Country | United Kingdom |
Start | 05/2022 |
End | 05/2024 |
Title | Clustering methodology |
Description | mmVAE: multimorbidity clustering using Relaxed Bernoulli ß-Variational Autoencoders |
Type Of Material | Improvements to research infrastructure |
Year Produced | 2022 |
Provided To Others? | Yes |
Impact | NA |
URL | https://proceedings.mlr.press/v193/gadd22a/gadd22a.pdf |
Title | DextER Updated version |
Description | DExtER is a software that was created before the fellowship. This forms the basis on which the whole new Automated Clinical Epidemiology Studies (ACES) platform will work. |
Type Of Material | Improvements to research infrastructure |
Year Produced | 2019 |
Provided To Others? | No |
Impact | Needless to say the tool enable data extraction according to study designs within a couple of hours compared to weeks and months previously |
URL | https://www.birmingham.ac.uk/research/activity/applied-health/research/health-informatics/Automated-... |
Title | Additional file 4 of Polypharmacy during pregnancy and associated risk factors: a retrospective analysis of 577 medication exposures among 1.5 million pregnancies in the UK, 2000-2019 |
Description | Additional file 4: Table S1. Proportions of pregnancies with a prescribed medication - primary analysis. |
Type Of Material | Database/Collection of data |
Year Produced | 2023 |
Provided To Others? | Yes |
URL | https://springernature.figshare.com/articles/dataset/Additional_file_4_of_Polypharmacy_during_pregna... |
Title | Additional file 4 of Polypharmacy during pregnancy and associated risk factors: a retrospective analysis of 577 medication exposures among 1.5 million pregnancies in the UK, 2000-2019 |
Description | Additional file 4: Table S1. Proportions of pregnancies with a prescribed medication - primary analysis. |
Type Of Material | Database/Collection of data |
Year Produced | 2023 |
Provided To Others? | Yes |
URL | https://springernature.figshare.com/articles/dataset/Additional_file_4_of_Polypharmacy_during_pregna... |
Title | Additional file 5 of Polypharmacy during pregnancy and associated risk factors: a retrospective analysis of 577 medication exposures among 1.5 million pregnancies in the UK, 2000-2019 |
Description | Additional file 5: Table S2. Proportions of pregnancies with a prescribed medication - sensitivity analysis. |
Type Of Material | Database/Collection of data |
Year Produced | 2023 |
Provided To Others? | Yes |
URL | https://springernature.figshare.com/articles/dataset/Additional_file_5_of_Polypharmacy_during_pregna... |
Title | Additional file 5 of Polypharmacy during pregnancy and associated risk factors: a retrospective analysis of 577 medication exposures among 1.5 million pregnancies in the UK, 2000-2019 |
Description | Additional file 5: Table S2. Proportions of pregnancies with a prescribed medication - sensitivity analysis. |
Type Of Material | Database/Collection of data |
Year Produced | 2023 |
Provided To Others? | Yes |
URL | https://springernature.figshare.com/articles/dataset/Additional_file_5_of_Polypharmacy_during_pregna... |
Title | Additional file 6 of Polypharmacy during pregnancy and associated risk factors: a retrospective analysis of 577 medication exposures among 1.5 million pregnancies in the UK, 2000-2019 |
Description | Additional file 6: Table S3. Proportions of pregnancies with prescribed medication pairs - primary analysis. |
Type Of Material | Database/Collection of data |
Year Produced | 2023 |
Provided To Others? | Yes |
URL | https://springernature.figshare.com/articles/dataset/Additional_file_6_of_Polypharmacy_during_pregna... |
Title | Additional file 6 of Polypharmacy during pregnancy and associated risk factors: a retrospective analysis of 577 medication exposures among 1.5 million pregnancies in the UK, 2000-2019 |
Description | Additional file 6: Table S3. Proportions of pregnancies with prescribed medication pairs - primary analysis. |
Type Of Material | Database/Collection of data |
Year Produced | 2023 |
Provided To Others? | Yes |
URL | https://springernature.figshare.com/articles/dataset/Additional_file_6_of_Polypharmacy_during_pregna... |
Title | Additional file 7 of Polypharmacy during pregnancy and associated risk factors: a retrospective analysis of 577 medication exposures among 1.5 million pregnancies in the UK, 2000-2019 |
Description | Additional file 7: Table S4. Proportions of pregnancies with prescribed medication pairs - sensitivity analysis. |
Type Of Material | Database/Collection of data |
Year Produced | 2023 |
Provided To Others? | Yes |
URL | https://springernature.figshare.com/articles/dataset/Additional_file_7_of_Polypharmacy_during_pregna... |
Title | Additional file 7 of Polypharmacy during pregnancy and associated risk factors: a retrospective analysis of 577 medication exposures among 1.5 million pregnancies in the UK, 2000-2019 |
Description | Additional file 7: Table S4. Proportions of pregnancies with prescribed medication pairs - sensitivity analysis. |
Type Of Material | Database/Collection of data |
Year Produced | 2023 |
Provided To Others? | Yes |
URL | https://springernature.figshare.com/articles/dataset/Additional_file_7_of_Polypharmacy_during_pregna... |
Title | Clustering methodology |
Description | mmVAE: multimorbidity clustering using Relaxed Bernoulli ß-Variational Autoencoders |
Type Of Material | Data analysis technique |
Year Produced | 2022 |
Provided To Others? | Yes |
Impact | NA |
URL | https://proceedings.mlr.press/v193/gadd22a/gadd22a.pdf |
Description | ACES Global: Maastricht University |
Organisation | Maastricht University (UM) |
Country | Netherlands |
Sector | Academic/University |
PI Contribution | We have established a collaboration with the Maastricht University primary care to implement and evaluate the tool. We successfully managed to do check the feasibility to implement the tool during our visit to Maastricht. We are now in the process of finalising the contract. Once the contract is done we will be able to jointly perform research |
Collaborator Contribution | They have made available their RNFM database for the evaluation. |
Impact | The key output has been the testing of the feasibility. |
Start Year | 2018 |
Description | ACES for CALIBER |
Organisation | University College London |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | We are implementing the DExtER software to the CALIBER platform. This will enable seamless data extraction and produce analysable datasets within hours. |
Collaborator Contribution | They have provided access to the CALIBER platform. |
Impact | We are currently working jointly towards a grant on Informatics Consult |
Start Year | 2019 |
Description | Breastfeeding in women with MLTCs |
Organisation | University of Dundee |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | MuM-PreDiCT team provided share there experiences and the outcomes from the WP2 interview study around breastfeeding in women with MLTCs |
Collaborator Contribution | Provided insight into what other questions might be important to be addresses around breast feeding in women with MLTCs |
Impact | After the collaboration, new interview question regarding the difficulty/ support available during postanatal period for women with MLTCs. |
Start Year | 2023 |
Description | Cegedim |
Organisation | Cegedim |
Country | France |
Sector | Private |
PI Contribution | Cegedim is an industry that provides THIN data and also the provider of the VISION EHR. We have provided license to them to use DExtER, our innovative tool for automated clinical epidemiology studies. We have also provided expertise on processing the THIN database |
Collaborator Contribution | Cegedim provided the THIN data for COVID19 related research. |
Impact | 4 Publications on COVID19 research |
Start Year | 2020 |
Description | Christine Damase-Michel-Pharmaco-epidemiologist,Associate Professor, Senior Pharmacologist, Medical and Clinical Pharmacology, |
Organisation | University of Toulouse |
Country | France |
Sector | Academic/University |
PI Contribution | Team to provide pharmaco-epidemiology studies and clinical insight to to the observations made in the process |
Collaborator Contribution | guide all the pharmaco-epidemiology studies and contribute to organising the pharmacovigilance workshops,help with the study using EUROmediCAT database |
Impact | Form a team to conduct the pharmaco-epidemiology studies and help with the study using EUROmediCAT database |
Start Year | 2020 |
Description | Gillian Santorelli,Principal Statistician, Bradford Institute for Health Research |
Organisation | Bradford Institute for Health Research (BIHR) |
Department | Born in Bradford |
Country | United Kingdom |
Sector | Public |
PI Contribution | Provide support with the analysis of the data and clinical insight |
Collaborator Contribution | ensuring the linkage to required data is in place, and extracting data from BiBs data warehouses |
Impact | NA |
Start Year | 2020 |
Description | Helen Dolk,Prof of Epidemiology and Health Services Research |
Organisation | Ulster University |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Provide a wider team to access and identify the gaps and provide clinical support |
Collaborator Contribution | contributing to WP4, on polypharmacy, to identify suitable European data sources, help build research protocols for the future, and contribute to the design and conduct of an exemplar study using the EUROmediCAT database. |
Impact | NA |
Start Year | 2020 |
Description | Holly Hope-epidemiologist within the Centre for Women's Mental Health in Manchester University |
Organisation | University of Manchester |
Department | Manchester Museum |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Provided insight about pharmacoepidemiology in the pregnant women with multimorbidity |
Collaborator Contribution | Using specific expertise and knowledge of the CPRD dataset developed an algorithm to identify mental health conditions from routinely collected health data. Instrumental to the phenome definitions of mental health conditions across datasets. Involved in interpreting data from the consolidator phase, and contributed to writing the resulting manuscripts and collaborator grant proposal. |
Impact | Using specific expertise and knowledge of the CPRD dataset developed an algorithm to identify mental health conditions from routinely collected health data. Instrumental to the phenome definitions of mental health conditions across datasets. Involved in interpreting data from the consolidator phase, and contributed to writing the resulting manuscripts and collaborator grant proposal. |
Start Year | 2020 |
Description | Kathryn M Abel Professor of Psychological Medicine and Reproductive Psychiatry |
Organisation | University of Manchester |
Department | Manchester Museum |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | We provided insight around pharmaco-epidemiology methods for polypharmacy |
Collaborator Contribution | Provided clinical insights for perinatal mental health and advised on how mental health conditions interacts with physical health conditions, the epidemiology of perinatal mental health conditions and the maternal and offspring outcomes for mothers with mental health conditions. Also advised on how to engage with traditionally hard-to-reach under-represented groups and advised on the ethical issues of engaging women with mental health conditions in research. |
Impact | will be the mental health lead and co-lead WP1's work on identifying the determinants of morbidity clusters dominated by mental health conditions and the determinants of their trajectories. Use my clinical network to help engage women with complex social factors and mental health conditions to participate in WP2 and as PPI. |
Start Year | 2020 |
Description | Maria Loane Reader/ Senior Research Fellow in Public Health. |
Organisation | Ulster University |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Provided clinical expertise and |
Collaborator Contribution | Liaise with the EUROmediCAT registries about their data on the chosen combination of medications for the combination of health conditions that will be included in the exemplar study. I will help build protocols using the EUROmediCAT database and will also contribute my experience of NI pregnancy (NIMATS) and prescription (EPD) data to other WP. |
Impact | None so far |
Start Year | 2020 |
Description | Maria Loane,Reader/ Senior Research Fellow in Public Health, |
Organisation | Ulster University |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Provide clinical insight to the various questions and hurdles arising during the process of data analysis |
Collaborator Contribution | liaise with the EUROmediCAT registries about their data on the chosen combination of medications for the combination of health conditions |
Impact | None yet |
Start Year | 2020 |
Description | Nelson-Piercy, Catherine - Professor of obstetric medicine and consultant obstetric physician |
Organisation | St George’s Hospital |
Country | United Kingdom |
Sector | Hospitals |
PI Contribution | We provided insight around pharmaco-epidemiology methods for polypharmacy |
Collaborator Contribution | provided clinical insight from an obstetric medicine's perspective and clinical interpretation of the epidemiological findings.Also advised on the pathway to impact and established the link with the Safer Medicines in Pregnancy & Breastfeeding consortium as impact partners. |
Impact | Provided clinical interpretation of the epidemiological findings |
Start Year | 2020 |
Description | Ulster University |
Organisation | Ulster University |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | We have analysed data to identify combination of medications that needs studied in multimorbid pregnancies. |
Collaborator Contribution | Key study designs for the euromedicat database |
Impact | We have added Ulster University as a collaborator |
Start Year | 2020 |
Description | University College London |
Organisation | University College London |
Country | United Kingdom |
Sector | Academic/University |
PI Contribution | Project 1: LHS4NHS We have developed a prototype for a data driven learning health systems for hospital care in the National Health Service (LHS4NHS). The project expands on the existing success of the data extraction for epidemiological research (DExtER) tool developed by our team at the University of Birmingham. By adding on additional functionality such as automated study analytics and computable guideline we demonstrated the flow of data to knowledge and knowledge to practice in secondary care (Figure 1). Project 2: OPEHRRA We are currently in the process of developing OPEHRRA (OPen Electronic Health Record Research and Analytics platform) which is a novel platform designed for researchers and clinicians, by researchers and clinicians, to support them in managing their local, regional and national patient populations. The purpose of the platform will enable researchers and clinicians to engage all aspects of the 'open science' cycle including the open release of study design, data extraction and publication. They will have the opportunity to review the work of others in the network as well as request reviews for your own work. The ultimate goal is to make science transparent, reliable and accurate. OPEHRRA has several key elements to it including: 1. Open access protocol submission 2. Open protocol peer review comments and ethical approval 3. Open clinical code list generation and storage 4. Open data extraction 5. Open analytics 6. Open manuscript deposition and peer review |
Collaborator Contribution | They developed a framework for informatics consult |
Impact | The main output of LHS4NHS is a demonstrator of a data driven learning health system with inbuilt computable clinical guideline and an informatics consult tool for secondary care data. The example we demonstrated in the better care event was based on a case study for managing diabetes in hospitalised patients with COVID19. We are currently in the process of writing this up as a manuscript. The main output of OPEHRRA is an online demonstration of a portal for the research community to conduct 'open-science' using electronic health record data. |
Start Year | 2020 |
Description | Zoe Vowles Clinical Research Midwife |
Organisation | Guy's and St Thomas' NHS Foundation Trust |
Country | United Kingdom |
Sector | Public |
PI Contribution | Using clinical experience as a registered midwife, will contribute in the collaborative phase of MuM-PreDiCT by offering a clinical insight from a midwifery perspective. |
Collaborator Contribution | bbbbbbbbbbb |
Impact | Using clinical experience as a registered midwife, will contribute in the collaborative phase of MuM-PreDiCT by offering a clinical insight from a midwifery perspective. |
Start Year | 2021 |
Description | Deep dive sessions |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Patients, carers and/or patient groups |
Results and Impact | Various deepdives were organised in an effort to estimate the issues with certain groups facing more issues during the maternity pathways We have conducted the deeepdives focuused on the LGBT mommies ,mental health conditions and various other local comminitiesand these have helped understand the gaps in the services and various other issues in the care pathway.Conducted 4 deep dive sessions and few planned over the year. |
Year(s) Of Engagement Activity | 2022,2023 |
Description | IAHR seminar |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | presentation of the various programmes |
Year(s) Of Engagement Activity | 2020,2021 |
Description | MuM-Pre-DiCT website |
Form Of Engagement Activity | Engagement focused website, blog or social media channel |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Media (as a channel to the public) |
Results and Impact | The website is the platform for disseminating information about the programme through,publishing resources, videolinks,blogs and meeting minutes(of the operational monthly meetings of mumpredict) |
Year(s) Of Engagement Activity | 2021 |
Description | MuM-PreDiCT dissemination event |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Study participants or study members |
Results and Impact | NA |
Year(s) Of Engagement Activity | 2022 |
Description | MuMPreDiCT: Dissemination and engagement |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | The event was organised to share findings from the work we carried out during the grant period. All videos can be found in: https://mumpredict.org/video-recordings-from-the-18th-feb-2021-dissemination-webinar/ |
Year(s) Of Engagement Activity | 2021 |
URL | https://mumpredict.org/video-recordings-from-the-18th-feb-2021-dissemination-webinar/ |
Description | Newcastle-Birmingham joint seminar |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Discussion and presentations on Epidemiology of multimorbidity in pregnant women and birthing people and medications in pregnancy |
Year(s) Of Engagement Activity | 2021 |
Description | PPI Advisory group meetings |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Patients, carers and/or patient groups |
Results and Impact | These engagments occur regularly and the items discuused can be accessed on the mumpredict website https://docs.google.com/document/d/1dbbeGljpJzB7T8p8RjfGbf1xmyPYh8Rehs1PKRZbQP8/edit The following points were discussed in these meetings Aug 2020 - Research very much needed - too many questions during pregnancy answered with "that's just how it's done" - Reduction in number of appointments (and support) between 1st and subsequent pregnancies, even if long term conditions developed after 1st pregnancy - Would like to know if there is a higher incidence of mental health conditions amongst women with two or more long term health conditions, especially postnatally - What's the impact on breastfeeding? - Will you be collecting data on over-the-counter supplements? - Women with two or more long term health conditions need more support to plan both becoming pregnant and postnatal care - Do these women experience more trauma in childbirth? - Managing (and trying to enjoy) a healthy pregnancy, as well as managing clinicians' concerns about your medical history - Feeling privileged that we're able to use some crappy experiences to improve things for other women - Lots of care available (for some) during pregnancy, especially when hospital appointments took place, but then felt like you were dropped very soon after birth. GPs didn't have any specialist knowledge. - Very varied support for mental health. Also a lack of knowledge, even among GPs, about what is available - Really excited about the project and really proud to be part of it - Good antenatal care helps give women confidence about birth and becoming a mother - Partners are particularly important for feeling like you've got someone on your side - Some health professionals expect too much of their patients - they expect you to know everything about your conditions, but also give the impression they don't believe you when you ask for things like pain medication - Planning for this research to have impact for pregnant women is very important - Planning postnatal care is important, and we'd like to know how long a postnatal period the study is looking at. Postnatal care needs to be extended, and to take account of factors such as long term health conditions, premature baby, feeding preferences, help at home - Want to know more about experiences in different stages: pregnancy, labour, postnatal - breastfeeding, perineal care - Can we make recommendations about how to speak sensitively to women in labour? - Interested in any links between two or more health conditions and prematurity - The project title needs to be simpler - MumPredict is ok but the tagline needs to be more easily understandable for parents Oct 2020 - To consider both physical and mental trauma related to pregnancy affected by 2 or more medical conditions - Be aware of impact of previous abuse on pregnancy and birth experiences, especially in women with disabilities where the incidence of abuse is much higher - Post natal period should cover 12 months Nov 2020 - Define what 'long-term' health conditions mean ?12months ? 5 years, this will help women to self-identify when we recruit participants - Study results presentation: o Would like to see quantitative results o Presented as visual charts/ images/ infographics with headline results / animation like TED talks o Videos of mothers talking about their maternity care experience, in a more personal way, and how the study results fit in - Women with MM would like to have information on: o how MM impacts on their babies (labour, short, long term impact) o if it is safe to have a pregnancy o how pregnancy will impact on family planning, especially 2nd pregnancy as having to cope with 2 babies/children may be harder with the underlying MM o discussed the importance for antenatal pregnancy planning for high risk women - Other items: o reassurance, not to be made to feel they stand out in a negative way, and more emphasis on the normality of their pregnancy o what support they are entitled to o how to address their concerns, o what information sources are available, and supportive communication o Want to be inspiring and a role model - Recruitment for video recording of interviews (WP2) - Women will be at different stages of journey and have different readiness / willingness for video recording to be shared. - Filming may make some feel more vulnerable. Also, some health conditions carry more stigma. Consider anonymising video recordings (not to show face, changing voice, use animation) as some of the stories can be quite sensitive and personal. - Women with MM value having inspirational models of success pregnancy stories. Could consider selling this positive impact it can have for others, to recruit women for video recording. - Recruitment strategies include channels and wording - Lack of information on drug safety - often onus is on women to decide whether to take medications or not - Lack of follow up after child birth Feb 2021 - Would like to ensure rare debilitating diseases are not missed out as felt change in practice is required most for those with complex health needs (severity of impact of condition vs common low impact conditions) - Further suggestion on how to advertise dissemination event to the public, including via food bank, local authorities, social media platforms frequented by parents. Also discussed impact to pathway. - Keen to see what are the outcomes 1 year post pregnancy as some underlying diseases can get worse in that first year - Research proposal some parts were quite technical, especially the part about modelling - Suggestions to the website design and layout |
Year(s) Of Engagement Activity | 2022,2023 |
Description | PPIE Webinars |
Form Of Engagement Activity | Participation in an activity, workshop or similar |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Patients, carers and/or patient groups |
Results and Impact | Various lunch time webinars as a part of expanding our PPIE approach and help the members understand the next steps |
Year(s) Of Engagement Activity | 2024 |
Description | PPIE webinars on youtube channel |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Third sector organisations |
Results and Impact | The video upoaded on the youtube channel was well received. |
Year(s) Of Engagement Activity | 2024 |
URL | https://youtu.be/1PtAbYtk01Y |
Description | Role model: Krishnarajah Nirantharakumar |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Article in the bmj open about the principal investigator Prof.Krishnarajah Nirantharakumar |
Year(s) Of Engagement Activity | 2021 |
URL | https://www.bmj.com/content/374/bmj.n2221 |
Description | SPF Multimorbidity Wave 2 Launch and Networking Event/Steering Group Meeting |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | Presentations and discussions on other programmes on multimorbidities. Followed by Group work and discussions |
Year(s) Of Engagement Activity | 2021 |
Description | Workshop-Mumpredict-to decide on the long term health conditions |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Professional Practitioners |
Results and Impact | The purpose for this workshop was to finalise the list of long term health conditions to be included |
Year(s) Of Engagement Activity | 2021 |
Description | local university news briefing |
Form Of Engagement Activity | A press release, press conference or response to a media enquiry/interview |
Part Of Official Scheme? | No |
Geographic Reach | Local |
Primary Audience | Media (as a channel to the public) |
Results and Impact | local university news briefing of receiving the new grant, https://mumpredict.org/mum-predict-gets-funded/ |
Year(s) Of Engagement Activity | 2021 |
URL | https://mumpredict.org/mum-predict-gets-funded/ |