The way pharmacy has engaged with Oxford University’s PRINCIPLE Covid-19 trial to help strengthen recruitment is opening researchers’ eyes to how its reach, particularly in community pharmacy, can support engagement and participation. So says the University of Bradford’s Mahendra Patel, who joined the trial team as an investigator and national BAME (black, Asian and minority ethnic) community and pharmacy research lead in September. 

The trial started in March, and six months later, recruitment from the target demographic stood at 1,000. “Today [22 December] they have 2,790. That’s due more to the work of the trial team in building the platform, but pharmacy is playing a significant role in helping to raise awareness UK-wide,” Professor Patel says. “The trial is an excellent opportunity for new, innovative ways of engaging in and conducting research.” 

He says the actions of community pharmacy (and others across the profession) in helping to recruit patients to the Platform Randomised trial of INterventions against Covid-19 In older peoPLE is planting huge seeds at the heart of the UK’s clinical research effort. 

“How pharmacy has stepped forward in a matter of months is barely sinking in for me,” he says. “Bringing pharmacy into one of world’s leading research centres, working closely with senior scientists and researchers at Oxford – it’s opened many people’s eyes to the opportunity pharmacy presents for delivering research in practice.

“I believe this is going to be very promising for pharmacy in opening up opportunities for wider collaboration and greater involvement through research. I’m intending to build up a UK-wide reservoir of pharmacies, pharmacy organisations and local community networks that researchers can look to in future.”

Community pharmacies large and small have joined the effort. 

Well and Lloydspharmacy were unveiled as trial supporters in November; Community Pharmacy Scotland recently came forward on behalf of 1,258 pharmacies. Independents are getting on board, whether that’s locally through groups, LPCs, or as individual businesses. A general call to pharmacy teams to refer patients was issued in October by Oxford’s Nuffield Department of Primary Care Health Sciences. 

Patients are eligible if they have Covid-19 symptoms and are 50 or over with a co-morbidity, or 65 and over with or without. Pharmacy teams can signpost those eligible to the trial website and display a poster which can be ordered online or downloaded for printing. 

I believe this is going to be very promising for pharmacy in opening up opportunities for wider collaboration

The trial is looking at whether early treatment in the community can help people recover quickly from illness, without the need for hospital admission. It is currently evaluating whether budesonide offers any additional benefit to usual care alone. Early treatment arms have examined hydroxycholoroquine, azithromycin and doxycycline; treatment arms may be stopped, replaced or added as the trial, described as “unique in primary care and the only truly national trial of treatments for Covid-19 in the community”, is ongoing. 

Professor Patel says the trial fits with his longstanding research interests in health inequalities. “As the National Institute for Health Research  community pharmacy research champion for Yorkshire & Humber, I’ve always tried to encourage pharmacists to get involved and support research to help develop evidence-based practice and ultimately improve health and health outcomes,” he says. 

“Early in the summer, I had an article published about engaging BAME communities and how we may help address the wider health inequalities witnessed, especially through Covid-19. I went on to develop the Covid-19 risk assessment for Lloydspharmacy and subsequently Well. I’m determined to show what a valuable platform pharmacy is in reaching out, even more so during the pandemic. Working closely with various religious and community leaders over the years, I’ve also managed to gain the support of national Hindu, Islamic, Jain and Tamil communities for the trial.”

Professor Patel continues to look for support. “If you feel you can reach out into your community to support the UK trial to find a treatment for Covid-19 using known medicines, you can contact me, for sure, or you can visit the trial website.” 

In return, he is interested in how people set about the task. “Some are developing innovative methods and approaches to inspiring people to take public health seriously – I want to see that too and to share wider,” he says. 

Since starting with the trial team, Professor Patel has been contacted by organisations nationally and overseas, keen to learn more. “There’s a ‘win-win’ at the end for pharmacy and research,” he says. “It’s encouraging to see how far pharmacy can reach and join up with other disciplines in the manner it has.”

The PRINCIPLE trial is funded through the NIHR as part of the UK Government’s rapid research response fund. It can be contacted on 0800 138 0880 or via principle@phc.ox.ac.uk