Developing the CHARMER trial: The experience of an NHS Research Project Manager

By Ania Spurdens, Research Project Manager, Norfolk and Norwich University Hospital

The CHARMER research programme aims to develop and test a behaviour change intervention for hospital doctors and pharmacists to encourage proactive deprescribing – this means stopping medicines before they cause harm.

In summer 2022, Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUH) took part in the CHARMER feasibility study (Work Package 3). The aim of the feasibility study was to test and then fine-tune processes for delivering the CHARMER intervention and trial. This was to ensure that hospitals across the country would be able to deliver the processes with ease in the definitive trial.

I was invited to work closely with the CHARMER team from an early stage. This was particularly useful as it meant I had access to information about the study early on, allowing plenty of time for us to plan ahead as an organisation and consider what resources would be needed. There were a few things that were different about the CHARMER feasibility study compared to studies I’d set up previously:

  1. It is rare to implement organisational changes as part of a trial – however, the clinical research team had previous experience in implementing organisational changes and we were able to follow our local processes. Senior staff in the hospital were also interested in and supportive of the study and its wider aims.

  2. Some data was collected through data linkage with routinely collected datasets from NHS Digital to minimise the burden on staff collecting data. This was something we were keen to make work. The CHARMER team, our Information Governance team, and our Senior R&D leaders worked to ensure patient data would be handled appropriately and kept secure.

  3. The Principal Investigator (PI) at the organisation was given training by the CHARMER team on how to facilitate workshops for staff taking part in the study.

  4. A benchmarking element of the intervention allowed NNUH to monitor and benchmark its progress with other hospitals taking part in the feasibility study. During set-up, we had to work out who would prepare these reports and we worked closely with specialist pharmacists to pull data from the hospital’s electronic prescribing programme.

I enjoyed setting up the CHARMER feasibility study and learned a lot along the way gaining experience and developing connections with teams across the hospital that I don’t usually work with. The CHARMER team were incredibly helpful and approachable throughout, and it was clear they wanted to support our staff and make things as easy as possible for us. There were a few things we hadn’t fully considered during set-up that came up during the active study window; however, working closely with the CHARMER team, we were able to feedback on our experience and improve the processes in preparation for the definitive trial.

Sign up to the definitive trial here.

Guest Blog: Patient and Public Involvement in Deprescribing Research

Members of the CHARMER team – Katherine Murphy (Patient and Public Involvement Lead), Doreen Pegg (Patient and Public Involvement member), David Wright (Professor of Health Services Research) and Caroline Smith (Research Associate) – have written about the importance of Patient and Public Involvement (PPI) in deprescribing research for deprescribing.org.

Patient and public members have been central to CHARMER programme of research and in the blog they describe their involvement in the project. Here’s a snippet:

“My motivation is to give suggestive ideas… to improve the service in which there is a focus on remedying the way repetition of medications can be reviewed at every opportunity which will be of value to those who are not reviewed in their circumstances.”

– CHARMER PPI member

Read the full guest blog here.