Three awards announced for Trinity researchers in new HRB Evidence for Policy programme

Posted on: 20 December 2024

The awards are part of the HRB’s investment of €2.4 million as part of a new Evidence for Policy (EfP) programme that was developed in collaboration with the Department of Health (DOH).

The Health Research Board’s (HRB) Evidence for Policy programme aims to support research projects to generate evidence that will strengthen policy development or evaluate how policy is currently implemented. It will advance Ireland’s capacity to respond quickly to priority research questions for policymakers and foster collaboration among the teams of researchers and individual policy units within the DOH.

Trinity researchers were awarded three out of the seven awards, with a total value of €952,944.13. All researchers come from the School of Medicine at Trinity.

Trinity awardees

1: Dr Sara Burke,  Centre for Health Policy and Management, School of Medicine

Project: Producing a Health in Transition health system review (HiT) for Ireland as part of the European Observatory on Health Systems and Policies HiT series

Patient-Oriented Research

Award Amount: €223,896

Sara said:

“The team from The Centre for Health Policy and Management is delighted to collaborate with colleagues from the ESRI to carry out this important research for the Department of Health and the European Observatory on Health Systems and Policies. Producing a new Health in Transition health system review for Ireland is an opportunity to take stock at progress made over the last 15 years, benchmark how our health system is doing, facilitate international comparisons and inform the future direction of Irish health system reform.”

Summary of Sara’s research

This project is about creating a new, detailed definitive report on Ireland's health system, updating in light of changes that have happened since the last such report in 2009. Ireland has experienced economic ups and downs, a growing and ageing population and the COVID-19 pandemic. Analysing the impact of these events is important since it can help to inform health system delivery and also our reform plan, called Sláintecare, which aims to make healthcare better and more accessible for everyone in Ireland. The study brings together a team of experts, using data from Ireland and other countries to better understand how Ireland's health system works and what needs to be improved.

The project is split into four main parts: researching the current situation (WP1); making sure all the information is accurate (WP2); figuring out what information is missing (WP3); and communicating with lots of different people involved in healthcare to get their perspectives (WP4). By doing this, we will provide evidence on which to make Ireland's health system better for everyone who uses the service - the public, patients, carers, healthcare workers. This report could also help other countries learn from what we're doing here in Ireland, showing how research can help shape better health policies.

2: Dr Laura McCullagh, Pharmacology and Therapeutics, School of Medicine

Project: The development of data infrastructures to support on-going analyses of the impact of reimbursed medicines on healthcare service utilisation in Ireland

Patient-Oriented Research

Award Amount: €354,348.25

Laura said:

“Our Research Group (from Trinity, the NCPE, TILDA, the NCRI along with international experts) are delighted to have been awarded this inaugural HRB EfP funding.

The current HSE spend on medicines, in Ireland, exceeds €2.5 billion per annum. Historically, national financial systems (which provide information on spend and healthcare utilisation) have not been linked directly to patient-outcomes data. By developing approaches to connecting existing national databases (to form better data infrastructure), our Research Group aims to allow the health service to more accurately quantify the impact of medicines using this real-world data. Our research outputs will be of interest to many, including patients and their families, healthcare providers and policy decision makers.

The EfP Award has been developed by the HRB, in collaboration with the DoH. Within this structure, our research questions will be aligned with the particular needs of national policy decision makers. Further, our research outputs will be directly available to those involved in national sustainable medicines policies. We will also be well placed to highlight any barriers encountered, and resources required for the development of permanent data infrastructures.”

Summary of Laura’s research

In Ireland, the current process for the assessment of the expected value of new medicines involves predictions, made by experts, about how the medicines are likely to affect patients' health outcomes and how much the medicines will cost the health-state payer. According to this assessment a recommendation is made, to the state decision makers, on whether the medicine in question is likely to be effective and to provide value for money. The decision maker uses this information when deciding if the medicine should be funded for use by patients in Ireland. However, these predictions are often associated with uncertainty and the true value of the medicine is often not measured after if has been funded for use. 

This research programme will use national databases to assess the health outcomes actually experienced by patients and the costs actually incurred by the health-state-payer. We will bring together data from the national medicines-funding database (PCRS), the National Cancer Registry of Ireland (NCRI) and the Irish Longitudinal Study of Aging (TILDA) to inform the use, health outcomes and costs associated with medicines in Ireland. The main health conditions, for close examination here, will be cancer and chronic diseases. These are considered to be the areas of highest spend on medicines. 

The research team includes experts from Trinity College Dublin, the National Centre for Pharmacoeconomics, the NCRI, TILDA and national and international collaborators. The aim of the research is to inform national decision-making in relation to sustainable medicine policies. We will do this by providing evidence on the predicted and realised health outcomes associated with new and existing medicines. The team will investigate this over five work packages. In the final work package, we will deliver recommendations that take into account both national and international evidence.

3: Dr Irina Kinchin, Centre for Health Policy and Management, Public Health and Primary Care, School of Medicine

Project: Optimising PrEP delivery in Ireland: A model for an integrated digital-hybrid clinical service enhancing Value for Money in healthcare

Patient-Oriented Research

Award Amount: €374,700.03

Irina said:

“This project is in partnership with the HSE Sexual Health Programme, the MPOWER Programme at HIV Ireland, the GUIDE clinic at St James’s Hospital Dublin, the GUM service at South Infirmary Victoria University Hospital Cork, and the free HSE home STI testing provider, SH24. This project will pilot ways to use a hybrid digital/in person care approach to deliver HIV pre-exposure prophylaxis (PrEP). PrEP reduces the risk of HIV in individuals at increased risk. The goal of this pilot is to develop and evaluate a hybrid PrEP service that increases access and capacity to PrEP in a way that is acceptable and cost efficient. Outputs from this project are expected to inform digital healthcare delivery in Ireland”.   

Summary of Irina’s research

Context and gap: The introduction of new treatments can enhance health and benefit society, yet their success depends on developing effective and efficient service models. For example, Pre-exposure Prophylaxis (PrEP) has enhanced HIV prevention. However, in Ireland, service capacity and access pose challenges to equitable service implementation. Drawing from the experiences of Ireland’s national home Sexually Transmitted Infections (STIs) testing and the COVID-19, adopting a hybrid-digital approach could enhance PrEP service delivery and offer lessons applicable to other healthcare settings.

Specific aims: 

• Develop a new digital-hybrid, online and in-person, model of PrEP care to improve service capacity, efficiency, and value for money.
• Explore how this model can be applied to other healthcare services in Ireland to maximise the potential benefits and inform standards for digital healthcare.

Approach: Irina's team will work with SH:24, a leader in online sexual health services, users, providers, designers, and the Department of Health, using policy analysis, routinely collected data, surveys, and interviews to:

• co-develop the digital-hybrid, online and in-person, PrEP care model;
• pilot in two locations (Dublin and Cork) and gather feedback; and,
• evaluate and refine, analysing process and outcome data, including cost, patient, staff, and organisational experiences to refine the model for broader use and transferability in other healthcare settings.

Impact: By making PrEP services more accessible and efficient, this project offers to overcome capacity and access challenges providing equitable access to PrEP and reducing HIV infections in Ireland. It sets the stage for transforming other healthcare services with hybrid-digital solutions, making the healthcare system more responsive to the needs of the modern patient. Ultimately, this project will demonstrate how integrating digital services in healthcare can lead to better patient experiences, improved health outcomes, and more efficient use of resources

According to Dr Mairéad O’Driscoll, Chief Executive at the Health Research Board

“These awards focus specifically on policy priorities that have been determined by the Department of Health. They will generate timely, high-quality evidence for policymakers that will enhance decision-making in health and social care to create better outcomes for people and society.”

According to Minister for Health, Stephen Donnelly, T.D.

“The Evidence for Policy programme is a significant step in developing new approaches to bringing health researchers and policymakers together to address important topics in health.

“The programme, funded by the Department of Health through the Health Research Board, will help develop research projects to support evidence-based policy making in many areas of health and social care in a timely, open and transparent manner. The programme will ensure that evidence is steering our investment into the sustainability and resilience of our health service, and that it meets the needs of patients."

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