Evaluating the impact of a molecular point-of-care test and treat strategy for influenza in hospitalised adults

Aims: This fellowship aims to train the applicant and develop their skills so that they are able to design and run clinical studies in the future without needing help from more senior researchers. This is done by helping the applicant to plan and carry out a clinical study whilst doing some specific training courses and being supported and supervised by more senior researchers. The care of patients with influenza in hospital needs to be improved. The study within this fellowship will see whether using a new rapid test for influenza in adults admitted to hospital can improve their care compared to the usual way that patients are tested and treated. Background: Influenza causes thousands of people to become unwell and be admitted to hospital every year. There is a vaccine available to prevent influenza but not everybody receives it and some of those who do still catch influenza and become unwell. There are antiviral drugs available to treat influenza but they are not used as often as they should be. This is because patients admitted to hospital with influenza are not always tested for it and when they are, the standard test takes 24-48 hours to give a result. Recent studies have shown that antiviral drugs are very helpful in unwell patients admitted to hospital with influenza and so we must find a way to improve the numbers of patients who are diagnosed with influenza and treated with antivirals. We have a new test which is very accurate, gives results within 1 hour and can be used at the bedside as soon as patients come into hospital. We think that by using this test in patients admitted to hospital we may improve the number of cases of influenza diagnosed and increase the number given antivirals. Design and methods: Patients will be put into one of two groups. One group will have the new test performed as soon as they come into hospital and the results given to the doctors and the patient. Patients with a positive test for influenza will be offered antiviral medicines in accordance with UK guidelines. The other group will be managed in the standard way where doctors will decide whether or not to send a test to the laboratory and then whether to offer antiviral medicines. The two groups will be compared to see if having the new rapid test made any difference to their care or outcome. To allow the applicant to become more skilled in running studies and analysing the results of trials they will have specific training classes during the fellowship and will also have help and support from local experts in statistics and health economics (studying whether new treatments are good value for money). Patient and public involvement: We asked patients how their care and experience could have been improved when they were admitted to hospital with possible influenza and their answers have helped to design this research study. Patients preferred to have the rapid tests as they got their results sooner. Patients said that having a named virus as the cause of their symptoms was reassuring compared to being told it was 'probably a viral illness'. Patients also said that they wanted to be part of any decision making about using antiviral treatment rather than having this decision made for them. Dissemination: The results of the study within this fellowship may change the way in which patients are routinely tested and treated for influenza. The results of the study will be presented at medical conferences and published in well respected scientific journals. Members of the public helping with this study will also help to inform the wider general public of the results both locally and nationally.