00:00Hi, I'm Alex Miros. I'm a professor of endocrinology at Ulster University and a consultant endocrinologist in the Western Trust.
00:07Tell us a little bit about the Peace Time project. It's a major investment now over the following year.
00:13Ten million euros through the EA Peace Plus money.
00:16It is a major investment from this Peace Plus programme which is delivered by the SEUPV
00:23and it is to set up the first obesity management services in the northwest of the islands.
00:32This is the first time that we are setting up services in Northern Ireland
00:36and enhancing some of the existing services in the neighbouring county of Donegal.
00:42We will be treating 9,000 people who have got obesity and its complications.
00:48We will be doing that for a period of 12 months for every patient with assessments and inputs also after the 12 months.
00:57This is a four year project and what we would ideally like to achieve is to demonstrate that this is feasible
01:04and that it can be adopted and rolled out throughout Northern Ireland if not throughout national services here and beyond.
01:16I am David Gibson. I am Professor of Personalised Medicine at Ulster University in the School of Medicine here.
01:22Tell us a bit about the IMPROVE project which you are heading up David.
01:26It is a significant investment of ten million from the EU Peace Plus money.
01:31It is really targeting, I suppose using innovation to prescribe more optimally for patients in a personalised way.
01:41That's right, that's right. So this is first in Ireland in GP practices.
01:46What we are aiming to do is to really address need around some of the key long term health conditions
01:53which people in the cross border regions of Ireland really suffer in higher numbers than anywhere else in the UK or Ireland.
02:00So those would be things like pain medications, in heart disease as well and then also with depression.
02:08And the way we want to address these is to try and improve the treatments that people are already on and make sure they are appropriate.
02:16And to do that we are going to apply what is called a patient centred medication review.
02:20So we will look at all the medications that people are on if they are suffering from multiple conditions
02:25and they have drugs which might cause issues, might cause symptoms to worsen or actually might at very worst put them in hospital.
02:34And the other approach we are going to take is a personalised medicine view.
02:38So that's where we are trying to tailor the treatments to somebody's genetic make-up.
02:41So we are going to look at people's DNA in a way that will help make the prescribing much more precise
02:47and get the right treatment at the right dose to the right patient.
02:51And attacking obesity is one of the biggest drivers of chronic ill-health and poor mobility rates and early unexpected mortality and things like that.
03:04So this is key to sort of getting rid of those health inequalities that we suffer from up here.
03:09So obesity, as we say, is a gateway disease.
03:13It can lead to more than 200 complications.
03:17These complications don't only cost the health service, they don't only cost society, but, as you rightly say,
03:27make people live shorter lives and they cause suffering on a day-to-day basis.
03:34If we address obesity upstream, early on, then you can have a major impact on these people's lives later on
03:44with reduced costs to the health care service and reduced costs to society.
03:49That's right. I'm just trying to get people, whilst they're still vertical, rather than when they're horizontal,
03:54and they have to use the frontline health care services.
03:57Tell me a little bit about how it's going to work.
03:59Yeah. So it's going to be operational in Darien-Straban and Donogol.
04:04We will be treating 5,000 patients in Northern Ireland, 4,000 patients in the Republic of Ireland.
04:10People will be able to be referred to us through the GPs, but also through other community partners
04:16that we are working with. They will be assessed by a multidisciplinary team of professionals.
04:23That involves doctors, nurses, dietitians, psychologists, physical activities specialists, and health coaches.
04:33And what we will be doing is we will be personalizing the treatment depending on the needs of the individual.
04:41In addition to that, people will not be just getting one-to-one or group support.
04:47They will also be getting a lot of digital support, which is a very cost-effective way of achieving and maintaining
04:55some of the health benefits from the human interaction.
04:59David, I think what you said very timely, because I've heard this before,
05:03it's with people on poly medications, you don't know what I think could be killing me, you know what I mean?
05:08Like, people end up having difficulties with their kidneys and things like that, and end up in hospitals.
05:12So this, because you've got so much data now, and everything's computerized,
05:16we've got data sets that we wouldn't have dreamt of, maybe even 10 years ago, but come out there 30 years ago, certainly.
05:23So there's a harness in all that to try and make sure that...
05:26It is, and you're absolutely right.
05:29We're wanting to harness, in one sense, the genetic information that we're born with.
05:34You know, that we all have little individual changes in that,
05:37and those can determine whether you would respond well to a treatment
05:40or might have an issue, like you're relaying there, where it makes you feel worse
05:43and there could be a risk that you would end up in hospital.
05:46So in tailoring our treatments to that, it means it reduces that risk of any adverse event,
05:52and also means that you're getting the best possible benefit from that treatment as well.
05:56So it's that two-fold approach.
05:58And doing this all in collaboration with patients as well, in a way that makes it much more accessible, is our wish here.
06:05I'm working with the multidisciplinary teams in GP practices across the northwest of Ireland.
06:11That will be in counties Donegal and Sligo, and then also into county Tyrone and county Derry as well.
06:16But with help, importantly, from our partners in Scotland, in Tayside, the Dundee region there as well.
06:21Yeah, and all of those areas, peripheral regions, characterised by, as we know, some permorbidity and mortality and life expectancy rates.
06:33So they'll be cross-working there that will probably benefit everybody.
06:37That's right. Recent figures, there was a report that's just come out, that again reports nothing new really,
06:43that the northwest regions, and the border area in particular, county Derry was highlighted as suffering
06:49some of the lowest deprivation index compared to anywhere else in the UK.
06:54And that has health consequences and also then translates into health inequalities.
07:00You're absolutely right too. Again, in the cross-border regions, people are suffering from multiple long-term conditions
07:05in much higher numbers than anywhere else in the island of Ireland and in the UK.
07:11So we're really addressing a core need here, which also comes through in high levels of prescribing for those conditions
07:18and a burden on the healthcare system itself too is what we would also hope to alleviate.
07:23And it's a significant project. It's going to be around 10,000 people over four years. It's a significant investment.
07:30That's right. And there will be 7,500 in the island of Ireland.
07:35That's a bit between our southern regions and into the north of Ireland as well.
07:40We'll be able to avail of this approach through GP practices.
07:43We're the SBA of lyes.
07:44Have you heard a few times?
07:48We know everyone was hearing a lot of confidence already.
07:53Yes, sir, he was guessing the papers in that jay cap s, etc.
07:57We've been studying everyday.
08:00Yes, sir.
08:01Dave in my whole country and that say it sounds beautiful.
08:07Let's not learn better around this town in the United States.
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