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ENHANCE: tailored approaches to optimise brain health


Professor Joanne Reeve

Professor Joanne Reeve

Professor of Primary Care Research


April 2023 to April 2029


Why this research is needed

Primary care and the NHS are overwhelmed. Growing numbers of patients seek healthcare support every day. Currently English primary care delivers over 33 million appointments every month – that’s more than half the country accessing formal health care. We need to rethink our approach to healthcare.

Public health and other voices have long called for a culture change that shifts our focus to looking at upstream health care measures. These voices call for initiatives that aim to prevent and reduce disease, rather than treat it when it happens.

Yet we still medicalise a lot of this health promotion work. For example, we look to reduce the rate of heart disease by measuring more people’s blood pressure and using medication to treat them. We try to reduce cancer by screening people so that we can operate and treat them earlier.

But some of the most effective public health initiatives look further upstream – focusing on the lifestyle and societal factors that affect our long term health. Such ideas can sometimes be seen as ‘radical’ or even ‘old fashioned’ when we have a host of new technological disease solutions. But the growing burden of overmedicalisation is driving renewed interest in rebalancing health care using these wider approaches.

This is the focus for our new ENHANCE study. The Academy of Primary Care is a partner in this project led by Dr Sergi Costafreda Gonzalez at UCL. We are the key primary care partner with a role in advising and supporting the development of a new approach that offers something very different to both primary care patients and healthcare services/staff.

What we are doing

ENHANCE –TailorEd iNtervention for brain HeAlth aNd Cognitive augmentation – is a novel primary study which builds on successful work done in South Korea. There, they develop ed a novel public health approach to identify and address known risk factors for developing dementia. The study in South Korea successfully reduced risk factor burden in that population. Now we look to redevelop the intervention here and so re-run the study in a UK population.

We are currently nearing the end of the initial development phase. Working with gaming designers, patients, clinicians and researchers, we have developed a novel fun resource for patients and their clinical teams to use. Once the tool is ready, we will continue on to a feasibility study, pilot trial and – if supported by the development work – full trial.

What we found so far

So far, we’ve learned how hard is to develop good apps that meet the needs of patients, clinicians, and researchers alike.

Our work has also highlighted the challenges of introducing any change into such a large and complex system as general practice and primary care.

Our experienced team is working hard to integrate our learning into the ongoing development, implementation and evaluation of the study.

Contact us

We welcome enquiries about our research, or if you are interested in collaborating, visiting or postgraduate research opportunities with us.

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