Chronic disease management

Stethoscope with bar chart and figures in the backgroundThe role played by primary care in the management of chronic disease continues to grow. Novel ways of meeting the demands of an aging chronically ill population within the pressurised environment of modern family practice are required and we are using the latest methods in software engineering and informatics to both support patients and inform care.  

Dr Ian Litchfield

Theme lead
Dr Ian Litchfield

Research Fellow

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Aims of the research

  • Use original analysis of electronic primary care records to understand and refine existing models of primary health care, prescribing.
  • Exploit software engineering solutions to manage the care of complex chronically ill patients

Current research groups

 Chronic disease epidemiology and management


Banerjee A,, Benedetto V, Gichuru P, Burnell J, Antoniou S, Schilling RJ, Strain WD, Ryan R, Watkins C, Marshall T, Sutton CJ. Adherence and persistence to direct oral anticoagulants in atrial fibrillation: a population-based study. Heart. 2019 Oct 10. pii: heartjnl-2019-315307. doi: 10.1136/heartjnl-2019-315307.

Šumilo D; Nichols L, Ryan R, Marshall T. Incidence of indications for tonsillectomy and frequency of evidence-based surgery: a 12-year retrospective cohort study of primary care electronic records. BJGP 2019 Jan;69(678):e33-e41. doi: 10.3399/bjgp18X699833. 

Holt TA, Dalton AR, Kirkpatrick S, Hislop J, Marshall T, et al F. Barriers to a software reminder system for risk assessment of stroke in atrial fibrillation: a process evaluation of a cluster randomised trial in general practice. Br J Gen Pract. 2018 Dec;68(677): 

Adderley N., Nirantharakumar K., Marshall T. Risk of stroke and transient ischaemic attack in patients with a diagnosis of ‘resolved’ atrial fibrillation. BMJ. 2018 May 9;361:k1717. 

Turner G, Calvert M, Feltham MG, Ryan R, Finnikin S, Marshall T. Clinical & Demographic Characteristics Associated with Sub-optimal Primary Stroke/TIA Prevention: Retrospective Analysis Stroke 2018 Mar;49(3):682-687. 

I. Litchfield, C. Hoye, D. Shukla, R. Backman, A. Turner, M. Lee, P. Weber.Automated conflict resolution between multiple clinical pathways: A technology report    J Innov Health Inform.2018;25(3):142–148. 

Weber, Philip, João Bosco Ferreira Filho, Behzad Bordbar, Mark Lee, Ian J Litchfield and Ruth Backman. “Automated conflict detection between medical care pathways.” Journal of Software: Evolution and Process 30 (2018): 

Assessing the extent of drug interactions amongst patients with multimorbidity in primary and secondary care in the West Midlands (UK): A study protocol for the Mixed Methods Multimorbidity Study (MiMMS). R. Backman, P. Weber, A. M. Turner, M. G. Lee and I. Litchfield. BMJ Open, 7(9):e016713 (8 pages), 2017. 

Finnikin S, Ryan R, Marshall T. Statin initiations and QRISK2 scoring in UK general practice: A THIN database study. British Journal of General Practice 2017 Dec;67(665)