Dr. Miles D Witham

Clinical Reader in Ageing and Health

Address:

Ageing and Health
Ninewells Hospital
Dundee
DD1 9SY

Phone Number:

+(44) 01382 383086

Email Address:

m.witham@dundee.ac.uk

Biography

Dr Witham graduated from Oxford University and worked in a number of hospitals in the south of England and Australia before discovering the delights of Scotland. He undertook his PhD in Dundee running a randomised controlled trial of exercise training for older chronic heart failure patients, before taking up post as Clinical Lecturer in Ageing and Health in 2003.



In October 2007, he commenced an NES / CSO Clinician Scientist award, with a duration of 5 years; he completed clinical training in geriatrics and general medicine in late 2009 before taking up post as Clinical Senior Lecturer in Ageing and Health, becoming Clinical Reader in Ageing and Health in July 2013.



Dr Witham works as an honorary consultant geriatrician with NHS Tayside, supervising acutely admitted older inpatients, general older people’s outpatients and helps to run the Dundee Memory Clinic service. He is a member of the Health Services and Population research Committee (Chief Scientist Office, Scottish Government) and contributes to the Scottish polypharmacy guideline working group.



 

Research

Pleiotropic interventions to improve the health of older people:

Multimorbidity is the norm in older people, but most interventions are tested in younger people without comorbid disease, who take few other medications. Conducting trials in typical frail older people is therefore critical if we are to build the evidence base we need to treat older people, and this forms a major focus of work in our department. Recent trials have included extensive work on the cardiovascular effects of vitamin D in different populations, the effects of exercise training in older heart failure patients, interventions for muscle weakness in older people, and a large, ongoing trial of bicarbonate for older patients with advanced CKD.

Finding interventions with multiple beneficial effects in older people (e.g. on cardiovascular disease, bone health, sarcopenia) is a key goal – such interventions could circumvent the hazard and inconvenience of polypharmacy –i.e. having to take multiple medications for each illness an older person has. By using routinely collected health, functional and social care data, we aim to find potential candidate interventions that might provide overall benefit to the health and function of older people, and use this observational data as a platform for future trials.



 

Publications

Witham MD, Ireland SE, Houston JG, Gandy SJ, Waugh S, MacDonald TM, Mackenzie IS, Struthers AD. Vitamin D therapy to reduce blood pressure and left ventricular hypertrophy in resistant hypertension – a randomised controlled trial. Hypertension 2014 (in press)

Witham MD, Price RJG, Struthers AD, Donnan PT, Messow CM, Ford I, McMurdo MET. High-dose, intermittent Vitamin D treatment to reduce blood pressure in older patients with isolated systolic hypertension. JAMA Intern Med 2013; 173: 1672-9.

Witham MD, Dove FJ, Khan F, Lang CC, Belch JJF, Struthers AD. Effect of vitamin D supplementation on markers of vascular function after myocardial infarction – a randomised controlled trial. Int J Cardiol 2013; 167: 745-9.

Beveridge LA, Ramage L, McMurdo MET, George J, Witham MD. Allopurinol use is associated with greater functional gains in older rehabilitation patients. Age Ageing 2013; 42: 400-4.

Logan IC, Witham MD.  Efficacy of treatments for orthostatic hypotension – a systematic review. Age Ageing 2012; 41: 587-94.

George PS, Pearson ER, Witham MD. Effect of vitamin D supplementation on glycaemic control and insulin resistance: a systematic review and meta-analysis. Diabet Med 2012; 29: e142-50.

Wilkinson AH, Burns SL, Witham MD. Aspiration in older patients without stroke; a systematic review of bedside diagnostic tests and predictors of pneumonia. Eur Geriatr Med 2012; 3: 145-52.

Witham MD, Fulton RL, Greig CA, Johnston DW, Lang CC, van der Pol M, Boyers D, Struthers AD, McMurdo MET. Efficacy and cost of an exercise programme for functionally impaired older heart failure patients – a randomized controlled trial. Circ Heart Fail 2012; 5: 209-16.

Lynch J, Henderson N, Ramage L, McMurdo MET, Witham MD. Association between statin medication use and improved outcomes during inpatient rehabilitation in older people. Age Ageing 2012; 41: 260-262.

Witham MD, Dove FJ, Dryburgh M, Sugden JA, Morris AD, Struthers AD. The effect of different doses of vitamin D3 on markers of vascular health in type 2 diabetes – a randomised controlled trial. Diabetalogia 2010; 53: 2112-9.

Witham MD, Crighton LJ, Gillespie ND, Struthers AD, McMurdo MET. The effects of Vitamin D supplementation on physical function and quality of life in older heart failure patients - a randomised controlled trial. Circ Heart Fail 2010; 3: 195-201

Witham MD, Avenell A. Interventions to achieve long-term weight loss in obese older people - A systematic review and meta-analysis. Age Ageing 2010; 39: 176-84

Witham MD, Nadir M, Struthers AD. Effect of Vitamin D on blood pressure – a systematic review and meta-analysis. J Hypertens 2009; 27: 1948-54.

Teaching

Dr Witham runs the third year Ageing and Health teaching and examining, and contributes to administering, marking and examining fourth year undergraduate geriatric medicine teaching. He also contributes to medical postgraduate and nursing staff teaching, and runs the Tayside StR Research training course for higher specialist medical trainee doctors. He is an associate member of the Higher Education Academy.

PhD Supervision

Mrs Roberta Fulton – Adherence to medication in older heart failure patients (CSO Doctoral fellowship, 2014-2017)

Conferences

  • Vitamin D and Cardiovascular disease. (ECTS annual symposium, Stockholm, May 2012)
  • Vitamin D – Ray of sunshine or foggy outlook? (RCPE Moving Points in Medicine Symposium, Dundee, Feb 2012)
  • Broadening horizons: can we use vitamin D to treat cardiovascular disease in older people (part of Vitamin D in the elderly symposium at IAGG 2011 meeting, Bologna, Italy, April 2011)
  • Hard times in the NHS (Invited Presentation and debate at RCPE Members and Trainees Day, Oct 2010)
  •  Vitamin D and cardiovascular disease – cause or coincidence? Invited presentation to FOCUS 2010 (annual conference of the Association of Clinical Biochemistry, Glasgow, May 2010). Abstract: Ann Clin Biochem 2010; 47 Supp 1: 17