Professor Bruce Guthrie

Head of Population Health Sciences Division, Professor of Primary Care Medicine and Honorary Consultant NHS Fife

Understanding and improving healthcare quality and safety, particularly in relation to prescribing and multimorbidity

Address:

Quality, Safety and Informatics Research Group
Mackenzie Building
Kirsty Semple Way
Dundee
DD2 4BF

Phone Number:

+(44) 01382 383740

Email Address:

b.guthrie@dundee.ac.uk

Biography

Professor Guthrie is currently Professor of Primary Care Medicine at the University of Dundee Medical School where he leads the Quality, Safety and Informatics Research Group, which conducts applied research to translate basic and clinical research into effective and reliable clinical practice. He was previously a Medical Research Council Health Services Research Fellow at University of Edinburgh, an National Institute for Health Research post-doctoral research fellow at University of Dundee, and a 2006/7 Commonwealth Fund Harkness Fellow in Healthcare Policy at University of California San Francisco where he was also a Visiting Professor in 2010. His main research interests are the quality and safety of healthcare, particularly in primary care and currently focused on prescribing and the organisation of healthcare. Professor Guthrie is a mixed methods researcher and collaborate with researchers from a wide range of disciplines and institutions. He regularly reviews for various grant-making bodies and journals, contribute to undergraduate and postgraduate medical teaching, and supervise and examine MSc and PhD students in Dundee and other universities.

As well as conducting research, Professor Guthrie practices clinically in a general practice in Cardenden in NHS Fife, and is a member of a number of National Health Service advisory bodies. In 2014, he was appointed the Scottish Primary Care Research Champion by Scottish Government Chief Scientist Office, and was appointed by NICE to chair the guideline development group for the NICE Clinical Guideline on Multimorbidity.

Research

My main research interests are the quality and safety of healthcare, particularly in primary care and currently focused on prescribing and the organisation of healthcare. I am a mixed methods researcher and collaborate with researchers from a wide range of disciplines and institutions. 

Current research grants

Chief Investigator

Guthrie B, Donnan P, Grant S, Mellon N, Dreischulte T. Enhanced Medication Summaries to reduce high-risk prescribing in people with polypharmacy in primary care: a cluster randomised trial. Chief Scientist Office Oct 2015 to Jan 2018. £224,992

Guthrie B, Davey P, Clarkson J, Marwick S. Improvement Science PhD Programme Award. Health Foundation Oct 2013 to Sep 2017. £278,872

Guthrie B, Rees C, Dowell J. UK Clinical Aptitude Test (UKCAT) Research Data Management. UKCAT Consortium Apr 2011 to Mar 2016 Extension £91,339

Main fellowship supervisor or mentor

Hernandez Santiago V, Guthrie B, Davey PG, Marwick CA. A multilevel analysis of the impact of changes in antimicrobial prescribing on antimicrobial resistance. Chief Scientist Office Clinical Academic Fellowship for Dr Virginia Hernandez Santiago. Jan 2013 to Dec 2016. £232,847

Co-applicant

Reynish E, Bowes A, Rutherford A, Donnan PT, Guthrie B. Understanding the outcomes of people with cognitive impairment and/or dementia admitted to the general hospital. NIHR Health Services and Delivery Research Programme. Jun 2015 to May 2017. £290,306.

Salisbury C, Hollinghurst S, Mercer S, Bower P, Guthrie B, Brookes S, Heawood A, Rafi I, Mann C, Gjini A. Improving the management of patients with multimorbidity in general practice. NIHR Health Services and Delivery Research Programme. Jan 2014 to Jun 2017. £1,890,000.

Renfrew M (CI), Guthrie B (coapplicant) and others. Scottish Improvement Science Research, Development And Knowledge Translation Collaborating Centre (SISCC). Chief Scientist Office, Scottish Funding Council, NHS Health Improvement Scotland, The Health Foundation. June 2014 to May 2019. £3,500,000.

 

 

Publications

2016

Dreischulte T, Donnan P, Hapca A, Grant A, McCowan C, Guthrie B. Safer prescribing: a trial of incentives, informatics and education. New England Journal of Medicine 2016:374 1053-1064

Ruscitto A, Mercer SW, Morales D, Guthrie B. Accounting for multimorbidity in pay-for-performance: a modelling study using United Kingdom Quality and Outcomes Framework data. In press BJGP Feb 2016.

Mercer SW, O'Brien R, Fitzpatrick B, Higgins M, Guthrie B, Watt G, Wyke S. The development and optimisation of a primary care-based whole system complex intervention (CARE Plus) for patients with multimorbidity living in areas of high socioeconomic deprivation. Chronic Illness Mar 2016 online early http://chi.sagepub.com/content/early/2016/04/08/1742395316644304.full.pdf+html

Kontopantelis E, Springate D, Ashcroft D, Valderas JM, van der Veer S, Reeves D, Guthrie B, Doran T. Determinants of exemption from the UK’s primary care pay-for-performance programme and survival outcomes: a retrospective cohort study. BMJ Quality and Safety Oct 2015 online early http://qualitysafety.bmj.com/content/early/2015/12/01/bmjqs-2015-004602.full.pdf

Heath C, Mercer SW, Guthrie B. Vascular co-morbidities in younger people with dementia: a cross-sectional population based study of 616,245 middle-aged people in Scotland. Journal of Neurology, Neurosurgery and Psychiatry 2014 online first 0:1–6. doi:10.1136/jnnp-2014-309033 http://jnnp.bmj.com/content/early/2014/11/18/jnnp-2014-309033.abstract

Agur K, McLean G, Hunt K, Guthrie B, Mercer S. How does gender influence multimorbidity? Secondary analysis of a large nationally representative dataset. International Journal of Environmental Research and Public Health Jan 2016;13(4):391

Thomson A, Guthrie B, Payne K. Do pills have no ills? Capturing the impact of direct treatment disutility. Pharmacoeconomics 2016:34:333–336

Steven K, Dowell J, Jackson C, Guthrie B. Fair access to medicine? Retrospective analysis of UK medical schools’ application data 2009-2012 using four measures of socioeconomic status. BMC Medical Education 2016:16(1):1-10.

Grant S, Mesman J, Guthrie B. Spatio-temporal elements of articulation work in the achievement of repeat prescribing safety in UK general practice. Sociology of Health and Illness 2016; 38(2);306-324

Hughes LD, Cochrane L, McMcurdo MET, Guthrie B. Psychoactive prescribing for older people: what difference does 15 years make? International Journal of Geriatric Psychiatry 2016:31;49-57

2015

McLean G, Guthrie B, Mercer SE, Watt GCM. General practice funding underpins the persistence of the inverse care law: cross-sectional analysis of multimorbidity, consultation rates and funding in Scottish general practice. BJGP 2015:65:e799-e805.

Guthrie B, Donnan PT, Murphy D, Makubate B, Dreischulte T. Bad apples or spoiled barrels? Multilevel modelling analysis of variation in high-risk prescribing between general practitioners and between the practices they work in. BMJ Open 2015:15:11

Hernandez Santiago V, Marwick C, Patton A, Davey PG, Donnan PT, Guthrie B. Time series analysis of the impact of an intervention to improve prescribing of antimicrobials related to Clostridium difficile infection in Tayside, Scotland. Journal of Antimicrobial Chemotherapy 2015:70;2397-2404 

Dowell J, Norbury M, Steven K, Guthrie B. Widening access to medicine may improve general practitioner recruitment in deprived and rural communities. BMC Medical Education 2015:15(1):165.

Tonelli M, Wiebe N, Guthrie B, James MT, Quan H, Fortin M, Klarenbach SW, Sargious P, Straous S, Lewanczuk R, Ronksley P Manns BJ, Hemmelgarn BR.  Comorbidity as a driver of adverse outcomes in people with chronic kidney disease: a cohort study. Kidney International 2015;88:859-866.

Cooper S, McLean G, Guthrie B, McConnachie A, Mercer S, Sullivan F, Morrison J. Physical and mental health comorbidity in adults with intellectual disabilities: population-based cross-sectional analysis. BMC Family Practice 2015: 16:110

Dreischulte T, Morales D, Bell S, Guthrie B. Combined use of NSAIDs with diuretics and renin-angiotensin system inhibitors and the risk of acute kidney injury in the community. Kidney International 2015; 88, 396–403

Morales D, Guthrie B, Lipworth B, Jackson C, Donnan PT, Santiago VH. Aspirin intolerant asthma: a meta-analysis evaluating prevalence, mean provocative dose of aspirin and increased asthma morbidity. Allergy 2015:70;828-835

Guthrie B, Makubate B, Hernandez-Santiago V, Dreischulte TD. The rising tide of polypharmacy and drug-drug interactions: population database analysis 1995-2010. BMC Medicine 2015;13:74.

Tonelli M, Wiebe N, Martin F, Guthrie B, Hemmelgarn BR, James MT, Klarenbach SW, Lewanczuk R, Manns BJ, Ronksley P, Sargious P, Straus S, Quan H and For the Alberta Kidney Disease Network. Methods for identifying 27 chronic conditions: Application to administrative data. BMC Med Inform Decis Mak 2015;15:31.

Dumbreck S, Flynn A, Nairn M, Wilson M, Treweek S, Mercer SW, Alderson P, Thompson A, Payne K, Guthrie B. Systematic examination of drug-disease and drug-drug interactions from following recommendations in 12 UK national clinical guidelines. BMJ 2015;350:h949

Ruscitto R, Smith B, Guthrie B. Changes in opioid and other analgesic use 1995-2010: repeated cross-sectional analysis of dispensed prescribing for a large geographical population in Scotland. European Journal of Pain 2015;19(1):59-66

Grant S, Ring A, Mclean G, Guthrie B, Gabbay M, Mair F, Watt G, Heaney D, O’Donnell, C. Soft governance, restratification and the 2004 general medical services contract: the case of UK primary care organisations and general practice teams. Sociology of Health and Illness 2015 37(1);30-51

Wallace E, Salisbury C, Guthrie B, Lewis C, Fahey T, Smith SM. Clinical review: managing patients with multimorbidity in general practice. BMJ 2015;350:h176

 

 

 

Teaching

Although research is the focus of my academic activity, I maintain a regular teaching commitment at both undergraduate and postgraduate level. I completed the University of Dundee Learning, Teaching and Assessment in Higher Education module in 2010 and am an Associate Member of the Higher Education Academy.

 Undergraduate

  •  4th year project and summer studentship supervision
  •  Tutor on various primary care led areas of the undergraduate course

 Postgraduate

  • 2006-2009 External Examiner, MSc in International Primary Healthcare, University College London
  • 2007 to date, PhD External Examiner on a number of theses in Scotland, England and Eire
  • 1999-date designed and run NHS Education Scotland Continuing Professional Development courses on Evidence Based Medicine, Medicine and the Internet, and Critical Reading and Thinking
  • 1999-2005 designed and ran Evidence Based Medicine and Searching for Information/Knowledge Management teaching for GP Registrar groups in three Scottish Regions

PhD Supervision

Sean Macbride-Stewart. Measuring and improving primary care prescribing quality and safety using routine data. Started 2014, ongoing.

Xinyu Zhang. Measuring the safety of commonly prescribed drugs. Started 2013, ongoing.

Virginia Hernandez Santiago. A multilevel analysis of the impact of changes in antimicrobial prescribing on antimicrobial resistance. Ongoing.

Daniel Morales. Measuring the risk of β-blocker and NSAID prescribing in asthma. Completed 2015.

Debbie Baldie. What scope is there to improve the use of patient experience feedback data for quality improvement in primary care? Ongoing.

Anne Duguid. Managed clinical and care networks (MCNs) and work: an ethnographic study for non-prioritised clinical conditions in NHS Scotland. Completed 2012.

Charis Marwick. Design, implementation and primary evaluation of a complex intervention to improve the management of sepsis in general hospital wards. Completed 2011.

Heather Milne. Linking professional organisations of health care to patients’ perceptions and experiences of chronic illness. A discussion of health services for type 2 diabetes in Scottish primary care. Completed 2010.

Faranak Ansari. Evaluation and management of hospital antibiotic use. Completed 2010.

Conferences

Selected recent presentations 

  • October 2015. Scottish Prescribing Advisers’ Association conference, Glasgow. Invited workshop. “Can primary care prescribing be improved?”
  • October 2015. Guidelines International Network Conference, Amsterdam. Invited plenary. “Multimorbidity in guidelines.”
  • July 2015. Society for Academic Primary Care Conference, Oxford. Invited keynote. “Multimorbidity: new paradigm of the emperor’s new clothes?”
  • July 2015. Society for Academic Primary Care Conference, Oxford. “Variation between practices in high-risk prescribing: multilevel modelling study of six indicators over five years in 190 practices.”
  • July 2015. Society for Academic Primary Care Conference, Oxford. Workshop. “Successfully (mis)translating organisational interventions from research to practice.”
  • July 2015. University of Cambridge. Invited seminar. “Prescribing safety in a world of multimorbidity.”
  • June 2015. Scottish Intercollegiate Guidelines Network Strategy Group, Edinburgh. Invited presentation. “Multimorbidity in guidelines.”
  • June 2015. NICE Board Strategy Day, London. Invited presentation. “Multimorbidity in guidelines.”
  • June 2015. Scottish Intercollegiate Guidelines Network/Health Improvement Scotland, Edinburgh. “The challenges of making guidelines in a world of multimorbidity.”
  • May 2015. NICE Technical Workshop, Manchester. “Multimorbidity in guidelines.”
  • November 2014. North American Primary Care Research Group, New York. “Bad Apples or Spoiled Barrels? Multilevel Modelling of Variation in High-Risk Prescribing Between Physicians and Between Practices in United Kingdom General Practice.”
  • June 2014. DECIDE conference: Better clinical guidelines, better healthcare decisions. Invited opening plenary. “How useful are evidence-based guidelines to primary care?”
  • May 2014. University of Bristol. Invited seminar. “Prescribing safety in a world of multimorbidity.”
  • March 2014. NIHR Scottish Age and Ageing Speciality Group. Invited seminar. “People not diseases. The challenges of applying UK clinical guidelines to people with multimorbidity.”
  • November 2013. St Andrews Medical School. Invited seminar. “Using routine data for research across the translational spectrum.”
  • October 2013. British Geriatrics Society Scotland autumn meeting Glasgow. Invited presentation – “Polypharmacy and changing emphasis towards the end of life”
  • October 2013. REPOSI International Seminar on Multimorbidity, Milan Italy. Invited presentation – “New approaches for clinical trials and guidelines”.
  • July 2013. Australian Commission on Safety and Quality and Healthcare, Sydney Australia. “Multimorbidity and polypharmacy: emerging challenges in primary care.”
  • July 2013. Royal Australian College of General Practitioners workshop, Primary Health Care Research Conference, Sydney Australia. “Resourcing practices to manage patients with complex multimorbidity.”
  • July 2013. Patient Safety Collaboratives Symposium, Primary Health Care Research Conference, Sydney Australia. “The Scottish Patient Safety Programme in Primary Care.”
  • July 2013. Multimorbidity Symposium, Primary Health Care Research Conference, Sydney Australia. “The rising tide of multimorbidity and polypharmacy.”
  • July 2013. University of Melbourne. “Use of routinely collected data for research in general practice and primary care.”
  • July 2013. Primary Health Care Research Information Service, Flinders University, Adelaide. “Allies in research, policy and practice: what can we do about multimorbidity?”
  • July 2013. Centre for Remote Health, Alice Springs. “Multimorbidity and polypharmacy: emerging challenges in primary care.”
  • May 2013. Scottish Government Health Directorates Multimorbidity Workshop. “Multimorbidity in Scotland.”
  • March 2013. University of Zurich. Invited presentation. “Multimorbidity and polypharmacy in UK primary care: from epidemiology to interventions.”
  • February 2013. Multimorbidity and the Last Phase of Life conference, Edinburgh. “Making guidelines work for people with multimorbidity.”
  • October 2012 Society for Academic Primary Care Annual Scientific Meeting, Glasgow. “The rising tide of polypharmacy and potentially serious drug interactions 1995-2010: repeated cross-sectional analysis of dispensed prescribing in one region.”
  • October 2012 Society for Academic Primary Care Annual Scientific Meeting, Glasgow. “The impact of the 2004 and 2009 regulatory warnings on antipsychotic prescribing to older people with dementia: segmented regression time series analysis of general practice clinical data 2001-2011”
  • April 2012 Scottish Government Health Department Dementia Strategy Group. Invited presentation – “Time trends in psychoactive prescribing to people with dementia in Scotland 2001-2011”
  • May 2011 Commonwealth Fund Policy Forum, Washington DC. Invited presentation - “Improving Patient Safety Across An Entire National Health System: The Scottish Patient Safety Programme and the Safety Improvement in Primary Care Collaborative”
  • May 2011 Agency for Healthcare Research and Quality, Washington DC. Invited presentation – “Improving patient safety in primary care”
  • April 2011 Agency for Healthcare Research and Quality/Commonwealth Fund/American Academy of Family Practitioners workshop on International Learning on Increasing the Value and Effectiveness of Primary Care – “Quality and Safety in UK Primary Care”
  • June 2010 Scottish Government Health Department – “Using primary care data for quality and safety improvement: high risk prescribing in Scottish general practice - an analysis of data from 315 (30%) of Scottish practices"
  • Oct 2009 Royal Australian College of General Practitioners Annual Conference, Perth, Australia Invited keynote address – “What kind of continuity and what kind of access are best for General Practice?”