Professor Bruce Guthrie

Professor of Primary Care Medicine and Honorary Consultant NHS Fife

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, including the National Institute for Health and Clinical Excellence Quality and Outcomes Framework Indicators Advisory Committee (which recommends which quality indicators should be included in the UK primary care pay for performance programme) where he chairs the Methods, Retirement, Thresholds and Review Sub-committee.

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

  • Guthrie B, Davey P, Clarkson J, Marwick S. Improvement Science PhD Programme Award. Health Foundation Oct 2013 to Sep 2017. £278,872
  • Guthrie B, Payne K, McCowan C, Wilson M, Stokes T, Sutton M, Alderson P, Treweek S. Better guidelines for better care: accounting for multimorbidity in clinical guidelines. NIHR Health Services and Delivery Research Programme. Oct 2012 to April 2015. £487,999
  • van der Pol M, Elliott B, Dusheiko M, Guthrie B, Jorm L, Leyland A, Olajide D. Avoidable Scottish Hospitalisations (ASH). Chief Scientist Office, Scottish Government Health Department. Jul 2013 to Jun 2015. £187,820
  • Guthrie B, Dreischulte T, Murphy D, Donnan PT. Measuring prevalence, reliability and variation in high risk prescribing in general practice using multilevel modelling in a population database. NIHR Health Services Research Programme. Aug 2011 to July 2013. £193,724
  • Guthrie B, Bennie M, Petrie D, Robertson C, Ritchie L, Treweek S. Effective Feedback to Improve Primary Care Prescribing Safety (EFIPPS): a randomised controlled trial using ePrescribing data. Chief Scientist Office, Scottish Government Health Department. June 2011 to May 2014. £224,512
  • Guthrie B, Rees C, Dowell J. UK Clinical Aptitude Test (UKCAT) Research Data Management. UKCAT Consortium Apr 2011 to Mar 2014 £91,339
  • Guthrie B, Russell A, Clark S, Scahill L, Donnan PT, Love T, McCowan C, Cunningham S, Morris A, Wells A, Davey P, Wyatt J. Data-driven quality improvement in primary care: using informatics to implement new prescribing quality measures integrated with educational interventions and existing quality improvement mechanisms. Chief Scientist Office, Scottish Government Health Department. Apr 2009 to Mar 2014. £974,645
  • Watt G, Mercer S, Wyke S, Fenwick E, Guthrie B, Findlay F. Living well with multiple morbidity: The development and evaluation of a primary care-based complex intervention to support patients with multiple morbidities. Chief Scientist Office, Scottish Government Health Department. Dec 2008 to Nov 2012. £813,982

 Current fellowship supervision

  • Hernandez Santiago V, Guthrie B, Davey P, 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
  • Morales D, Donnan PT, Jackson C, Guthrie B. Measuring the risk of β-blocker and NSAID prescribing in asthma. Chief Scientist Office, Scottish Government Health Department Clinical Academic Fellowship for Dr Dan Morales. Sep 2011 to Aug 2014. £241,098
  • Grant S, Williams B, Guthrie B, Rapport N. Mixed ethnographic and quantitative methods to understand and measure organisational culture in UK General Practice. MRC Population Health Scientist Postdoctoral Fellowship for Dr Suzanne Grant. Sept 2009 to Aug 2013. £353,293
  • Baldie D, Entwisle V, Williams B, Guthrie B. What scope is there to improve the use of patient experience feedback data for quality improvement in primary care? Chief Scientist Office, Scottish Government Health Department Doctoral Fellowship for Debbie Baldie (first supervisor since 2012). Feb 2009 to Jan 2014. £109,156

 

 

 

Publications

Sumakadas D, McMurdo MET, ET, Mangoni AA, Guthrie B. Temporal trends in anticholinergic medication prescription in older people: repeated cross-sectional analysis of population prescribing data. Age and Ageing 2013 in press.

Dreischulte T, Madhok V, Barnett K, Guthrie B. Oral anticoagulation and antiplatelet treatment in relation to stroke risk in patients with atrial fibrillation: a population database analysis. European Journal of General Practice 2013 in press.

Marwick C, Guthrie B, Pringle J, Evans J, Nathwani D, Donnan P, Davey P. A multifaceted intervention to improve sepsis management in general hospital wards with evaluation using segmented regression of interrupted time series. BMJ Qual Saf 2013 in press.

Grant S, Guthrie B, Entwistle VA, Williams B. Dimensions of culture in primary care medical practices: insights from a systematic literature search and meta-ethnography of qualitative research from the UK, US, Canada, Australia and New Zealand. Journal of Health Organisation and Management 2013 in press.

Morales D, Jackson C, Lipworth B, Donnan P, Guthrie B. Adverse respiratory effect of acute beta-blocker exposure in asthma: a systematic review and meta-analysis of randomized controlled trials. Chest online early Nov 2013

Lawson K, Mercer S, Wyke S, Grieve E, Guthrie B, Watt G, Fenwick E: Double trouble: The impact of multimorbidity and deprivation on preference-weighted health related quality of life a cross sectional analysis of the Scottish Health Survey. International Journal for Equity in Health 2013, 12(1):67.

Guthrie B, Clark SA, Reynish EL, Morales DR, McCowan C. Differential impact of two risk communications on antipsychotic prescribing to people with dementia in Scotland: segmented regression time series analysis 2001-2011. PLoS One 2013;8(7): e6897.

Mathieson L, Severn A, Guthrie B. Monitoring and adverse events in relation to ACE inhibitor/angiotensin receptor blocker initiation in people with diabetes in general practice: a population database study. Scottish Medical Journal 2013;58, 69-76. 

Smith, DJ, Langan J, McLean M, Guthrie B, Mercer SW. Schizophrenia is associated with excess multiple physical-health comorbidities but low levels of recorded cardiovascular disease in primary care: cross-sectional study. BMJ Open 2013;3(4).

Duffy MA, Hernandez Santiago V, Orange G, Davey PG, Guthrie B. Prior trimethoprim prescription and trimethoprim resistance in childhood urinary tract infections: multilevel modelling of population data 2004-2009. British Journal of General Practice 2013; 623: e238-e243

Payne RA, Abel GA, Guthrie B, Mercer SW. The impact of physical multimorbidity, mental health conditions and socioeconomic deprivation on unplanned hospital admissions: a retrospective cohort study. Canadian Medical Association Journal 185:E221-E228: online publication ahead of print Feb 2013

Saunders, C, Byrne CD, Guthrie B, Lindsay R, McKnight J, Philip S, Sattar N, Walker JJ, Wild SH on behalf of the Scottish Diabetes Research Network Epidemiology Group. External validity of randomised controlled trials in glycaemic control and the influence on vascular disease: how representative are participants? Diabetic Medicine 2013;30(3);300-308

Morales DR, Jackson C, Fielding S, Guthrie B. Long acting β-agonist prescribing in people with asthma in primary care. Thorax 2013;68:192-194

McCowan C, Magin P, Clark S, Guthrie B. An observational study of psychotropic drug use in older patients resident in their own home or in care. Age and Ageing 2013; 42(1):51-56

Hughes L, McMurdo MET, Guthrie B. Guidelines for people not for diseases: the challenges of applying UK clinical guidelines to people with multimorbidity. Age and Ageing 2013; 42(1): 62-69

Guthrie B, Treweek S, Petrie D, Barnett K, Ritchie LD, Robertson C, Bennie M. Protocol for the Effective Feedback to Improve Primary Care Prescribing Safety (EFIPPS) study: a cluster randomised controlled trial using ePrescribing data (clinicaltrials.gov registration NCT01602705). BMJ Open 2012; 2(6)

Guthrie B, Payne K, Alderson P, McMurdo MET, ET, Mercer SW. Adapting clinical guidelines to take account of multimorbidity. BMJ 2012;345:e6341

Mercer SW, Gunn J, Bower P, Wyke S, Guthrie B. Managing patients with mental and physical health comorbidity. BMJ 2012;345:e5559

Grant A, Dreischulte T, Treweek S, Guthrie B. Protocol of a mixed methods evaluation of a cluster randomised trial to improve the safety of NSAID and antiplatelet prescribing: Data-drive quality improvement in primary care (DQIP). Trials 2012; 13:154 

Morales DR, Jackson C, Fielding S, Guthrie B. Long acting β-agonist prescribing in people with asthma in primary care. Online first Thorax Sep 2012

Smith BH, Guthrie B, Sullivan F, Morris AD. A thesis that still warrants defence and promotion: Commentary on Mackenzie J. A defence of the thesis that “The opportunities of the general practitioner are essential for the investigation of disease and the progress of medicine”.  Br Med J 1921 1 (3153) 797-804. International Journal of Epidemiology 2012; 41(6): 1518-1522

Mercer S, Guthrie B, Furler J, Watt G, Hart JT. Multimorbidity and the inverse care law in primary care. BMJ 2012;344:e4152

Barnett K, Mercer S, Norbury M, Watt G, Wyke S, Guthrie B. The epidemiology of multimorbidity in a large cross-sectional dataset: implications for health care, research and medical education. The Lancet 2012: 380; 37-43

Dreischulte T, Guthrie B. High-risk prescribing and monitoring in primary care: how common is it, and how can it be improved? Therapeutic Advances in Drug Safety 2012; 3(12): 175-184

Murphy D, Guthrie B, Sullivan S, Mercer S, Russell A, Bruce D. Insightful Practice: a useful measure for professional revalidation. BMJ Quality and Safety 2012;21(8);649-656

Dreischulte T, Grant A, McCowan C, McAnaw J, Guthrie B. Quality and safety of medication use in primary care: consensus validation of a new set of explicit medication assessment criteria and prioritisation of topics for improvement. BMC Clinical Pharmacology 2012:12;5 doi:10.1186/1472-6904-12-5

Dreischulte T, Grant A, Donnan P, McCowan C, Davey P, Petrie D, Treweek S, Guthrie B. A cluster randomised stepped wedge trial to evaluate the effectiveness of a multifaceted IT-based intervention in reducing high-risk prescribing of non-steroidal anti-inflammatory drugs and antiplatelets in primary medical care: The DQIP study protocol. Implementation Science 2012;7:24

Roland M, Guthrie B, Colin Thomé D. Primary care in the UK. Journal of the American Board of Family Medicine Nov 2011 The Journal of the American Board of Family Medicine 25: S6-S11

Guthrie B, McCowan C, Davey P, Simpson C, Dreischulte T, Barnett K. High-risk prescribing in primary care patients particularly vulnerable to adverse drug events: cross-sectional population database analysis in Scottish general practice. BMJ 2011;342:d3514

Morales DR, Guthrie B, Lipworth BJ, Donnan PT, Jackson C. Prescribing of β-adrenoceptor antagonists in asthma: an observational study. Thorax 2011:66(6);502-506

Lockhart P, Guthrie B. Trends in antidepressant prescribing 1995 - 2007: a longitudinal population database analysis. British Journal of General Practice 2011 61(590);e565-e572

Roland M, Rao SR, Sibbald B, Hann M, Harrison S, Walter A, Guthrie B, Desroches C, Ferris TG, Campbell EG. Professional values and reported behaviours of doctors in the United States and United Kingdom: quantitative survey. BMJ Quality & Safety 2011 20(6): 515-521

Norbury M, Fawkes N, Guthrie B. The GP contract, influenza immunisation and inequalities: a retrospective population database analysis. British Journal of General Practice 2011:61(588):379-85

O'Brien, R., S. Wyke, Guthrie B, Watt G, Mercer S. An ‘endless struggle’: a qualitative study of general practitioners’ and practice nurses’ experiences of managing multimorbidity in socio-economically deprived areas of Scotland. Chronic Illness 2011 7(1): 45-59.

Guthrie B, Auerbach G, Bindman A. Health plan competition for Medicaid enrolees based on performance does not improve quality of care. Health Affairs 2010:29; 1507-1516

Guthrie B, Clark S, McCowan C. The burden of psychotropic drug prescribing in people with dementia: a population database study. Age and Ageing 2010:39; 637-642

Sutton M, Elder R, Guthrie B, Watt G. Record rewards: the effect on risk factor monitoring of new financial incentives for UK general practices. Health Economics 2010: 19(1); 1-13

Guthrie B, Emslie-Smith A, Morris AD. Which people with type 2 diabetes achieve good control of intermediate outcomes? Population database study in a UK region. Diabetic Medicine 2009: 26(12); 1269-1276

Greene A, Pagliari C, Cunningham S, Donnan P, Evans J, Emslie-Smith A, Morris AD, Guthrie B. Do managed clinical networks improve quality of diabetes care? Evidence from a retrospective mixed methods evaluation. Quality and Safety in Healthcare 2009: 18; 456-461

Grant S, Huby G, Watkins F, Checkland K, McDonald R, Davies HTO, Guthrie B. The impact of pay-for-performance on professional boundaries in UK general practice: an ethnographic study. Sociology of Health and Illness 2009;31(2):229-245

McLean G, Guthrie B, Watt G, Gabbay M, O'Donnell CA. Practice postcode versus patient population: a comparison of data sources in England and Scotland. International Journal of Health Geographics 2008, 7:37

Guthrie B. Measuring the quality of healthcare systems using composites. BMJ 2008;337:a639

Guthrie B, Saultz J, Freeman G, Haggerty J. Continuity of care matters: time to make it a policy and organisational priority. BMJ 2008;337:a867

Huby G, Guthrie B, Grant S, Watkins F, Checkland K, MacDonald R, Davies H. Whither British General Practice after the 2004 GMS contract? Stories and realities of change in four UK general practices. Journal of Health Organisation and Management 2008: 22: 63-78

Checkland K, Harrison S, McDonald R, Grant S, Campbell S, Guthrie B. Biomedicine, holism and general medical practice: responses to the 2004 General Practitioner contract. Sociology of Health and Illness. 2008;30:788-803

Guthrie B, Love T, Kaye R, MacLeod M, Chalmers M. Modelling the effectiveness of routine mortality monitoring in detecting mass murder in UK General Practice. British Journal of General Practice 2008; 58: 311-317.

Evans JMM, Guthrie B, Pagliari HC, Greene A, Morris AD, Cunningham S, Donnan PT. Do General Practice characteristics influence uptake of an IT innovation in primary care? Informatics in Primary Care 2008;16:3-8

Mclean G, Sutton M, Guthrie B. Differences in the quality of medical care services by remoteness from urban settlements. Quality and Safety in Healthcare 2007;16:446-449

Guthrie B, Inkster M, Fahey T. Tackling therapeutic inertia: role of treatment data in quality indicators. BMJ 2007;335:542-544

Campbell NC, Murray E, Darbyshire J, Emery J, Farmer A, Griffiths F, Guthrie B, Lester H, Wilson P, Kinmonth AL. Designing and evaluating complex interventions to improve health care. BMJ 2007; 334: 455-459

McLean G, Sutton M, Guthrie B. Differences in the quality of primary medical care for CVD and diabetes across the NHS: evidence from the Quality and Outcomes Framework. BMC Health Services Research 2007; 7:74

Guthrie B, McLean G, Sutton M. Workload and reward in the Quality and Outcomes Framework of the 2004 General Practice contract. BJGP 2006; 56; 842-847

McLean G, Sutton M, Guthrie B. Deprivation-related variation in primary care treatment: evidence from the Quality and Outcomes Framework in Scotland. Journal of Epidemiology and Community Health, 2006; 60:917-922.

Guthrie B, Wyke S. Access and continuity in UK general practice: a qualitative study of general practitioners’ and patients’ perceptions of when and how they matter. BMC Family Practice 2006; 7: 11

Guthrie B, Love T, Fahey T, Morris A, Sullivan F. Control, compare and communicate: designing control charts to efficiently summarise data from multiple quality indicators. Quality and Safety in Health Care 2005; 14: 450-454

 

 

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

  •  Co-ordinate (with Dr Vishnu Madhok) a 4 week Student Selected Component in Population Health Research
  •  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

Xinyu Zhang. Measuring the safety of commonly prescribed drugs. 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. Ongoing.

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 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?”