Research

Public Health is the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals. It involves many disciplines which share health care system approach, and focus on entire populations rather than individual patients alone. Furthermore, disciplines involved in public health share strengths in a variety of methodological approaches (quantitative (epidemiologic, health economic, qualitative, mixed methods research & implementation science).

Highlights current projects

The DYNAMIC project is a cluster randomized controlled trial in Tanzania and parallel group cohort study in Rwanda to test the effect of clinical decision support tool for health workers in primary care who manage sick children, to improve clinical cure and prevent unnecessary antibiotic prescriptions. Swiss TPH led the development of clinical algorithms for the CDSS and contributed to the CDSS software development process, and the responsible applicant for this proposal is responsible for all algorithms and research relating to sick young infants. IHI is responsible for research in Tanzania.

ENDOSCAPE (a clinically applicable non-viral gene delivery technology)
Gene therapy is one of the most promising treatment options for future advanced therapies in a broad range of diseases. Successful gene delivery requires the recognition of target cells as well as cytosolic and nucleosolic uptake of the gene. Currently,  non-viral based gene delivery such as transfection reagents are only suitable for in vitro applications and clinical gene therapeutics delivery is accomplished via viral vectors, which still has major safety concerns and complex and costly manufacturing procedures, preventing future implementation for the treatment of diseases with large patients groups. In the last 15 years, a class of secondary plant metabolites has been discovered that selectively mediates endosomal escape and cytoplasmic delivery of macromolecules only at low endosomal pH, thereby inducing a 40-fold enhanced gene delivery efficacy, in vivo. The currently employed methods of applying endosomal escape enhancers and gene therapeutic product, however, do not ensure that both compounds are at the same time at the site of interaction. The ENDOSCAPE technology platform will develop and collect proof of concept for a non-viral gene delivery technology with increased synchronization (in time and place) of both compounds. Proof of concept of the ENDOSCAPE technology has a major impact on the therapeutic opportunities for current and future macromolecule drugs for a broad range of diseases. All this induces new biotech-based businesses; new research projects and creates new technology platforms for development of new macromolecule therapeutics for a broad range of disease indications. The non-viral bases ENDOSCAPE technology will enhance therapeutic efficacy with lower therapeutic dose thereby reducing costs of healthcare, improving the health of patients worldwide, and strengthening the competitive landscape of the EU in the worldwide quest for such an advanced technology. Within ENDOSCAPE, ECPM is assessing expected/required health economic performance characteristics of the ENDOSCAPE technology in medical applications.

HBM4EU (coordinating and advancing human biomonitoring in Europe to provide evidence for chemical policy making)
is a joint effort of 28 countries, the European Environment Agency and the European Commission, co-funded under Horizon 2020 with more than 70 Mio. Euro. The main aim of the initiative is to coordinate and advance human biomonitoring in Europe.

INSPIRE  (Implementation of an Integrated Community-based Care Program for Senior Citizens) is a multiphase project that aims to develop, implement and evaluate a nurse-led integrated care program for older adults living at home in Canton Basel-Landschaft. The project is designed according to the framework of the Medical Research Council (MRC) Framework, yet integrates different implementation science components at each phase of the project. The project is led by the Institute of Nursing Science, in close collaboration Swiss Tropical and Public Health, University Center for Primary Care Medicine beider (both) Basel, Basel Institute for Clinical Epidemiology and Statistics, European Center for Pharmaceutical Medicine, Evidence-based Insurance Medicine and the Ärztegesellschaft Baselland.

INTERCARE (Nurse-led models of care in Swiss nursing homes: improving INTERprofessional CARE for better resident outcomes) is an implementation science research project which combines qualitative and quantitative methods to explore implementation processes and assesses the effectiveness of a new model of care. It addresses several key issues of the healthcare system in Switzerland including the development and assessment of new care models, interprofessional collaboration and the quality of care in nursing homes.

OPERAM (Optimising PharmacothERApy in the Multimorbid elderly)
Many older adults have multiple chronic diseases (multi-morbidity) and multiple medications (polypharmacy). However, multi-morbid patients are often excluded from clinical trials and most guidelines address diseases in isolation. OPERAM investigators developed STOPP/START criteria to detect inappropriate drug use, both over- and underuse. OPERAM performs a multicentre randomised controlled trial to assess the impact of a user-friendly software-assisted intervention to optimise pharmacotherapy and to enhance compliance in 1900 multi-morbid patients aged 75 years or older. OPERAM ultimately aims at better healthcare delivery in primary and hospital care, based on effective, safe, personalised and cost-effective interventions that can be applied to the rapidly growing older population in Europe. Within OPERAM, ECPM is responsible for the work package devoted to health economics. The clinical results have been published in the BMJ, health economic results in PLoS One and Health Services Insights, and a sub-study comparing quality of life instruments in Health and quality of life outcomes.

OSPIC (University Center for Primary Care Medicine beider (both) Basel (uniham-bb)) Trial: (Oral corticosteroids for post-infectious cough in adults: A double-blind randomised placebo-controlled trial in Swiss family practices) is supported by an SNF grand (investor initiated clinical trail 2019). Cough is one of the most common causes for seeking medical advice in general practices. Post-infectious cough is defined as lasting 3 to 8 weeks after an upper respiratory tract infection (URTI). It can be very bothersome and disabling in daily activities and with significant impact on physical and psycho-social health, leading to impaired quality of life. Recommendations for the management of post-infectious cough in primary care are scarce and incoherent No therapy according to evidence-based standard is available to date. The main research question of the OSPIC trial is whether a 5-day treatment with orally administered prednisone can improve the cough related QoL as measured by the Leicester Cough Questionnaire (LCQ) of adult primary care patients with post-infectious cough triggered by an URTI. (for further project information)

SAPALDIA (Swiss study on Air Pollution And Lung Disease in Adults) is the only Swiss-wide chronic disease cohort with associated biobank. It was initiated in 1991 and has since been funded by the SNF, the Federal Offices for the Environment and Public Health, different Lung Leagues and cantons. SAPALDIA is at the center of national and international air pollution (FP7 Projects ESCAPE; Exposomics) and respiratory health research (Horizon2020 Project: ALEC). The rich risk factor, environmental and health data as well as the genome- and methylome-wide data is used in studies ranging from assessing the role of physical activity, sleep, and transportation noise in cardio-metabolic disease etiology to the evaluation of chronic disease diagnosis and treatment as well as aging in general.

The SPEARHEAD project, led by the University of Basel Innovation Office with funding from the Innosuisse Flagship programme, brings together research institutions (University of Basel, SUPSI), university hospitals (UKBB, USB, CHUV), and industry partners (Novartis, SwissRe, SWICA) to develop novel approaches to strengthen antimicrobialsStewardship. The project builds on existing initiatives and expertise in pandemic response to rapidly deploy digital solutions to mitigate the clinical, economic, and societal impacts of antimicrobial resistance (AMR) by enabling real-time data flow to and from decision-makers, better use of big data for risk stratification, timely diagnostics that can leapfrog centralized laboratory infrastructure, citizen and community engagement, and early consideration of resource needs and efficiency to inform prioritization of candidate technologies. The tools being developed within SPEARHEAD are aimed to be easily adaptable to address future emerging infections and thereby result in a more resilient healthcare system and society. ECPM leads the Societal and Health Economics work package of SPEARHEAD that aims to analyse the cost-effectiveness of the piloted solutions, inform their scale-up, and consider their broader societal and equity implications.

SQUEEZE (Development, implementation and pilot testing of an innovative eHealth powered integrated care model for rheumatoid arthritis) is a EU Horizon Project that aims to maximise the impact of disease modifying antirheumatic drugs (DMARDs) in rheumatoid arthritis (RA) with the use of clinical, laboratory, molecular, digital and behavioural biomarkers to (1) select the right DMARD for a specific patient at a specific point of his/her therapeutic journey, (2) optimise the DMARD regimen (dose, route) and (3) inform an eHealth facilitated integrated care model. Within the SQUEEZE consortium, the Basel project team is responsible for work package 8 (WP#8). Its overarching objective is to develop, implement and pilot test the SQUEEZE eHealth facilitated integrated care model including digital therapeutics focusing on patient´s preferences and needs to increase adherence to prescribed drugs.

Tools for Integrated Management of Childhood Illness (TIMCI) is aimed at improving the quality of care for sick children, by introducing pulse oximetry and clinical decision support in primary care health facilities in four low and middle-income countries (Tanzania, Kenya, Senegal, India). The project is a consortium of PATH, Swiss TPH, and IHI in Tanzania, as well as other local research partners in Kenya, Senegal and India. TIMCI includes two cluster randomized controlled trials and 2 cohort studies to test the impact of pulse oximetry and clinical decision support on health outcomes and health service use, as well as qualitative research and social science to explore feasibility, acceptability and barriers and supportive factors that influence uptake and sustainable use of the tools in these settings. The respon-sible applicant is responsible for the clinical algorithm development for sick young infants in all countries. The responsi-ble applicant from PATH is the Country Lead in Tanzania for implementation, and the responsible applicant from IHI is the research manager and head social scientist for research in Tanzania.