First steps in research – working as a Research Nurse on the TIGER Study
By Emily Baldwin
I have recently joined the TIGER Study research team at the University of Bristol in my first role as a Research Nurse. I am new to research and eczema/food allergies, so it’s been a steep learning curve but incredibly rewarding!
The TIGER study aims to answer whether food allergy test-guided dietary advice improves disease control in children with eczema. I was amazed to find out how little research there is in this area, especially when many parents are keen to find out whether a food allergy could be causing their child’s eczema. In my role as a TIGER research nurse, I discuss the study in detail with the parents, assess their child’s eligibility and receive consent, should they decide to take part.
After the initial telephone calls and questionnaires, I meet with the parent and child at a GP surgery for the “baseline appointment”, when they are assigned at random into one of two groups – intervention (which means they will get dietary advice base on the results of food allergy tests) or standard care. Both groups are equally valuable because we simply don’t know whether telling families to include or exclude cow’s milk, hen’s egg, wheat or soya based on skin prick tests is helpful or not. We follow up everyone with a monthly questionnaire for 9 months and see them again in a face-to-face appointment at 6 months.
Prior to joining TIGER, I had mostly worked in hospitals, in particular cardiology. Moving to research nursing appealed to me as I have always been drawn to the innovation of clinical research and I am passionate about improving patient outcomes and quality of life. Supporting a clinical study enables nurses to contribute to evidence-based changes in healthcare whilst practicing autonomously and being a key contact and advocate for patients.
As an adult-trained nurse, this is also my first time working with children. The collaborative nature of research has helped me to settle into my role and I’ve been fortunate to have been supported by an enthusiastic and knowledgeable team. After spending a couple of years away from a patient-facing role, I have enjoyed meeting the families participating in the study. I have also learnt how to assess eczema and do skin prick testing.
Working on, and taking part in, TIGER is a fantastic opportunity and I can’t wait to see the results of the study, in 2025.
Published 25 March 2024
Why I’m supporting the Trial of food allergy IgE tests for Eczema Relief (TIGER) study
Hannah’s story, as a lay member of the research team
“Having had eczema my entire life, it came as no surprise when my daughter first showed signs at a couple of weeks old. I raised it with the GP, and was given the usual prescription for a weak steroid cream (to be used initially for a week), alongside regular application of an emollient.
As Imogen began weaning her eczema worsened. I was reticent to progress to stronger steroid creams – it felt counter-intuitive when I try to live and eat fairly organic and ‘clean’. Knowing through trial and error with myself certain foods can aggravate my skin, I remember asking if food allergy testing was now an option. I don’t remember the conversation exactly, but in essence the GP said no research had been done to determine whether food allergy testing would be helpful in the treatment of eczema and that traditional eczema care was the best option. I felt really frustrated that in the last 30+ years since my mother had had the same conversation with my GP nothing had changed.
Around this time I attended a public engagement event for families with young children. It was there I met the University of Bristol Patient Public Involvement (PPI) team and learned they were looking for parents of children with eczema to support research. I was so pleased that, not only is research actually happening (something which is so badly needed), but to also have the opportunity to input – I of course signed up!
My first experience as member of the parent advisory group on the Best Emollients for Eczema (BEE) Study. I was later asked if I’d like to get involved with the TIGER study, which will answer the question “Does dietary advice based on skin prick food allergy tests improve disease control in children with eczema?” As a lay co-applicant, I have been able to input to the design and rollout of the trial, helping the researchers avoid any blind spots and helping them keep focused on the patients.
Only by people taking part in the TIGER trial will we ever know whether food allergy tests are helpful in the treatment of eczema. And only then will GPs be able to refer on, or reassure parents about, this issue.
Published 9 January 2024