Academic Spotlight: Dr Caroline Flurey

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In this Academic Spotlight we asked Dr Caroline Flurey, Senior Lecturer in Health Psychology at UWE Bristol.

Tell us about your background and how you became interested in your research area?

I never really had that big long-term plan for what I wanted to do when I grow up, I’m a pretty good example of keep your eyes and your options open and the right thing will come along. My undergraduate degree was Psychology BSc at Swansea University, I was the first in my family to go to University so getting a degree was the end goal, I hadn’t even considered post-grad as a possibility. After graduating I worked as a Health Care Assistant at North Bristol NHS Trust for around a year while I figured out what I wanted to do – and decided on an MSc in Health Psychology at UWE. After my MSc, I got some experience working as an assistant psychologist and worked in a bank to pay the bills, which is what I was doing when I saw a funded PhD studentship advertised through UWE alumni comms.

My PhD studentship was funded by Arthritis Research UK (now Versus Arthritis) supervised by Prof. Sarah Hewlett (emeritus), Dr Marianne Morris, Dr Jon Pollock, and Dr Rod Hughes and focused on rheumatoid arthritis (RA), specifically how patients self-manage, their tipping points for seeking help for an RA flare, and whether patterns of symptoms or early warnings of RA flares could be identified. My PhD unexpectedly found that men were struggling to cope and/or self-manage more than women, and they reported that the support currently offered in rheumatology didn’t meet their needs. This led me to connect with Prof. Alan White at the Centre for Men’s Health at Leeds Beckett University to gain a better understanding of men’s health and along with Prof. John Kirwan and Prof. Karen Rodham develop an application for a competitive Arthritis Research UK post-doctoral fellowship.

Tell us more about your research and research projects, are there any particular projects you want to highlight?

My main research focus is men’s health, particularly men with long-term conditions, which so far has been focused within rheumatology. My Arthritis Research UK post-doctoral fellowship focused on experiences, coping styles, and support needs of men with rheumatoid arthritis (RA) to understand how better to support men with RA. I then broadened this out to another rheumatic condition – Systemic Sclerosis (also known as Scleroderma), which is a rare condition that men are dying from at around twice the rate of women, but no studies had focused on men before. So funded by the World Scleroderma Foundation & French Scleroderma Association (alongside a team of collaborators) I ran focus groups with men with systemic sclerosis in the UK and USA to understand their experiences and support needs – and I’m currently in the process of publishing the findings from that. These two different but related conditions have also helped me to look at whether it’s possible to design support for men across rheumatic diseases potentially broadening out to across long-term conditions, or whether disease-specific support is needed. Findings would suggest there is certainly over-lapping needs, although a modular approach to support with some disease or symptom specific components would be ideal – for example men want the opportunity to discuss erectile dysfunction or intimacy issues, or worries about mortality but preferably amongst other men who also experience these issues.

My key messages from my work with men with rheumatic diseases are despite public narratives suggesting ‘men don’t talk about their health’ – they do – when given a safe, trusted environment, and when given permission by being explicitly asked. For support, men tend to prefer ‘covert intimacy’ – support occurring as a by-product of taking part in other shared activities, and my future work (in development) will focus on developing support that meet these preferences for men within healthcare.

Whilst my own work has focused mainly on men aged 30 and over, one of my current PhD students Ruben McNeil-Walsh is funded by ESRC South West Doctoral Training Partnership scheme to focus on the experiences and support needs of younger men (age 16-30) with inflammatory arthritis.

Within Rheumatology, I’m also interested more broadly in psychosocial support, self-management, and patient reported outcome measures. I’m part of OMERACT (Outcome measures in rheumatology trials), which is an international initiative of key stakeholders (clinicians, researchers, patients, methodologists, industry) interested in outcome measures.

I’m co-chair for the OMERACT Drug Safety group in which we’re aiming to develop a way to measure the cumulative burden of drug side-effects in rheumatology clinical trials in a way that is meaningful to patients.

I’m also co-chair for OMERACT Remission in rheumatoid arthritis (RA): patient perspective working group, which is working towards including the patient perspective in how remission is measured for RA. Our previous work has found that according to patients: pain, fatigue, and independence are missing from the current measure of remission in RA. Whilst instruments exist to measure pain and fatigue, there isn’t a measure for independence. I’m currently funded by Arthritis Australia to conduct focus groups with patients from UK, North America, and Australia to understand how patients define independence in the context of remission in RA, and to see how patients suggest measuring this. The next steps would be to gain consensus on what to include in such a measure and then to develop and validate that measure.

How could your academic expertise be practically applied for a business partner or external collaboration?

My current work includes collaboration with rheumatologists, researchers, and patients internationally and I am always happy to be contacted to develop new connections and consider new collaborations. For broader studies I can contribute a men’s health focus, including advice on how to improve recruitment of male participants – who are often under-recruited to qualitative and psychosocial studies.

I’m a Trustee for the Men and Boys Coalition, which enables me to contribute an academic perspective to the charitable aims including connecting the various sectors that focus on improving wellbeing for men and boys. I’m always open to collaborate and engage with charities/grass roots organisations/industry with an interest in men’s health or mental health.

You can connect with Dr Caroline Flurey via her LinkedIn

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