Michael Moore

Michael Moore
University of Southampton · Primary Care Population Science and Medical Education

BM BS MRCP FRCGP

About

465
Publications
71,320
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Introduction
Michael Moore has retired from the Academic Unit of Primary Care Population Science and Medical Education, University of Southampton. Michael's research interests included infectious diseases, antimicrobial stewardship mental health and hepatology.
Additional affiliations
May 2014 - present
University of Southampton
Position
  • Professor
September 2004 - April 2014
University of Southampton
Position
  • Professor (Full)

Publications

Publications (465)
Article
Full-text available
Background Antimicrobial resistance is a global patient safety priority and inappropriate antimicrobial use is a key contributing factor. Evidence have shown that delayed (back-up) antibiotic prescriptions (DP) are an effective and safe strategy for reducing unnecessary antibiotic consumption but its use is controversial. Methods We conducted a re...
Preprint
Background People with persistent musculoskeletal (MSK) pain often report depressive symptoms. Distress and depression have been found to predict the development of chronic pain conditions. Evidence suggests pain-related distress is qualitatively different from depressive illness, and current referral pathways and available interventions are sub-op...
Article
Supporting behavioural self-management is increasingly important in the care for chronic widespread pain (CWP), including fibromyalgia. Understanding peoples' experiences of these interventions may elucidate processes and mechanisms that lead to or hinder their intended impact. We conducted a systematic review and thematic synthesis of qualitative...
Article
Full-text available
Introduction Evaluating the safety and acceptability of reusing catheters for intermittent catheterisation (IC) is one of the top 10 continence research priorities identified by the UK James Lind Alliance Priority Setting Partnership in 2008. There are an estimated 50 000 IC users in England and this number is rising. Globally, both single-use cath...
Article
Importance There is significant concern regarding increasing long-term antidepressant treatment for depression beyond an evidence-based duration. Objective To determine whether adding internet and telephone support to a family practitioner review to consider discontinuing long-term antidepressant treatment is safe and more effective than a practit...
Article
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Bacteria are becoming increasingly resistant to antibiotics, reducing our ability to treat infections and threatening to undermine modern health care. Optimising antibiotic use is a key element in tackling the problem. Traditional economic evaluation methods do not capture many of the benefits from improved antibiotic use and the potential impact o...
Preprint
UNSTRUCTURED Background: Sore throat is a common problem and a common reason for the overuse of antibiotics. A web-based tool that helps people assess their sore throat, through the use of clinical prediction rules, taking throat swabs or saliva samples, and taking throat photographs, has the potential to improve self-management and help identify t...
Article
Importance Recurrent urinary tract infection (UTI) is a common debilitating condition in women, with limited prophylactic options. d -Mannose has shown promise in trials based in secondary care, but effectiveness in placebo-controlled studies and community settings has not been established. Objective To determine whether d -mannose taken for 6 mon...
Article
Full-text available
Background Primary care clinicians see people experiencing the full range of mental health problems. Determining when symptoms reflect disorder is complex. The Four-Dimensional Symptom Questionnaire (4DSQ) uniquely distinguishes general distress from depressive and anxiety disorders. It may support diagnostic conversations and targeting of treatmen...
Article
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Background: Acute respiratory tract infections (ARTIs) are the most common cause of morbidity and mortality worldwide, with most people experiencing at least one episode per year. Current treatment options are mainly symptomatic therapy. Antivirals, antibiotics, and glucocorticoids are of limited benefit for most infections. Traditional Chinese med...
Article
Background Guidelines on the management of depression recommend that practitioners use patient-reported outcome measures for the follow-up monitoring of symptoms, but there is a lack of evidence of benefit in terms of patient outcomes. Objective To test using the Patient Health Questionnaire-9 questionnaire as a patient-reported outcome measure fo...
Article
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Background Outcome monitoring of depression treatment is recommended but there is a lack of evidence on patient benefit in primary care. Aim To test monitoring depression using the Patient Health Questionnaire (PHQ-9) with patient feedback. Design and setting An open cluster-randomised controlled trial was undertaken in 141 group practices. Meth...
Article
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Objectives Infections in primary care are often treated with non-steroidal anti-inflammatory drugs (NSAIDs). This study evaluates whether NSAID prescribing is associated with adverse outcomes for respiratory (RTIs) or urinary track (UTI) infections. Objectives To determine whether there is an association between NSAID prescribing and the rate of a...
Article
Full-text available
Background Community pharmacists have an essential role in antimicrobial stewardship by providing self-care advice for self-limiting infections. Aim To explore community pharmacists’ perceptions and experiences of advising patients on management of acute respiratory tract infections (RTIs) and urinary tract infections (UTIs), and to explore issues...
Article
Background Sore throat is a common problem and a common reason for the overuse of antibiotics. A web-based tool that helps people assess their sore throat, through the use of clinical prediction rules, taking throat swabs or saliva samples, and taking throat photographs, has the potential to improve self-management and help identify those who are t...
Article
Full-text available
Background Germ Defence ( www.germdefence.org ) is an evidence-based interactive website that promotes behaviour change for infection control within households. To maximise the potential of Germ Defence to effectively reduce the spread of COVID-19, the intervention needed to be implemented at scale rapidly. Methods With NHS England approval, we co...
Preprint
Full-text available
Background: Antimicrobial resistance is a global patient safety priority and inappropriate antimicrobial use is a key contributing factor. Trials have shown that delayed (back-up) antibiotic prescriptions (DP) are an effective and safe strategy for reducing unnecessary antibiotic use but its uptake is controversial. Methods: We conducted a realist...
Article
Full-text available
Introduction Chronic obstructive pulmonary disease (COPD) represents one of the leading causes of death worldwide. Published clinical trials suggest that the Chinese patent herbal medicine Shufeng Jiedu capsule (SFJD) is safe and may be effective for treating acute exacerbations of COPD (AECOPD). However, these effects have been reported with low o...
Article
Full-text available
Background This paper investigates whether age of onset of depression, duration of the last episode, number of episodes, and residual symptoms of depression and anxiety are associated with depression relapse in primary care patients who have been on long–term maintenance antidepressant treatment and no longer meet ICD10 criteria for depression. Me...
Article
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Background: Although many acute exacerbations of COPD (AECOPD) are triggered by non-bacterial causes, they are often treated with antibiotics. Preliminary research suggests that the Chinese herbal medicine “Shufeng Jiedu” (SFJD), may improve recovery and therefore reduce antibiotic use in patients with AECOPD. Aims: To assess the feasibility of con...
Article
Objective: To describe prevalence of potentially clinically relevant gut pathogens and associations with carriage of resistant organisms in UK care home residents. Methods: Stool samples were collected pre-randomisation from care home residents participating in a randomised placebo-controlled trial. Cultivable clinically relevant bacteria were a...
Article
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Background Most adults in the UK experience at least one viral respiratory tract infection (RTI) per year. Individuals with comorbidities and those with recurrent RTIs are at higher risk of infections. This can lead to more severe illness, worse quality of life and more days off work. There is promising evidence that using common nasal sprays or im...
Preprint
Full-text available
Background: Germ Defence (www.germdefence.org) is an evidence-based interactive website that promotes behaviour change for infection control within households. To maximise the potential of Germ Defence to effectively reduce the spread of COVID-19 the intervention needed to be implemented at scale rapidly. Methods: With the approval of NHS England,...
Article
Full-text available
Background Antibiotics are commonly prescribed for children with lower respiratory tract infections (LRTIs), fuelling antibiotic resistance, and there are few prognostic tools available to inform management. Aim To externally validate an existing prognostic model (STARWAVe) to identify children at low risk of illness progression, and if model perf...
Article
Full-text available
Background Antimicrobial resistance is a global health threat. Antibiotics are commonly prescribed for children with uncomplicated lower respiratory tract infections, but there is little randomised evidence to support the effectiveness of antibiotics in treating these infections, either overall or relating to key clinical subgroups in which antibio...
Article
Full-text available
Background Diagnosis of suspected urinary tract infection (UTI) in care home residents is commonly based on vague non-localising symptoms (eg, confusion), potentially leading to innapropriate antibiotic prescription. The safety of withholding antibiotics in such cases could be addressed by a randomised-controlled trial (RCT), however this would req...
Article
Full-text available
Introduction: Non-pharmaceutical interventions (NPIs), such as handwashing, social distancing and face mask wearing, have been widely promoted to reduce the spread of COVID-19. This study aimed to explore the relationship between self-reported use of NPIs and COVID-19 infection. Methods: We conducted an online questionnaire study recruiting memb...
Article
Full-text available
Background: Antidepressants have been proposed to act via their influence on emotional processing. We investigated the effect of discontinuing maintenance antidepressant treatment on positive and negative self-referential recall and the association between self-referential recall and risk of relapse. Methods: The ANTLER trial was a large (N = 47...
Conference Paper
Context: Acute sore throat is a common presentation in primary care and often results in antibiotic prescription. The Covid pandemic has driven changes in consultation with less face to face visits. Scoring tools are available to target antibiotics and widely used in the UK but it is not clear whether patient self assessment is feasible and suffici...
Article
Full-text available
Background Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are a major reason for consultations in primary care, hospital admissions, deterioration in function, and mortality. Despite the majority of exacerbations not being caused by bacteria, as many as 70% of patients who present in UK primary care with AECOPD are prescribed...
Article
Full-text available
Background: Uncomplicated urinary tract infections (UTIs) are among the most common presentations of bacterial infections in the outpatient setting. The variation of outcomes reported in trials to assess the most effective treatment interventions for uncomplicated UTIs has meant that comparing and synthesising the outcomes across trials is challeng...
Article
Full-text available
Background Trials have identified antimicrobial stewardship (AMS) strategies that effectively reduce antibiotic use in primary care. However, many are not commonly used in England. The authors co-developed an implementation intervention to improve use of three AMS strategies: enhanced communication strategies, delayed prescriptions, and point-of-ca...
Article
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Background This study aimed to identify use of various treatments and their association with the use of antibiotics and patient reported clinical recovery in Chinese adults with acute cough. Methods An online survey recruiting people who had recently experienced cough was conducted. Their sociodemographic, clinical characteristics, treatments rece...
Article
p>Background: randomised trials provide high-quality evidence on the effects of prescribing antibiotics for urinary tract infection (UTI) but may not reflect the effects in those who consume antibiotics. Moreover, they mostly compare different antibiotic types or regimens but rarely include a 'no antibiotic' group. Aim: to estimate the effect of a...
Article
Full-text available
Background There is a lack of evidence regarding post-consultation symptom trajectories for patients with respiratory tract infections (RTIs) and whether patient characteristics can be used to predict illness duration. Aim To describe symptom trajectories in patients with RTIs, and assess baseline characteristics and adverse events associated with...
Article
Full-text available
Background Peptic ulcers in patients receiving aspirin are associated with Helicobacter pylori infection. We aimed to investigate whether H pylori eradication would protect against aspirin-associated ulcer bleeding. Methods We conducted a randomised, double-blind, placebo-controlled trial (Helicobacter Eradication Aspirin Trial [HEAT]) at 1208 pri...
Article
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Background Antibiotics are commonly prescribed for children with chest infections but there is little randomised evidence and trials commonly recruit selected populations, which undermines their applicability. Aim To document the effectiveness of antibiotics for chest infections in children. Design and setting This was a prospective cohort study...
Article
Full-text available
Introduction Sore throat is a common reason for overuse of antibiotics. The value of inflammatory or biomarkers in throat swab or saliva samples in predicting benefit from antibiotics is unknown. Methods We used the ‘person-based approach’ to develop an online tool to support self-swabbing and recruited adults and children with sore throats throug...
Article
Full-text available
Background Randomised trials provide high-quality evidence on the effects of prescribing antibiotics for urinary tract infection (UTI) but may not reflect the effects in those who consume antibiotics. Moreover, they mostly compare different antibiotic types or regimens but rarely include a ‘no antibiotic’ group. Aim To estimate the effect of antib...
Preprint
Full-text available
Background: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are a major reason for consultations in primary care, hospital admissions, deterioration in function, and mortality. 70% of patients presenting with AECOPD in UK primary care are currently in receipt of antibiotics which is part of the standard care. However, the major...
Article
Full-text available
Background: Shufeng Jiedu (SFJD) capsules can be used as adjunctive treatment for patients with community-acquired pneumonia, but the effectiveness and safety of SFJD are not clear. This review aims to evaluate the effectiveness and safety of SFJD based on randomized controlled trials (RCTs). Methods: A systematic review was conducted by searching...
Article
Full-text available
Background: Randomised controlled trials (RCTs) investigated analgesics, herbal formulations, delayed prescription of antibiotics and placebo to prevent overprescription of antibiotics in women with uncomplicated urinary tract infections (uUTI). Objectives: To estimate the effect of these strategies and to identify symptoms, signs or other facto...
Conference Paper
Introduction Helicobacter pylori (H. pylori) may be pivotal in the pathogenesis of upper gastrointestinal (UGI) ulcer bleeding from aspirin therapy. The Helicobacter Eradication Aspirin Trial (HEAT) investigated whether H. pylori eradication reduces the risk of UGI ulcer bleeding in aspirin users. Methods HEAT was conducted using novel real-world...
Article
Full-text available
Background: Low mood and distress are commonly reported by people who have persistent musculoskeletal (MSK) pain, which may be labelled as 'depression'. It is important to understand how pain-related distress is conceptualised and managed in primary care consultations. Aim: To explore understanding of pain-related distress and depression from th...
Preprint
BACKGROUND Sore throat is a common problem and a common reason for the overuse of antibiotics. A web-based tool that helps people assess their sore throat, through the use of clinical prediction rules, taking throat swabs or saliva samples, and taking throat photographs, has the potential to improve self-management and help identify those who are t...
Preprint
Full-text available
Introduction: Non-pharmaceutical interventions (NPIs), such as handwashing, social distancing and face mask wearing, have been widely promoted to reduce the spread of COVID-19. This study aimed to explore the relationship between self-reported use of NPIs and COVID-19 infection. Methods: We conducted an online questionnaire study recruiting members...
Article
Full-text available
Background Chronic kidney disease (CKD) is a very common long-term condition and powerful risk factor for cardiovascular disease (CVD). Low-dose aspirin is of proven benefit in the secondary prevention of myocardial infarction (MI) and stroke in people with pre-existing CVD. However, in people without CVD, the rates of MI and stroke are much lower,...
Article
Full-text available
Background: Uncomplicated urinary tract infections (UTIs) are amongst the most frequent infections presenting in the outpatient setting. A growing number of clinical trials are assessing the most effective treatment interventions for uncomplicated UTI. Due to the heterogeneity of the outcomes reported in these trials, however, comparing these outc...
Article
Antibiotics are commonly prescribed for sore throat in primary care, yet are often of limited benefit.1 They are commonly associated with adverse effects, and contribute towards healthcare costs and antibiotic resistance at both the global and individual level.1 Prescribing antibiotics also reinforces patients’ belief in the need for antibiotics, a...
Article
Full-text available
Objective To assess whether the presence of bacteria or viruses in the upper airway of children presenting with uncomplicated lower respiratory tract infection (LRTI) predicts benefit from antibiotics. Methods Children between 6 months and twelve years old presenting to UK general practices with an acute LRTI were randomised to receive amoxicillin...
Article
Full-text available
Introduction: Respiratory tract infections (RTIs) are a major cause of morbidity and mortality in some high-risk groups including children and older adults. There is evidence that Chinese herbal medicine has an effect on RTIs. Reynoutria japonica Houtt (better known under its synonym Fallopia japonica (Houtt.) Ronse Decr.) (F. japonica), a commonly...
Article
Full-text available
Background: Recognising patients who need immediate hospital treatment for sepsis while simultaneously limiting unnecessary referrals is challenging for GPs. Aim: To develop and validate a sepsis prediction model for adult patients in primary care. Design and setting: This was a prospective cohort study in four out-of-hours primary care servic...
Article
Full-text available
Background Public misconceptions about antibiotic use persist despite the efforts of antibiotic awareness campaigns. These campaigns have often followed a top-down approach and have not sought input from the public. Communities need to see antibiotic campaign messages as relevant, accessible and important in order to have an influence on health-see...
Article
Full-text available
Background The Helicobacter Eradication Aspirin Trial (HEAT) is a multicentre, double blind, randomised controlled trial investigating whether Helicobacter (H.) pylori eradication reduces hospitalisation for peptic ulcer bleeding. Recruited participants were aged 60 and over and taking aspirin (≤325 mg daily) for at least four months prior to conse...
Article
Full-text available
Objective: To evaluate the efficacy, clinical effectiveness, and safety of the Chinese herb Bupleuri radix for the treatment of acute uncomplicated respiratory tract infections (ARTIs). Methods: Four English and four Chinese databases were searched from their inception to June 2021. Randomized controlled trials (RCTs) assessing therapeutic effects...
Article
Full-text available
Objectives To examine the effectiveness of randomising dissemination of the Germ Defence behaviour change website via GP practices across England UK. Trial design A two-arm (1:1 ratio) cluster randomised controlled trial implementing Germ Defence via GP practices compared with usual care. Participants Setting: All Primary care GP practices in Eng...
Article
Full-text available
Shufeng Jiedu capsule (SFJDC) is a Chinese herbal medicine formula for treating acute respiratory tract infections. This review aims to assess its potential safety for clinical setting. Systematic literature searches were conducted across multiple databases to: investigate the phytochemistry and safety data on SFJD and its constituents; produce a m...
Article
Full-text available
Background Around 15%–20% of children with acute otitis media present with ear discharge due to a spontaneous tear or perforation of the eardrum (AOMd). Current guidance recommends clinicians to consider oral antibiotics as first-line treatment in this condition. The opening in the eardrum however should allow topical antibiotics to enter the middl...
Article
Full-text available
Background Depression is a common mental health condition with considerable negative impact on health and well-being. Although antidepressants are recommended as first-line treatment, there is limited evidence regarding the cost effectiveness of long-term maintenance antidepressants for preventing relapse.Objectives Our objective was to calculate t...