Researcher Spotlight: Professor Patricia Fitzpatrick
PROFESSOR PATRICIA FITZPATRICK
UCD School of Public Health, Physiotherapy and Sports Science
Professor Patricia Fitzpatrick is a Full Professor in the UCD School of Public Health, Physiotherapy and Sports Science.
She is currently involved in three major projects: The Irish Comparative Outcome Study (ICOS) of Cystic Fibrosis, the CERVIVA-CervicalCheck Applied Partnership Award and the Irish Cancer Society-funded Study of Smoking Cessation in Patients with Cancer.
The Irish Comparative Outcome Study (ICOS) of Cystic Fibrosis
Cystic fibrosis screening was introduced in Ireland on the basis of clinical trial. However there was a need to ensure screening in practice is matching trial results. Professor Fitzpatrick and colleagues aimed to achieve this need through conducting the ICOS Part 1 project.
ICOS is a national historical cohort study, funded by the Health Research Board and began in 2013, involving 6 Irish hospitals caring for children with cystic fibrosis.
The researchers followed two cohorts of children with a diagnosis of cystic fibrosis, comparing children with cystic fibrosis who were detected by newborn screening through the heel prick test, with children who were diagnosed with cystic fibrosis after presenting clinically.
Cohort A were a clinical cohort of children clinically diagnosed with cystic fibrosis, born in the Republic of Ireland between 1st July 2008 and 30th June 2011. Cohort B were a Newborn Screening (NBS) cohort which were children diagnosed with cystic fibrosis through NBS, born in the Republic of Ireland between 1st July 2011 and 30th June 2016.
Study results of ICOS Part 1 showed improved growth and height, fewer hospital admissions for infections related to cystic fibrosis and delayed acquisition of a serious respiratory pathogen, Pseudomonas Aeruginosa in the screen-detected group of children.
ICOS Part 1 followed children with cystic fibrosis up to age 3-4 years old. Professor Fitzpatrick's research team are now commencing ICOS Part 2 which will follow children with cystic fibrosis up to 8-11 years old.
There are also additional developments in cystic fibrosis care which may alter the impact of screening. Since earlier this year, children from age 2 can be prescribed Ivacaftor in Ireland for cystic fibrosis associated genetic mutation G551D.
Orkambi is prescribed in Ireland from age 6, for the treatment of cystic fibrosis in patients homozygous for cystic fibrosis F508del genetic mutation. Ireland has a very high rate of homozygous F508del mutation and was among the first European countries to introduce Orkambi. Similarily, it is one of the first to provide Kalydeco (Ivacaftor) to children as young as 2.
As part of ICOS Part 2, Professor Fitzpatrick's research team aim to determine the impact of the recent introduction of Orkambi (Lumacaftor/Ivacaftor) and Kalydeco (Ivacaftor).
The results of ICOS Part 1 have potential impact on health communications and policy as this may lead to recommendations around increasing public awareness about what is included in the NBS. Follow up of children aged 8-11 in ICOS Part 2 will allow greater comparison of respiratory outcomes, as older children can undertake lung function tests such as spirometry and other investigations.
All the cystic fibrosis pediatric consultants in the country have been involved since the ICOS cohort study was established and have been central to the study success.
ICOS part 2 continues this collaboration, with further international collaborators in the UK and Europe, and the Cystic Fibrosis Registry of Ireland (CFRI) and with Cystic Fibrosis Ireland. Study results will be benchmarked against European countries, using data from the European Cystic Fibrosis Registry.
CERVIVA-CervicalCheck Applied Partnership Award
Professor Fitzpatrick is also Co-applicant on a Health Research Board funded project, with Cerviva research group (Trinity College Dublin) and the National Screening Service.
The CERVIVA-CervicalCheck project aims to determine why fewer women over 45 years of age come for cervical screening compared to women under 45. It also examine attitudes to Human Papilloma Virus (HPV) screening which will be introduced by CervicalCheck next year.
This CERVIVA-CervicalCheck project will generate evidence on the influences on cervical screening participation among older women in Ireland, and attitudes to HPV screening. This project aims to inform development and implementation of enhanced health policy and public communication strategies by the National Screening Service to increase screening coverage in this group.
A second HRB funded study "Cervivavax" with the same group will examine the influence of the HPV vaccine on screening results and will aid in planning of revised screening protocols. Investigating the reasons why people do not attend screening and seeing what could be done to change this is paramount.
This research will inform development and implementation of enhanced public communication strategies aiming to increase cervical screening coverage. Greater uptake of cervical screening tests can potentially mitigate the devastating effects of cervical cancer by catching women at a precancerous stage.
Irish Cancer Society-funded Study of Smoking Cessation in Patients with Cancer
Professor Patricia Fitzpatrick and a research team from UCD, the HSE Tobacco Free Ireland Programme, specialist cancer hospitals and patient representatives, conducted a research programme funded by the Irish Cancer Society entitled “Smoking cessation for cancer patients in Ireland: a scoping and feasibility initiative.”
It is well-known that tobacco smoking increases the risk of several cancers. It also has an impact on outcomes for people with cancer who continue to smoke but this is often overlooked. Tobacco smoking is associated with poorer treatment outcomes (including treatment-related complications and toxicities), increased risk of recurrence, the development of second primaries, lower survival, and decreased quality of life among continuing smokers.Notwithstanding the adverse outcomes, a significant number of people who have been diagnosed with cancer continue to smoke.
This research had 6 work packages: a rapid review of smoking cessation interventions in cancer patients; a review of national smoking rates among cancer patients (2014-2018); a national audit of existing SC services across all adult cancer hospitals; semi-structured interviews with 25 cancer patients who smoke or quit at diagnosis, semi-structured interviews with 18 cancer healthcare professionals, and a Patient Voice in Cancer Research workshop (www.ucd.ie/patientvoicecancer).
Professor Fitzpatrick led the Healthy UCD Steering Committee between 2016 and February 2023, which has been instrumental in the removal of sugar sweetened drinks from the UCD campus. This has had manifold impacts; retail sales of alternative drinks have risen and there has been great media interest and presentations at international and national meetings. Assistant Professor Celine Murrin has taken over as Chair of the Healthy UCD Steering Committee.
Further impact will be on student and staff physical and oral health and purchasing habits which will be determined by a combination of surveys and retail sales analysis.
Healthy UCD was designed to create a sustainable health university campus. In 2018, the Government placed a levy on high sugar sweetened drinks as part of the Irish obesity intervention. Prior to introduction of the levy Professor Fitzpatrick and colleagues conducted a trial removal of these beverages on the Belfield campus over 7 weeks.
They then surveyed a sample of the university population; of those surveyed who said they bought high sugar drinks regularly, 38% would support removal of high sugar sweetened drinks, 32% would oppose removal and 30% did not care.
The findings provided the motivation to the University Management Team to remove all high sugar sweetened drinks on a permanent basis from all UCD Campuses.
Lower sugar consumption has multiple potential health impacts including healthier teeth, stronger bones, improved mood and concentration, better skin and most importantly reduced risk of overweight, obesity, diabetes, metabolic and cardiovascular diseases amongst others.
The removal of high sugar drinks from campus did not appear to negatively impact the UCD community. 51% of people regularly purchased these drinks, 64% were aware of the sugar levy but 74.9% were not aware that the sugary drinks were unavailable.
The national advice regarding access to high sugar products in the case of hypoglycemia from Diabetes Ireland was provided satisfactorily for all staff and students through the Healthy UCD website.
The study evidence enabled the University Management to permanently remove these products from sale in UCD. UCD were the first third level institution in Ireland to do this. This is seen as exemplar for other campuses to follow. Professor Fitzpatrick comments;
"There is not a lot in the literature around universities undertaking health promotion. The overall feedback from social media was that both students and staff within UCD and further afield were positive about the initiative."
Four retail outlets on the UCD campus which hold 67% of the share of soft drinks on campus were involved in the trial.
The overall impact was that sales of alternative drinks increased by 7% during the period of the study compared to 2017. Retail sales for drinks continued to grow, with 8% growth in the year following removal.
Healthy UCD also won the Irish Heart Foundation Gold Active at Work Award and have given presentations at National and International Scientific Conferences and Other Meetings.
Healthy Ireland committee member Dr. Celine Murrin won the short presentation award for a talk on this topic at the Faculty of Public Health Medicine Scientific Meeting, RCPI, 2018.
Following a UCD press release, the project topic was featured in an interview on Today FMs Matt Cooper show, Dublin Live, the Irish Independent, Irish Mirror, University Times and the magazine Shelf Life.
ABOUT THE RESEARCHER
Patricia Fitzpatrick MD, MPH, FRCPI, FFPHMI is Full Professor of Epidemiology & Biomedical Statistics and Head of Subject for Public Health. She is Consultant in Preventative Medicine in St Vincent's University Hospital and Consultant Epidemiologist/Director of Evaluation for the National Cancer Screening Service. She qualified in medicine from UCD and worked in clinical medicine followed by a Masters in Public Health, and undertaking Higher Specialist Training in Public Health Medicine.
On completion of specialist training, she was appointed to the Department of Public Health Medicine & Epidemiology, UCD. She is former Chair of the Steering Committee for Healthy UCD & recipient of the Healthy UCD awarded Irish Heart Foundation active@work Gold Award 2018.
She is a former Dean of the Faculty of Public Health Medicine and is currently a Board Member, Examination Committee Member and Fellowship Committee Member. She is an Examiner for Part I and Part II MFPHMI. She is a registered trainer for the Faculty of Public Health Medicine.
Board Member, Medical Bureau of Road Safety 2017-2022.
Board Member, Institute of Public Health (www.publichealth.ie.)
Member of Guidelines Development Group of the Joint Research Council European Council Initiative on Breast Cancer.
College of Life Sciences Teaching Award 2011
Invited Subject Expert University of Swansea MSc in Public Health & Health Promotion Quality Review 2019
External Examiner University of Sunderland MSc in Public Health 2012-2016
Murrin, C., O'Connor, J., Doyle, G., Delany, L., Lades, L., O'Malley, G., Lawlor, O., Harold, L., Mullins, B. and Fitzpatrick, P., 2018. Removing sugar sweetened beverages from a university campus. European Journal of Public Health, 28(suppl_4), pp.cky214-014.