British Science Week 2021: Zainab Khanbhai

To celebrate British Science Week at Royal Brompton and Harefield hospitals we’re highlighting some of the important work our researchers are tackling.

In this instalment we asked Zainab Khanbhai to reflect on her work and the role pharmacists play in research.

Zainab is a a senior cardiothoracic surgical pharmacist, with a special interest in atrial fibrillation (AF),

Why pharmacists are crucial to research

I qualified as a pharmacist in 2003 and have worked at Royal Brompton and Harefield hospitals since 2006. My work involves providing a clinical pharmacy service to patients admitted for cardiac and thoracic surgery. 

I also work closely with the pre-operative team, helping to assess patients before surgery, advising on medication and ensuring appropriate management and optimisation of medications such as anticoagulation. 

I believe that pharmacists have a major role to play in the research and management of chronic conditions such as diabetes and AF and can play a significant role in improving patient care. However, the skills and expertise of pharmacists are often overlooked and underutilised. 

Pharmacists have the skills and in-depth clinical knowledge of medications, and often work closely with consultants, GPs and other medical colleagues. Many are non-medical prescribers (are able to prescribe medication without a doctor) and therefore are ideally placed to improve management of these chronic conditions and conduct research. 

I love working in research because it’s so varied and there are so many aspects to it, including patient interaction, using innovative technology, writing papers and understanding statistics. It keeps me constantly challenged and there are new aspects that I am introduced to every day. It also means I get to interact with many different professionals and learn about how to engage and influence people. What drives me, when it comes to research, is the knowledge that I could be potentially shaping the clinical picture for the future.

My current projects are in two chronic conditions; AF and diabetes. 

Atrial fibrillation research

AF is a heart condition that causes an irregular and often abnormally fast heart rate. Approximately 1.4 million people in the UK are estimated to have the disease. AF is often undiagnosed, and it is estimated that there are a further half a million people in the UK with the disease. 

AF is a major risk factor for AF-related stroke and a contributing factor for 1 in 5 strokes, which can cost the NHS approximately £45,000 in the first year. By improving the detection and management of AF there is a potential to reduce the incidence of AF related stroke, saving lives and saving costs for the NHS.

In 2015 I became the lead for the Capture AF research service, funded by The Health Foundation. The aim was to determine whether it would be possible for community pharmacists to lead on AF detection and treatment. I worked with the arrhythmia team at Harefield Hospital, community pharmacists and primary care services to develop this service which has proven successful, with further funding received to develop a primary care AF hub.

Diabetes research

The other project I’m working on is a service evaluation for a pharmacist led pre-operative diabetes optimisation clinic and is linked to my newly appointed role as the Diabetes UK Clinical Champion 2020-2022.

Diabetes is an established risk factor for the development and progression of cardiovascular disease, with the prevalence of coronary artery disease has been estimated as high as 55% in the diabetic population. Uncontrolled diabetes also increases the risk of complications post-surgery, including surgical site infections and acute renal failure. 

The pre-operative diabetes clinic aims to improve glycaemic (blood glucose) control and optimise cardiovascular outcomes for patients coming to Harefield Hospital for cardiac surgery. 

If successful, the aim will be expanded to determine the benefits of post-operative optimisation and then look at how this can be integrated with primary care.

The future

My projects in both AF and diabetes show that pharmacists can have a massive impact on the management of these conditions. Research has not historically been associated with the pharmacy profession; however, there is increasing recognition that pharmacists have a unique role within research and can contribute to advances in healthcare. 

Moving forward I hope more of my fellow pharmacists will be given the opportunity to work in research.

Read the other posts in our British Science Week 2021 series:

Dr Anand Shah
Professor Sabine Ernst 
Dr Siobhan Carr