King's College London

Research portal

Professor Leone Ridsdale

Research interests

Headache
Guy’s & St Thomas’s Hospital Charity fund the Neurology & General Practice Unit for Service Delivery and Evaluation of innovation in Headache Services . Six GPs with Special Interest in Headache have been trained. Intermediate Care Clinics have been set up in Southwark and Lambeth and an evaluation published in the BJGP. Patients seen by the GP with Special Interest Service were more satisfied than patients who saw hospital-based general neurologists. The PCT was charged less for the GPwSI service than for hospital care. The RCP/ABN have used this evidence in a report (2011) to recommend this as a service model in all districts.

Prior work funded by the MRC set the stage for this by examining reasons for referral of patients with headache to specialists. GPs referred only 2% of consulters for primary headache to neurologists. These patients reported the same level of headache severity and disability as patients managed in primary care. Referred patients expressed more fear and anxiety about their headache symptoms. GPs reported patient pressure was important in the referral decision, and their wish for a brain scan.

The results of a study designed to describe the prevalence of PFO with migraine, and trial clopidogrel in the prevention of migraine in collaboration with John Chambers, cariologist, was funded by the Dunhill Trust, and published in 2013-4. In 2012-14 the NIHR RfPB funded a pilot trial to assess an intervention which includes relaxation and a CBT approach for people with migraine. Results are being presented, and submitted for publication.

In 2014 LR was CI in a successful proposal to evaluate the impact of open access to MRI for GPs, funded by Guy's & St Thomas Charity with over £2million. This forms part of a programme Transforming Outcome & Health Economics Through Imaging (TOHETI), led by Reza Rezavi. The overal aim is to improve the interaction and pathways between primary and secondary care.


Fatigue
A Wellcome Trust grant funded the third complex intervention trial by this unit for patients with chronic fatigue in primary care. This three-arm RCT of Graded Exercise, Counselling and Usual Care plus a booklet on CBT was published in 2012. No difference was found in fatigue outcomes for the three groups.

Epilepsy
Prior work has included trials of nurse interventions for people with new and chronic epilepsy, with 6 papers cited by NICE. In 2008-12 the NIHR SDO funded the unit for a study titled: Can nurse-led rehabilitation for epilepsy patients prevent non-planned admissions? A comparison of cost and effectiveness of service models at two centres. This study is complete with papers published in 2012-14. We found 60% of Emergency Department attenders reaattended in the same year, with an average rate of 3pa. Prior attendance and felt stigma were predictors of ED use, which accounts for 50% of their service costs.
Epilepsy Bereaved funded an epidemiological study of causes of mortality in epilepsy, using the General Practice Research Database. Epilepsy Bereaved continues to fund the unit for studies of epilepsy in Cornwall, and epilepsy and ethnicity, some of which led to publications 2011-15.


In 2013-16 the NIHR HTA funded a trial of ‘Self-Management education for adults with poorly controlled epILEpsy’ (SMILE). This trial will recruit people from all over London, and use mixed methods to describe outcomes, including quality of life. The protocol has been published, and baseline recruitment complete.

Teaching activities
Leone Ridsdale was Director of Neurology Undergraduate Clinical Teaching 1999-2015, and remains Chair of Clinical Teaching in Year 3 for the Neurology-Opthalmology-Psychiatry Rotation. In the past, medical graduates have reported lack of competence and confidence in neurology, amounting to ‘neurophobia’. KCL students do 12 a week rotation in clinical neurology, linked with psychiatry teaching. This has been evaluated, and KCL students report as much confidence in their neurology knowledge and skills, as in other Year 3 subjects. Students rated neurology as top, tied with cardiology, for interest and as the subject in which they would like to specialize (Ridsdale L, Massey R, Clark L. (2007) Preventing ‘neurophobia’ in medical students, and so future doctors. Practical Neurology 7:116-123).

Editorial activity

Medicom UK LTD (Publisher)

Ridsdale, L. (Editor)
30 Sep 2016

Activity: Publication peer-review and editorial workEditorial activity

Medicom UK LTD (Publisher)

Ridsdale, L. (Editor)
31 Mar 2016

Activity: Publication peer-review and editorial workEditorial activity

Types of Public engagement and outreach - Media article or participation

Epilepsy Deaths Increase

Ridsdale, L. (Reviewer)
11 Mar 2018

Activity: OtherTypes of Public engagement and outreach - Media article or participation

Types of External academic engagement - Invited talk

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