Professor Chris Butler - Co-Chair AWARD SE Wales

Chris Butler is Head of Department of Primary Care and Public Health at Cardiff University and part time professor in Family Medicine at McMaster University, Canada. His research interests include infections in primary care and the appropriate use of antibiotics, physician behavior change, otitis media with effusion, philosophical aspects of medicine, and clinician-patient communication around health related behaviours. He was awarded a doctorate for a randomized controlled trial and qualitative research into health behavior change and clinician-patient communication in 1999, and trained in Clinical Epidemiology at The University of Toronto. He has been consulted widely on antibiotic prescribing. He has authored 50 peer reviewed papers and helped win more than 25 research grants, including from the MRC, Wellcome Foundation and Department of Health. He is on the Medical Advisory Board of the MRC and on the Editorial Board of the British Journal of General Practice.

Qualifications
1977-1980 BA, Rhodes University
1981-1986 MBChB, Medical School, University of Cape Town
1989 Diploma in Child Health, College of Medicine of South Africa
1993 MRCGP, Royal College of General Practitioners
Aug 98-Jul 99 CCH (Clinical Epidemiology) University of Toronto
1999 Doctor of Medicine, University of Wales College of Medicine.

Current position
Head of Department, Primary Care and Public Health, Cardiff University
Clinical Professor (part time), Department of Family Medicine, McMaster University, Canada.

Key Recent Peer Reviewed Publications (out of a total of > 80)
Butler CC, Hillier S, Roberts Z, Dunstan F, Howard A, Palmer S. Antibiotic resistant infections in primary care are symptomatic for longer and increase workload: outcomes for patients with E.coli urinary tract infection. British Journal of General Practice, 56 (530):686-92, 2006.

Hopstaken RM, Coenen S, Butler CC, Nelemans P, Muris JW, Rinkens PE, Kester AD, Dinant GJ. Prognostic factors and clinical outcome in acute lower respiratory tract infections: a prospective study in general practice. Fam Pract. 2006 Oct;23(5):512-9. Epub 2006 Jun 20. PMID: 16787958

Lindbaek M, Francis N, Cannings-John R, Butler CC, Hjortdahl P. Clinical course of suspected viral sore throat in young adults: cohort study. Scand J Prim Health Care. 2006 Jun;24(2):93-7.

van Duijn HJ, Kuyvenhoven MM, Butler CC, Coenen S, Verheij TJ. Variation in outpatient antibiotic use in three European countries: exploration of possible determinants. Eur J Gen Pract. 2005 Sep-Dec;11(3-4):139-40.

van Driel ML, De Sutter A, Deveugele M, Peersman W, Butler CC, De Meyere M, De Maeseneer J, Christiaens T. Are sore throat patients who hope for antibiotics actually asking for pain relief? Ann Fam Med. 2006 Nov-Dec;4(6):494-9. PMID: 17148626

Vidal-Alaball J, Butler CC, Potter CC. Comparing costs of intramuscular and oral vitamin B12 administration in primary care: A cost-minimization analysis.Eur J Gen Pract. 2006;12(4):169-73. PMID: 17127603

McCambridge J, Strang J, Butler CC, Kearney F, Anderson P. Hazardous drinking and the NHS: the costs of pessimism and the benefits of optimism. Br J Gen Pract. 2006 Apr;56(525):247-8. (Editorial)

Butler C, Francis N, Dinant GJ. Whooping cough in general practice. BMJ. 2006 Jul 22;333(7560):159-60. (Editorial)

Hillier S, Bell J, Heginbothom M, Roberts Z, Dunstan F, Howard A, Mason B, Butler CC. When do general practitioners request urine specimens for microbiology analysis? The applicability of antibiotic resistance surveillance based on routinely collected data. J Antimicrob Chemother. 2006 Dec;58(6):1303-6. PMID: 17062608

Cals JW. Hopstaken RM. Butler CC. Hood K. Severens JL. Dinant GJ. Improving management of patients with acute cough by C-reactive protein point of care testing and communication training (IMPAC3T): study protocol of a cluster randomised controlled trial. BMC Family Practice. 8:15, 2007. UI: 17394651

Metcalf EP. Davies JC. Wood F. Butler CC. Unwrapping the diagnosis of tuberculosis in primary care: a qualitative study. British Journal of General Practice. 57(535):116-22, 2007 Feb. UI: 17263928

O'Brien K, Hillier S, Simpson S, Hood K, Butler C. An observational study of empirical antibiotics for adult women with uncomplicated UTI in general practice. J Antimicrob Chemother. 2007 Jun;59(6):1200-3. PMID: 17449887

Sharon A. Simpson, Fiona Wood, and Christopher C. Butler. General practitioners' perceptions of antimicrobial resistance: a qualitative study. J. Antimicrob. Chemother., February 2007; 59: 292 - 296.

Nancy J. Hawkings, Fiona Wood, and Christopher C. Butler. Public attitudes towards bacterial resistance: a qualitative study. J. Antimicrob. Chemother., Advance Access published on April 21, 2007

Evans MR. Prout H. Prior L. Tapper-Jones LM. Butler CC. A qualitative study of lay beliefs about influenza immunisation in older people. British Journal of General Practice. 57(538):352-8, 2007 May.

Kinnersley P, Edwards A, Hood K, Cadbury N, Ryan R, Prout H, Owen D, Macbeth F, Butow P, Butler C. Interventions before consultations for helping patients address their information needs. Cochrane Database Syst Rev. 2007 Jul 18;(3):CD004565. PMID: 17636767 [PubMed - in process]

Butler CC, Dunstan F, Heginbothom M, Mason B, Roberts Z, Hillier S, Howe R, Palmer S, Howard A. Containing antibiotic resistance: demonstration of decreased antibiotic resistant coliform urinary tract infections with reduction in antibiotic prescribing by general medical practices. BJGP 2007;57(543), 785-792

Wood F, Simpson S, Butler CC. Socially responsible antibiotic choices in primary care: a qualitative study of GPs' decisions to prescribe broad-spectrum and fluroquinolone antibiotics. Fam Pract. 2007 Oct;24(5):427-34. PMID: 17728289

Cals JW, Boumans D, Lardinois RJ, Gonzales R, Hopstaken RM, Butler CC, Dinant GJ. Public beliefs on antibiotics and respiratory tract infections: an internet-based questionnaire study. Br J Gen Pract. 2007 Dec;57(545):942-7. PMID: 18252068

Cals JW, Scheppers NA, Hopstaken RM, Hood K, Dinant GJ, Goettsch H, Butler CC. Evidence based management of acute bronchitis; sustained competence of enhanced communication skills acquisition in general practice. Patient Educ Couns. 2007 Nov;68(3):270-8.

Sullivan F, Butler C, Cupples M, Kinmonth AL. Primary care research networks in the United Kingdom. BMJ. 2007 May 26;334(7603):1093-4. (Editorial)

Hillier S, Roberts Z, Dunstan F, Butler C, Howard A, Palmer S. Prior antibiotics and risk of antibiotic-resistant community-acquired urinary tract infection: a case-control study. J Antimicrob Chemother. 2007 Jul;60(1):92-9. Epub 2007 May 30. PMID: 17540675

Cosby JL, Francis N, Butler CC. The role of evidence in the decline of antibiotic use for common respiratory infections in primary care. Lancet Infect Dis. 2007 Nov;7(11):749-56. PMID: 17961860

Dinant GJ, Buntinx FF, Butler CC. The necessary shift from diagnostic to prognostic research. BMC Fam Pract. 2007 Sep 13;8:53.PMID: 17854488 [PubMed - indexed for MEDLINE]

Coenen S, Ferech M, Haaijer-Ruskamp FM, Butler CC, Vander Stichele RH, Verheij TJ, Monnet DL, Little P, Goossens H; ESAC Project Group. European Surveillance of Antimicrobial Consumption (ESAC): quality indicators for outpatient antibiotic use in Europe. Qual Saf Health Care. 2007 Dec;16(6):440-5. PMID: 18055888

Seale C, Butler CC, Hutchby I, Kinnersley P, Rollnick S. Negotiating frame ambiguity: a study of simulated encounters in medical education. Commun Med. 2007;4(2):177-87. PMID: 18052817 [PubMed - in process]

Christopher C. Butler; Sharon Simpson; Fiona Wood. General practitioners' perceptions of introducing near-patient testing for common infections into routine primary care: A qualitative study. Scand J Prim Health Care. DOI: 10.1080/02813430701726285

Books
Rollnick S, Miller WR, Butler CC. Motivational interviewing in health care. The Guildford Press New York, NY. 2007

Rollnick S, Mason P, Butler CC. Behaviour change: a guide for health care professionals. Churchill Livingstone, 1999. Japanese edition published 2001.

Butler CC, Rollnick S. Compliance. Mosby-Elsevier Science Ltd, 2003.

Selected current and recent research grants (total number of grants 35, value >£61m)

1. Geert Jan Dinant (Applicant)
Butler CC (Project leader)
Severns H, Wesseling G, Stobberingh E, Schouten J, Little P, Lindbaek M, Hood K, Hopstaken R. (Co-investigators)
Randomised controlled trial of point of care C-reactive protein test and enhanced communication skills for managing acute cough due to lower respiratory tract infection in general practice: cost effectiveness and effect on diagnostic testing, antibiotic prescribing and recovery
ZonMw (Netherlands)
2004, three years
Euros 232 500.

2. Gregory J and Robling M (PIs)
Rollnick S, Channon S, Hood K, Butler CC, Lowes L, Cohen D, Russell I, Crawley C, Crowne E, Longo M. Co applicants.
DEVELOPMENT AND EVALUATION OF A PSYCHOSOCIAL INTERVENTION FOR CHILDREN AND TEENAGERS EXPERIENCING DIABETES (The DEPICTED Study)
Health Technology Assessment Program
£856 000
2004-7

3. Huw Morris (PI)
Yoav Ben-Shlomo (co-applicant)
Chris Butler (collaborator)
A population based study of young onset Parkinson’s Disease: clinical features, treatment response, quality of life and role of familial/genetic factors.
£211 656
Start 1 May 2005. Three years.

4. Chris Butler, supervisor
MRC Health services/Health of the Public Fellowship for Dr Nick Francis
£298 152
2005
4 years

5. Goosens H, PI and others including
Chris Butler, leader of clinical platform
Genomics To Combat Resistance Against Antibiotics In Community-Acquired Lower Respiratory Tract Infections In Europe (GRACE)
Euros 11 500 000, £804 740 to Cardiff University
2006-2011

6. Department of Health Fellowship for Rebecca Cannings.
Chris Butler and Frank Dunstan supervisors.
Common infections, their complications, antibiotic prescribing and resistance: Moving away from simple correlations.
£160,118
1 September 2005
3 years

7 Butler CC (PI).
Cohen D, Edwards A, Hood K, Lane C, McCambridge J, Moore L, Rollnick S, Simpson S, Strang J, Wood F.
The PRE-EMPT STUDY: Preventing disease through opportunistic, Rapid EngagEMent by Primary care Teams using Behaviour Change Counselling
MRC/NPRI
£628 587
2006-2009

8 Butler CC (PI)
Cohen D, Dunstan F, Evans M, Hayes J, Hood K, Howard T, Moore L, Palmer S, Rollnick S, Simpson S.
Stemming the tide of antibiotic resistance: A trial of a complex intervention addressing the ‘why’ and ‘how’ of appropriate antibiotic prescribing in general practices (the STAR Educational Program).
MRC
£360K
42 months, 2005

9. Little P (PI)
Butler C, Campbell JL, Delaney B, Hay AD, Hobbs R, Mant D, Moore M, Mullee MA, Williamson I.
DEcision rule for severe Symptoms and Complications of Acute Red Throat in Everyday practice (DESCARTE).
MRC
£722K
30 months, 01/07/2006

10. Verheij (Coordinator)
Butler CC is leader of Workpackage 4
Changing behaviour of Health care professionals And the general public towards a More Prudent use of anti-microbial agents (CHAMP)
Euros 1 445 260, £114 287 to Cardiff University.
EU FP6.

11. Butler CC (PI)
O’Brien K, Powell C, Hood K, Edwards A, Topley N, O’Donnell V, Howe R. (Co-applicants)
EURICA: The Epidemiology of Urinary Tract Infection (UTI) in Children with Acute Illness in Primary Care
£139,897.
WORD/MRC
April 2007-2009