Asthma has different phenotypes and different triggers so not all treatments are suitable for every type of asthma.
This programme of work is looking at how and why different people respond differently to treatment.
Poor adherence and under-treatment are major causes of poor asthma control, exacerbations and hospitalisations. Poor adherence may in part be due to not everyone responding to treatment in the same way.
We aim to help people with asthma manage their symptoms and maximise the benefits they get from treatment.
For example, the ‘Perceptions and Practicalities Approach’ (PAPA). PAPA recognises that non-adherence may be intentional and/or non-intentional and is best understood as a combination of perceptual factors (e.g. beliefs about illness) and practical factors (e.g. capacity).
The aim is to profile these perceptual and practical barriers and then tailor interventions to address specific barriers.
We also aim to evaluate incentive-based interventions to improve adherence.
There are a complex mix of asthma phenotypes and the effectiveness of various treatments will differ in people with different asthma phenotypes.
Initially we will look at inhaled corticosteroid (ICS) dose in children with eosinophilic asthma.
Prescription medication is free in Scotland, Wales and Northern Ireland, but not in England. We will carry out data linkage of prescribing and morbidity from Scotland and Wales and use England as a comparator to determine the association of free asthma medication with dispensing and asthma morbidity.
Identifying children who need help taking their asthma medication | Dr Louise Fleming
Clinical utility and feasibility of a shortened multiple breath washout technique and offline exhaled nitric oxide in preschool children with wheezing disorders | Professor Andrew Bush
Use of molecular profiling to determine optimal management for moderate to severe preschool wheeze | Professor Sejal Saglani
Pulmonary epithelial barrier and immunological functions at birth and in early life – key determinants of the development of asthma? | Professor Andrew Bush