2. Maximising benefits of treatment

lady taking blue reliever inhaler

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.

Treating asthma

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.

What can we do?

We aim to help people with asthma manage their symptoms and maximise the benefits they get from treatment.

  • Develop novel, effective behavioural approaches to improve adherence

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.

  • Develop approaches to target and optimise pharmacotherapies to different asthma phenotypes

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.

  • Assess the impact of free medication

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.

Programme leads

Bush
Andy Bush
Co-Lead: Maximise Treatment Benefits
Rob Horne Headshot
Rob Horne
Lead: Maximise Treatment Benefits

PhD students

The following students are working on projects as part of the 'Maximising the benefits of treatment' programme.

 

Shauna McKibben
Shauna McKibben
PhD Student
Queen Mary University of London
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Christina Pearce
Christina Pearce
PhD Student
University College London
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Associated Projects

Children and Asthma Medication

Identifying children who need help taking their asthma medication | Dr Louise Fleming

Lung function in pre-school children

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

Pre-school wheeze

Use of molecular profiling to determine optimal management for moderate to severe preschool wheeze | Professor Sejal Saglani

Can we tell who will develop asthma?

Pulmonary epithelial barrier and immunological functions at birth and in early life – key determinants of the development of asthma? | Professor Andrew Bush

© 2015 AUKCAR