A5090876831- Asthma and respiratory diseases
- Respiratory and Cough-Related Research
- Inhalation and Respiratory Drug Delivery
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Chronic Disease Management Strategies
- Allergic Rhinitis and Sensitization
- Genomics and Rare Diseases
- Respiratory Support and Mechanisms
- Pharmaceutical studies and practices
- Cystic Fibrosis Research Advances
- Pulmonary Hypertension Research and Treatments
- Health, Environment, Cognitive Aging
- Long-Term Effects of COVID-19
- Ethics in Clinical Research
- Health Promotion and Cardiovascular Prevention
- Data-Driven Disease Surveillance
- Immunodeficiency and Autoimmune Disorders
- RNA regulation and disease
- Medical Coding and Health Information
- Bioinformatics and Genomic Networks
- Cardiovascular and Diving-Related Complications
- Primary Care and Health Outcomes
- Medical Imaging and Pathology Studies
- Nursing Diagnosis and Documentation
- Genomic variations and chromosomal abnormalities
University of Cambridge
2016-2022
Cambridge University Hospitals NHS Foundation Trust
2020-2022
NHS Blood and Transplant
2016
Observational & Pragmatic Research Institute
2011-2015
Norwich Research Park
2010-2014
Patterns of health-care use and comorbidities present in patients the period before diagnosis chronic obstructive pulmonary disease (COPD) are unknown. We investigated these factors to inform future case-finding strategies.We did a retrospective analysis clinical cohort UK with data from Jan 1, 1990 Dec 31, 2009 (General Practice Research Database Optimum Patient Care Database). assessed aged 40 years or older who had an electronically coded COPD their primary care records minimum 3...
As more inhaled corticosteroid (ICS) devices become available, there may be pressure for health-care providers to switch patients with asthma cheaper inhaler devices. Our objective was evaluate impact on control of device switching without an accompanying consultation in general practice. This 2-year retrospective matched cohort study used the UK General Practice Research Database identify practices where ICS were changed a ≥5 within 3 months. Patients 6–65 years age from these whose...
Summary Background The extrafine‐particle formulation of hydrofluoroalkane–beclometasone (EF HFA–BDP; Qvar ® ) demonstrates improved total and small airway deposition compared with large‐particle chlorofluorocarbon (CFC)–BDP. In some short‐term studies, EF HFA–BDP provides greater effects on lung function than CFC–BDP, hence is recommended to be prescribed at a lower dose, but whether there are differences in asthma outcomes during long‐term treatment unknown. Objective To compare the...
ed by pressing down on the canister to release a dose in coordination with start of inhalation.Breath-actuated metered-dose inhalers (BAIs) and dry powder (DPIs) are actuated patient's inhalation but vary requirements for speed character, which should be slow deep BAI sharp rapid DPI.Because these differences, several authors have recommended that patients always prescribed same device
Background: Randomized controlled trials indicate that addition of a long-acting muscarinic antagonist (LAMA) such as tiotropium may improve asthma control and reduce exacerbation risk in patients with poorly asthma, but broader clinical studies are needed to investigate the effectiveness LAMA real-life care. Methods: Medical records adults (aged ≥18 years) prescribed were obtained from UK Optimum Patient Care Research Database for period 2001–2013. Patients diagnosed chronic obstructive...
Inhaled corticosteroids (ICS) are effective treatment for childhood asthma. Cross-sectional studies indicate that some asthmatic children treated with excessively high doses of ICS and at risk serious adverse effects.To describe longitudinal trends in asthma prescribing children, particular reference to very-high-dose (unlicensed) prescribing.Retrospective, cross-sectional, observational study general practitioner drugs aged under 12 years a recorded diagnosis between 1992 2004 using the...
Because randomized controlled trials of established pediatric asthma therapies are expensive and difficult to perform, observational studies may fill gaps in the evidence base.To compare effectiveness representative small-particle inhaled corticosteroid (ICS) with that standard size-particle ICS for children initiating or stepping up therapy (analysis 1) dose step-up using adding long-acting β2-agonist (LABA) 2).These historical matched cohort analyses drew on electronic medical records aged...
Purpose: Small airway changes and dysfunction contribute importantly to obstruction in chronic obstructive pulmonary disease (COPD), which is currently treated with inhaled corticosteroids (ICS) long-acting bronchodilators at Global initiative for Obstructive Lung Disease (GOLD) grades 2–4. This retrospective matched cohort analysis compared effectiveness of a representative small-particle ICS (extrafine beclomethasone) larger-particle (fluticasone) primary care patients COPD. Patients...
Abstract Little data on UK prescribing patterns and treatment effectiveness for allergic rhinitis (AR) are available. We quantified unmet pharmacologic needs in AR by assessing based the behaviour of general practitioners (GP) during two consecutive pollen seasons (2009 2010). conducted a retrospective observational study with from Optimum Patient Care Research Database. assessed diagnoses prescription patients recorded diagnosis who took medication period. 25,069 2009 22,381 2010....
Real-life studies are needed to determine the cost-effectiveness of asthma therapies in clinical practice. To compare extrafine-particle inhaled corticosteroid (ICS) with standard size-particle ICS United Kingdom (UK) and States (US). These retrospective matched cohort analyses used large electronic databases study asthma-related outcomes for patients UK (12–60 years old; n=1730) US (12–80 years; n=10,312) prescribed extrafine beclomethasone or fluticasone as their first therapy asthma....
Rationale: Guidelines advocate adding long-acting β-agonist (LABA) to inhaled corticosteroid as the preferred step-up therapy increasing dose for patients with uncontrolled asthma on monotherapy. However, less than 5% of qualify randomized controlled trials which guidelines are based. Thus, real-world data needed complement results narrow entry criteria.Objectives: To compare effectiveness stepping up an increased various types compared add-on LABA.Methods: We performed a historical matched...
Observational research is essential to evaluate the real-life effectiveness of asthma treatments and can now make use outcomes derived from electronic medical records.
Purpose: To investigate the clinical and cost effectiveness of switching real-life asthma patients from other types inhalers to Easyhaler ® (EH) for administration inhaled corticosteroids (ICS). Patients methods: Historical, matched-cohort study 1,958 (children adults) treated in UK primary-care practices, using data obtained Optimum Patient Care Research Database Clinical Practice Datalink. Other (OH) included pressurized metered-dose inhalers, breath-actuated dry-powder delivering...