Consensus outcomes between health professionals and parents for oral corticosteroids in treating preschool wheeze: a multi-national survey and nominal group technique study.

Objective: To obtain priority consensus for outcome measures of oral corticosteroid treatment of preschool wheeze that represent stakeholder groups.

Design: (1) A systematic review to identify a set of outcome measures; (2) an international survey for healthcare professionals (HCPs) and a nominal group meeting with parents; (3) a final consensus nominal group meeting with key HCPs (trial investigators and paediatric emergency medicine clinicians) and the same parent group.

Main Outcome Measures: Consensus priority of treatment outcome measures, outcome minimal clinically important differences (MCIDs) and level of concerns about adverse effects.

Antidiabetic Medication and Asthma Attacks.

Importance: Elevated body mass index (BMI) and type 2 diabetes are prevalent in asthma and are associated with an increase in the risk of asthma attacks. In experimental studies, the diabetes medications metformin and glucagon-like peptide-1 receptor agonists (GLP-1RA) have mitigated airway inflammation, hyperresponsiveness, and remodeling. However, epidemiological evidence is limited.

Prevalence and predictors of annual asthma reviews in Scottish primary care data.

Background: People with asthma are recommended to have regular reviews in primary care, with assessment of symptoms, adjustment of treatment and self-management processes, and the delivery of a written action plan for emergencies.

Aim: Our study aimed to investigate the incidence and factors associated with attendance of annual reviews.

Design & Setting: electronic health records for approximately 50 000 Scottish asthma patients, between 2008 and 2016.

Development of the face-to-face component and recruitment strategy of a primary care digital social intervention for patients with asthma: Qualitative focus groups and interviews with stakeholders.

Background: 5.4 million people in the UK have asthma, with one third experiencing suboptimal control, leading to co-morbidities and increased healthcare use. A quarter of people with long-term conditions informally access peer support through online health communities (OHCs).

Vitamin D for the management of chronic obstructive pulmonary disease.

Background: COPD is a common, preventable and treatable airway disease, and is currently the third leading cause of death worldwide. About one billion people worldwide are estimated to have vitamin D deficiency or insufficiency. Vitamin D deficiency is common among people with COPD, and has been reported to be associated with reduced lung function and increased risk of acute exacerbations of COPD.

Developing theoretically underpinned primary care resources for patients with asthma: an exemplar from the IMPART trial.

Aim: This article reports on the development of patient resources for the IMPlementing IMProved Asthma self-management as RouTine (IMPART) programme that aimed to encourage patients to attend asthma reviews (invitation letters), encourage patients to enquire about asthma action plans (posters), and equip patients with the knowledge to manage their asthma (information website).

Background: To improve supported asthma self-management in UK primary care, the IMPART programme developed a whole-systems approach (patient resources, professional education, and organisational strategies).

Methods: Linked to behaviour change theory, we developed a range of patient resources for primary care general practices (an information website, invitation letters to invite patients for asthma reviews, and posters to encourage asthma action plan ownership).

Children's Health in London and Luton (CHILL) cohort: a 12-month natural experimental study of the effects of the Ultra Low Emission Zone on children's travel to school.

Background: The Ultra-Low Emission Zone (ULEZ), introduced in Central London in April 2019, aims to enhance air quality and improve public health. The Children's Health in London and Luton (CHILL) study evaluates the impact of the ULEZ on children's health. This analysis focuses on the one-year impacts on the shift towards active travel to school.

Association between socioeconomic deprivation, ethnicity and health outcomes in preschool children with recurrent wheeze in England: a retrospective cohort study.

Background: Preschool-aged children have among the highest burden of acute wheeze. We investigated differences in healthcare use, treatment and outcomes for recurrent wheeze/asthma in preschoolers from different ethno-socioeconomic backgrounds.

Methods: Retrospective cohort study using data from the Clinical Practice Research Datalink linked to Hospital Episode Statistics in England.

Deploying an asthma dashboard to support quality improvement across a nationally representative sentinel network of 7.6 million people in England.

Every year, there are ~100,000 hospital admissions for asthma in the UK, many of which are potentially preventable. Evidence suggests that carefully conceptualised and implemented audit and feedback (A&F) cycles have the potential to improve clinical outcomes for those with chronic conditions. We wanted to investigate the technical feasibility of developing a near-real time asthma dashboard to support A&F interventions for asthma management in primary care.

The UK Soft Drinks Industry Levy and childhood hospital admissions for asthma in England.

Sugar sweetened beverage consumption has been suggested as a risk factor for childhood asthma symptoms. We examined whether the UK Soft Drinks Industry Levy (SDIL), announced in March 2016 and implemented in April 2018, was associated with changes in National Health Service hospital admission rates for asthma in children, 22 months post-implementation of SDIL. We conducted interrupted time series analyses (2012-2020) to measure changes in monthly incidence rates of hospital admissions.

Exploring the perspectives of healthcare professionals on providing supported asthma self-management for Bangladeshi and Pakistani people in the UK.

Background: Self-management support improves asthma outcomes and is widely recommended in guidelines, yet it is poorly implemented in routine practice. There may be additional challenges in the context of ethnic minority groups, where making sense of culture may be necessary. This study aimed to explore the perspectives of healthcare professionals on supporting UK Bangladeshi and Pakistani patients to self-manage their asthma.

Modifiable risk factors for asthma exacerbations during the COVID-19 pandemic: a population-based repeated cross-sectional study using the Research and Surveillance Centre primary care database.

Background: There were substantial reductions in asthma exacerbations during the COVID-19 pandemic for reasons that remain poorly understood. We investigated changes in modifiable risk factors which might help explain the reductions in asthma exacerbations.

Methods: Multilevel generalised linear mixed models were fitted to examine changes in modifiable risk factors for asthma exacerbations during 2020-2022, compared to pre-pandemic year (2019), using observational, routine data from general practices in the Oxford-Royal College of General Practitioners Research and Surveillance Centre.

Cause of death coding in asthma.

Background: While clinical coding is intended to be an objective and standardized practice, it is important to recognize that it is not entirely the case. The clinical and bureaucratic practices from event of death to a case being entered into a research dataset are important context for analysing and interpreting this data. Variation in practices can influence the accuracy of the final coded record in two different stages: the reporting of the death certificate, and the International Classification of Diseases (Version 10; ICD-10) coding of that certificate.

Understanding the processes underpinning IMPlementing IMProved Asthma self-management as RouTine (IMPART) in primary care: study protocol for a process evaluation within a cluster randomised controlled implementation trial.

Background: Providing supported self-management for people with asthma can reduce the burden on patients, health services and wider society. Implementation, however, remains poor in routine clinical practice. IMPlementing IMProved Asthma self-management as RouTine (IMPART) is a UK-wide cluster randomised implementation trial that aims to test the impact of a whole-systems implementation strategy, embedding supported asthma self-management in primary care compared with usual care.

Patient and public involvement workshop to shape artificial intelligence-supported connected asthma self-management research.

Digital interventions with artificial intelligence (AI) can potentially support people with asthma to reduce the risk of exacerbation. Engaging patients throughout the development process is essential to ensure usability of the intervention for the end-users. Using our Connected for Asthma (C4A) intervention as an exemplar, we explore how patient involvement can shape a digital intervention.

Development of a conceptual framework for defining trial efficiency.

Background: Globally, there is a growing focus on efficient trials, yet numerous interpretations have emerged, suggesting a significant heterogeneity in understanding "efficiency" within the trial context. Therefore in this study, we aimed to dissect the multifaceted nature of trial efficiency by establishing a comprehensive conceptual framework for its definition.

Objectives: To collate diverse perspectives regarding trial efficiency and to achieve consensus on a conceptual framework for defining trial efficiency.

Recommendations for asthma monitoring in children: A PeARL document endorsed by APAPARI, EAACI, INTERASMA, REG, and WAO.

Monitoring is a major component of asthma management in children. Regular monitoring allows for diagnosis confirmation, treatment optimization, and natural history review. Numerous factors that may affect disease activity and patient well-being need to be monitored: response and adherence to treatment, disease control, disease progression, comorbidities, quality of life, medication side-effects, allergen and irritant exposures, diet and more.

Efficacy of oral corticosteroids for acute preschool wheeze: a systematic review and individual participant data meta-analysis of randomised clinical trials.

Background: Oral corticosteroids are commonly used for acute preschool wheeze, although there is conflicting evidence of their benefit. We assessed the clinical efficacy of oral corticosteroids by means of a systematic review and individual participant data (IPD) meta-analysis.

Methods: In this systematic review with IPD meta-analysis, we systematically searched eight databases (PubMed, Ovid Embase, CINAHLplus, CENTRAL, ClinicalTrials.

Primary Care Asthma Attack Prediction Models for Adults: A Systematic Review of Reported Methodologies and Outcomes.

Prognostic models hold great potential for predicting asthma exacerbations, providing opportunities for early intervention, and are a popular area of current research. However, it is unclear how models should be compared and contrasted, given their differences in both design and performance, particularly with a view to potential implementation in routine practice. This systematic review aimed to identify novel predictive models of asthma attacks in adults and compare differences in construction related to populations, outcome definitions, prediction time horizons, algorithms, validation, and performance estimation.

Outdoor air pollution and near-fatal/fatal asthma attacks in children: A systematic review.

Background: Globally, observational studies have demonstrated an association between high levels of air pollution and asthma attacks in children. It remains unclear whether and to what extent exposure may be associated with increased near-fatal/fatal attacks.

Objective: To systematically review the evidence for an association between ambient outdoor air pollution and fatal and/or near-fatal asthma (NFA).

Long-term air pollution exposure and risk of SARS-CoV-2 infection: A UK-wide cohort study.

Background: The association between air quality and risk of SARS-CoV-2 infection is poorly understood. We investigated this association using serological individual-level data adjusting for a wide range of confounders, in a large population-based cohort (COVIDENCE UK).

Methods: We assessed the associations between long-term (2015-19) nitrogen dioxide (NO) and fine particulate matter with an aerodynamic diameter of ≤2.

Risk of winter hospitalisation and death from acute respiratory infections in Scotland: national retrospective cohort study.

Objectives: We undertook a national analysis to characterise and identify risk factors for acute respiratory infections (ARIs) resulting in hospitalisation during the winter period in Scotland.

Design: A population-based retrospective cohort analysis.

Setting: Scotland.