Research & Development
RESEARCH AND DEVELOPMENT
Asthma Research in Australia
We are invested in respiratory research and the development of a new clinical tool for Australian primary care physicians. Our tools will improve asthma patient outcomes and generate more effective asthma management strategies and protocols for healthcare professionals.
Investigations and analysis of current data and world’s best practice programmes (e.g. quality improvement programs in UK, USA and worldwide), as applied to Australia
Information gathering and GP liaison activities. Design and development of information gathering systems
Development of algorithms and database programming to achieve appropriate information gathering for the analysis phase
Testing of conclusions based on analysis of the evidence gathered. Concept development of preliminary theoretical treatment protocols to reduce the incidence and severity of asthma in Australia
Our research aims to reduce the incidence and severity of asthma in Australia through the faster identification of patients who do not respond to standard asthma therapies, those who may benefit from enhanced biologic treatment or specialist referral and the tailoring of asthma management plans to account for complex factors such as environmental triggers.
Our aim is to highlight patients who are self-managing their asthma with over the counter Inhaler device when a more optimal course of action would be an asthma review or specialist referral.
Our focuses are on improving patient outcomes by implementing more effective asthma management strategies and earlier intervention to control the disease before it worsens.
Our research will be used to improve asthma patient outcomes in Australia.
Our research is governed by the highest ethical standards and is subject to a rigorous review process. Past research references are included below.
Improper use of inhaler device is a common and well-established reason for failure to achieve asthma control. Previously, however, there was no study investigating the impact of each inhalation error towards asthma outcome. The CRITical Inhaler mistaKes and Asthma (CRITIKAL) project was thus initiated to answer the pertinent question of which inhaler technique errors represent the “critical” errors which were common and negatively impacts asthma outcomes.
This is a systematic, investigative and experimental project conceived using our expertise in real-life respiratory research in-collaboration with iHARP (initiative Helping Asthma in Real-life Patients). The iHARP is an asthma review service supported by the Respiratory Effectiveness Group, which prospectively collects data from primary care practices encompassing Australia and 7 European countries. The iHARP conducts questionnaire-led and practitioner-led assessments to collect extensive information about patients’ demographic characteristics, asthma symptoms, lung function, inhaler technique, and occurrence of exacerbations.
A cross-sectional, real-life study was conducted using data collected for iHARP asthma review. More than 5,000 patients with asthma who were using either dry powder inhalers (DPI) or metered-dose inhalers (MDI) for delivery of fixed-dose inhaled corticosteroid and long-acting beta-agonist were recruited. A checklist of predefined inhaler technique errors was also created with inputs from multiple respiratory experts involved in this project. Patients’ inhaler technique was assessed in reference to this checklist.
Insufficient inspiratory effort was identified as one of the critical errors among DPI users. This error was common (32-38% of users) and was observed to be associated with uncontrolled symptoms and increased exacerbation rates. Within MDI users, actuation of medication before inhalation was identified as one of the critical errors, observed in 24.9% patients and associated with uncontrolled asthma. Several other errors were also identified as critical errors.
This project is the first in the world to identify the “critical” inhaler technique errors which were frequent and associated with poor asthma outcomes. Findings from this study were published in the Journal of Allergy and Clinical Immunology: In Practice (Impact factor: 7.0). Results of this project will enable healthcare practitioners to formulate effective training strategies to reduce these critical errors.