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Technologies Working Group ERS 2017

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Technologies Working Group ERS 2017

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Technologies Working Group ERS 2017

  1. 1. ERS 2017 Milan, 9th September 2017 Technology Working Group Meeting
  2. 2. Agenda • Working group progress update • Priorities for future research o Review potential studies – Are they still relevant, feasible, valid and a priority o Other research ideas o Setting priorities • Additional items
  3. 3. Attendees John Blakey (chair – dial in) K F Chung Nicholas Roche Ron Dandurand Danny McBryan Heather Hoch
  4. 4. Progress update • Published papers o Effective deployment of technology-supported management of chronic respiratory conditions: a call for stakeholder engagement, Pragmat Obs Res 2017 o Use of electronic medical records and biomarkers to manage risk and resource efficiencies, Eur Clin Respir J 2017
  5. 5. • REG_P41: Predicting the risk of future asthma exacerbations in a claims-based healthcare system o Protocol complete Active study update (1) Objective Use claims-based healthcare data to • Characterise the frequent exacerbator subgroup of asthma patients. • Identifying individual risk factors (demographic and clinical) and exploring clusters of risk factors associated with increased future exacerbation risk • Validate REG’s UK Asthma Risk Prediction model, using administrative health data to identify patients at increased risk of future exacerbations.
  6. 6. • Historical cohort study using population based clinical records from the BC Ministry of Health • 3 year study period Clinical and demographic characterisation of patients Univariate analysis to identify individual baseline factors associated with risk of recurrent exacerbations in the outcome period Multivariate analysis to identify composite groups of risk factors predictive of future risk Develop an individualised risk scoring tool Compare and contrast tool with UK clinical tools Methods Value Study concept Findings Interpretation Study Design Validation of the UK model in an administrative healthcare data system. Independent predictors (demographic and clinical) associated with future attacks
  7. 7. Suggested areas for research Adherence Replacing annual reviews Early detection of deterioration Education
  8. 8. Future interests with draft proposals • REG_P025: Identify and prioritise multi-stakeholder end-user needs for TBS in respiratory and allergic airway disease • REG_P026: Guidance to standardise the development of TBS with utility for respiratory and allergic airway diseases • REG_P028: Systematic review of behavioural change theory in the context of TBS for respiratory and allergic airways disease
  9. 9. Working title Optimizing the Delivery of Triple Therapy in the Real- World Management of Patients with Chronic Obstructive Pulmonary Disease. Objective To develop a series of end user specific checklists to guide developers in their creation of meaningful and relevant respiratory technologies. Rationale • Technology based solutions in respiratory medicine must be “needs-focussed” and address an end user’s need in order to ensure their engagement and persistence. • there is a need for consideration of specific subgroups as the needs of patients differ depending on their primary diagnosis and change depending on the current clinical scenario of the patient, their stage of disease and their age and attitude to technologies. Identify and prioritise multi-stakeholder end-user needs for TBS in respiratory and allergic airway disease (REG_P025) Proposed methodology Design: Parallel Delphi procedures to capture and prioritise different stakeholder specific needs Population: Non-selective real-life COPD population Exposures: Triple therapy compared to other treatment options Outcomes: Exacerbations, adherence
  10. 10. • Similar approach: Identify and prioritise multi-stakeholder end-user needs for TBS in respiratory and allergic airway disease (REG_P025)
  11. 11. Objective 1. To examine published literature AND/OR available solutions from a communication and behavioral perspective to identify the content and format of the intervention delivered 2. To investigate the relationships between these characteristics and intervention success (defined in terms of user satisfaction, behavior change and health outcomes) Proposed methodology Design: Systematic review of existing literature with coding of communication and behavioural content and format Inclusion criteria: peer reviewed articles describing m-health solutions, focusing on self-management and used in respiratory conditions Systematic review of behavioural change theory in the context of TBS for respiratory and allergic airways disease (REG_P028) Working title M-health solutions for self- management in respiratory health: what are their active ingredients and how are they delivered? Rationale • Long-term respiratory condition requires continuous self-management • Numerous m-health solutions have been developed to support self- management, however they are often developed with minimal input from communication or behavioral science and limited testing, with mixed success • Clinicians and health technology developers would benefit from clear guidelines for using these conceptual tools in developing m-health solutions • A first step in developing these recommendations is to assess the current state-of-the-art in m-health interventions in order to identify how behavior change support is delivered by available technology.
  12. 12. Future interests • Advertising/promoting the asthma risk tool on the REG website • Device optimisation for improved adherence and outcomes (Novartis study) o Phase 1 - Develop a standard setting piece by means of a Delphi exercise to identify and detail what all new types of technologies must do/gather in order to deliver relevant and necessary information. o Phase 2 - Study design that could be used to test all new technologies/combination of technologies. • Meta-analysis of existing data on effectiveness of SMART-inhalers o Link with Asthma UK • Varying the length between a patient’s asthma review based on risk profile o Using the work on asthma risk prediction, determine patient-specific review schedules, rather than an annual review
  13. 13. Other research ideas?
  14. 14. Setting priorities • Are these projects still: o Relevant? o Feasible? o Valid? o A priority? • How do we set priorities in technologies research? • How to we ensure these priorities are pursued? o Grant submissions? Commercial funding? How to bridge the gap from small start ups to large-scale studies • What are the two most important projects to push forwards?
  15. 15. Any other business?