GAAPP Publications

GAAPP Co-authored Publications

An international group of investigators developed the International Collaborative Asthma Network (ICAN) with the goal of sharing innovative research on disease mechanisms, developing new technologies and therapies, organising pilot studies and engaging early-stage career investigators from across the world. This report describes the purpose, development and outcomes of the first ICAN forum.

Read the publication: https://pubmed.ncbi.nlm.nih.gov/37260461/

We identified four evidence-based care bundle items for review prior to a patient’s discharge from hospital, including (1) smoking cessation and assessment of environmental exposures, (2) treatment optimisation, (3) pulmonary rehabilitation, and (4) continuity of care. 

Read the publication: https://link.springer.com/article/10.1007/s12325-023-02609-8

Poor EAD recognition by HCPs often contributes to delayed diagnoses, further delaying patient access to appropriate care and effective treatments and poor health outcomes. This charter aims to outline key patient rights and expectations concerning the management of their condition(s) and to set forth an ambitious action plan to improve health outcomes for patients with EADs.

Read the publication: https://pubmed.ncbi.nlm.nih.gov/35489014/

Asthma affects 339 million people worldwide, with an estimated 5–10% experiencing severe asthma. In emergency settings, oral corticosteroids (OCS) can be lifesaving, but acute and long-term treatment can produce clinically important adverse outcomes and increase the risk of mortality. Therefore, global guidelines recommend limiting the use of OCS. 

Read the publication: https://link.springer.com/article/10.1007/s12325-023-02479-0

Patient values and preferences can inform atopic dermatitis (AD) care. Systematic summaries of evidence addressing patient values and preferences have not previously been available. The objective is to inform the American Academy of Allergy, Asthma & Immunology (AAAAI)/American College of Allergy, Asthma and Immunology (ACAAI) Joint Task Force on Practice Parameters AD guideline development, patient and caregiver values and preferences in the management of AD were systematically synthesized.

Read the publication: https://jamanetwork.com/journals/jamadermatology/article-abstract/2800632 

Access to affordable inhaled medicines for chronic respiratory diseases (CRDs) is severely limited in low- and middle-income countries (LMICs), causing avoidable morbidity and mortality. There are opportunities to achieve improved access to affordable, quality-assured inhaled medicines in LMICs through coordinated, multi-stakeholder, collaborative efforts.

Read the publication: https://www.ingentaconnect.com/contentone/iuatld/ijtld/2022/00000026/00000011/art00006

The 2021 purchase of the respiratory pharmaceutical company Vectura by Phillip Morris International has been criticized by the public health and medical community, as a conflict of interest, with little input to date, from the patient community or the public.

Read the Publication: https://thorax.bmj.com/content/early/2022/07/14/thorax-2022-219142

These quality standard position statements emphasize the core elements of COPD care, including diagnosis,  adequate patient and caregiver education, access to medical and nonmedical treatments aligned with the latest evidence-based recommendations and appropriate management by a respiratory specialist when required, appropriate management of acute COPD exacerbations, and regular patient and caregiver follow-up for care plan reviews.

Read the Publication: https://link.springer.com/article/10.1007/s12325-022-02137-x

Asthma is one of the most prevalent chronic diseases managed by school nurses, and its management often includes the administration of bronchodilators delivered via a metered-dose inhaler (MDI). The use of an MDI requires coordination and mastery of steps that must be performed correctly and in the proper order. These steps are greatly enhanced, especially in the pediatric population, through the use of medical devices—spacers and valved holding chambers. The purpose of this article is to review the rationale and implications for the use of these devices in the school setting.

Read the Publication: https://journals.sagepub.com/doi/10.1177/1942602X16646593

Pharmacists are valuable member of the physician-led collaborative care team. A survey of pharmacists conducted by the Allergy & Asthma Network showed that pharmacists could provide valuable patient education on the proper technique and action of inhaled asthma medications within the framework of the National Asthma Education and Prevention Program (NAEPP).

Read the Publication: https://www.jacionline.org/article/S0091-6749(16)32456-3/fulltext

Shared decision-making (SDM) is becoming more commonly appreciated and used in medical practice as a way to empower patients who are facing treatment preference-sensitive conditions, such as allergic rhinitis, atopic dermatitis, food allergy, and persistent asthma. The purpose of this review is to educate the allergy health care provider about how SDM works and provide practical advice and allergist-specific SDM resources.

Read the Publication: https://www.annallergy.org/article/S1081-1206(18)30710-5/fulltext

Here we provide a Patient Charter for severe asthma, consisting of six core principles, to mobilize national governments, health care providers, payer policymakers, lung health industry partners, and patients/caregivers to address the unmet need and burden in severe asthma and ultimately work together to deliver meaningful improvements in care.

Read the Publication: https://link.springer.com/article/10.1007/s12325-018-0777-y

Chronic spontaneous urticaria is challenging to manage and substantially affects the quality of life. This US, non-interventional qualitative study examined patients’ clinical journeys and emotional burden from symptom onset through disease management. Chronic spontaneous urticaria patients participated in interviews and completed diaries focusing on disease and treatment history/perspectives, impact on personal/family life, and relationships with physicians/other healthcare providers. Physicians were interviewed about their views on disease management and patient care.

Read the Publication: https://www.medicaljournals.se/acta/content/abstract/10.2340/00015555-3282

Shared decision-making (SDM) is becoming more commonly appreciated and used in medical practice as a way to empower patients who are facing treatment preference-sensitive conditions, such as allergic rhinitis, atopic dermatitis, food allergy, and persistent asthma. The purpose of this review is to educate the allergy health care provider about how SDM works and provide practical advice and allergist-specific SDM resources.

Read the Publication: https://linkinghub.elsevier.com/retrieve/pii/S1081120618307105

Although severe asthma can be life-threatening, many patients are unaware they have this condition. Patient Understanding Leading to Assessment for a Severe Asthma Referral (PULSAR) is a novel, multidisciplinary working group aiming to develop and disseminate a global, patient-centered description of severe asthma to improve patient understanding of severe asthma and effect a change in patient behavior whereby patients are encouraged to visit their healthcare professional, when appropriate.

Read the Publication: https://link.springer.com/article/10.1007/s40271-019-00371-0

The NHLBI held an Asthma Research Strategic Planning workshop in 2014 to help accelerate the translation of new discoveries to the care of patients with severe asthma. The workshop called on investigators to build on recent advances in technology and asthma pathobiology to improve severe asthma management, using precision interventions to optimize patient outcomes and reduce the public health burden of asthma.

Read the Publication: https://www.atsjournals.org/doi/10.1164/rccm.201809-1817PP#_i1

Shared decision making (SDM) is the process through which patients and their medical provider mutually explore therapy goals, risk/benefit, and treatment options regarding medical care. Decision aids are tools that aid in the process of values clarification and help assess decisional needs and potential decisional conflicts. The objective of this study was to develop and assess the acceptability of a decision aid for commercial peanut allergy therapies.

Pediatric asthma remains a public health challenge with enormous impact worldwide. The aim of this study was to identify and prioritize unmet clinical needs in pediatric asthma, which could be used to guide future research and policy activities.

Read the publication: https://www.jaci-inpractice.org/article/S2213-2198(20)30147-1/fulltext

As global patient advocates, we have co-developed this patient charter to set a standard of care that people living with COPD should expect, raising awareness and understanding of the causes and consequences of COPD as well as the potential to improve patient care. Patients with COPD should be empowered to live the highest quality of life possible with the least number of flare-ups. We set out six principles in line with current COPD guideline recommendations, that should be implemented by governments, healthcare providers, policymakers, lung health industry partners and patients/caregivers to drive meaningful change in COPD care.

Read the publication: https://link.springer.com/article/10.1007/s12325-020-01577-7#Abs1 

Although only 10% of patients with asthma have severe disease, these patients use up to half of all health care resources used to treat asthma. For the patient, severe asthma is associated with substantial morbidity, increased risk of death, and poor quality of life. Effective treatments for severe asthma are available, yet access to these treatments varies for many patients around the globe, and they are not always used effectively when available.

Read the publication: https://link.springer.com/article/10.1007/s12325-020-01450-7

The purpose of this paper is to provide an overview of key aspects of specialised dermatology nursing practice in the management of patients with moderate to severe atopic dermatitis. The role of dermatology nurse specialists in supporting patients and promoting disease understanding, education and treatment adherence continues to evolve. As features of specialised nursing care can also inform other nursing staff in a wide range of care settings, an overview of key components is examined. Observations presented are from a pan-European perspective and represent the collected view of a group of dermatology nurse specialists, dermatologists and patient advocates following two round-table discussions.

Read the publication: https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-020-00494-y 

Severe asthma is a subtype of asthma that can be hard to control, resulting in an exceptional impact on an individual’s quality of life. The aim of this review article is to explore the misalignment of perceptions of severe asthma among different stakeholders to identify how to reduce burden and improve delivery of care.

Read the publication: https://www.worldallergyorganizationjournal.org/article/S1939-4551(20)30403-8/fulltext

Cannabis use in patients with allergy/asthma, a high-risk group for adverse effects to cannabis, is unknown. The objective of this study was to determine the patterns of use and attitudes toward cannabis in patients with allergy/asthma.

Read the publication: https://www.annallergy.org/article/S1081-1206(21)00022-3/fulltext 

The main goal of this study was to conduct a needs assessment to ascertain professionals’ and parents’ knowledge of and perceptions about education for self-management of asthma for children with physical and intellectual disabilities (IDs). Another goal was to understand needs for education of children with IDs about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; coronavirus) and other infectious diseases.

Read the publication: https://www.tandfonline.com/doi/abs/10.1080/02770903.2021.1878534?journalCode=ijas20 

There is a need to minimize oral corticosteroid (OCS) use in patients with asthma to prevent their costly and burdensome adverse effects. Current guidelines do not provide recommendations for OCS tapering in patients with asthma. The objective of this paper was to develop an expert consensus on OCS tapering among international experts.

Read the publication: https://www.atsjournals.org/doi/10.1164/rccm.202007-2721OC 

People with allergic rhinitis (AR) who are not controlled on conventional therapy can be treated using allergy immunotherapy (AIT) administered as tablets, injections or drops. In the US, the use of sublingual immunotherapy as tablets (SLIT-tablets) is limited in comparison to subcutaneous immunotherapy (SCIT). This study investigated patients’ preference for SLIT-tablets vs monthly or weekly SCIT from a US patient perspective.

Read the publication: https://www.dovepress.com/preference-for-immunotherapy-with-tablets-by-people-with-allergic-rhin-peer-reviewed-fulltext-article-PPA

Severe asthma is a subtype of asthma that can be hard to control, resulting in an exceptional impact on an individual’s quality of life. The aim of this review article is to explore the misalignment of perceptions of severe asthma among different stakeholders to identify how to reduce the burden and improve the delivery of care.

Read the publication: https://www.worldallergyorganizationjournal.org/article/S1939-4551(20)30403-8/fulltext 

This study evaluates the frequency of acute respiratory and febrile presentations during the first wave of COVID‐19 pandemic in childhood asthma. Data from the multinational PeARL cohort reveal improved health and asthma activity during the first wave of the COVID‐19 pandemic, probably attributed to decreased exposure to asthma triggers and increased treatment adherence. During that period, children with asthma experienced fewer URTIs, episodes of pyrexia, emergency visits, hospital admissions, asthma attacks, and hospitalizations due to asthma, in comparison to the preceding year.

Read the publication: https://www.atsjournals.org/doi/10.1164/rccm.202007-2721OC

Mismatch between asthma symptoms and spirometry: implications for managing asthma in children.

Spirometry was performed on 894 children (5-19) in Connecticut in whom clinical assessment had found intermittent asthma in 30% and mild, moderate and severe persistent asthma in 32%, 33% and 5% respectively. Worsening spirometric parameters were associated with more severe clinical disease. But spirometric assessment showed greater disease severity than clinical asessment in 36% and concordance between spirometric results and clinical symptoms was poor, 0.2 after adjustment for bias and prevalence. Asthma morbidity is known to be reduced by appropriate treatment and the authors suggest that spirometry results may be a better guide for therapy decisions than symptomatology.

Schifano ED et al. J Pediatr. 2014 Aug 28. pii: S0022-3476(14)00650-7. doi: 10.1016/j.jpeds.2014.07.026. [Epub ahead of print]

Read the publication: http://www.ncbi.nlm.nih.gov/pubmed/25175496

Grandmother’s smoking when pregnant with the mother and asthma in the grandchild: the Norwegian Mother and Child Cohort Study.

The Norwegian Mother and Child Cohort Study includes about 100,000 mothers and children. The grandmother’s smoking when pregnant with the mother was examined in relation to asthma outcomes in the grandchild. For 23.5% of children, mothers stated their own mothers had smoked when pregnant with them. Asthma was reported in 5.7% of 53,169 children with follow up data at age 36 months, and 5.1% of 25,394 children with data at age 7. There was prescription registry data on dispensed asthma drugs for 4.8% of 45,607 children with data available at age 7. There was positive association between grandmother’s smoking when pregnant and asthma in all 3 groups of grandchildren, independent of mother’s smoking status. Because of few information about the socioeconomic status and asthma status of the grandmothers, unmeasured confounding factors may be present.

Magnus MC et al. Thorax. 2015 Jan 8. pii: thoraxjnl-2014-206438.

Read the publication: http://www.ncbi.nlm.nih.gov/pubmed/25572596

The reliability and utility of spirometry performed on people with asthma in community pharmacies.

Australian researchers assessed data from 2593 spirometry sessions performed by community pharmacists for 892 asthmatics within two large asthma intervention trials. There were three acceptable tests in 68.5% of sessions and at least one acceptable test in 96%. Acceptability was defined as meeting ATS/ERS guideline criteria. Around 40% had results indicating obstruction. As a result of the service, FEV1, and FEV1/FVC increased significantly in study participants, as did asthma control. Those who were referred to GPs had significantly worse spirometry results. The authors concluded that spirometry by pharmacists could be reliable and useful for a community asthma review.

Burton DL et al. J Asthma. 2015 Jan 7:1-27

Read the publication: http://www.ncbi.nlm.nih.gov/pubmed/25563059

Efficacy and effectiveness of seasonal and pandemic A (H1N1) 2009 influenza vaccines in low and middle-income countries: a systematic review and meta-analysis.

Influenza vaccination is recommended in low and middle-income countries (LICs and MICs) for at-risk populations. A search in 3 medical databases for English, French, Spanish or Portuguese papers on the effectiveness and efficacy of flu vaccine in these countries from 1960- 2011 yielded 41 studies. In MICs, flu vaccine showed pooled efficacy 72% and 81% for 1 and 2 year follow-up in children and 43% and 58% pooled efficacy for live attenuated and inactivated vaccines respectively in the elderly. Inactivated vaccine reduced cardiovascular outcomes in at-risk patients. Effectiveness was similar to that in high-income countries. Data for LICs and other at-risk groups in MICs were limited.

Breteler JK et al. Vaccine. 2013 Oct 25;31(45):5168-77. doi: 10.1016/j.vaccine.2013.08.056. Epub 2013 Sep 5.

Read the publication: http://www.ncbi.nlm.nih.gov/pubmed/24012574

International Guidelines

Other recommended publications

  1. Short-acting β2-agonist prescriptions are associated with poor clinical outcomes of asthma: the multi-country, cross-sectional SABINA III study
  2. Assets and needs of respiratory patient organizations: differences between developed and developing countries
  3. Asthma Yardstick: Practical recommendations for a sustained step-up in asthma therapy for poorly controlled asthma
  4. Unveiling the true costs and societal impacts of moderate-to-severe atopic dermatitis in Europe