oalib

Publish in OALib Journal

ISSN: 2333-9721

APC: Only $99

Submit

Any time

2019 ( 138 )

2018 ( 320 )

2017 ( 295 )

2016 ( 454 )

Custom range...

Search Results: 1 - 10 of 297415 matches for " Haughney J "
All listed articles are free for downloading (OA Articles)
Page 1 /297415
Display every page Item
Physicians’ attitudes towards combination therapy with inhaled corticosteroids and long-acting 2-agonists: an observational study in UK specialist care
Thomas M, Haughney J, Price D
Pragmatic and Observational Research , 2011, DOI: http://dx.doi.org/10.2147/POR.S24674
Abstract: icians’ attitudes towards combination therapy with inhaled corticosteroids and long-acting 2-agonists: an observational study in UK specialist care Rapid Communication (1768) Total Article Views Authors: Thomas M, Haughney J, Price D Video presented by Dr Mike Thomas Views: 90 Published Date December 2011 Volume 2011:2 Pages 25 - 31 DOI: http://dx.doi.org/10.2147/POR.S24674 Mike Thomas, John Haughney, David Price Centre of Academic Primary Care, School of Medicine and Dentistry, University of Aberdeen, Foresterhill Health Centre, Aberdeen, UK Purpose: Recent real-world studies have demonstrated that asthma control remains suboptimal in many patients. The aim of this study was to evaluate physicians’ perceptions of the effectiveness of combination therapy with an inhaled corticosteroid (ICS) and a long-acting β2-agonist (LABA) in routine clinical practice. Methods: In November 2009, UK respiratory specialists were invited by medeConnect Healthcare Insight to complete a survey on the effectiveness of different single- or dual-inhaler combinations of an ICS and a LABA in the context of asthma management. Respondents were permitted to specify combinations of available ICSs and LABAs, based on their knowledge and experience of the individual components. Questions elicited both unprompted free-text responses and prompted responses selected from a list of options. Results: A total of 98 physicians completed the survey, of whom 82 (84%) gave permission to publish their data. The majority of respondents (63%) were consultants and 57% reported a caseload of more than 40 patients with asthma or chronic obstructive pulmonary disease per month. Fluticasone and formoterol were considered to be the most effective combination for the treatment of asthma (37% unprompted, 41% prompted), followed by budesonide and formoterol (22% unprompted, 24% prompted). The most common reasons for choosing specific combinations were: rapid onset of action (60%), high potency of the ICS (39%), efficacy (15%), experience of prescribing (13%), clinical evidence (12%), and long-lasting effect (10%). Key properties of the preferred fluticasone and formoterol combination were rapid onset of action and high potency of the ICS (79% for both). Conclusion: The results of this survey suggest that the ICS and LABA combination considered most effective by UK physicians in the management of asthma is fluticasone and formoterol, which is not currently available as a single-inhaler combination. The development of new single-inhaler combinations of ICSs and LABAs may improve real-world asthma management.
Physicians’ attitudes towards combination therapy with inhaled corticosteroids and long-acting ß2-agonists: an observational study in UK specialist care
Thomas M,Haughney J,Price D
Pragmatic and Observational Research , 2011,
Abstract: Mike Thomas, John Haughney, David PriceCentre of Academic Primary Care, School of Medicine and Dentistry, University of Aberdeen, Foresterhill Health Centre, Aberdeen, UKPurpose: Recent real-world studies have demonstrated that asthma control remains suboptimal in many patients. The aim of this study was to evaluate physicians’ perceptions of the effectiveness of combination therapy with an inhaled corticosteroid (ICS) and a long-acting β2-agonist (LABA) in routine clinical practice.Methods: In November 2009, UK respiratory specialists were invited by medeConnect Healthcare Insight to complete a survey on the effectiveness of different single- or dual-inhaler combinations of an ICS and a LABA in the context of asthma management. Respondents were permitted to specify combinations of available ICSs and LABAs, based on their knowledge and experience of the individual components. Questions elicited both unprompted free-text responses and prompted responses selected from a list of options.Results: A total of 98 physicians completed the survey, of whom 82 (84%) gave permission to publish their data. The majority of respondents (63%) were consultants and 57% reported a caseload of more than 40 patients with asthma or chronic obstructive pulmonary disease per month. Fluticasone and formoterol were considered to be the most effective combination for the treatment of asthma (37% unprompted, 41% prompted), followed by budesonide and formoterol (22% unprompted, 24% prompted). The most common reasons for choosing specific combinations were: rapid onset of action (60%), high potency of the ICS (39%), efficacy (15%), experience of prescribing (13%), clinical evidence (12%), and long-lasting effect (10%). Key properties of the preferred fluticasone and formoterol combination were rapid onset of action and high potency of the ICS (79% for both).Conclusion: The results of this survey suggest that the ICS and LABA combination considered most effective by UK physicians in the management of asthma is fluticasone and formoterol, which is not currently available as a single-inhaler combination. The development of new single-inhaler combinations of ICSs and LABAs may improve real-world asthma management.Keywords: asthma, LABA, ICS, combination, effectiveness, real-world
Effectiveness of inhaler types for real-world asthma management: retrospective observational study using the GPRD
Price D,Haughney J,Sims E,Ali M
Journal of Asthma and Allergy , 2011,
Abstract: David Price1,2 John Haughney1, Erika Sims2, Muzammil Ali2, Julie von Ziegenweidt2, Elizabeth V Hillyer2, Amanda J Lee3, Alison Chisholm2, Neil Barnes41Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK; 2Research in Real Life Ltd, Cawston, Norwich, UK; 3Section of Population Health, University of Aberdeen, UK; 4Department of Respiratory Medicine, London Chest Hospital, Barts and The London NHS Trust, London, UKPurpose: Results of randomized controlled trials may not predict effectiveness of inhaled corticosteroids (ICS) in real-world clinical practice, where inhaler technique and device characteristics can influence effectiveness. We compared asthma outcomes for ICS delivered via three different inhaler devices: pressurized metered-dose inhaler (pMDI), breath-actuated MDI (BAI), and dry powder inhaler (DPI).Patients and methods: This retrospective database study evaluated 1-year outcomes for primary care patients with asthma aged 5–60 years prescribed their first ICS (initiation population) by pMDI (n = 39,746), BAI (n = 9809), or DPI (n = 6792), or their first ICS dose increase (step-up population) by pMDI (n = 6245), BAI (n = 1388), or DPI (n = 1536). Co-primary outcome measures were composite proxy measures of asthma control (no hospital attendance for asthma, oral corticosteroids, or antibiotics for lower respiratory infection) and severe exacerbations (unscheduled hospital admission, emergency room attendance, or oral corticosteroids). Outcomes were adjusted for potential confounding factors identified during a baseline year.Results: In the initiation population, adjusted odds ratios (95% confidence intervals [CI]) for asthma control, as compared with pMDIs, were significantly better for BAIs (1.08 [1.02–1.14]) and DPIs (1.13 [1.06–1.21]), while adjusted exacerbation rate ratios (95% CI) were 1.00 (0.93–1.08) and 0.88 (0.81–0.95), respectively. In the step-up population, adjusted odds of asthma control were 1.21 (1.05–1.39) for BAIs and 1.13 (0.99–1.29) for DPIs; adjusted exacerbation rate ratios were 0.83 (0.71–0.98) for BAIs and 0.85 (0.74–0.98) for DPIs, compared with pMDIs.Conclusion: Inhaler device selection may have a bearing on clinical outcomes. Differences in real-world effectiveness among these devices require closer evaluation in well-designed prospective trials.Keywords: asthma control, dry powder inhaler, breath-actuated inhaler, metered-dose inhaler, primary care
Effectiveness of inhaler types for real-world asthma management: retrospective observational study using the GPRD
Price D, Haughney J, Sims E, Ali M, von Ziegenweidt J, Hillyer EV, Lee AJ, Chisholm A, Barnes N
Journal of Asthma and Allergy , 2011, DOI: http://dx.doi.org/10.2147/JAA.S17709
Abstract: tiveness of inhaler types for real-world asthma management: retrospective observational study using the GPRD Original Research (5724) Total Article Views Authors: Price D, Haughney J, Sims E, Ali M, von Ziegenweidt J, Hillyer EV, Lee AJ, Chisholm A, Barnes N Published Date April 2011 Volume 2011:4 Pages 37 - 47 DOI: http://dx.doi.org/10.2147/JAA.S17709 David Price1,2 John Haughney1, Erika Sims2, Muzammil Ali2, Julie von Ziegenweidt2, Elizabeth V Hillyer2, Amanda J Lee3, Alison Chisholm2, Neil Barnes4 1Centre of Academic Primary Care, University of Aberdeen, Aberdeen, UK; 2Research in Real Life Ltd, Cawston, Norwich, UK; 3Section of Population Health, University of Aberdeen, UK; 4Department of Respiratory Medicine, London Chest Hospital, Barts and The London NHS Trust, London, UK Purpose: Results of randomized controlled trials may not predict effectiveness of inhaled corticosteroids (ICS) in real-world clinical practice, where inhaler technique and device characteristics can influence effectiveness. We compared asthma outcomes for ICS delivered via three different inhaler devices: pressurized metered-dose inhaler (pMDI), breath-actuated MDI (BAI), and dry powder inhaler (DPI). Patients and methods: This retrospective database study evaluated 1-year outcomes for primary care patients with asthma aged 5–60 years prescribed their first ICS (initiation population) by pMDI (n = 39,746), BAI (n = 9809), or DPI (n = 6792), or their first ICS dose increase (step-up population) by pMDI (n = 6245), BAI (n = 1388), or DPI (n = 1536). Co-primary outcome measures were composite proxy measures of asthma control (no hospital attendance for asthma, oral corticosteroids, or antibiotics for lower respiratory infection) and severe exacerbations (unscheduled hospital admission, emergency room attendance, or oral corticosteroids). Outcomes were adjusted for potential confounding factors identified during a baseline year. Results: In the initiation population, adjusted odds ratios (95% confidence intervals [CI]) for asthma control, as compared with pMDIs, were significantly better for BAIs (1.08 [1.02–1.14]) and DPIs (1.13 [1.06–1.21]), while adjusted exacerbation rate ratios (95% CI) were 1.00 (0.93–1.08) and 0.88 (0.81–0.95), respectively. In the step-up population, adjusted odds of asthma control were 1.21 (1.05–1.39) for BAIs and 1.13 (0.99–1.29) for DPIs; adjusted exacerbation rate ratios were 0.83 (0.71–0.98) for BAIs and 0.85 (0.74–0.98) for DPIs, compared with pMDIs. Conclusion: Inhaler device selection may have a bearing on clinical outcomes. Differences in real-world effectiveness among these devices require closer evaluation in well-designed prospective trials.
Can asthma control be improved by understanding the patient's perspective?
Rob Horne, David Price, Jen Cleland, Rui Costa, Donna Covey, Kevin Gruffydd-Jones, John Haughney, Svein Henrichsen, Alan Kaplan, Arnulf Langhammer, Anders ?strem, Mike Thomas, Thys van der Molen, J Christian Virchow, Sian Williams
BMC Pulmonary Medicine , 2007, DOI: 10.1186/1471-2466-7-8
Abstract: Causes of poor controlClinical factors such as exposure to triggers and concomitant rhinitis are important but so are patient behavioural factors. Behaviours such as smoking and nonadherence may reduce the efficacy of treatment and patients' perceptions influence these behaviours. Perceptual barriers to adherence include doubting the need for treatment when symptoms are absent and concerns about potential adverse effects. Under-treatment may also be related to patients' underestimation of the significance of symptoms, and lack of awareness of achievable control.ImplicationsThree key implications for healthcare professionals emerged from the debate. First, the need for simple tools to assess asthma control. Two approaches considered were the monitoring of biometric markers of control and questionnaires to record patient-reported outcomes. Second, to understand the reasons for poor control for individual patients, identifying both clinical (e.g. rhinitis) and behavioural factors (e.g. smoking and nonadherence to treatment). Third was the need to incorporate, within asthma review, an assessment of patient perspectives including their goals and aspirations and to elicit their beliefs and concerns about asthma and its treatment. This can be used as a basis for agreement between the healthcare professional and patient on a predefined target regarding asthma control and a treatment plan to achieve this.Optimum review of asthma is essential to improve control. A key priority is the development of simple and effective tools for identifying poor control for individual patients coupled with a tailored approach to treatment to enable patients to set and achieve realistic goals for asthma control.Asthma is a chronic inflammatory disease of the airways, resulting in widespread but variable airflow obstruction in response to a variety of stimuli[1]. Airflow obstruction is usually reversible, either spontaneously or with treatment, though remodelling may lead to irreversible struct
Cost-effectiveness analysis of corticosteroid inhaler devices in primary care asthma management: A real world observational study
Linda Kemp, John Haughney, Neil Barnes, et al
ClinicoEconomics and Outcomes Research , 2010, DOI: http://dx.doi.org/10.2147/CEOR.S10835
Abstract: st-effectiveness analysis of corticosteroid inhaler devices in primary care asthma management: A real world observational study Original Research (3662) Total Article Views Authors: Linda Kemp, John Haughney, Neil Barnes, et al Published Date July 2010 Volume 2010:2 Pages 75 - 85 DOI: http://dx.doi.org/10.2147/CEOR.S10835 Linda Kemp1, John Haughney2, Neil Barnes3, Erika Sims1, Julie von Ziegenweidt1, Elizabeth V Hillyer1, Amanda J Lee4, Alison Chisholm1, David Price1,2 1Research in Real Life Ltd, Old Winery Business Park, Cawston, Norwich, UK; 2Centre of Academic Primary Care, University of Aberdeen, Foresterhill Health Centre, Westburn Road, Aberdeen, UK; 3Department of Respiratory Medicine, London Chest Hospital, Bonner Road, London, UK; 4Medical Statistics Team, Section of Population Health, University of Aberdeen, Foresterhill, Aberdeen, UK Purpose: To evaluate and compare real world cost-effectiveness of inhaled corticosteroids (ICS) administered by metered dose inhaler (MDI), breath-actuated MDI (BAI), or dry powder inhaler (DPI) in asthma. Patients and methods: This retrospective database study analyzed the direct health care costs and proportion of patients (aged 5–60 years) achieving asthma control over 1 year in two population groups: those starting ICS (initiation population) and those receiving a first increase in ICS dose (step-up population). Asthma control was defined as no unplanned asthma visits, oral corticosteroids, or antibiotics for lower respiratory infection; outcomes were adjusted for confounding variables. Cost-effectiveness of BAI and DPI were compared with MDI. Results: For the initiation population (n = 56,347), average annual health care costs per person (adjusted results), as compared with MDIs, were £9 higher (95% CI: -1.65 to 19.71) for BAIs and £32 higher (95% CI: 19.51 to 43.66) for DPIs. The probability of BAIs being the dominant strategy (more effective and less costly than MDIs) was 5% and of BAIs being more effective and more costly than MDIs was 94%. DPIs were consistently more effective and more costly than MDIs, with an incremental cost-effectiveness ratio of £1711 (95% CI: 760 to 3,576) per additional controlled patient per year. For the step-up population (n = 9169), mean total health care costs per person, (adjusted) as compared with MDIs, were £1 higher (95% CI: -27.28 to 31.55) for BAIs and £73 higher (95% CI: 44.48 to 103.29) for DPIs. The probability of BAIs being dominant was 48% and of BAIs being more effective but more costly than MDIs was 52%; the probability of DPIs being more effective but more costly than MDIs was 96%. Conclusion: The real world effectiveness of ICS inhalers may vary, and inhaler device selection for patients with asthma should take into consideration not only initial device cost but also the subsequent health care resource costs.
Cost-effectiveness analysis of corticosteroid inhaler devices in primary care asthma management: A real world observational study
Linda Kemp,John Haughney,Neil Barnes,et al
ClinicoEconomics and Outcomes Research , 2010,
Abstract: Linda Kemp1, John Haughney2, Neil Barnes3, Erika Sims1, Julie von Ziegenweidt1, Elizabeth V Hillyer1, Amanda J Lee4, Alison Chisholm1, David Price1,21Research in Real Life Ltd, Old Winery Business Park, Cawston, Norwich, UK; 2Centre of Academic Primary Care, University of Aberdeen, Foresterhill Health Centre, Westburn Road, Aberdeen, UK; 3Department of Respiratory Medicine, London Chest Hospital, Bonner Road, London, UK; 4Medical Statistics Team, Section of Population Health, University of Aberdeen, Foresterhill, Aberdeen, UKPurpose: To evaluate and compare real world cost-effectiveness of inhaled corticosteroids (ICS) administered by metered dose inhaler (MDI), breath-actuated MDI (BAI), or dry powder inhaler (DPI) in asthma.Patients and methods: This retrospective database study analyzed the direct health care costs and proportion of patients (aged 5–60 years) achieving asthma control over 1 year in two population groups: those starting ICS (initiation population) and those receiving a first increase in ICS dose (step-up population). Asthma control was defined as no unplanned asthma visits, oral corticosteroids, or antibiotics for lower respiratory infection; outcomes were adjusted for confounding variables. Cost-effectiveness of BAI and DPI were compared with MDI.Results: For the initiation population (n = 56,347), average annual health care costs per person (adjusted results), as compared with MDIs, were £9 higher (95% CI: -1.65 to 19.71) for BAIs and £32 higher (95% CI: 19.51 to 43.66) for DPIs. The probability of BAIs being the dominant strategy (more effective and less costly than MDIs) was 5% and of BAIs being more effective and more costly than MDIs was 94%. DPIs were consistently more effective and more costly than MDIs, with an incremental cost-effectiveness ratio of £1711 (95% CI: 760 to 3,576) per additional controlled patient per year. For the step-up population (n = 9169), mean total health care costs per person, (adjusted) as compared with MDIs, were £1 higher (95% CI: -27.28 to 31.55) for BAIs and £73 higher (95% CI: 44.48 to 103.29) for DPIs. The probability of BAIs being dominant was 48% and of BAIs being more effective but more costly than MDIs was 52%; the probability of DPIs being more effective but more costly than MDIs was 96%.Conclusion: The real world effectiveness of ICS inhalers may vary, and inhaler device selection for patients with asthma should take into consideration not only initial device cost but also the subsequent health care resource costs.Keywords: asthma control, breath-actuated inhaler, dry powder inhaler, meter
Features of asthma management: quantifying the patient perspective
John Haughney, Monica Fletcher, Stephanie Wolfe, Julie Ratcliffe, Roger Brice, Martyn R Partridge
BMC Pulmonary Medicine , 2007, DOI: 10.1186/1471-2466-7-16
Abstract: We used the technique of discrete choice experiment (DCE). Patients over 18 years of age with asthma, prescribed and taking medicine at step 3 of the UK guidelines were recruited from 15 general (family) practices in three areas of the UK. 147 evaluable questionnaires were returned from a total of 348 sent out. The outcome measures were the relative importance to patients of features of asthma management and the impact of changes in asthma management, as measured by utility shift between the features tested.The largest shift in mean utility values was recorded in "number of inhalers" and "use of inhaled steroid". Use of a personal asthma action plan was ranked next highest.This study suggests that adults with moderate or severe asthma would trade some improvements in symptom relief in favour of, for example, simpler treatment regimens that use as few inhalers as possible and a lower dose of inhaled steroid.Patient "self management" or "self care," a concept that enables patients to take a guided but ultimately personal involvement in the management of their condition, is an increasingly debated element of healthcare provision. It is particularly relevant as the prevalence of long term conditions increases and growing numbers of people desire a more active role in their own care with a less paternalistic approach from healthcare professionals [1]. Effective self care has the potential to improve clinical outcomes and reduce use of healthcare resources [1,2].Asthma is an ideal condition in which to strive for improved patient outcomes by optimising self management because it typically fluctuates over time, with symptoms and exacerbations that can potentially be minimised with self monitoring and appropriate adjustment of treatment [3,4]. Self management of asthma is currently suboptimal in many patients, with around 50% self managing in ways that differ from recommended guidance [5-7].A key step in improving the self management of asthma is to understand what patients
Polyanhydride Nanoparticle Delivery Platform Dramatically Enhances Killing of Filarial Worms
Andrea M. Binnebose?,Shannon L. Haughney,Richard Martin?,Paula M. Imerman?,Balaji Narasimhan?,Bryan H. Bellaire
PLOS Neglected Tropical Diseases , 2015, DOI: 10.1371/journal.pntd.0004173
Abstract: Filarial diseases represent a significant social and economic burden to over 120 million people worldwide and are caused by endoparasites that require the presence of symbiotic bacteria of the genus Wolbachia for fertility and viability of the host parasite. Targeting Wolbachia for elimination is a therapeutic approach that shows promise in the treatment of onchocerciasis and lymphatic filariasis. Here we demonstrate the use of a biodegradable polyanhydride nanoparticle-based platform for the co-delivery of the antibiotic doxycycline with the antiparasitic drug, ivermectin, to reduce microfilarial burden and rapidly kill adult worms. When doxycycline and ivermectin were co-delivered within polyanhydride nanoparticles, effective killing of adult female Brugia malayi filarial worms was achieved with approximately 4,000-fold reduction in the amount of drug used. Additionally the time to death of the macrofilaria was also significantly reduced (five-fold) when the anti-filarial drug cocktail was delivered within polyanhydride nanoparticles. We hypothesize that the mechanism behind this dramatically enhanced killing of the macrofilaria is the ability of the polyanhydride nanoparticles to behave as a Trojan horse and penetrate the cuticle, bypassing excretory pumps of B. malayi, and effectively deliver drug directly to both the worm and Wolbachia at high enough microenvironmental concentrations to cause death. These provocative findings may have significant consequences for the reduction in the amount of drug and the length of treatment required for filarial infections in terms of patient compliance and reduced cost of treatment.
New components of the mercury’s perihelion precession  [PDF]
J. J. Smulsky
Natural Science (NS) , 2011, DOI: 10.4236/ns.2011.34034
Abstract: The velocity of perihelion rotation of Mercury's orbit relatively motionless space is computed. It is prove that it coincides with that calculated by the Newtonian interaction of the planets and of the compound model of the Sun’s rotation.
Page 1 /297415
Display every page Item


Home
Copyright © 2008-2017 Open Access Library. All rights reserved.