RESPIRATORY DISEASES

Airways Disease in Older Australians
(Dr Jodie Simpson / Hayley Scott)

This NHMRC funded project involves the collection of data samples which will be assessed for markers of airway and systemic inflammation. Data collection is complete. Data analysis and manuscript submission is underway. Other work in this area will investigate toll like receptor activation of airway and blood cells. Cell isolation has been optimised for peripheral blood assessment and optimisation for sputum cell isolation should be complete in February 2009. In addition, we are investigating treatment of airway disease in older patients by conducting a randomised controlled trial of macrolide therapy.

Obstructive Airways Disease
(Vanessa McDonald)

Characterisation

A large characterisation study to describe the frequency and prevalence of person centred and clinical problems among people over the age of 55 years with Obstructive Airway Disease’s (OAD) found that participants had multiple clinical problems and that health related quality of life was increasingly impaired with an increasing number of problems. Of the 100 participant, 22 also participated in a qualitative interview. These interviews were conducted to gain insight in the experience of older people with OAD’s and to inform the design of a treatment study which will trial a new model of care. The interviews provided us with valuable insight into the symptoms, coping ability and barriers relating to living with and managing their disease.

Treatment

Data derived from the OAD characterisation study were fundamental in the design of a person centred, multi component, and multidisciplinary model of care. This model has been termed “Integrated Problem Based Management” (IPBM). This study has been granted ethics approval to pilot test this model of management in a clinical controlled trial and will commence in January 2009. We hypothesise that in patients with Obstructive Airways Disease who are over the age of 55 years, IPBM will improve health related quality of life, measured by the St George Respiratory Questionnaire (SGRQ), by 20% compared to usual care. Current management approaches fail to acknowledge the complex co morbidities and clinical problems faced by patients with OAD. This research will explore treatment strategies for older people and generate new knowledge that will impact on clinical practice guidelines and treatment plans. An Expert Advisory Group of key opinion leaders was convened to provide feedback in relation to the feasibility of the model and to form effective collaborations which we hope will lead to a NHMRC funding application for a multi centre trial of this model.