International Primary Care Respiratory Group working locally, collaborating globally Delivering value for respiratory research, Prof Mike Thomas, Uppsala May 2013

• IPCRG’s charitable mission is “to improve public

health by carrying out, funding and organising

research into the care, treatment and prevention of

respiratory illnesses, diseases and problems in a

community setting, and to make available the results

of such research for the benefit of the public and

healthcare professionals.”

Research is the reason the IPCRG exists

• What’s the problem we need to sort?

• What have we done?

• What’s left to do?

• How will we tackle it?

What’s the problem we need to sort?

Global Action Plan against NCDs

• 25% reduction in mortality from NCDs by 2025

• 30% reduction in tobacco use

• Learning shared between low, middle and high

income countries

There is a need for research:

• Undertaken within primary care

• Recruiting populations representative of primary care

patients

• Evaluating interventions realistically delivered within

primary care

• Drawing conclusions meaningful to professionals

working within primary care

Having the set the agenda, take action

This thorough assessment of research needs in primary care is of enormous significance and is to be highly commended. What is now needed is to turn these priorities into research questions and grant proposals and, of course, for funding to follow. The only way this will occur is for the respiratory research community to join forces with this in mind and to move the exciting challenge provided by this game-changing exercise into high quality research proposals, capacity building, new evidence and subsequent benefit to patients. We now all need to take individual and joint responsibility for this grand challenge

Holgate ST. The importance of primary care research in the management of respiratory disease. /10.4104/pcrj.2012.00015

What have we done?

• Built capacity

o E-Faculty Vietnam, Romania, Chile

o Offered opportunities: 9 meetings in 11 years

International Primary Care Respiratory Group

• Provided primary care voice in major EU projects: UBIOPRED

• UNLOCK COPD and asthma

• FRESH AIR Vietnam, Uganda

What’s left to do?

• Promote questions in IPCRG research

needs statement

• Deliver IPCRG research projects

• Raise profile of chronic respiratory disease

as NCD

• Demonstrate practical primary care

solutions

No WHO respiratory best buys (population level)Best buys

• Protecting people from tobacco smoke and banning smoking in public places;

• Warning about the dangers of tobacco use;

• Enforcing bans on tobacco advertising, promotion and sponsorship;

• Raising taxes on tobacco;

• Restricting access to retailed alcohol;

• Enforcing bans on alcohol advertising;

• Raising taxes on alcohol;

• Reduce salt intake and salt content of food;

• Replacing trans-fat in food with polyunsaturated fat;

• Promoting public awareness about diet and physical activity, including through mass media

Good buys

• Nicotine dependence treatment;

• Promoting adequate breastfeeding and complementary feeding;

• Enforcing drink-driving laws;

• Restrictions on marketing of foods and beverages high in salt, fats and sugar, especially to

children;

• Food taxes and subsidies to promote healthy diets.

No WHO respiratory best buys (individual level)Best buys

• Counselling and multidrug therapy, including glycaemic control for diabetes for people ≥ 30 years old

with a 10-year risk of fatal or nonfatal cardiovascular events

≥ 30%;

• Aspirin therapy for acute myocardial infarction;

• Screening for cervical cancer, once, at age 40, followed by removal of any discovered cancerous lesion;

Good buys

• Early case finding for breast cancer through biennial mammographic screening (50–70 years) and

treatment of all stages;

• Early detection of colorectal and oral cancer;

• Treatment of persistent asthma with inhaled corticosteroids and beta-2 agonists

How?

• IPCRG Research Fellow

• Multi-national projects

• New generations of researchers

• Making evidence available widely and

freely (PCRJ)

IPCRG Associate

Through our global network

Using real life primary care population data

• UNLOCK - Uncovering and Noting Long-term Outcomes

in COPD and asthma to enhance Knowledge

• 22,000 COPD records

• 115,000 asthma records

• Rosetta support system for coding for meaningful use

and comparison

• First studies (Jones et al, Chavannes et al) submitted

Finally

• 83 abstracts presented at Uppsala

• New teams eg Canada, Chile, Bangladesh, India,

Russia

• New industry partners supporting conference: Meda

joining Mundipharma, Almirall and Boehringer Ingelheim

• Saturday – research design day

• Enjoy!