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Article: Unmet needs in asthma.

Gruffydd-Jones, Kevin

Therapeutics and clinical risk management

2019 Volume 15, Page(s) 409–421

Abstract: Despite advances in the diagnosis and management of asthma, uncontrolled disease is still associated with a substantial mortality and morbidity burden. Patients often overestimate their level of asthma control while also reporting that asthma symptoms ... ...

Abstract	Despite advances in the diagnosis and management of asthma, uncontrolled disease is still associated with a substantial mortality and morbidity burden. Patients often overestimate their level of asthma control while also reporting that asthma symptoms affect their quality of life and ability to work or study. There is some evidence of success with primary prevention measures in high-risk children and the secondary prevention of asthma in sensitized individuals or those at risk of developing occupational asthma. There are challenges with diagnosis - with under- and overdiagnosis and misdiagnosis being common - and in the treatment of asthma, despite clear treatment guidelines. In particular, severe asthma presents a huge challenge to the clinician, and its complex and heterogeneous nature warrants a personalized medicine approach to match therapies to individual patients. However, the tools for this are currently lacking in primary care. This article reviews the current unmet need in the diagnosis and clinical management of asthma, and provides an overview of the limitations of current therapies.
Language	English
Publishing date	2019-03-14
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	2186560-7
ISSN	1178-203X ; 1176-6336
ISSN (online)	1178-203X
ISSN	1176-6336
DOI	10.2147/TCRM.S160327
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Article ; Online: Working for Better Asthma Control: How Can We Improve the Dialogue Between Patients and Healthcare Professionals?

Gruffydd-Jones, Kevin / Hansen, Kjeld

Advances in therapy

2019 Volume 37, Issue 1, Page(s) 1–9

Abstract: Asthma is a chronic disease affecting more than 300 million people globally. Poor asthma control that leads to unnecessary symptoms is estimated to affect nearly half of people with asthma. A critical way to address poor control is for healthcare ... ...

Abstract	Asthma is a chronic disease affecting more than 300 million people globally. Poor asthma control that leads to unnecessary symptoms is estimated to affect nearly half of people with asthma. A critical way to address poor control is for healthcare professionals (HCPs) and patients to enter a shared dialogue on treatment and asthma management. This article explores the views of both patient and HCP to better understand how to achieve asthma control. From the patient's perspective, being a person with asthma has ramifications to one's sense of identity, and thus one's ability and willingness to actively manage their asthma. Furthermore, lack of education and concerns about the effectiveness of treatment can also ultimately lead to poor control, a term that can be understood differently by patients and HCPs. One goal is to help to normalise life for people with asthma. For this, HCPs need to align on what this means for each individual and then work together to produce a plan that can be applied to the patient's daily life. Training for HCPs on good communication skills and empowering patients to be involved in their asthma management are both critical to ensure effective shared decision-making and, ultimately, improved quality of life for people with asthma. FUNDING: Boehringer Ingelheim. Plain language summary available for this article.
MeSH term(s)	Asthma/psychology ; Asthma/therapy ; Communication ; Disease Management ; Health Personnel/psychology ; Humans ; Patient Participation ; Professional-Patient Relations ; Quality of Life
Language	English
Publishing date	2019-10-29
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632651-1
ISSN	1865-8652 ; 0741-238X
ISSN (online)	1865-8652
ISSN	0741-238X
DOI	10.1007/s12325-019-01131-0
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Article ; Online: Managing bronchiectasis in adults in primary care: a clinical update.

Gruffydd-Jones, Kevin / Keeley, Duncan / Wildgoose, James / Hill, Adam

The British journal of general practice : the journal of the Royal College of General Practitioners

2021 Volume 71, Issue 705, Page(s) 183–184

MeSH term(s)	Adult ; Bronchiectasis/diagnosis ; Bronchiectasis/therapy ; Humans ; Primary Health Care
Language	English
Publishing date	2021-03-26
Publishing country	England
Document type	Journal Article
ZDB-ID	1043148-2
ISSN	1478-5242 ; 0035-8797 ; 0960-1643
ISSN (online)	1478-5242
ISSN	0035-8797 ; 0960-1643
DOI	10.3399/bjgp21X715565
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Article ; Online: Unmet needs in asthma

Gruffydd-Jones K

Therapeutics and Clinical Risk Management, Vol Volume 15, Pp 409-

2019 Volume 421

Abstract: Kevin Gruffydd-Jones Box Surgery, Box, UK Abstract: Despite advances in the diagnosis and ...

Abstract	Kevin Gruffydd-Jones Box Surgery, Box, UK Abstract: Despite advances in the diagnosis and management of asthma, uncontrolled disease is still associated with a substantial mortality and morbidity burden. Patients often overestimate their level of asthma control while also reporting that asthma symptoms affect their quality of life and ability to work or study. There is some evidence of success with primary prevention measures in high-risk children and the secondary prevention of asthma in sensitized individuals or those at risk of developing occupational asthma. There are challenges with diagnosis – with under- and overdiagnosis and misdiagnosis being common – and in the treatment of asthma, despite clear treatment guidelines. In particular, severe asthma presents a huge challenge to the clinician, and its complex and heterogeneous nature warrants a personalized medicine approach to match therapies to individual patients. However, the tools for this are currently lacking in primary care. This article reviews the current unmet need in the diagnosis and clinical management of asthma, and provides an overview of the limitations of current therapies. Keywords: β2-agonists, anticholinergics, inhaled corticosteroids, respiratory disease, unmet need, asthma management
Keywords	Beta2-agonists ; anticholinergics ; inhaled corticosteroids ; respiratory disease ; unmet need ; asthma management ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2019-03-01T00:00:00Z
Publisher	Dove Medical Press
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: British Thoracic Society Quality Standard for Clinically Significant Bronchiectasis in Adults 2022.

Hill, Adam T / Grillo, Lizzie / Gruffydd-Jones, Kevin / Payne, Karen / Souto, Miguel / Sullivan, Anita / Wildgoose, James / Loebinger, Michael R

BMJ open respiratory research

2022 Volume 9, Issue 1

Abstract: This British Thoracic Society Quality Standard for Clinically Significant Bronchiectasis in Adults 2022 aims to encourage good practice by setting standards of high-quality respiratory care that services should follow. ...

Abstract	This British Thoracic Society Quality Standard for Clinically Significant Bronchiectasis in Adults 2022 aims to encourage good practice by setting standards of high-quality respiratory care that services should follow.
MeSH term(s)	Adult ; Bronchiectasis/therapy ; Humans ; Respiratory Therapy ; Societies, Medical
Language	English
Publishing date	2022-10-05
Publishing country	England
Document type	Journal Article
ZDB-ID	2736454-9
ISSN	2052-4439 ; 2052-4439
ISSN (online)	2052-4439
ISSN	2052-4439
DOI	10.1136/bmjresp-2022-001369
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Article ; Online: GOLD guidelines 2011: what are the implications for primary care?

Gruffydd-Jones, Kevin

Primary care respiratory journal : journal of the General Practice Airways Group

2012 Volume 21, Issue 4, Page(s) 437–441

Abstract: A major revision of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines was published in December 2011, which takes account of the fact that chronic obstructive pulmonary disease (COPD) is a multi-system disease with effects on ... ...

Abstract	A major revision of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines was published in December 2011, which takes account of the fact that chronic obstructive pulmonary disease (COPD) is a multi-system disease with effects on the patient beyond the effects of airflow limitation alone. The guidelines present a novel way of assessing the patient with COPD, linked to the major goals of stable COPD management of reducing symptoms (measured by the modified Medical Research Council Dyspnoea Score and/or COPD Assessment Tool) and reducing future risk (measured by the severity of airflow limitation and/or exacerbation history in the previous 12 months). Four patient groups are identified on the basis of their symptom/risk profile and a pharmacotherapy strategy is described using this profile. Emphasis is still placed on three pivotal features of non-pharmacological management: (1) reduction of exposure to risk factors (principally tobacco smoke); (2) promotion of exercise; and (3) immunisation against influenza and pneumococcal disease. In addition, there is a new chapter on the importance of assessing and treating co-morbid disease. The guidelines are a welcome advance in the management of COPD, but need further development to guide the more holistic approach to the management of patients with COPD in primary care.
MeSH term(s)	Humans ; Practice Guidelines as Topic ; Primary Health Care ; Pulmonary Disease, Chronic Obstructive/complications ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/therapy
Language	English
Publishing date	2012-07-11
Publishing country	England
Document type	Journal Article
ZDB-ID	2129033-7
ISSN	1475-1534 ; 1475-1534
ISSN (online)	1475-1534
ISSN	1475-1534
DOI	10.4104/pcrj.2012.00058
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Article ; Online: British Thoracic Society Clinical Statement on chronic cough in adults.

Parker, Sean M / Smith, Jaclyn Ann / Birring, Surinder S / Chamberlain-Mitchell, Sarah / Gruffydd-Jones, Kevin / Haines, Jemma / Hennessey, Sarah / McGarvey, Lorcan P / Marsden, Paul / Martin, Matthew James / Morice, Alyn / O'Hara, James / Thomas, Mike

Thorax

2023 Volume 78, Issue Suppl 6, Page(s) s3–s19

MeSH term(s)	Adult ; Humans ; Cough/diagnosis ; Cough/etiology ; Cough/therapy ; Chronic Disease
Language	English
Publishing date	2023-12-06
Publishing country	England
Document type	Journal Article
ZDB-ID	204353-1
ISSN	1468-3296 ; 0040-6376
ISSN (online)	1468-3296
ISSN	0040-6376
DOI	10.1136/thorax-2023-220592
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Article ; Online: Quality Standard Position Statements for Health System Policy Changes in Diagnosis and Management of COPD: A Global Perspective.

Bhutani, Mohit / Price, David B / Winders, Tonya A / Worth, Heinrich / Gruffydd-Jones, Kevin / Tal-Singer, Ruth / Correia-de-Sousa, Jaime / Dransfield, Mark T / Peché, Rudi / Stolz, Daiana / Hurst, John R

Advances in therapy

2022 Volume 39, Issue 6, Page(s) 2302–2322

Abstract: Introduction: Despite being a leading cause of death worldwide, chronic obstructive pulmonary disease (COPD) is underdiagnosed and underprioritized within healthcare systems. Existing healthcare policies should be revisited to include COPD prevention ... ...

Abstract	Introduction: Despite being a leading cause of death worldwide, chronic obstructive pulmonary disease (COPD) is underdiagnosed and underprioritized within healthcare systems. Existing healthcare policies should be revisited to include COPD prevention and management as a global priority. Here, we propose and describe health system quality standard position statements that should be implemented as a consistent standard of care for patients with COPD. Methods: A multidisciplinary group of clinicians with expertise in COPD management together with patient advocates from eight countries participated in a quality standards review meeting convened in April 2021. The principal objective was to achieve consensus on global health system priorities to ensure consistent standards of care for COPD. These quality standard position statements were either evidence-based or reflected the combined views of the panel. Results: On the basis of discussions, the experts adopted five quality standard position statements, including the rationale for their inclusion, supporting clinical evidence, and essential criteria for quality metrics. These quality standard position statements emphasize the core elements of COPD care, including (1) diagnosis, (2) adequate patient and caregiver education, (3) access to medical and nonmedical treatments aligned with the latest evidence-based recommendations and appropriate management by a respiratory specialist when required, (4) appropriate management of acute COPD exacerbations, and (5) regular patient and caregiver follow-up for care plan reviews. Conclusions: These practical quality standards may be applicable to and implemented at both local and national levels. While universally applicable to the core elements of appropriate COPD care, they can be adapted to consider differences in healthcare resources and priorities, organizational structure, and care delivery capabilities of individual healthcare systems. We encourage the adoption of these global quality standards by policymakers and healthcare practitioners alike to inform national and regional health system policy revisions to improve the quality and consistency of COPD care worldwide.
MeSH term(s)	Global Health ; Health Policy ; Humans ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/therapy
Language	English
Publishing date	2022-04-28
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632651-1
ISSN	1865-8652 ; 0741-238X
ISSN (online)	1865-8652
ISSN	0741-238X
DOI	10.1007/s12325-022-02137-x
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Article: A national strategy for the management of chronic obstructive pulmonary disease (COPD) in England: aiming to improve the quality of care for patients.

Gruffydd-Jones, Kevin

Primary care respiratory journal : journal of the General Practice Airways Group

2008 Volume 17 Suppl 1, Page(s) S1–8

Abstract: This article examines the rationale behind the development of the National Clinical Strategy for Chronic Obstructive Pulmonary Disease (COPD) in England which will be launched in 2009. It focuses on the burden which COPD places on the healthcare service ... ...

Abstract	This article examines the rationale behind the development of the National Clinical Strategy for Chronic Obstructive Pulmonary Disease (COPD) in England which will be launched in 2009. It focuses on the burden which COPD places on the healthcare service and the effect it has on patients, and highlights the important steps in the development of the Clinical Strategy. The general recommendations which are likely to be contained within the Clinical Strategy are discussed, as well as the possible implications for primary care.
MeSH term(s)	Cost of Illness ; England ; Humans ; Primary Health Care ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/therapy ; Quality of Health Care
Language	English
Publishing date	2008-11-05
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2129033-7
ISSN	1475-1534 ; 1471-4418
ISSN (online)	1475-1534
ISSN	1471-4418
DOI	10.3132/pcrj.2008.00071
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Article ; Online: Efficacy and Safety of LAMA/LABA Fixed-Dose Combination Therapies in Chronic Obstructive Pulmonary Disease: A Systematic Review of Direct and Indirect Treatment Comparisons.

Hurst, John R / Gruffydd-Jones, Kevin / Biswas, Mousumi / Guranlioglu, Deniz / Jenkins, Martin / Stjepanovic, Neda / Bamrara, Arushi

International journal of chronic obstructive pulmonary disease

2020 Volume 15, Page(s) 1529–1543

Abstract: Background: This literature review assessed comparative efficacy and safety of long-acting muscarinic antagonist/long-acting β: Methods: Two systematic literature reviews were conducted to identify direct comparisons (head-to-head randomized ... ...

Abstract	Background: This literature review assessed comparative efficacy and safety of long-acting muscarinic antagonist/long-acting β Methods: Two systematic literature reviews were conducted to identify direct comparisons (head-to-head randomized controlled trials [RCTs]) and indirect comparisons (network meta-analyses [NMAs]; indirect treatment comparisons; meta-analyses) in patients with COPD with moderate-to-very severe airflow limitation. Study/Analysis characteristics, eligibility criteria, patient characteristics, and overall conclusions were extracted from relevant publications. The review of indirect comparisons focused on NMAs reporting efficacy outcomes at 12 and 24 weeks of treatment (established durations of symptomatic studies in COPD recommended by regulators). Results: Direct comparisons: Conclusion: Although there were some inconsistencies between the outcomes of RCTs and NMAs for lung function, the totality of lung function, symptoms, exacerbations, and safety data suggests that currently available LAMA/LABA FDCs have comparable efficacy and safety in patients with COPD and moderate-to-very severe airflow limitation.
MeSH term(s)	Administration, Inhalation ; Adrenergic beta-2 Receptor Agonists/adverse effects ; Bronchodilator Agents/adverse effects ; Drug Combinations ; Humans ; Lung ; Muscarinic Antagonists/adverse effects ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/drug therapy
Chemical Substances	Adrenergic beta-2 Receptor Agonists ; Bronchodilator Agents ; Drug Combinations ; Muscarinic Antagonists
Language	English
Publishing date	2020-07-01
Publishing country	New Zealand
Document type	Journal Article ; Systematic Review
ISSN	1178-2005
ISSN (online)	1178-2005
DOI	10.2147/COPD.S230955
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