CLAHRC research reveals poor asthma control and knowledge common among London schoolchildren

Newly published CLAHRC research has revealed that nearly half of secondary school pupils living with asthma have sub-optimal control of their condition and gaps in knowledge around symptoms, triggers and treatments.

The findings, published in the Journal of Asthma,  emerged from the results of nearly 800 pupils from across London schools completing questionnaires incorporating the asthma control test (ACT) – a validated tool for assessing control in asthmatic children aged 12 years and older. Using the ACT, we sought to assess asthma control and knowledge in London secondary school children.

Results showed a high prevalence of poor asthma control, poor asthma knowledge, and a high morbidity in London children with asthma.

799 children with doctor-diagnosed asthma completed the questionnaire;

  • suboptimal asthma control was reported by 49.6% of students
  • over a third (42.4%) prescribed a short-acting β2-agonist inhaler felt uncomfortable using it at school, and 29.2% reported not using this inhaler when wheezy
  • 56.4% of those with regular inhaled corticosteroids did not take them as prescribed, and 41.7% did not know what this inhaler was for.
  • suboptimal control was associated with a greater proportion of students reporting that they were “somewhat”, “hardly” or “not at all” comfortable using inhalers at school (52.7% vs 29.1 %) and outside school (22.8% vs. 14.8%)

Since suboptimal control by ACT is a risk factor for future severe exacerbations, and should prompt more intense clinical monitoring, our results suggest a need for interventions aimed at addressing poor asthma control in UK schoolchildren.

Read the full paper below

Asthma control in London secondary school children

Katherine Harris , MSc, Gioia Mosler Centre for Genomics and Child Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, London, UK , PhD, Samson A. Williams , BSc, Abigail Whitehouse , MBChB, Rosalind Raine , MBBS, PhD & Jonathan Grigg , MD

Journal of Asthma

http://dx.doi.org/10.1080/02770903.2017.1299757

Leading the campaign against pollution caused by diesel engines

The Doctors Against Diesel campaign that was launched in December 2016 and has already received widespread media coverage with ongoing interest from the health community, local government and media. The campaign is led by health professionals and is calling for the use of diesel fuels to be banned in urban areas and progressively phased out elsewhere. On February 22nd the CLAHRC’s Professor Jonathan Grigg led a workshop of nurses, doctors and allied health professionals to formulate health messaging and decide next steps in the campaign to reduce diesel use.

Child Health Theme Lead Professor Jonathan Grigg is a prominent member of the campaign group and co-author of the Royal Colleges Report Every Breath We Take. Professor Grigg is a practising paediatrician with experitse in respiratory health, seeing first hand how pollution damages young and developing lungs. He also leads our School Asthma project which aims to improve management of the condition among children and young people.

Diesel engines are the single biggest source of nitrogen dioxide, which accounts for the vast majority of breaches of legal air pollution limits in the UK. Exposure to pollution can impact children and young people’s current and future health as strong evidence suggest it impairs lung growth in children.

 

 

 

 

Making the Jump….to improved asthma management

Our Asthma Schools project is investigating asthma control among young people in schools and developing interventions to help them manage the condition better.

The project worked with Greenwich and Lewisham Young People’s Theatre (GLYPT) to produce a short film – Behind the Jump – about the importance of asthma awareness among young people. It carries an important message for all young people living with the condition.

The film was shot at the LEAP Parkour Park in Westminster, London.

 

How to guide to establish NHS youth forums

Children and young people are a key population for everyone working in the NHS and Public Health. Involving them in commissioning and designing services makes for more appropriate care that’s more likely to be taken up by those who need it

Our ground-breaking diabetes project worked with young people impacted by the condition in east London – we trained young co-inquirers in research skills so they could run community engagement events and analyse feedback on how to improve local diabetes services.

Our work was integral in shaping new NHS “how to” guidance to help commissioners and providers think through and develop youth forums to support person-centred commissioning of children and young people in health and care services.

The ‘how to guide’ is a recipient of the NHS England’s Celebrating Participation in Healthcare grant award scheme and has been authored by the University of East London (UEL)

Prof Jonathan Grigg

Professor Jonathan Grigg is one of the UK’s top paediatricians and an international leader in paediatric respiratory research. Since 2003, he has obtained over £11M in research grants as PI and co-applicant from MRC, NIHR, DH and charities. These funds supported air pollution and asthma research with national and international impact. He is the lead paediatrician for government advice on air pollution and children’s health as a member of the Committee on the Medical Effects of Air Pollution, and provides ad hoc advice on respiratory toxicity to the Committee on Carcinogens. He co-chairs the Royal College of Physicians Committee into “air pollution throughout the life course”. In leading the national paediatric research agenda, he organises all paediatric input into British Thoracic Society’s meetings, and as elected secretary to the Royal College Paediatrics and Child Health’s Academic Board, organises its Annual Meeting. He develops national research priorities in paediatric respiratory medicine as Chair of the British Paediatric Respiratory Society, ex chair and, now member, of the Clinical Study Group (Respiratory) for the Medicines for Children network, NIHR Programme Grant Experts Panel. He leads on paediatric respiratory infection and immunology as elected chair of this group in the European Respiratory Society. Nationally, he evaluates the cost effectiveness of therapies, as the paediatric lead of NICE Appraisal Panel A, and is an RCPCH-appointed expert adviser on asthma therapies to other appraisal panels. Locally, he leads on paediatric non-medicines research in NE London as regional LCRN representative to the national committee, and supports academic training as the RCPCH regional academic advisor.

Prof Monica Lakhanpaul

Professor Monica Lakhanpaul leads a multi-disciplinary translational research group at UCL, that focuses on Health Services Research which has direct impact on health policy and clinical practice. Her research program aims to take a multi-disciplinary, integrated and collaborative approach to improving outcomes for children. Her research also aims to transform services for patients.

Professor Lakhanpaul’s research focuses on the translation of evidence into clinical practice and health policy, drawing together education, primary and secondary research to improve health outcomes for children. Her research crosses primary, community and hospital care, social care and education.

Professor Lakhanpaul’s research falls under four main themes; Applied Translation of Evidence In to Policy and Practice (through systematic review, guideline development, decision and prediction rule development), Improvement Science (with a particular focus on partnership production with parents, patients and health professionals; co-production with communities to develop tailored health interventions: MIA study), Conditions (with a specific interest in respiratory illness; asthma, and the acutely sick child) and Inequalities in Health (tailoring interventions for hard to reach groups, health tourism and the use of translators and interpreters to reduce inequalities).

David Law

David Law is the Chief Executive of Hertfordshire Community NHS Trust. He has also worked in primary care and community services in London prior to working in Hertfordshire. He worked in a number of planning roles in health organisations in the County during the 1990s before joining West Hertfordshire Hospitals NHS Trust in 2001 as Director of Strategy. In 2004 he was appointed Chief Executive of the Trust, a post he held till 2007.

After leaving West Hertfordshire Hospitals, David worked at Healthcare for London, initially focusing on the organisation of acute services in the capital and then on end of life care.  He worked extensively for the NHS Institute for Innovation and Improvement. Before moving to Hertfordshire Community Trust he worked on the Transforming Community Services programme in Lambeth and Southwark and in Tower Hamlets.

Dr Taryn Smith

Taryn is a Research Associate working with Professor Monica Lakhanpaul on the NEON (Nurture Early for Optimal Nutrition) Project. Taryn’s background is in nutrition and her PhD research focused on establishing evidence-based dietary requirements for vitamin D in 14-18 year old adolescents. Taryn’s research interests include understanding the effects of nutrition on health outcomes in population groups at risk of nutritional deficiencies, particularly pregnant women, children and adolescents, and nutritional interventions targeted at these populations to improve health and nutritional status and avoid deficiencies.

NEON project makes the news

Our innovative Nurture Early for Optimal Nutrition (NEON) project has made the headlines..in India!. The project is exploring whether a South Asian model proven to promote healthy nutrition in children can “travel” successfully to the UK and help children of Bangladeshi origin in East London.Professor Monica Lakhanpaul is leading the project and spoke to The Goan newspaper about the bi-directional exchange of knowledge that is making a difference in one of London’s less advantaged communities.