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1. Mood Monitoring Over One Year for People With Chronic Obstructive Pulmonary Disease Using a Mobile Health System: Retrospective Analysis of a Randomized Controlled Trial

Author

Whelan, Maxine E, Velardo, Carmelo, Rutter, Heather, Tarassenko, Lionel, and Farmer, Andrew J

Subjects
Information technology, T58.5-58.64, Public aspects of medicine, RA1-1270
Abstract

BackgroundComorbid anxiety and depression can add to the complexity of managing treatment for people living with chronic obstructive pulmonary disease (COPD). Monitoring mood has the potential to identify individuals who might benefit from additional support and treatment. ObjectiveWe used data from the sElf-management anD support proGrammE (EDGE) trial to examine: (1) the extent to which the mood-monitoring components of a mobile health system for patients with COPD were used by participants; (2) the levels of anxiety and depression symptoms among study participants; (3) the extent to which videos providing advice about coping with low mood were viewed; and (4) the characteristics of participants with differing levels of mood and utilization of mood monitoring. MethodsA total of 107 men and women with a clinical diagnosis of COPD, aged ≥40 years old, were recruited to the intervention arm of the EDGE trial. Participants were invited to complete the Patient Health Questionnaire-8 and the Generalized Anxiety Disorder-7 test every four weeks using a tablet computer. Mood disturbance based on these measures was defined as a score ≥5 on either scale. Participants reporting a mood disturbance were automatically directed (signposted) to a stress or mood management video. Study outcomes included measures of health status, respiratory quality of life, and symptoms of anxiety and depression. ResultsOverall, 94 (87.9%) participants completed the 12-month study. A total of 80 participants entered at least one response each month for at least ten months. On average, 16 participants (range 8-38 participants) entered ≥2 responses each month. Of all the participants, 47 (50%) gave responses indicating a mood disturbance. Participants with a mood disturbance score for both scales (n=47) compared with those without (n=20) had lower health status (P=.008), lower quality of life (P=.009), and greater anxiety (P

Published
2019
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2. Molnupiravir plus usual care versus usual care alone as early treatment for adults with COVID-19 at increased risk of adverse outcomes (PANORAMIC): an open-label, platform-adaptive randomised controlled trial

Author

Agyeman, Akosua A, Ahmed, Tanveer, Allcock, Damien, Beltran-Martinez, Adrian, Benedict, Oluseye E, Bird, Nigel, Brennan, Laura, Brown, Julianne, Burns, Gerard, Butler, Mike, Cheng, Zelda, Danson, Ruth, de Kare-Silver, Nigel, Dhasmana, Devesh, Dickson, Jon, Engamba, Serge, Fisher, Stacey, Fox, Robin, Frost, Eve, Gaunt, Richard, Ghosh, Sarit, Gilkar, Ishtiaq, Goodman, Anna, Granier, Steve, Howell, Aleksandra, Hussain, Iqbal, Hutchinson, Simon, Imlach, Marie, Irving, Greg, Jacobsen, Nicholas, Kennard, James, Khan, Umar, Knox, Kyle, Krasucki, Christopher, Law, Tom, Lee, Rem, Lester, Nicola, Lewis, David, Lunn, James, Mackintosh, Claire I., Mathukia, Mehul, Moore, Patrick, Morton, Seb, Murphy, Daniel, Nally, Rhiannon, Ndukauba, Chinonso, Ogundapo, Olufunto, Okeke, Henry, Patel, Amit, Patel, Kavil, Penfold, Ruth, Poonian, Satveer, Popoola, Olajide, Pora, Alexander, Prasad, Vibhore, Prasad, Rishabh, Razzaq, Omair, Richardson, Scot, Royal, Simon, Safa, Afsana, Sehdev, Satash, Sevenoaks, Tamsin, Shah, Divya, Sheikh, Aadil, Short, Vanessa, Sidhu, Baljinder S, Singh, Ivor, Soni, Yusuf, Thalasselis, Chris, Wilson, Pete, Wingfield, David, Wong, Michael, Woodall, Maximillian N J, Wooding, Nick, Woods, Sharon, Yong, Joanna, Yongblah, Francis, Zafar, Azhar, Butler, Christopher C, Hobbs, F D Richard, Gbinigie, Oghenekome A, Rahman, Najib M, Hayward, Gail, Richards, Duncan B, Dorward, Jienchi, Lowe, David M, Standing, Joseph F, Breuer, Judith, Khoo, Saye, Petrou, Stavros, Hood, Kerenza, Nguyen-Van-Tam, Jonathan S, Patel, Mahendra G, Saville, Benjamin R, Marion, Joe, Ogburn, Emma, Allen, Julie, Rutter, Heather, Francis, Nick, Thomas, Nicholas P B, Evans, Philip, Dobson, Melissa, Madden, Tracie-Ann, Holmes, Jane, Harris, Victoria, Png, May Ee, Lown, Mark, van Hecke, Oliver, Detry, Michelle A, Saunders, Christina T, Fitzgerald, Mark, Berry, Nicholas S, Mwandigha, Lazaro, Galal, Ushma, Mort, Sam, Jani, Bhautesh D, Hart, Nigel D, Ahmed, Haroon, Butler, Daniel, McKenna, Micheal, Chalk, Jem, Lavallee, Layla, Hadley, Elizabeth, Cureton, Lucy, Benysek, Magdalena, Andersson, Monique, Coates, Maria, Barrett, Sarah, Bateman, Clare, Davies, Jennifer C, Raymundo-Wood, Ivy, Ustianowski, Andrew, Carson-Stevens, Andrew, Yu, Ly-Mee, and Little, Paul

Published
2023
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3. Efficacy and safety of intramuscular administration of tixagevimab–cilgavimab for early outpatient treatment of COVID-19 (TACKLE): a phase 3, randomised, double-blind, placebo-controlled trial

Author

Abe, Wakana, Adan De Varona, Tania, Adiatullina, Daria, Aguilar Zapata, Daniel, Ahlers, Kevin, Aimo, Carolina, Akere, Ayoade, Akimova, Elena, Alatorre Alexander, Jorge, Aldrich, Logan, Ali Garcia, Ismael, Ali García, Karim, Allison, Lee, Alonso Zuñiga, Rosa, Aloysius, Ivan, Altclas, Javier, Alvarisqueta, Andres, Antila, Martti, Anton, Camila, Árboix Alamo, Elisabet, Arora, Samir, Avilés Felix, Ramón Alejandro, Bakhtina, Natalya, Barbero-Becerra, Varenka, Barragan-Reyes, Armando, Barreira, Alejandro, Barrett, Mitchell, Beran, Jiri, Berki, Nikolett, Berki, Viktoria, Betten, Richard, Binelli, Claudia, Brunzová, Lenka, Bussolari, Cecilia, Byargeon, Karianna, Bytnar, Justyna, Camberos, Carlos, Campos Corzo, Pedro, Cannon, Grazia, Canovi, Valentina, Carla da Rosa, Simone, Moser, Ana Caroline, Carrera Rivas, Luis, Casas, Marcelo Martin, Castañeda-Méndez, Paulo, Cavalcante, Ana, Cherepova, Eugenia, Chermenskii, Alexei, Clark, Lauren, Codeluppi, Mauro, Coelho, Flavia, Contreras, Belinda, Cran, Alex, Dao, Taylor, Dharma, Chrisette, Di Castri, Cosimo, Diaz Balocchi, Victoria, Durán, Omar, Earl, Kara, Ellery, Adam, Endo, Tomoko, Everding, Andrea, Fischer, Rainald, Fonseca, Benedito, Franklin, Chelsea C., Franz, Susan-Beatrice, Fumagalli, Anna, Galindo-Amaya, Mauricio, Galli, Mariagiulia, Gerna, Laura, Gil Ureña, Karolly, Gomes Antila, Henrikki, Gomes Maricato, Laura Ines, Goncalvez, Gabriela, Gonzalez, Martin, González-Lama, Jesús, Granier, Stephen, Granier, Jacob, Grunwald, Stephan, Guardeño-Ropero, David, Guberti, Monica, Guduri, Sridhar, Guerrero García, Carolina, Haggiagi, Jehad, Hale, Kacie, Hayashi, Toshimasa, Hermes, Maiara, Hernandez Colin, Dante, Hirai, Yuji, Hojo, Masayuki, Homma, Tetsuya, Hour, Billy, Huber, Andreas, Iacovelli, Diego, Ishibashi, Noriomi, Iwabe, Yutaro, Izumi, Shinyu, Jessen, Arne, Jessen, Heiko, Jeudy, Wilner, Jiménez Marcos, Marta, Johnson, Rebecca, Juárez-Hernández, Eva, Kabasawa, Kiyomi, Kamińska, Katarzyna, Kawabe, Megumi, Kemp, Angela, Khmelnitskiy, Oleg, Klassen, Carina, Kobrynska, Olena, Koleckar, Pavel, Korn, Stephanie, Kornmann, Marc, Kostenko, Viktor, Kovalchuk, Evgenii, Kovalchuk, Yana, Kümmerle, Tim, Lachmund, Ulrike, Lammersmann, Kerstin, Lastebasse, Flávio, Lattuada, Ivana, Lauer, Felicitas, Lebed, Kyrylo, Lebed, Olga, Lecona-Garcia, Diego, Leoni, Maria Christina, Lima, Marina, Little, Raymond, Little, Holly, Lizardi-Díaz, Andrea, Lobo-Becker, Michele, Luppi, Francesco, Macias, Veronica, Maesaki, Shigefumi, Magnaghi, Cristiano, Mancini, Annalisa, Mazur, Stanisław, Melnikova, Tatiana, Menchaca, Sergio, Menendez-Perez, Ibrahim, Międlar, Ewa, Mizunuma, Shuuichi, Mochalova, Anastasiya, Mohamed, Mihad, Moll, Theresa, Montalvo, Camila, Mottola, Amber, Mück, Birgit, Mussi Brugnolli, Rebeca, Nanda, Akanksha, Neuner, Dörthe, Ngwueke, Agatha, Noe, Sebastian, Novacek, Martin, Nuzzolo-Shihadeh, Laura, Obiekwe, Emeka, Ocampo Gaytán, Isaias G., Ohmagari, Norio, Ohta, Shin, Onyewuchi, Ptuonye, Pankov, Iurii, Pedrosa, Maurício, Peré, Yael, Pereyra, Alejandro, Perez, Eliana, Perez-Alba, Eduardo, Perpiña Lozano, Paloma, Perrei, Tanya, Peterson, Dena, Pierroti, Ligia, Pineda-Cárdenas, Felipe, Plascencia Sanchez, Teresa, Poletti, Camila, Pomaranzi, Chiara, Portes, Lisette, Postel, Nils, Ramirez, Monica, Ramírez, Isabel, Ramirez-Baena, Miguel, Ramjee, Mahadev, Ratti, Giovanna, Reeve, Jackie, Reichert, Petr, Reichertová, Petra, Reyes Garcia, Edgar Alejandro, Ricardo, Celso, Rodríguez Rodríguez, Nicomedes, Roldán Sánchez, Jaun, Romero-Lopez, Matilde, Rosales, Tyrone, Rosales, Harvey, Roshan, Mohamed, Roshan, Simran, Rovere Querini, Patrizia, Rutter, Heather, Sachwani, Sadaf, Sagara, Hironori, Sakai, Jun, Samson, Nina, Sánchez Mijangos, José Héctor, Sánchez, Liliana, Sánchez-González, Ana, Sandford, Micko, Santana, Laura, Santos de Carvalho, Felipe, Sasao, Reiko, Sato, Lubna, Scheuermann, Elizabeth, Schmidt, Olaf, Seki, Masafumi, Shaikh, Safia, Shimada, Daishi, Shinkai, Masaharu, Shinoda, Masahiro, Smith, Jackie, Solorzano, Fernando, Soncini, Silvia, Soregine, Katalin, Sosa, Erica, Sowade, Olalekan, Špinková, Veronika, Staniford, Ruth, Steigemann, Iska, Steiner, Vivien, Strelkov, Vladimir, Suárez Pineda, Cintya R., Suenaga, Hiroki, Suzaki, Shintaro, Swayze, Hannah, Tada, Yuji, Takeshita, Yuichiro, Takiguchi, Yasuo, Tanaka, Akihiko, Tarumoto, Norihito, Tatarintseva, Albina, Taubert, Michelle, Terenya, Elizaveta, Tinoco, César, Tomiyasu, Tomohiro, Torres-Vidal, Gladys, Trejo-Aguiar, Gabriela, Tsushima, Kenji, Tunstall, Emma, Turrà, Caterina, Valdes, Yoandy, Valencia Castro, Nelly, Visconti, Guilherme, Vitali, Giordano, Vutikullird, Apinya, Watti, Jezdancher, Werth, Doreen, Wilson, Cheyanne, Wilson, Philippe, Workman, Amy, Wörle, Pamela, Wyen, Christoph, Yamaguchi, Yoshiko, Yamamoto, Kei, Montgomery, Hugh, Hobbs, F D Richard, Padilla, Francisco, Arbetter, Douglas, Templeton, Alison, Seegobin, Seth, Kim, Kenneth, Campos, Jesus Abraham Simón, Arends, Rosalinda H, Brodek, Bryan H, Brooks, Dennis, Garbes, Pedro, Jimenez, Julieta, Koh, Gavin C K W, Padilla, Kelly W, Streicher, Katie, Viani, Rolando M, Alagappan, Vijay, Pangalos, Menelas N, and Esser, Mark T

Published
2022
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4. Efficacy of self-monitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): an unmasked randomised controlled trial

Author

Bradley, Brendan, Lovekin, Chris, Judge, David, Castello, Luis, Dawson, Maureen, Brice, Rebecca, Dunbabin, Bethany, Maslen, Sophie, Rutter, Heather, Norris, Mary, French, Lauren, Loynd, Michael, Whitbread, Pippa, Saldana Ortaga, Luisa, Noel, Irene, Madronal, Karen, Timmins, Julie, Bradburn, Peter, Hughes, Lucy, Hinks, Beth, Bailey, Sheila, Read, Sue, Weston, Andrea, Spannuth, Somi, Maiden, Sue, Chermahini, Makiko, McDonald, Ann, Rajan, Shelina, Allen, Sue, Deboys, Brenda, Fell, Kim, Johnson, Jenny, Jung, Helen, Lister, Rachel, Osborne, Ruth, Secker, Amy, Qasim, Irene, William, Kirsty, Harris, Abi, Zhao, Susan, Butcher, Elaine, Darbyshire, Pauline, Joshi, Sarah, Davies, Jon, Talbot, Claire, Hoverd, Eleanor, Field, Linda, Adcock, Tracey, Rooney, Julia, Cooter, Nina, Butler, Aaron, Allen, Naomi, Abdul-Wahab, Maria, McNicholas, Kathryn, Peniket, Lara, Dodd, Kate, Mugurza, Julie, Baskerville, Richard, Syed, Rakshan, Bailey, Clare, Adams, Jill, Uglow, Paul, Townsend, Neil, Macleod, Alison, Hawkins, Charlotte, Behura, Suparna, Crawshaw, Jonathan, Fox, Robin, Doski, Waleed, Aylward, Martin, A'Court, Christine, Rapley, David, Walsh, Jo, Batra, Paul, Seoane, Ana, Mukherjee, Sluti, Dixon, Jonathan, Arthur, Peter, Sutcliffe, Karen, Paschallides, Costas, Woof, Richard, Winfrey, Peter, Clark, Matthew, Kamali, Roya, Thomas, Paul, Ebbs, David, Mather, Liz, Beattie, Andre, Ladha, Karim, Smondulak, Larisa, Jemahl, Surinder, Hickson, Peter, Stevens, Liam, Crockett, Tony, Shukla, David, Binnian, Ian, Vinson, Paul, DeKare-Silver, Nigel, Patel, Ramila, Singh, Ivor, Lumley, Louise, Williams, Glennis, Webb, Mark, Bambrough, Jack, Shah, Neetul, Dosanjh, Hergeven, Spannuth, Frank, Paul, Carolyn, Ganesegaram, Jude, Pike, Laurie, Maheswaran, Vijaysundari, Paruk, Farah, Ford, Stephen, Verma, Vineeta, Milne, Kate, Lockhat, Farhana, Ferguson, Jennifer, Quirk, Anne-Marie, Wilson, Hugo, Copping, David, Bajallan, Sam, Tanvir, Simria, Khan, Faheem, Alderson, Tom, Ali, Amar, Young, Richard, Chauhan, Umesh, Crockett, Lindsey, McGovern, Louise, Cubitt, Claire, Weatherill, Simon, Tabassum, Abdul, Saunders, Philip, Chauhan, Naresh, Johnson, Samantha, Marok, Inderjit, Sharma, Rajiv, Lumb, William, Tweedale, John, Smith, Ian, Miller, Lawrence, Ahmed, Tanveer, Sanderson, Mark, Jones, Claire, Stokell, Peter, Edwards, Matthew J, Askey, Andrew, Spencer, Jason, Morgan, Kathryn, Knox, Kyle, Baker, Robert, Fisher, Crispin, Halstead, Rachel, Modha, Neil, Buckley, David, Stokell, Catherine, McCabe, John Gerald, Taylor, Jennifer, Nutbeam, Helen, Smith, Richard, MacGregor, Christopher, Davies, Sam, Lindsey, Mark, Cartwright, Simon, Whittle, Jonathan, Colclough, Julie, Crumbie, Alison, Thomas, Nicholas, Premchand, Vattakkatt, Hamid, Rafia, Ali, Zishan, Ward, John, Pinney, Philip, Thurston, Stephen, Banerjee, Tina, McManus, Richard J, Mant, Jonathan, Franssen, Marloes, Nickless, Alecia, Schwartz, Claire, Hodgkinson, James, Farmer, Andrew, Grant, Sabrina, Greenfield, Sheila M, Heneghan, Carl, Jowett, Susan, Martin, Una, Milner, Siobhan, Monahan, Mark, Mort, Sam, Ogburn, Emma, Perera-Salazar, Rafael, Shah, Syed Ahmar, Yu, Ly-Mee, Tarassenko, Lionel, and Hobbs, F D Richard

Published
2018
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5. Platform adaptive trial of novel antivirals for early treatment of COVID-19 In the community (PANORAMIC): protocol for a randomised, controlled, open-label, adaptive platform trial of community novel antiviral treatment of COVID-19 in people at increased risk of more severe disease

Author

Gbinigie, Oghenekome, primary, Ogburn, Emma, additional, Allen, Julie, additional, Dorward, Jienchi, additional, Dobson, Melissa, additional, Madden, Tracie-Ann, additional, Yu, Ly-Mee, additional, Lowe, David M, additional, Rahman, Najib, additional, Petrou, Stavros, additional, Richards, Duncan, additional, Hood, Kerenza, additional, Patel, Mahendra, additional, Saville, Benjamin R, additional, Marion, Joe, additional, Holmes, Jane, additional, Png, May Ee, additional, Hayward, Gail, additional, Lown, Mark, additional, Harris, Victoria, additional, Jani, Bhautesh, additional, Hart, Nigel, additional, Khoo, Saye, additional, Rutter, Heather, additional, Chalk, Jem, additional, Standing, Joseph F, additional, Breuer, Judith, additional, Lavallee, Layla, additional, Hadley, Elizabeth, additional, Cureton, Lucy, additional, Benysek, Magdalena, additional, Andersson, Monique I, additional, Francis, Nick, additional, Thomas, Nicholas P B, additional, Evans, Philip, additional, van Hecke, Oliver, additional, Koshkouei, Mona, additional, Coates, Maria, additional, Barrett, Sarah, additional, Bateman, Clare, additional, Davies, Jennifer, additional, Raymundo-Wood, Ivy, additional, Ustianowski, Andrew, additional, Nguyen-Van-Tam, Jonathan, additional, Carson-Stevens, Andrew, additional, Hobbs, Richard, additional, Little, Paul, additional, and Butler, Christopher C, additional

Published
2023
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6. Molnupiravir plus usual care versus usual care alone as early treatment for adults with COVID-19 at increased risk of adverse outcomes (PANORAMIC): an open-label, platform-adaptive randomised controlled trial

Author

Butler, Christopher C, primary, Hobbs, F D Richard, additional, Gbinigie, Oghenekome A, additional, Rahman, Najib M, additional, Hayward, Gail, additional, Richards, Duncan B, additional, Dorward, Jienchi, additional, Lowe, David M, additional, Standing, Joseph F, additional, Breuer, Judith, additional, Khoo, Saye, additional, Petrou, Stavros, additional, Hood, Kerenza, additional, Nguyen-Van-Tam, Jonathan S, additional, Patel, Mahendra G, additional, Saville, Benjamin R, additional, Marion, Joe, additional, Ogburn, Emma, additional, Allen, Julie, additional, Rutter, Heather, additional, Francis, Nick, additional, Thomas, Nicholas P B, additional, Evans, Philip, additional, Dobson, Melissa, additional, Madden, Tracie-Ann, additional, Holmes, Jane, additional, Harris, Victoria, additional, Png, May Ee, additional, Lown, Mark, additional, van Hecke, Oliver, additional, Detry, Michelle A, additional, Saunders, Christina T, additional, Fitzgerald, Mark, additional, Berry, Nicholas S, additional, Mwandigha, Lazaro, additional, Galal, Ushma, additional, Mort, Sam, additional, Jani, Bhautesh D, additional, Hart, Nigel D, additional, Ahmed, Haroon, additional, Butler, Daniel, additional, McKenna, Micheal, additional, Chalk, Jem, additional, Lavallee, Layla, additional, Hadley, Elizabeth, additional, Cureton, Lucy, additional, Benysek, Magdalena, additional, Andersson, Monique, additional, Coates, Maria, additional, Barrett, Sarah, additional, Bateman, Clare, additional, Davies, Jennifer C, additional, Raymundo-Wood, Ivy, additional, Ustianowski, Andrew, additional, Carson-Stevens, Andrew, additional, Yu, Ly-Mee, additional, Little, Paul, additional, Agyeman, Akosua A, additional, Ahmed, Tanveer, additional, Allcock, Damien, additional, Beltran-Martinez, Adrian, additional, Benedict, Oluseye E, additional, Bird, Nigel, additional, Brennan, Laura, additional, Brown, Julianne, additional, Burns, Gerard, additional, Butler, Mike, additional, Cheng, Zelda, additional, Danson, Ruth, additional, de Kare-Silver, Nigel, additional, Dhasmana, Devesh, additional, Dickson, Jon, additional, Engamba, Serge, additional, Fisher, Stacey, additional, Fox, Robin, additional, Frost, Eve, additional, Gaunt, Richard, additional, Ghosh, Sarit, additional, Gilkar, Ishtiaq, additional, Goodman, Anna, additional, Granier, Steve, additional, Howell, Aleksandra, additional, Hussain, Iqbal, additional, Hutchinson, Simon, additional, Imlach, Marie, additional, Irving, Greg, additional, Jacobsen, Nicholas, additional, Kennard, James, additional, Khan, Umar, additional, Knox, Kyle, additional, Krasucki, Christopher, additional, Law, Tom, additional, Lee, Rem, additional, Lester, Nicola, additional, Lewis, David, additional, Lunn, James, additional, Mackintosh, Claire I., additional, Mathukia, Mehul, additional, Moore, Patrick, additional, Morton, Seb, additional, Murphy, Daniel, additional, Nally, Rhiannon, additional, Ndukauba, Chinonso, additional, Ogundapo, Olufunto, additional, Okeke, Henry, additional, Patel, Amit, additional, Patel, Kavil, additional, Penfold, Ruth, additional, Poonian, Satveer, additional, Popoola, Olajide, additional, Pora, Alexander, additional, Prasad, Vibhore, additional, Prasad, Rishabh, additional, Razzaq, Omair, additional, Richardson, Scot, additional, Royal, Simon, additional, Safa, Afsana, additional, Sehdev, Satash, additional, Sevenoaks, Tamsin, additional, Shah, Divya, additional, Sheikh, Aadil, additional, Short, Vanessa, additional, Sidhu, Baljinder S, additional, Singh, Ivor, additional, Soni, Yusuf, additional, Thalasselis, Chris, additional, Wilson, Pete, additional, Wingfield, David, additional, Wong, Michael, additional, Woodall, Maximillian N J, additional, Wooding, Nick, additional, Woods, Sharon, additional, Yong, Joanna, additional, Yongblah, Francis, additional, and Zafar, Azhar, additional

Published
2023
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7. Efficacy and safety of intramuscular administration of tixagevimab–cilgavimab for early outpatient treatment of COVID-19 (TACKLE): a phase 3, randomised, double-blind, placebo-controlled trial

Author

Montgomery, Hugh, primary, Hobbs, F D Richard, additional, Padilla, Francisco, additional, Arbetter, Douglas, additional, Templeton, Alison, additional, Seegobin, Seth, additional, Kim, Kenneth, additional, Campos, Jesus Abraham Simón, additional, Arends, Rosalinda H, additional, Brodek, Bryan H, additional, Brooks, Dennis, additional, Garbes, Pedro, additional, Jimenez, Julieta, additional, Koh, Gavin C K W, additional, Padilla, Kelly W, additional, Streicher, Katie, additional, Viani, Rolando M, additional, Alagappan, Vijay, additional, Pangalos, Menelas N, additional, Esser, Mark T, additional, Abe, Wakana, additional, Adan De Varona, Tania, additional, Adiatullina, Daria, additional, Aguilar Zapata, Daniel, additional, Ahlers, Kevin, additional, Aimo, Carolina, additional, Akere, Ayoade, additional, Akimova, Elena, additional, Alatorre Alexander, Jorge, additional, Aldrich, Logan, additional, Ali Garcia, Ismael, additional, Ali García, Karim, additional, Allison, Lee, additional, Alonso Zuñiga, Rosa, additional, Aloysius, Ivan, additional, Altclas, Javier, additional, Alvarisqueta, Andres, additional, Antila, Martti, additional, Anton, Camila, additional, Árboix Alamo, Elisabet, additional, Arora, Samir, additional, Avilés Felix, Ramón Alejandro, additional, Bakhtina, Natalya, additional, Barbero-Becerra, Varenka, additional, Barragan-Reyes, Armando, additional, Barreira, Alejandro, additional, Barrett, Mitchell, additional, Beran, Jiri, additional, Berki, Nikolett, additional, Berki, Viktoria, additional, Betten, Richard, additional, Binelli, Claudia, additional, Brunzová, Lenka, additional, Bussolari, Cecilia, additional, Byargeon, Karianna, additional, Bytnar, Justyna, additional, Camberos, Carlos, additional, Campos Corzo, Pedro, additional, Cannon, Grazia, additional, Canovi, Valentina, additional, Carla da Rosa, Simone, additional, Moser, Ana Caroline, additional, Carrera Rivas, Luis, additional, Casas, Marcelo Martin, additional, Castañeda-Méndez, Paulo, additional, Cavalcante, Ana, additional, Cherepova, Eugenia, additional, Chermenskii, Alexei, additional, Clark, Lauren, additional, Codeluppi, Mauro, additional, Coelho, Flavia, additional, Contreras, Belinda, additional, Cran, Alex, additional, Dao, Taylor, additional, Dharma, Chrisette, additional, Di Castri, Cosimo, additional, Diaz Balocchi, Victoria, additional, Durán, Omar, additional, Earl, Kara, additional, Ellery, Adam, additional, Endo, Tomoko, additional, Everding, Andrea, additional, Fischer, Rainald, additional, Fonseca, Benedito, additional, Franklin, Chelsea C., additional, Franz, Susan-Beatrice, additional, Fumagalli, Anna, additional, Galindo-Amaya, Mauricio, additional, Galli, Mariagiulia, additional, Gerna, Laura, additional, Gil Ureña, Karolly, additional, Gomes Antila, Henrikki, additional, Gomes Maricato, Laura Ines, additional, Goncalvez, Gabriela, additional, Gonzalez, Martin, additional, González-Lama, Jesús, additional, Granier, Stephen, additional, Granier, Jacob, additional, Grunwald, Stephan, additional, Guardeño-Ropero, David, additional, Guberti, Monica, additional, Guduri, Sridhar, additional, Guerrero García, Carolina, additional, Haggiagi, Jehad, additional, Hale, Kacie, additional, Hayashi, Toshimasa, additional, Hermes, Maiara, additional, Hernandez Colin, Dante, additional, Hirai, Yuji, additional, Hojo, Masayuki, additional, Homma, Tetsuya, additional, Hour, Billy, additional, Huber, Andreas, additional, Iacovelli, Diego, additional, Ishibashi, Noriomi, additional, Iwabe, Yutaro, additional, Izumi, Shinyu, additional, Jessen, Arne, additional, Jessen, Heiko, additional, Jeudy, Wilner, additional, Jiménez Marcos, Marta, additional, Johnson, Rebecca, additional, Juárez-Hernández, Eva, additional, Kabasawa, Kiyomi, additional, Kamińska, Katarzyna, additional, Kawabe, Megumi, additional, Kemp, Angela, additional, Khmelnitskiy, Oleg, additional, Klassen, Carina, additional, Kobrynska, Olena, additional, Koleckar, Pavel, additional, Korn, Stephanie, additional, Kornmann, Marc, additional, Kostenko, Viktor, additional, Kovalchuk, Evgenii, additional, Kovalchuk, Yana, additional, Kümmerle, Tim, additional, Lachmund, Ulrike, additional, Lammersmann, Kerstin, additional, Lastebasse, Flávio, additional, Lattuada, Ivana, additional, Lauer, Felicitas, additional, Lebed, Kyrylo, additional, Lebed, Olga, additional, Lecona-Garcia, Diego, additional, Leoni, Maria Christina, additional, Lima, Marina, additional, Little, Raymond, additional, Little, Holly, additional, Lizardi-Díaz, Andrea, additional, Lobo-Becker, Michele, additional, Luppi, Francesco, additional, Macias, Veronica, additional, Maesaki, Shigefumi, additional, Magnaghi, Cristiano, additional, Mancini, Annalisa, additional, Mazur, Stanisław, additional, Melnikova, Tatiana, additional, Menchaca, Sergio, additional, Menendez-Perez, Ibrahim, additional, Międlar, Ewa, additional, Mizunuma, Shuuichi, additional, Mochalova, Anastasiya, additional, Mohamed, Mihad, additional, Moll, Theresa, additional, Montalvo, Camila, additional, Mottola, Amber, additional, Mück, Birgit, additional, Mussi Brugnolli, Rebeca, additional, Nanda, Akanksha, additional, Neuner, Dörthe, additional, Ngwueke, Agatha, additional, Noe, Sebastian, additional, Novacek, Martin, additional, Nuzzolo-Shihadeh, Laura, additional, Obiekwe, Emeka, additional, Ocampo Gaytán, Isaias G., additional, Ohmagari, Norio, additional, Ohta, Shin, additional, Onyewuchi, Ptuonye, additional, Pankov, Iurii, additional, Pedrosa, Maurício, additional, Peré, Yael, additional, Pereyra, Alejandro, additional, Perez, Eliana, additional, Perez-Alba, Eduardo, additional, Perpiña Lozano, Paloma, additional, Perrei, Tanya, additional, Peterson, Dena, additional, Pierroti, Ligia, additional, Pineda-Cárdenas, Felipe, additional, Plascencia Sanchez, Teresa, additional, Poletti, Camila, additional, Pomaranzi, Chiara, additional, Portes, Lisette, additional, Postel, Nils, additional, Ramirez, Monica, additional, Ramírez, Isabel, additional, Ramirez-Baena, Miguel, additional, Ramjee, Mahadev, additional, Ratti, Giovanna, additional, Reeve, Jackie, additional, Reichert, Petr, additional, Reichertová, Petra, additional, Reyes Garcia, Edgar Alejandro, additional, Ricardo, Celso, additional, Rodríguez Rodríguez, Nicomedes, additional, Roldán Sánchez, Jaun, additional, Romero-Lopez, Matilde, additional, Rosales, Tyrone, additional, Rosales, Harvey, additional, Roshan, Mohamed, additional, Roshan, Simran, additional, Rovere Querini, Patrizia, additional, Rutter, Heather, additional, Sachwani, Sadaf, additional, Sagara, Hironori, additional, Sakai, Jun, additional, Samson, Nina, additional, Sánchez Mijangos, José Héctor, additional, Sánchez, Liliana, additional, Sánchez-González, Ana, additional, Sandford, Micko, additional, Santana, Laura, additional, Santos de Carvalho, Felipe, additional, Sasao, Reiko, additional, Sato, Lubna, additional, Scheuermann, Elizabeth, additional, Schmidt, Olaf, additional, Seki, Masafumi, additional, Shaikh, Safia, additional, Shimada, Daishi, additional, Shinkai, Masaharu, additional, Shinoda, Masahiro, additional, Smith, Jackie, additional, Solorzano, Fernando, additional, Soncini, Silvia, additional, Soregine, Katalin, additional, Sosa, Erica, additional, Sowade, Olalekan, additional, Špinková, Veronika, additional, Staniford, Ruth, additional, Steigemann, Iska, additional, Steiner, Vivien, additional, Strelkov, Vladimir, additional, Suárez Pineda, Cintya R., additional, Suenaga, Hiroki, additional, Suzaki, Shintaro, additional, Swayze, Hannah, additional, Tada, Yuji, additional, Takeshita, Yuichiro, additional, Takiguchi, Yasuo, additional, Tanaka, Akihiko, additional, Tarumoto, Norihito, additional, Tatarintseva, Albina, additional, Taubert, Michelle, additional, Terenya, Elizaveta, additional, Tinoco, César, additional, Tomiyasu, Tomohiro, additional, Torres-Vidal, Gladys, additional, Trejo-Aguiar, Gabriela, additional, Tsushima, Kenji, additional, Tunstall, Emma, additional, Turrà, Caterina, additional, Valdes, Yoandy, additional, Valencia Castro, Nelly, additional, Visconti, Guilherme, additional, Vitali, Giordano, additional, Vutikullird, Apinya, additional, Watti, Jezdancher, additional, Werth, Doreen, additional, Wilson, Cheyanne, additional, Wilson, Philippe, additional, Workman, Amy, additional, Wörle, Pamela, additional, Wyen, Christoph, additional, Yamaguchi, Yoshiko, additional, and Yamamoto, Kei, additional

Published
2022
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9. Machine diagnosis of chronic obstructive pulmonary disease using a novel fast-response capnometer.

Author

Talker, Leeran, Neville, Daniel, Wiffen, Laura, Selim, Ahmed B., Haines, Matthew, Carter, Julian C., Broomfield, Henry, Lim, Rui Hen, Lambert, Gabriel, Winter, Jonathon, Gribbin, Andrew, Chauhan, Milan, De Vos, Ruth, Kalra, Paul, Begum, Selina, Robinson, Barbara, Mundy, Bernadette, Rutter, Heather, Madronal, Karen, and Weiss, Scott T.

Subjects
CHRONIC obstructive pulmonary disease, MACHINE learning, RESPIRATORY obstructions
Abstract

Background: Although currently most widely used in mechanical ventilation and cardiopulmonary resuscitation, features of the carbon dioxide (CO2) waveform produced through capnometry have been shown to correlate with V/Q mismatch, dead space volume, type of breathing pattern, and small airway obstruction. This study applied feature engineering and machine learning techniques to capnography data collected by the N-Tidal™ device across four clinical studies to build a classifier that could distinguish CO2 recordings (capnograms) of patients with COPD from those without COPD. Methods: Capnography data from four longitudinal observational studies (CBRS, GBRS, CBRS2 and ABRS) was analysed from 295 patients, generating a total of 88,186 capnograms. CO2 sensor data was processed using TidalSense's regulated cloud platform, performing real-time geometric analysis on CO2 waveforms to generate 82 physiologic features per capnogram. These features were used to train machine learning classifiers to discriminate COPD from 'non-COPD' (a group that included healthy participants and those with other cardiorespiratory conditions); model performance was validated on independent test sets. Results: The best machine learning model (XGBoost) performance provided a class-balanced AUROC of 0.985 ± 0.013, positive predictive value (PPV) of 0.914 ± 0.039 and sensitivity of 0.915 ± 0.066 for a diagnosis of COPD. The waveform features that are most important for driving classification are related to the alpha angle and expiratory plateau regions. These features correlated with spirometry readings, supporting their proposed properties as markers of COPD. Conclusion: The N-Tidal™ device can be used to accurately diagnose COPD in near-real-time, lending support to future use in a clinical setting. Trial registration: Please see NCT03615365, NCT02814253, NCT04504838 and NCT03356288. [ABSTRACT FROM AUTHOR]

Published
2023
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10. Molnupiravir Plus Usual Care Versus Usual Care Alone as Early Treatment for Adults with COVID-19 at Increased Risk of Adverse Outcomes (PANORAMIC): Preliminary Analysis from the United Kingdom Randomised, Controlled Open-Label, Platform Adaptive Trial

Author

Butler, Christopher, primary, Hobbs, F.D. Richard, additional, Gbinigie, Oghenekome, additional, Rahman, Najib M., additional, Hayward, Gail, additional, Richards, Duncan, additional, Dorward, Jienchi, additional, Lowe, David, additional, Standing, Joseph F., additional, Breuer, Judith, additional, Khoo, Saye, additional, Petrou, Stavros, additional, Hood, Kerenza, additional, Nguyen-Van-Tam, Jonathan S., additional, Patel, Mahendra, additional, Saville, Benjamin R., additional, Marion, Joe, additional, Ogburn, Emma, additional, Allen, Julie, additional, Rutter, Heather, additional, Francis, Nick, additional, Thomas, Nicholas, additional, Evans, Philip, additional, Dobson, Melissa, additional, Madden, Tracie-Ann, additional, Holmes, Jane, additional, Harris, Victoria, additional, Png, May Ee, additional, Lown, Mark, additional, van Hecke, Oliver, additional, Detry, Michelle, additional, Saunders, Christina, additional, Fitzgerald, Mark, additional, Berry, Nicholas, additional, Mwandigha, Lazaro, additional, Galal, Ushma, additional, Jani, Bhautesh, additional, Hart, Nigel, additional, Butler, Daniel, additional, Chalk, Jeremy, additional, Lavallee, Layla, additional, Hadley, Elizabeth, additional, Cureton, Lucy, additional, Benysek, Magdalena, additional, Andersson, Monique, additional, Coates, Maria, additional, Barrett, Sarah, additional, Bateman, Clare, additional, Davies, Jennifer, additional, Raymundo-Wood, Ivy, additional, Ustianowski, Andrew, additional, Carson-Stevens, Andrew, additional, Yu, Ly-Mee, additional, and Little, Paul, additional

Published
2022
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11. Supporting people with type 2 diabetes in effective use of their medicine through mobile health technology integrated with clinical care to reduce cardiovascular risk (SuMMiT-D): a protocol for an effectiveness and cost-effectiveness randomised control trial (Preprint)

Author

Farmer, Andrew, primary, Jones, Louise, additional, Newhouse, Nikki, additional, Kenning, Cassandra, additional, Williams, Nicola, additional, Chi, Yuan, additional, Bartlett, Kiera, additional, Plumpton, Catrin, additional, McSharry, Jenny, additional, Cholerton, Rachel, additional, Holmes, Emily, additional, Robinson, Stephanie, additional, Allen, Julie, additional, Gudgin, Bernard, additional, Velardo, Carmelo, additional, Rutter, Heather, additional, Horne, Rob, additional, Tarassenko, Lionel, additional, Williams, Veronika, additional, Locock, Louise, additional, Rea, Rustam, additional, Yu, Ly-Mee, additional, Hughes, Dyfrig, additional, Bower, Peter, additional, and French, David, additional

Published
2021
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12. Supporting People With Type 2 Diabetes in the Effective Use of Their Medicine Through Mobile Health Technology Integrated With Clinical Care to Reduce Cardiovascular Risk: Protocol for an Effectiveness and Cost-effectiveness Randomized Controlled Trial (Preprint)

Author

Farmer, Andrew, primary, Jones, Louise, additional, Newhouse, Nikki, additional, Kenning, Cassandra, additional, Williams, Nicola, additional, Chi, Yuan, additional, Bartlett, Y Kiera, additional, Plumpton, Catrin, additional, McSharry, Jenny, additional, Cholerton, Rachel, additional, Holmes, Emily, additional, Robinson, Stephanie, additional, Allen, Julie, additional, Gudgin, Bernard, additional, Velardo, Carmelo, additional, Rutter, Heather, additional, Horne, Rob, additional, Tarassenko, Lionel, additional, Williams, Veronika, additional, Locock, Louise, additional, Rea, Rustam, additional, Yu, Ly-Mee, additional, Hughes, Dyfrig, additional, Bower, Peter, additional, and French, David, additional

Published
2021
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13. Home and Online Management and Evaluation of Blood Pressure (HOME BP) using a digital intervention in poorly controlled hypertension: randomised controlled trial

Author

McManus, Richard J., Little, Paul, Stuart, Beth, Morton, Katherine, Raftery, James, Kelly, Jo, Bradbury, Katherine, Zhang, Jin, Zhu, Shihua, Murray, Elizabeth, May, Carl R., Mair, Frances S., Michie, Susan, Smith, Peter, Band, Rebecca, Ogburn, Emma, Allen, Julie, Rice, Cathy, Nuttall, Jacqui, Williams, Bryan, Yardley, Lucy, HOME BP investigators, Jones, Adam, Hussain, Ajmal, McHardy, Alistair, Harrison, Anna, LaLonde, Anna, Malik, Asim, Hernandez-Diaz, Basilio, Cranfield, Ben, Nicholson, Brian, Anandan, Carl, Neden, Catherine, Bobrow, Cathy, Evans, Chloe, Keast, Christopher, Henderson, Clare, Sutherland, Corrine, Kyte, Craig, Henderson, Dan, Noble, Debbie, Capo-Bianco, Ed, Williams, Edward, Shaw, Elizabeth, Mohri, Fatima, Asal, Gaurav, Dougall, Greig, Bhupal, Hardeep, Luckhurst, Heidi, Dosanjh, Hergeven, Nowell, Hilary, Brown, Jan, Flett, Jennifer, Barber, Julian, Rutter, Heather, Thompson, Julian, Ramanan, Kanjhana, Madronal, Karen, Malone, Karen, Etherington, Katie, Tsoi, Kenney, Knox, Kyle, Amin, Laila, Hirst, Lisa, Allen, Lucy, Skellern, Luke, Flynn, Lynne, McEwan, Lorne, Pugsley, Mark, Frassen, Marloes, Gaw, Matthew, Prendergast, Matthew, Wallard, Matthew, Faisal, Muhammad, Wooding, Nick, Lees, Nienke, Wainman, Paul, Nanda, Nithya, Moore, Patrick, Conley, Paul, Johnson, Paul, Wilson, Penny, Jacobs, Phillip, Whitbred, Pippa, Zamir, Rebecca, Reed, Richard, Tribley, Richard, Woof, Richard, Danson, Ruth, Lawes, Ruth, Gallagher, Sarah, Wadsworth, Sarah, Macanovic, Serge, Cartwright, Simon, Pettitt, Simon, Tucker, Simon, Doggett, Stephen, Sevenoaks, Tamsin, Watson, Tara, Talbot, Tess, Imrie, Ruth, Herbert, Thomas, Crockett, Tony, Wright, Tony, Sharma, Vanshika, Telford, Vicki, Almashta, Zaid, Cheng, Zelda, Ali, Zishan, Grube, Alice, Claxton, Andy, Asante, Barbara, Weare, Becki, McKee, Eleanor, Werrett, Bertha, Barwell, Carmel, Mulvihill, Carole, Sherwood, Caroline, MacDonald, Clare, Tabor, Dadirayi, Denning, Dawn, Roberts, Debbie, Adshead, Diane, Clarke, Gemma, Huntley, Heather, Pinder, Heather, Qasim, Irene, Merrison, Jane, King, Jill, Allison, Julie, Johal, Kam, Terry, Karen, Wood, Karine, Balmford, Kathryn, Barnes, Katie, Post, Katie, Bowden, Kelly-Marie, Edmunds, Kirsty, Whittle, Klaire, Peniket, Lara, Carnegie, Leann, Neale, Linda, Davey, Lisa, Bartlett, Liz, Smith, Louise, Clack, Lucy, Brown, Martina, McKenna, Naomi, Kay, Pam, Jacobs, Polly, Cutts, Rebecca, Pearse, Robert, Atkinson, Ruth, Barter, Sally, Mackie, Sally, Norris, Sam, Cook, Sandra, Elderfield, Sarah, Nzante, Sarah, Cronin, Sharon, Maslen, Sophie, Marchant, Stephanie, Wright, Stephanie, Keene, Sue, Smith, Sue, Cimelli, Suzie, Stone, Tracy, Joyce, Tricia, Le Marechal, Trudie, Kettle, Vicky, Osborne, Victoria, Cubiss, Wendy, Marsden, Wendy, Kowalczyk-Williams, Wioletta, and Bailey, Zoe

Abstract

Objective: The HOME BP (Home and Online Management and Evaluation of Blood Pressure) trial aimed to test a digital intervention for hypertension management in primary care by combining self-monitoring of blood pressure with guided self-management. Design: Unmasked randomised controlled trial with automated ascertainment of primary endpoint. Setting: 76 general practices in the United Kingdom. Participants: 622 people with treated but poorly controlled hypertension (>140/90 mm Hg) and access to the internet. Interventions: Participants were randomised by using a minimisation algorithm to self-monitoring of blood pressure with a digital intervention (305 participants) or usual care (routine hypertension care, with appointments and drug changes made at the discretion of the general practitioner; 317 participants). The digital intervention provided feedback of blood pressure results to patients and professionals with optional lifestyle advice and motivational support. Target blood pressure for hypertension, diabetes, and people aged 80 or older followed UK national guidelines. Main outcome measures: The primary outcome was the difference in systolic blood pressure (mean of second and third readings) after one year, adjusted for baseline blood pressure, blood pressure target, age, and practice, with multiple imputation for missing values. Results: After one year, data were available from 552 participants (88.6%) with imputation for the remaining 70 participants (11.4%). Mean blood pressure dropped from 151.7/86.4 to 138.4/80.2 mm Hg in the intervention group and from 151.6/85.3 to 141.8/79.8 mm Hg in the usual care group, giving a mean difference in systolic blood pressure of −3.4 mm Hg (95% confidence interval −6.1 to −0.8 mm Hg) and a mean difference in diastolic blood pressure of −0.5 mm Hg (−1.9 to 0.9 mm Hg). Results were comparable in the complete case analysis and adverse effects were similar between groups. Within trial costs showed an incremental cost effectiveness ratio of £11 ($15, €12; 95% confidence interval £6 to £29) per mm Hg reduction. Conclusions: The HOME BP digital intervention for the management of hypertension by using self-monitored blood pressure led to better control of systolic blood pressure after one year than usual care, with low incremental costs. Implementation in primary care will require integration into clinical workflows and consideration of people who are digitally excluded. Trial registration: ISRCTN13790648.

Published
2021

14. Platform Randomised trial of INterventions against COVID-19 In older peoPLE (PRINCIPLE): protocol for a randomised, controlled, open-label, adaptive platform, trial of community treatment of COVID-19 syndromic illness in people at higher risk

Author

Hayward, Gail, primary, Butler, Christopher C, additional, Yu, Ly-Mee, additional, Saville, Benjamin R, additional, Berry, Nicholas, additional, Dorward, Jienchi, additional, Gbinigie, Oghenekome, additional, van Hecke, Oliver, additional, Ogburn, Emma, additional, Swayze, Hannah, additional, Bongard, Emily, additional, Allen, Julie, additional, Tonner, Sharon, additional, Rutter, Heather, additional, Tonkin-Crine, Sarah, additional, Borek, Aleksandra, additional, Judge, David, additional, Grabey, Jenna, additional, de Lusignan, Simon, additional, Thomas, Nicholas P B, additional, Evans, Philip H, additional, Andersson, Monique I, additional, Llewelyn, Martin, additional, Patel, Mahendra, additional, Hopkins, Susan, additional, and Hobbs, F D Richard, additional

Published
2021
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15. Probiotics to reduce antibiotic administration in care home residents aged 65 years and older: the PRINCESS RCT

Author

Butler, Christopher C, primary, Owen-Jones, Eleri, additional, Lau, Mandy, additional, Gillespie, David, additional, Lown, Mark, additional, Calder, Philip C, additional, Stanton, Helen, additional, Wootton, Mandy, additional, Castro Herrera, Vivian, additional, Bayer, Antony, additional, Davies, Jane, additional, Edwards, Alison, additional, Davoudianfar, Mina, additional, Rutter, Heather, additional, Hood, Kerenza, additional, Moore, Michael, additional, Little, Paul, additional, Shepherd, Victoria, additional, Lowe, Rachel, additional, Miles, Elizabeth A, additional, Townson, Julia, additional, Hobbs, FD Richard, additional, and Francis, Nick A, additional

Published
2021
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16. Home and Online Management and Evaluation of Blood Pressure (HOME BP) using a digital intervention in poorly controlled hypertension: randomised controlled trial

Author

McManus, Richard J, Little, Paul, Stuart, Beth, Morton, Katherine, Raftery, James, Kelly, Jo, Bradbury, Katherine, Zhang, Jin, Zhu, Shihua, Murray, Elizabeth, May, Carl R, Mair, Frances S, Michie, Susan, Smith, Peter, Band, Rebecca, Ogburn, Emma, Allen, Julie, Rice, Cathy, Nuttall, Jacqui, Williams, Bryan, Yardley, Lucy, Jones, Adam, Hussain, Ajmal, McHardy, Alistair, Harrison, Anna, LaLonde, Anna, Malik, Asim, Hernandez-Diaz, Basilio, Cranfield, Ben, Nicholson, Brian, Anandan, Carl, Neden, Catherine, Bobrow, Cathy, Evans, Chloe, Keast, Christopher, Henderson, Clare, Sutherland, Corrine, Kyte, Craig, Henderson, Dan, Noble, Debbie, Capo-Bianco, Ed, Williams, Edward, Shaw, Elizabeth, Mohri, Fatima, Asal, Gaurav, Dougall, Greig, Bhupal, Hardeep, Luckhurst, Heidi, Dosanjh, Hergeven, Nowell, Hilary, Brown, Jan, Flett, Jennifer, Barber, Julian, Rutter, Heather, Thompson, Julian, Ramanan, Kanjhana, Madronal, Karen, Malone, Karen, Etherington, Katie, Tsoi, Kenney, Knox, Kyle, Amin, Laila, Hirst, Lisa, Allen, Lucy, Skellern, Luke, Flynn, Lynne, McEwan, Lorne, Pugsley, Mark, Frassen, Marloes, Gaw, Matthew, Prendergast, Matthew, Wallard, Matthew, Faisal, Muhammad, Wooding, Nick, Lees, Nienke, Wainman, Paul, Nanda, Nithya, Moore, Patrick, Conley, Paul, Johnson, Paul, Wilson, Penny, Jacobs, Phillip, Whitbred, Pippa, Zamir, Rebecca, Reed, Richard, Tribley, Richard, Woof, Richard, Danson, Ruth, Lawes, Ruth, Gallagher, Sarah, Wadsworth, Sarah, Macanovic, Serge, Cartwright, Simon, Pettitt, Simon, Tucker, Simon, Doggett, Stephen, Sevenoaks, Tamsin, Watson, Tara, Talbot, Tess, Imrie, Ruth, Herbert, Thomas, Crockett, Tony, Wright, Tony, Sharma, Vanshika, Telford, Vicki, Almashta, Zaid, Cheng, Zelda, Ali, Zishan, Grube, Alice, Claxton, Andy, Asante, Barbara, Weare, Becki, McKee, Eleanor, Werrett, Bertha, Barwell, Carmel, Mulvihill, Carole, Sherwood, Caroline, MacDonald, Clare, Tabor, Dadirayi, Denning, Dawn, Roberts, Debbie, Adshead, Diane, Clarke, Gemma, Huntley, Heather, Pinder, Heather, Qasim, Irene, Merrison, Jane, King, Jill, Allison, Julie, Johal, Kam, Terry, Karen, Wood, Karine, Balmford, Kathryn, Barnes, Katie, Post, Katie, Bowden, Kelly-Marie, Edmunds, Kirsty, Whittle, Klaire, Peniket, Lara, Carnegie, Leann, Neale, Linda, Davey, Lisa, Bartlett, Liz, Smith, Louise, Clack, Lucy, Brown, Martina, McKenna, Naomi, Kay, Pam, Jacobs, Polly, Cutts, Rebecca, Pearse, Robert, Atkinson, Ruth, Barter, Sally, Mackie, Sally, Norris, Sam, Cook, Sandra, Elderfield, Sarah, Nzante, Sarah, Cronin, Sharon, Maslen, Sophie, Marchant, Stephanie, Wright, Stephanie, Keene, Sue, Smith, Sue, Cimelli, Suzie, Stone, Tracy, Joyce, Tricia, Le Marechal, Trudie, Kettle, Vicky, Osborne, Victoria, Cubiss, Wendy, Marsden, Wendy, Kowalczyk-Williams, Wioletta, and Bailey, Zoe

Subjects
Male, medicine.medical_specialty, General Practice, Psychological intervention, Blood Pressure, law.invention, Randomized controlled trial, law, Diabetes mellitus, Clinical endpoint, Humans, Medicine, Antihypertensive Agents, Aged, business.industry, Research, Self-Management, General Medicine, Blood Pressure Monitoring, Ambulatory, Middle Aged, medicine.disease, Telemedicine, United Kingdom, Confidence interval, Mean blood pressure, Blood pressure, Hypertension, Physical therapy, Female, Physical and Mental Health, business, Incremental cost-effectiveness ratio
Abstract

Objective The HOME BP (Home and Online Management and Evaluation of Blood Pressure) trial aimed to test a digital intervention for hypertension management in primary care by combining self-monitoring of blood pressure with guided self-management. Design Unmasked randomised controlled trial with automated ascertainment of primary endpoint. Setting 76 general practices in the United Kingdom. Participants 622 people with treated but poorly controlled hypertension (>140/90 mm Hg) and access to the internet. Interventions Participants were randomised by using a minimisation algorithm to self-monitoring of blood pressure with a digital intervention (305 participants) or usual care (routine hypertension care, with appointments and drug changes made at the discretion of the general practitioner; 317 participants). The digital intervention provided feedback of blood pressure results to patients and professionals with optional lifestyle advice and motivational support. Target blood pressure for hypertension, diabetes, and people aged 80 or older followed UK national guidelines. Main outcome measures The primary outcome was the difference in systolic blood pressure (mean of second and third readings) after one year, adjusted for baseline blood pressure, blood pressure target, age, and practice, with multiple imputation for missing values. Results After one year, data were available from 552 participants (88.6%) with imputation for the remaining 70 participants (11.4%). Mean blood pressure dropped from 151.7/86.4 to 138.4/80.2 mm Hg in the intervention group and from 151.6/85.3 to 141.8/79.8 mm Hg in the usual care group, giving a mean difference in systolic blood pressure of −3.4 mm Hg (95% confidence interval −6.1 to −0.8 mm Hg) and a mean difference in diastolic blood pressure of −0.5 mm Hg (−1.9 to 0.9 mm Hg). Results were comparable in the complete case analysis and adverse effects were similar between groups. Within trial costs showed an incremental cost effectiveness ratio of £11 ($15, €12; 95% confidence interval £6 to £29) per mm Hg reduction. Conclusions The HOME BP digital intervention for the management of hypertension by using self-monitored blood pressure led to better control of systolic blood pressure after one year than usual care, with low incremental costs. Implementation in primary care will require integration into clinical workflows and consideration of people who are digitally excluded. Trial registration ISRCTN13790648 .

Published
2020
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17. Burden of respiratory syncytial virus infection in community-dwelling older adults in Europe (RESCEU): an international prospective cohort study

Author

Korsten, Koos, primary, Adriaenssens, Niels, additional, Coenen, Samuel, additional, Butler, Christopher, additional, Ravanfar, Behnaz, additional, Rutter, Heather, additional, Allen, Julie, additional, Falsey, Ann, additional, Pirçon, Jean-Yves, additional, Gruselle, Olivier, additional, Pavot, Vincent, additional, Vernhes, Charlotte, additional, Balla-Jhagjhoorsingh, Sunita, additional, Öner, Deniz, additional, Ispas, Gabriela, additional, Aerssens, Jeroen, additional, Shinde, Vivek, additional, Verheij, Theo, additional, Bont, Louis, additional, and Wildenbeest, Joanne, additional

Published
2020
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18. Effect of Probiotic Use on Antibiotic Administration Among Care Home Residents

Author

Butler, Christopher C., primary, Lau, Mandy, additional, Gillespie, David, additional, Owen-Jones, Eleri, additional, Lown, Mark, additional, Wootton, Mandy, additional, Calder, Philip C., additional, Bayer, Antony J., additional, Moore, Michael, additional, Little, Paul, additional, Davies, Jane, additional, Edwards, Alison, additional, Shepherd, Victoria, additional, Hood, Kerenza, additional, Hobbs, F. D. Richard, additional, Davoudianfar, Mina, additional, Rutter, Heather, additional, Stanton, Helen, additional, Lowe, Rachel, additional, Fuller, Richard, additional, and Francis, Nick A., additional

Published
2020
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19. Supporting People With Type 2 Diabetes in the Effective Use of Their Medicine Through Mobile Health Technology Integrated With Clinical Care to Reduce Cardiovascular Risk: Protocol for an Effectiveness and Cost-effectiveness Randomized Controlled Trial.

Author

Farmer, Andrew, Jones, Louise, Newhouse, Nikki, Kenning, Cassandra, Williams, Nicola, Chi, Yuan, Bartlett, Y. Kiera, Plumpton, Catrin, McSharry, Jenny, Cholerton, Rachel, Holmes, Emily, Robinson, Stephanie, Allen, Julie, Gudgin, Bernard, Velardo, Carmelo, Rutter, Heather, Horne, Rob, Tarassenko, Lionel, Williams, Veronika, and Locock, Louise

Subjects
TYPE 2 diabetes, MOBILE health, MEDICAL care, CARDIOVASCULAR diseases risk factors, CLINICAL trials
Abstract

Background: Type 2 diabetes is a common lifelong condition that affects over 400 million people worldwide. The use of effective medications and active self-management can reduce the risk of serious complications. However, people often have concerns when starting new medications and face difficulties in taking their medications regularly. Support provided by brief messages delivered through mobile phone--based SMS text messages can be effective in some long-term conditions. We have identified promising behavior change techniques (BCTs) to promote medication adherence in this population via a systematic review and developed SMS text messages that target these BCTs. Feasibility work has shown that these messages have fidelity to intended BCTs, are acceptable to patients, and are successful in changing the intended determinants of medication adherence. We now plan to test this intervention on a larger scale in a clinical trial. Objective: The aim of this trial is to determine the effectiveness and cost-effectiveness of this intervention for reducing cardiovascular risk in people with type 2 diabetes by comparing it with usual care. Methods: The trial will be a 12-month, multicenter, individually randomized controlled trial in primary care and will recruit adults (aged ≥35 years) with type 2 diabetes in England. Consenting participants will be randomized to receive short SMS text messages intended to affect a change in medication adherence 3 to 4 times per week in addition to usual care. The aim is to test the effectiveness and cost-effectiveness of the intervention when it is added to usual care. The primary clinical outcome will be a composite cardiovascular risk measure. Data including patient-reported measures will be collected at baseline, at 13 and 26 weeks, and at the end of the 12-month follow-up period. With 958 participants (479 in each group), the trial is powered at 92.5% to detect a 4--percentage point difference in cardiovascular risk. The analysis will follow a prespecified plan. A nested quantitative and qualitative process analysis will be used to examine the putative mechanisms of behavior change and wider contextual influences. A health economic analysis will be used to assess the cost-effectiveness of the intervention. Results: The trial has completed the recruitment phase and is in the follow-up phase. The publication of results is anticipated in 2024. Conclusions: This trial will provide evidence regarding the effectiveness and cost-effectiveness of this intervention for people with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Published
2022
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22. Efficacy of self-monitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): an unmasked randomised controlled trial

Author

McManus, Richard J, primary, Mant, Jonathan, additional, Franssen, Marloes, additional, Nickless, Alecia, additional, Schwartz, Claire, additional, Hodgkinson, James, additional, Bradburn, Peter, additional, Farmer, Andrew, additional, Grant, Sabrina, additional, Greenfield, Sheila M, additional, Heneghan, Carl, additional, Jowett, Susan, additional, Martin, Una, additional, Milner, Siobhan, additional, Monahan, Mark, additional, Mort, Sam, additional, Ogburn, Emma, additional, Perera-Salazar, Rafael, additional, Shah, Syed Ahmar, additional, Yu, Ly-Mee, additional, Tarassenko, Lionel, additional, Hobbs, F D Richard, additional, Bradley, Brendan, additional, Lovekin, Chris, additional, Judge, David, additional, Castello, Luis, additional, Dawson, Maureen, additional, Brice, Rebecca, additional, Dunbabin, Bethany, additional, Maslen, Sophie, additional, Rutter, Heather, additional, Norris, Mary, additional, French, Lauren, additional, Loynd, Michael, additional, Whitbread, Pippa, additional, Saldana Ortaga, Luisa, additional, Noel, Irene, additional, Madronal, Karen, additional, Timmins, Julie, additional, Hughes, Lucy, additional, Hinks, Beth, additional, Bailey, Sheila, additional, Read, Sue, additional, Weston, Andrea, additional, Spannuth, Somi, additional, Maiden, Sue, additional, Chermahini, Makiko, additional, McDonald, Ann, additional, Rajan, Shelina, additional, Allen, Sue, additional, Deboys, Brenda, additional, Fell, Kim, additional, Johnson, Jenny, additional, Jung, Helen, additional, Lister, Rachel, additional, Osborne, Ruth, additional, Secker, Amy, additional, Qasim, Irene, additional, William, Kirsty, additional, Harris, Abi, additional, Zhao, Susan, additional, Butcher, Elaine, additional, Darbyshire, Pauline, additional, Joshi, Sarah, additional, Davies, Jon, additional, Talbot, Claire, additional, Hoverd, Eleanor, additional, Field, Linda, additional, Adcock, Tracey, additional, Rooney, Julia, additional, Cooter, Nina, additional, Butler, Aaron, additional, Allen, Naomi, additional, Abdul-Wahab, Maria, additional, McNicholas, Kathryn, additional, Peniket, Lara, additional, Dodd, Kate, additional, Mugurza, Julie, additional, Baskerville, Richard, additional, Syed, Rakshan, additional, Bailey, Clare, additional, Adams, Jill, additional, Uglow, Paul, additional, Townsend, Neil, additional, Macleod, Alison, additional, Hawkins, Charlotte, additional, Behura, Suparna, additional, Crawshaw, Jonathan, additional, Fox, Robin, additional, Doski, Waleed, additional, Aylward, Martin, additional, A'Court, Christine, additional, Rapley, David, additional, Walsh, Jo, additional, Batra, Paul, additional, Seoane, Ana, additional, Mukherjee, Sluti, additional, Dixon, Jonathan, additional, Arthur, Peter, additional, Sutcliffe, Karen, additional, Paschallides, Costas, additional, Woof, Richard, additional, Winfrey, Peter, additional, Clark, Matthew, additional, Kamali, Roya, additional, Thomas, Paul, additional, Ebbs, David, additional, Mather, Liz, additional, Beattie, Andre, additional, Ladha, Karim, additional, Smondulak, Larisa, additional, Jemahl, Surinder, additional, Hickson, Peter, additional, Stevens, Liam, additional, Crockett, Tony, additional, Shukla, David, additional, Binnian, Ian, additional, Vinson, Paul, additional, DeKare-Silver, Nigel, additional, Patel, Ramila, additional, Singh, Ivor, additional, Lumley, Louise, additional, Williams, Glennis, additional, Webb, Mark, additional, Bambrough, Jack, additional, Shah, Neetul, additional, Dosanjh, Hergeven, additional, Spannuth, Frank, additional, Paul, Carolyn, additional, Ganesegaram, Jude, additional, Pike, Laurie, additional, Maheswaran, Vijaysundari, additional, Paruk, Farah, additional, Ford, Stephen, additional, Verma, Vineeta, additional, Milne, Kate, additional, Lockhat, Farhana, additional, Ferguson, Jennifer, additional, Quirk, Anne-Marie, additional, Wilson, Hugo, additional, Copping, David, additional, Bajallan, Sam, additional, Tanvir, Simria, additional, Khan, Faheem, additional, Alderson, Tom, additional, Ali, Amar, additional, Young, Richard, additional, Chauhan, Umesh, additional, Crockett, Lindsey, additional, McGovern, Louise, additional, Cubitt, Claire, additional, Weatherill, Simon, additional, Tabassum, Abdul, additional, Saunders, Philip, additional, Chauhan, Naresh, additional, Johnson, Samantha, additional, Marok, Inderjit, additional, Sharma, Rajiv, additional, Lumb, William, additional, Tweedale, John, additional, Smith, Ian, additional, Miller, Lawrence, additional, Ahmed, Tanveer, additional, Sanderson, Mark, additional, Jones, Claire, additional, Stokell, Peter, additional, Edwards, Matthew J, additional, Askey, Andrew, additional, Spencer, Jason, additional, Morgan, Kathryn, additional, Knox, Kyle, additional, Baker, Robert, additional, Fisher, Crispin, additional, Halstead, Rachel, additional, Modha, Neil, additional, Buckley, David, additional, Stokell, Catherine, additional, McCabe, John Gerald, additional, Taylor, Jennifer, additional, Nutbeam, Helen, additional, Smith, Richard, additional, MacGregor, Christopher, additional, Davies, Sam, additional, Lindsey, Mark, additional, Cartwright, Simon, additional, Whittle, Jonathan, additional, Colclough, Julie, additional, Crumbie, Alison, additional, Thomas, Nicholas, additional, Premchand, Vattakkatt, additional, Hamid, Rafia, additional, Ali, Zishan, additional, Ward, John, additional, Pinney, Philip, additional, Thurston, Stephen, additional, and Banerjee, Tina, additional

Published
2018
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23. Self-Management Support Using a Digital Health System Compared With Usual Care for Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial

Author

Farmer, Andrew, primary, Williams, Veronika, additional, Velardo, Carmelo, additional, Shah, Syed Ahmar, additional, Yu, Ly-Mee, additional, Rutter, Heather, additional, Jones, Louise, additional, Williams, Nicola, additional, Heneghan, Carl, additional, Price, Jonathan, additional, Hardinge, Maxine, additional, and Tarassenko, Lionel, additional

Published
2017
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25. Digital health system for personalised COPD long-term management.

Author

Velardo, Carmelo, Shah, Syed Ahmar, Gibson, Oliver, Clifford, Gari, Heneghan, Carl, Rutter, Heather, Farmer, Andrew, Tarassenko, Lionel, and EDGE COPD Team

Subjects
OBSTRUCTIVE lung disease treatment, DISEASE management, PULSE oximeters, RANDOMIZED controlled trials, OXYGEN in the body, COMPARATIVE studies, RESEARCH methodology, MEDICAL cooperation, MEDICAL informatics, OXIMETRY, PATIENT monitoring, POCKET computers, RESEARCH, RESEARCH funding, HEALTH self-care, TELEMEDICINE, EVALUATION research
Abstract

Background: Recent telehealth studies have demonstrated minor impact on patients affected by long-term conditions. The use of technology does not guarantee the compliance required for sustained collection of high-quality symptom and physiological data. Remote monitoring alone is not sufficient for successful disease management. A patient-centred design approach is needed in order to allow the personalisation of interventions and encourage the completion of daily self-management tasks.Methods: A digital health system was designed to support patients suffering from chronic obstructive pulmonary disease in self-managing their condition. The system includes a mobile application running on a consumer tablet personal computer and a secure backend server accessible to the health professionals in charge of patient management. The patient daily routine included the completion of an adaptive, electronic symptom diary on the tablet, and the measurement of oxygen saturation via a wireless pulse oximeter.Results: The design of the system was based on a patient-centred design approach, informed by patient workshops. One hundred and ten patients in the intervention arm of a randomised controlled trial were subsequently given the tablet computer and pulse oximeter for a 12-month period. Patients were encouraged, but not mandated, to use the digital health system daily. The average used was 6.0 times a week by all those who participated in the full trial. Three months after enrolment, patients were able to complete their symptom diary and oxygen saturation measurement in less than 1 m 40s (96% of symptom diaries). Custom algorithms, based on the self-monitoring data collected during the first 50 days of use, were developed to personalise alert thresholds.Conclusions: Strategies and tools aimed at refining a digital health intervention require iterative use to enable convergence on an optimal, usable design. 'Continuous improvement' allowed feedback from users to have an immediate impact on the design of the system (e.g., collection of quality data), resulting in high compliance with self-monitoring over a prolonged period of time (12-month). Health professionals were prompted by prioritisation algorithms to review patient data, which led to their regular use of the remote monitoring website throughout the trial.Trial Registration: Trial registration: ISRCTN40367841 . Registered 17/10/2012. [ABSTRACT FROM AUTHOR]

Published
2017
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28. M-health for long-term management of COPD

Author

Tarassenko, Lionel, Velardo, Carmelo, Shah, Ahmar, Gibson, Oliver, Clifford, Gari, Heneghan, Carl, Rutter, Heather, Farmer, Andrew, Tarassenko, Lionel, Velardo, Carmelo, Shah, Ahmar, Gibson, Oliver, Clifford, Gari, Heneghan, Carl, Rutter, Heather, and Farmer, Andrew

Published
2013

31. M-health for long-term management of COPD

Author

Tarassenko, Lionel, primary, Velardo, Carmelo, additional, Shah, Ahmar, additional, Gibson, Oliver, additional, Clifford, Gari, additional, Heneghan, Carl, additional, Rutter, Heather, additional, and Farmer, Andrew, additional

Published
2013
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34. Using a mobile health application to support self-management in chronic obstructive pulmonary disease: a six-month cohort study

Author

Hardinge, Maxine, Rutter, Heather, Velardo, Carmelo, Shah, Syed Ahmar, Williams, Veronika, Tarassenko, Lionel, and Farmer, Andrew

Subjects
Chronic condition, Aged, 80 and over, E-health, Alerts, Chronic obstructive pulmonary disease, Health Policy, Health Informatics, Middle Aged, Mobile Applications, Telemedicine, Cohort Studies, Self Care, Pulmonary Disease, Chronic Obstructive, Telehealth, Self-management, Humans, Mobile health, Digital health, Research Article, Aged
Abstract

Background Self-management strategies have the potential to support patients with chronic obstructive pulmonary disease (COPD). Telehealth interventions may have a role in delivering this support along with the opportunity to monitor symptoms and physiological variables. This paper reports findings from a six-month, clinical, cohort study of COPD patients’ use of a mobile telehealth based (mHealth) application and how individually determined alerts in oxygen saturation levels, pulse rate and symptoms scores related to patient self-initiated treatment for exacerbations. Methods The development of the mHealth intervention involved a patient focus group and multidisciplinary team of researchers, engineers and clinicians. Individual data thresholds to set alerts were determined, and the relationship to exacerbations, defined by the initiation of stand-by medications, was measured. The sample comprised 18 patients (age range of 50–85 years) with varied levels of computer skills. Results Patients identified no difficulties in using the mHealth application and used all functions available. 40 % of exacerbations had an alert signal during the three days prior to a patient starting medication. Patients were able to use the mHealth application to support self- management, including monitoring of clinical data. Within three months, 95 % of symptom reporting sessions were completed in less than 100 s. Conclusions Home based, unassisted, daily use of the mHealth platform is feasible and acceptable to people with COPD for reporting daily symptoms and medicine use, and to measure physiological variables such as pulse rate and oxygen saturation. These findings provide evidence for integrating telehealth interventions with clinical care pathways to support self-management in COPD.

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35. The Tower to the Sun.

Author

Baillie, Carol, Rutter, Heather, and Thompson, Colin

Subjects
*TECHNOLOGY, *PRIMARY education, *CURRICULUM
Abstract

Focuses on the need of technology education in primary schools. Reference of technology education from the books 'The Lighthouse Keeper's' and 'The Tower to the Sun'; Importance of technology education in the primary schools.

Published
1997

36. Burden of respiratory syncytial virus infection in community-dwelling older adults in Europe (RESCEU): an international prospective cohort study.

Author

Korsten K, Adriaenssens N, Coenen S, Butler C, Ravanfar B, Rutter H, Allen J, Falsey A, Pirçon JY, Gruselle O, Pavot V, Vernhes C, Balla-Jhagjhoorsingh S, Öner D, Ispas G, Aerssens J, Shinde V, Verheij T, Bont L, and Wildenbeest J

Subjects
Aged, Aged, 80 and over, Europe epidemiology, Hospitalization, Humans, Independent Living, Infant, Middle Aged, Prospective Studies, Risk Factors, Respiratory Syncytial Virus Infections epidemiology, Respiratory Syncytial Virus, Human
Abstract

Background: Respiratory syncytial virus (RSV) infection in older adults is recognised as an important health issue. We aimed to assess the community burden of RSV in Europe in older adults aged ≥60 years., Methods: This international, prospective, observational cohort study is part of work by the REspiratory Syncytial virus Consortium in EUrope (RESCEU). Participants were recruited through general practitioners' (GPs) offices before two independent RSV seasons. Participants reported weekly about symptoms of acute respiratory tract infection (ARTI) during one RSV season. ARTI patients were tested for RSV during home visits and completed a daily symptom diary. RSV illness included PCR-confirmed ARTI and those showing seroconversion over the season. RSV ARTI was based on PCR alone (ClinicalTrials.gov, NCT03621930)., Results: We recruited 1040 participants (527 in season 2017-2018 and 513 in season 2018-2019) with a median age of 75 years (range 60-100 years). Of these, 1023 (99%) lived independently at home at baseline. RSV illness incidence was 22 out of 527 (4.2%) and 37 out of 513 (7.2%) in the respective seasons. RSV illness did not affect frailty or cardiopulmonary status during the course of the study. No patients were hospitalised or died from RSV illness. In the 36 patients with PCR confirmed RSV ARTI, symptom duration averaged 19 days, while a doctor's visit took place in 11 out of 36 cases (31%). RSV ARTI could not be differentiated clinically from all other ARTIs based on symptoms., Conclusion: This European study showed that RSV is prevalent in community-dwelling older adults and rarely causes severe disease. This suggests that watchful waiting, using a continuity of care approach to identify those who do need more intensive care, is often justified when RSV is suspected in family practice., Competing Interests: Conflict of interest: K. Korsten has nothing to disclose. Conflict of interest: N. Adriaenssens has nothing to disclose. Conflict of interest: S. Coenen reports grants and non-financial support from European Union (EU) Horizon 2020 research and innovation programme and the European Federation of Pharmaceutical Industries and Associations (EFPIA) Innovative Medicines Initiative 2 (IMI-2) Joint Undertaking (grant: 116019), during the conduct of the study. Conflict of interest: C. Butler reports grants from the National Institute for Health Research (NIHR) (as NIHR Senior Investigator), grants from the EU Horizon 2020 programme to support the study, grants from the NIHR Health Protection Research Unit on Health Care Associated Infections and Antimicrobial Resistance, grants from the NIHR Health for the MedTech and In Vitro Diagnostics Cooperative for innovative diagnostics and monitoring technology to enhance community healthcare, during the conduct of the study; personal fees for advisory board work from Pfizer and Roche Molecular Systems; and grants from Roche Molecular Diagnostics. Conflict of interest: B. Ravanfar has nothing to disclose. Conflict of interest: H. Rutter has nothing to disclose. Conflict of interest: J. Allen has nothing to disclose. Conflict of interest: A. Falsey reports grants from Janssen, Merck, Sharpe and Dohme, and Pfizer, as well as non-financial support for meeting attendance from Sanofi Pasteur, outside the submitted work. Conflict of interest: J-Y. Pirçon is an employee of GlaxoSmithKline Vaccines. Conflict of interest: O. Gruselle is an employee of GlaxoSmithKline. Conflict of interest: V. Pavot is an employee of Sanofi Pasteur. Conflict of interest: C. Vernhes is an employee of Sanofi Pasteur. Conflict of interest: S. Balla-Jhagjhoorsingh is an employee of Janssen Vaccines & Prevention. Conflict of interest: D. Öner is an employee of Janssen Pharmaceutica NV and reports grants from the IMI-2 Joint Undertaking (grant: 116019), during the conduct of the study. Conflict of interest: G. Ispas is an employee of Janssen Pharmaceutica NV. Conflict of interest: J. Aerssens is an employee of Janssen Pharmaceutica NV. Conflict of interest: V. Shinde has nothing to disclose. Conflict of interest: T. Verheij reports grants from Janssen Pharmaceuticals, Becton Dickinson, Abbott and Biomerieux, outside the submitted work. Conflict of interest: L. Bont has regular interaction with pharmaceutical and other industrial partners. He has not received personal fees or other personal benefits; however, University Medical Center Utrecht has received major funding for investigator-initiated studies from AbbVie, MedImmune, Janssen, the Bill and Melinda Gates Foundation, Nutricia (Danone) and MeMed Diagnostics; has received major cash or in kind funding as part of the public–private partnership, IMI-2 funded REspiratory Syncytial virus Consortium in EUrope (RESCEU) project from GlaxoSmithKline, Novavax, Janssen, AstraZeneca, Pfizer and Sanofi; has received major funding from Julius Clinical for participating in the INFORM study sponsored by MedImmune; has received minor funding for participation in trials by Regeneron and Janssen from 2015–2017; and has received minor funding for consultation and invited lectures by AbbVie, MedImmune, Ablynx, Bavaria Nordic, MabXience, Novavax, Pfizer and Janssen. L. Bont is also the founding chairman of the ReSViNET Foundation. Conflict of interest: J. Wildenbeest has nothing to disclose., (Copyright © ERS 2021.)

Published
2021
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37. Probiotics to reduce antibiotic administration in care home residents aged 65 years and older: the PRINCESS RCT

Author

Butler CC, Owen-Jones E, Lau M, Gillespie D, Lown M, Calder PC, Stanton H, Wootton M, Castro Herrera V, Bayer A, Davies J, Edwards A, Davoudianfar M, Rutter H, Hood K, Moore M, Little P, Shepherd V, Lowe R, Miles EA, Townson J, Hobbs FDR, and Francis NA

Abstract

Background: Care homes are an increasingly important sector of care. Care home residents are particularly vulnerable to infections and are often prescribed antibiotics, driving antibiotic resistance. Probiotics may be a cheap and safe way to reduce antibiotic use. Efficacy and possible mechanisms of action are yet to be rigorously evaluated in this group., Objective: The objective was to evaluate efficacy and explore mechanisms of action of a daily oral probiotic combination in reducing antibiotic use and infections in care home residents., Design: This was a multicentre, parallel, individually randomised, placebo-controlled, double-blind trial, with qualitative evaluation and mechanistic studies., Setting: A total of 310 care home residents were randomised from 23 UK care homes (from December 2016 to May 2018)., Participants: The participants were care home residents aged ≥ 65 years who were willing and able to give informed consent or, if they lacked capacity to consent, had a consultee to advise about participation on their behalf., Intervention: A daily capsule containing an oral probiotic combination of Lactobacillus rhamnosus GG and Bifidobacterium animalis subsp. lactis BB-12 ( n  = 155) or matched placebo ( n  = 155) for up to 1 year., Main Outcome Measures: The primary outcome was cumulative systemic antibiotic administration days for all-cause infections. Secondary outcomes included incidence and duration of infections, antibiotic-associated diarrhoea, quality of life, hospitalisations and the detection of resistant Enterobacterales cultured from stool samples (not exclusively)., Methods: Participants were randomised (1 : 1) to receive capsules containing probiotic or matched placebo. Minimisation was implemented for recruiting care home and care home resident sex. Care home residents were followed up for 12 months with a review by a research nurse at 3 months and at 6–12 months post randomisation. Care home residents, consultees, care home staff and all members of the trial team, including assessors and statisticians, were blinded to group allocation., Results: Care home residents who were randomised to probiotic had a mean 12.9 cumulative systemic antibiotic administration days (standard error 1.49 days) ( n  = 152) and care home residents randomised to placebo had a mean 12.0 cumulative systemic antibiotic administration days (standard error 1.50 days) ( n  = 153) (adjusted incidence rate ratio = 1.13, 95% confidence interval 0.79 to 1.63; p  = 0.495). There was no evidence of any beneficial effects on incidence and duration of infections, antibiotic-associated diarrhoea, quality of life, hospitalisations, the detection of resistant Enterobacterales cultured from stool samples or other secondary outcomes. There was no evidence that this probiotic combination improved blood immune cell numbers, subtypes or responses to seasonal influenza vaccination., Conclusions: Care home residents did not benefit from daily consumption of a combination of the probiotics Lactobacillus rhamnosus GG and Bifidobacterium animalis subsp. lactis BB-12 to reduce antibiotic consumption., Limitations: Limitations included the following: truncated follow-up of some participants; higher than expected probiotics in stool samples at baseline; fewer events than expected meant that study power may have been lower than anticipated; standard infection-related definitions were not used; and findings are not necessarily generalisable because effects may be strain specific and could vary according to patient population., Future Work: Future work could involve further rigorous efficacy, mechanisms and effectiveness trials of other probiotics in other population groups and settings regarding antibiotic use and susceptibility to and recovery from infections, in which potential harms should be carefully studied., Trial Registration: Current Controlled Trials ISRCTN16392920., Funding: This project was funded by the Efficacy and Mechanism Evaluation (EME) programme, a MRC and NIHR partnership. This will be published in full in Efficacy and Mechanism Evaluation ; Vol. 8, No. 7. See the NIHR Journals Library website for further project information., (Copyright © 2021 Butler et al. This work was produced by Butler et al. under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This is an Open Access publication distributed under the terms of the Creative Commons Attribution CC BY 4.0 licence, which permits unrestricted use, distribution, reproduction and adaption in any medium and for any purpose provided that it is properly attributed. See: https://creativecommons.org/licenses/by/4.0/. For attribution the title, original author(s), the publication source – NIHR Journals Library, and the DOI of the publication must be cited.)

Published
2021
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38. Personalized alerts for patients with COPD using pulse oximetry and symptom scores.

Author

Shah SA, Velardo C, Gibson OJ, Rutter H, Farmer A, and Tarassenko L

Subjects
Aged, Algorithms, Area Under Curve, Chronic Disease, Clinical Alarms, Computers, Handheld, Female, Heart Rate, Hospitalization, Humans, Male, Middle Aged, Multivariate Analysis, Oxygen blood, Pilot Projects, Quality of Life, Retrospective Studies, Signal Processing, Computer-Assisted, Software, User-Computer Interface, Oximetry methods, Pulmonary Disease, Chronic Obstructive physiopathology, Respiratory Rate
Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a progressive chronic disease, predicted to become the third leading cause of death by 2030. COPD patients are at risk of sudden and acute worsening of symptoms, reducing the patient's quality of life and leading to hospitalization. We present the results of a pilot study with 18 COPD patients using an m-Health system, based on a tablet computer and pulse oximeter, for a period of six months. For prioritizing patients for clinical review, a data-driven approach has been developed which generates personalized alerts using the electronic symptom diary, pulse rate, blood oxygen saturation, and respiratory rate derived from oximetry data. This work examines the advantages of multivariate novelty detection over univariate approaches and shows the benefit of including respiratory rate as a predictor.

Published
2014
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