Imperial College London

DrWilliamMan

Faculty of MedicineNational Heart & Lung Institute

Honorary Clinical Senior Lecturer
 
 
 
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Contact

 

+44 (0)1895 828 851w.man

 
 
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Location

 

Harefield HospitalHarefield Hospital

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Summary

 

Publications

Publication Type
Year
to

199 results found

Brighton LJ, Gao W, Farquhar M, Booth S, Bajwah S, Man WD-C, Reilly CC, Yi D, Higginson IJ, Maddocks Met al., 2019, Predicting outcomes following holistic breathlessness services: A pooled analysis of individual patient data., Palliat Med, Vol: 33, Pages: 462-466

BACKGROUND:: Holistic breathlessness services have been developed for people with advanced disease and chronic breathlessness, leading to improved psychological aspects of breathlessness and health. The extent to which patient characteristics influence outcomes is unclear. AIM:: To identify patient characteristics predicting outcomes of mastery and distress due to breathlessness following holistic breathlessness services. DESIGN:: Secondary analysis of pooled individual patient data from three clinical trials. Our primary analysis assessed predictors of clinically important improvements in Chronic Respiratory Questionnaire mastery scores (+0.5 point), and our secondary analysis predictors of improvements in Numerical Rating Scale distress due to breathlessness (-1 point). Variables significantly related to improvement in univariate models were considered in separate backwards stepwise logistic regression models. PARTICIPANTS:: The dataset comprised 259 participants (118 female; mean (standard deviation) age 69.2 (10.6) years) with primary diagnoses of chronic obstructive pulmonary disease (49.8%), cancer (34.7%) and interstitial lung disease (10.4%). RESULTS:: Controlling for age, sex and trial, baseline mastery remained the only significant independent predictor of improvement in mastery (odds ratio 0.57, 95% confidence intervals 0.43-0.74; p < 0.001), and baseline distress remained the only significant predictor of improvement in distress (odds ratio 1.64; 95% confidence intervals 1.35-2.03; p < 0.001). Baseline lung function, breathlessness severity, health status, mild anxiety and depression, and diagnosis did not predict outcomes. CONCLUSIONS:: Outcomes of mastery and distress following holistic breathlessness services are influenced by baseline scores for these variables, and not by diagnosis, lung function or health status. Stratifying patients by levels of mastery and/or distress due to breathlessness appears appropri

JOURNAL ARTICLE

Brighton LJ, Miller S, Farquhar M, Booth S, Yi D, Gao W, Bajwah S, Man WD-C, Higginson IJ, Maddocks Met al., 2019, Holistic services for people with advanced disease and chronic breathlessness: a systematic review and meta-analysis., Thorax, Vol: 74, Pages: 270-281

BACKGROUND: Breathlessness is a common, distressing symptom in people with advanced disease and a marker of deterioration. Holistic services that draw on integrated palliative care have been developed for this group. This systematic review aimed to examine the outcomes, experiences and therapeutic components of these services. METHODS: Systematic review searching nine databases to June 2017 for experimental, qualitative and observational studies. Eligibility and quality were independently assessed by two authors. Data on service models, health and cost outcomes were synthesised, using meta-analyses as indicated. Data on recipient experiences were synthesised thematically and integrated at the level of interpretation and reporting. RESULTS: From 3239 records identified, 37 articles were included representing 18 different services. Most services enrolled people with thoracic cancer, involved palliative care staff and comprised 4-6 contacts over 4-6 weeks. Commonly used interventions included breathing techniques, psychological support and relaxation techniques. Meta-analyses demonstrated reductions in Numeric Rating Scale distress due to breathlessness (n=324; mean difference (MD) -2.30, 95% CI -4.43 to -0.16, p=0.03) and Hospital Anxiety and Depression Scale (HADS) depression scores (n=408, MD -1.67, 95% CI -2.52 to -0.81, p<0.001) favouring the intervention. Statistically non-significant effects were observed for Chronic Respiratory Questionnaire (CRQ) mastery (n=259, MD 0.23, 95% CI -0.10 to 0.55, p=0.17) and HADS anxiety scores (n=552, MD -1.59, 95% CI -3.22 to 0.05, p=0.06). Patients and carers valued tailored education, self-management interventions and expert staff providing person-centred, dignified care. However, there was no observable effect on health status or quality of life, and mixed evidence around physical function. CONCLUSION: Holistic services for chronic breathlessness can reduce distress in patients with advanced dis

JOURNAL ARTICLE

Nolan CM, Maddocks M, Maher TM, Banya W, Patel S, Barker RE, Jones SE, George PM, Cullinan P, Man WD-Cet al., 2019, Gait speed and prognosis in patients with idiopathic pulmonary fibrosis: a prospective cohort study, EUROPEAN RESPIRATORY JOURNAL, Vol: 53, ISSN: 0903-1936

JOURNAL ARTICLE

Patel S, Cole AD, Nolan CM, Barker RE, Jones SE, Kon S, Cairn J, Loebinger M, Wilson R, Man WD-Cet al., 2019, Pulmonary rehabilitation in bronchiectasis: a propensity-matched study, EUROPEAN RESPIRATORY JOURNAL, Vol: 53, ISSN: 0903-1936

JOURNAL ARTICLE

Nolan CM, Maddocks M, Maher T, Patel S, Barker RE, Jones SE, Wynne SC, Walsh JA, George PM, Cullinan P, Man WDCet al., 2019, Single-Versus Multi-Component Physical Performance Measures and Mortality in Idiopathic Pulmonary Fibrosis, International Conference of the American-Thoracic-Society, Publisher: AMER THORACIC SOC, ISSN: 1073-449X

CONFERENCE PAPER

Barker RE, Jones SE, Banya W, Kon SSC, Fleming S, Nolan CM, Patel S, Clarke SF, Walsh JA, Wynne S, Maddocks M, Farquhar M, Wedzicha JA, Man Wet al., 2019, A Video Intervention to Increase Pulmonary Rehabilitation Uptake for Patients Hospitalized with Acute Exacerbations of COPD (virtue): A Randomized Controlled Trial, International Conference of the American-Thoracic-Society, Publisher: AMER THORACIC SOC, ISSN: 1073-449X

CONFERENCE PAPER

Brighton LJ, Tunnard I, Farquhar M, Booth S, Miller S, Yi D, Gao W, Bajwah S, Man WD, Reilly CC, Ogden M, Bailey S, Ewart C, Higginson IJ, Maddocks Met al., 2019, Recommendations for services for people living with chronic breathlessness in advanced disease: Results of a transparent expert consultation., Chron Respir Dis, Vol: 16

Chronic breathlessness is highly distressing for people with advanced disease and their informal carers, yet health services for this group remain highly heterogeneous. We aimed to generate evidence-based stakeholder-endorsed recommendations for practice, policy and research concerning services for people with advanced disease and chronic breathlessness. We used transparent expert consultation, comprising modified nominal group technique during a stakeholder workshop, and an online consensus survey. Stakeholders, representing multiple specialities and professions, and patient/carers were invited to participate. Thirty-seven participants attended the stakeholder workshop and generated 34 separate recommendations, rated by 74 online survey respondents. Seven recommendations had strong agreement and high levels of consensus. Stakeholders agreed services should be person-centred and flexible, should cut across multiple disciplines and providers and should prioritize breathlessness management in its own right. They advocated for wide geographical coverage and access to expert care, supported through skills-sharing among professionals. They also recommended recognition of informal carers and their role by clinicians and policymakers. Overall, stakeholders' recommendations reflect the need for improved access to person-centred, multi-professional care and support for carers to provide or access breathlessness management interventions. Future research should test the optimal models of care and educational strategies to meet these recommendations.

JOURNAL ARTICLE

Jones S, Nolan C, Patel S, Barker R, Kon S, Polkey M, Hopkinson N, Maddocks M, Man Wet al., 2018, Five-repetition sit-to-stand and mortality in COPD: a prospective cohort study, 28th International Congress of the European-Respiratory-Society (ERS), Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

CONFERENCE PAPER

Jones S, Maddocks M, Nolan C, Patel S, Barker R, Kon S, Hopkinson N, Man Wet al., 2018, Responsiveness of a short stair climb power test to pulmonary rehabilitation in COPD, 28th International Congress of the European-Respiratory-Society (ERS), Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

CONFERENCE PAPER

Jones S, Nolan C, Patel S, Barker R, Kon S, Polkey M, Hopkinson N, Maddocks M, Man Wet al., 2018, Development of a new prognosis index (BODS) in patients with COPD: a prospective cohort study, 28th International Congress of the European-Respiratory-Society (ERS), Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

CONFERENCE PAPER

Pavitt M, Tanner RJ, Lewis AP, Buttery SC, Mehta B, Jefford H, Curtis KJ, Banya W, Husain S, Satkunam K, Shrikrishna D, Man WD, Polkey MI, Hopkinson NSet al., 2018, Late Breaking Abstract - Dietary nitrate supplementation enhances the benefit of pulmonary rehabilitation in people with COPD, 28th International Congress of the European-Respiratory-Society (ERS), Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

CONFERENCE PAPER

Nolan CM, Delogu V, Maddocks M, Patel S, Barker RE, Jones SE, Kon SSC, Maher TM, Cullinan P, Man WD-Cet al., 2018, Validity, responsiveness and minimum clinically important difference of the incremental shuttle walk in idiopathic pulmonary fibrosis: a prospective study, International Conference of the American-Thoracic-Society (ATS), Publisher: BMJ PUBLISHING GROUP, Pages: 680-682, ISSN: 0040-6376

CONFERENCE PAPER

Nolan CM, Maddocks M, Maher TM, Canavan JL, Jones SE, Barker RE, Patel S, Jacob J, Cullinan P, Man WD-Cet al., 2018, Phenotypic characteristics associated with slow gait speed in idiopathic pulmonary fibrosis, RESPIROLOGY, Vol: 23, Pages: 498-506, ISSN: 1323-7799

JOURNAL ARTICLE

Jones SE, Barker RE, Nolan CM, Patel S, Maddocks M, Man WDCet al., 2018, Pulmonary rehabilitation in patients with an acute exacerbation of chronic obstructive pulmonary disease., J Thorac Dis, Vol: 10, Pages: S1390-S1399, ISSN: 2072-1439

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are one of the most common causes of emergency hospital admission and place great burden upon healthcare systems. Furthermore, AECOPD represent an important life event for patients, and are associated with significant reductions in physical activity, skeletal muscle function, exercise tolerance and health-related quality of life. Pulmonary rehabilitation, an intervention comprising supervised exercise-training and education, may counteract these negative consequences and target modifiable risk factors for hospital readmission. A recent Cochrane systematic review included 20 randomized controlled trials comparing pulmonary rehabilitation after exacerbation of COPD versus conventional care. Overall, the evidence supports moderate to large effects on health-related quality of life and exercise capacity. However, there is substantial heterogeneity across studies, and more recent studies have been more equivocal, including around hospital readmissions, particularly when rehabilitation is started in the inpatient setting. In this narrative review, we examine the rationale for pulmonary rehabilitation following AECOPD with a particular focus on skeletal muscle function, review the current evidence for pulmonary rehabilitation in the AECOPD setting, and identify areas that require future research, including the structure and nature of the intervention, improving uptake and adherence, and the role of alternative rehabilitation strategies for patients with AECOPD.

JOURNAL ARTICLE

Nolan CM, Maddocks M, Canavan JL, Jones SE, Delogu V, Kaliaraju D, Banya W, Kon SSC, Polkey MI, Man WD-Cet al., 2018, Increasing Physical Activity in Daily Life in Chronic Obstructive Pulmonary Disease: To Solve the Puzzle, Every Piece Counts Reply, AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Vol: 197, Pages: 1089-1090, ISSN: 1073-449X

JOURNAL ARTICLE

Patel S, Kon SSC, Nolan CM, Barker RE, Simonds AK, Morrell MJ, Man WD-Cet al., 2018, The Epworth Sleepiness Scale: Minimum Clinically Important Difference in Obstructive Sleep Apnea, AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Vol: 197, Pages: 961-963, ISSN: 1073-449X

JOURNAL ARTICLE

Nolan CM, Kon SSC, Patel S, Jones SE, Barker RE, Polkey MI, Maddocks M, Man WD-Cet al., 2018, Gait speed and pedestrian crossings in COPD, THORAX, Vol: 73, Pages: 191-192, ISSN: 0040-6376

JOURNAL ARTICLE

Nolan CM, Maddocks M, Canavan JL, Jones SE, Delogu V, Kaliaraju D, Banya W, Kon SSC, Polkey MI, Man WD-Cet al., 2018, Are All Steps Created Equal? Revisiting Pedometer Use during Pulmonary Rehabilitation for Individuals Living with Chronic Obstructive Pulmonary Disease Reply, AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Vol: 197, Pages: 406-409, ISSN: 1073-449X

JOURNAL ARTICLE

Kwan H, Maddocks M, Nolan CM, Jones SE, Patel S, Barker R, Kon S, Man Wet al., 2018, Cachexia and Response to Pulmonary Rehabilitation: A Propensity Matched Analysis, International Conference of the American-Thoracic-Society, Publisher: AMER THORACIC SOC, ISSN: 1073-449X

CONFERENCE PAPER

Patel S, Nolan CM, Jones SE, Barker R, Kon SS, Kwan H, Man WDet al., 2018, Responsiveness and Minimum Important Difference of Quadriceps Maximum Voluntary Contraction in Chronic Obstructive Pulmonary Disease, International Conference of the American-Thoracic-Society, Publisher: AMER THORACIC SOC, ISSN: 1073-449X

CONFERENCE PAPER

Patel S, Nolan CM, Jones SE, Barker RE, Kwan H, Maddocks M, Man WDet al., 2018, Responsiveness of the Short Physical Performance Battery to Pulmonary Rehabilitation in Patients with Chronic Respiratory Disease and Frailty, International Conference of the American-Thoracic-Society, Publisher: AMER THORACIC SOC, ISSN: 1073-449X

CONFERENCE PAPER

Kwan H, Maddocks M, Nolan CM, Jones SE, Patel S, Barker R, Kon S, Man Wet al., 2018, Cachexia, Precachexia and Mortality in Chronic Obstructive Pulmonary Disease (COPD), International Conference of the American-Thoracic-Society, Publisher: AMER THORACIC SOC, ISSN: 1073-449X

CONFERENCE PAPER

Barker R, Nolan CM, Jones SE, Patel S, Kwan H, Kon S, Farquhar M, Maddocks M, Man Wet al., 2018, Response of a Simple Functional Capacity Test to Home-Based Exercise Training in Chronic Obstructive Pulmonary Disease, International Conference of the American-Thoracic-Society, Publisher: AMER THORACIC SOC, ISSN: 1073-449X

CONFERENCE PAPER

Jones SE, Nolan CM, Patel S, Barker RE, Maddocks M, Kwan H, Kon SSC, Man WDet al., 2018, The Minimum Important Difference in Pedometer Step Count in Patients with Chronic Obstructive Pulmonary Disease, International Conference of the American-Thoracic-Society, Publisher: AMER THORACIC SOC, ISSN: 1073-449X

CONFERENCE PAPER

Jones SE, Nolan CM, Patel S, Barker RE, Kwan H, Maddocks M, Maher TM, Cullinan P, Man WDet al., 2018, Five-Repetition Sit-to-Stand Test in Idiopathic Pulmonary Fibrosis, International Conference of the American-Thoracic-Society, Publisher: AMER THORACIC SOC, ISSN: 1073-449X

CONFERENCE PAPER

Nolan CM, Maddocks M, Maher TM, Patel S, Barker RE, Jones SE, Kwan H, George PM, Cullinan P, Man WDet al., 2018, Physical Frailty in Idiopathic Pulmonary Fibrosis, International Conference of the American-Thoracic-Society, Publisher: AMER THORACIC SOC, ISSN: 1073-449X

CONFERENCE PAPER

Nolan CM, Maddocks M, Maher TM, Patel S, Barker RE, Jones SE, Kwan H, Mehta B, Hogg L, Tuffnell R, George PM, Cullinan P, Man WDet al., 2018, Improvement in Gait Speed with Pulmonary Rehabilitation Is Associated with Increased Survival in Idiopathic Pulmonary Fibrosis, International Conference of the American-Thoracic-Society, Publisher: AMER THORACIC SOC, ISSN: 1073-449X

CONFERENCE PAPER

Barker R, Kon S, Jones SE, Maddocks M, Gao W, Nolan CM, Patel S, Kwan H, Clarke SF, Polkey MI, Cullinan P, Man Wet al., 2018, Gait Speed and Mortality Following Hospitalization for Acute Exacerbations of Chronic Obstructive Pulmonary Disease: A Prospective Cohort Study, International Conference of the American-Thoracic-Society, Publisher: AMER THORACIC SOC, ISSN: 1073-449X

CONFERENCE PAPER

Abdullah R, Kent-Bramer J, Renzoni EA, Kouranos V, Chua FJ, Kokosi M, Wells AU, Maher TM, Man W, Molyneaux PL, Polkey MI, George PMet al., 2018, Severity of Sleep Disordered Breathing in Patients with Idiopathic Pulmonary Fibrosis and Chronic Hypersensitivity Pneumonitis, International Conference of the American-Thoracic-Society, Publisher: AMER THORACIC SOC, ISSN: 1073-449X

CONFERENCE PAPER

Wilson KC, Krishnan JA, Sliwinski P, Criner GJ, Miravitlles M, Hurst JR, Calverley PMA, Albert RK, Rigau D, Tonia T, Vestbo J, Papi A, Rabe KF, Anzueto A, Wedzicha JAet al., 2018, Pulmonary rehabilitation for patients with COPD during and after an exacerbation-related hospitalisation: back to the future?, EUROPEAN RESPIRATORY JOURNAL, Vol: 51, ISSN: 0903-1936

JOURNAL ARTICLE

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