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

181 results found

Patel S, Cole AD, Nolan CM, Barker RE, Jones SE, Kon S, Cairn J, Loebinger M, Wilson R, Man WD-Cet al., 2018, Pulmonary rehabilitation in bronchiectasis: a propensity matched study., Eur Respir J

Introduction: International guidelines recommend pulmonary rehabilitation (PR) for patients with bronchiectasis, supported by small trials and data extrapolated from chronic obstructive pulmonary disease (COPD). However, it is unknown whether real-life data on completion rates and response to PR are similar between patients with bronchiectasis and COPD.Methods: Using propensity score matching, 213 consecutive patients with bronchiectasis referred for a supervised PR programme were matched 1:1 with a control group of 213 patients with COPD. Completion rates, changes in incremental shuttle walk (ISW) and Chronic Respiratory Questionnaire (CRQ) with PR were compared between groups.Results: Completion rate was the same in both groups (74%). Improvements in ISW and most domains of CRQ with PR were similar between the bronchiectasis and COPD groups (ISW: 70 versus 63 metres; CRQ-Dyspnoea: 4.8 versus 5.3; CRQ-Emotion: 3.5 versus 4.6; CRQ-Mastery: 2.3 versus 2.9; all p>0.20). However, improvements in CRQ-Fatigue with PR were greater in the COPD group (bronchiectasis: 2.1 versus COPD: 3.3; p=0.02).Conclusion: In a real-life, propensity-matched control study, patients with bronchiectasis show similar completion rates and improvements in exercise and health status outcomes as patients with COPD. This supports the routine clinical provision of PR to patients with bronchiectasis.

JOURNAL ARTICLE

Brighton LJ, Miller S, Farquhar M, Booth S, Yi D, Gao W, Bajwah S, Man WD-C, Higginson IJ, Maddocks Met al., 2018, Holistic services for people with advanced disease and chronic breathlessness: a systematic review and meta-analysis., Thorax

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 P, Cullinan P, Man WD-Cet al., 2018, Gait speed and prognosis in patients with idiopathic pulmonary fibrosis: a prospective cohort study., Eur Respir J

The four metre gait speed (4 MGS), a simple physical performance measure and surrogate marker of frailty, consistently predicts adverse prognosis in older adults. We hypothesised that 4 MGS could predict all-cause mortality and non-elective hospitalisation in patients with idiopathic pulmonary fibrosis (IPF).4 MGS and lung function were measured at baseline in 130 outpatients newly diagnosed with IPF. Survival status and non-elective hospital admissions were recorded over one year. We assessed the predictive value of 4 MGS (as a continuous variable and as a binary variable: slow versus preserved 4 MGS) by calculating hazard ratios (HR) using Cox proportional regression, adjusting for potential confounding variables. Receiver Operating Characteristic curves assessed discrimination between the multivariable regression models and established prognostic indices.Continuous 4 MGS and slow 4 MGS were independent predictors of all-cause mortality (4 MGS: HR 0.03 (0.01-0.31), p=0.004; slow 4 MGS: 2.63 (1.01-6.87), p=0.049) and hospitalisation (4 MGS: HR 0.02 (0.01-0.14), p<0.001; slow 4 MGS: 2.76 (1.16-6.58), p=0.02). Multivariable models incorporating 4 MGS or slow 4 MGS had better discrimination for predicting mortality than either the Gender Age Physiology index or Composite Physiologic Index.In patients with IPF, 4 MGS is an independent predictor of all-cause mortality and non-elective hospitalisation.

JOURNAL ARTICLE

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, 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

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

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

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

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

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

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

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

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

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

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

Maddocks M, Lovell N, Booth S, Man WD-C, Higginson IJet al., 2017, Palliative care and management of troublesome symptoms for people with chronic obstructive pulmonary disease., Lancet, Vol: 390, Pages: 988-1002

People with advanced chronic obstructive pulmonary disease (COPD) have distressing physical and psychological symptoms, often have limited understanding of their disease, and infrequently discuss end-of-life issues in routine clinical care. These are strong indicators for expert multidisciplinary palliative care, which incorporates assessment and management of symptoms and concerns, patient and caregiver education, and sensitive communication to elicit preferences for care towards the end of life. The unpredictable course of COPD and the difficulty of predicting survival are barriers to timely referral and receipt of palliative care. Early integration of palliative care with respiratory, primary care, and rehabilitation services, with referral on the basis of the complexity of symptoms and concerns, rather than prognosis, can improve patient and caregiver outcomes. Models of integrated working in COPD could include: services triggered by troublesome symptoms such as refractory breathlessness; short-term palliative care; and, in settings with limited access to palliative care, consultation only in specific circumstances or for the most complex patients.

JOURNAL ARTICLE

Spina G, Spruit MA, Alison J, Benzo RP, Calverley PMA, Clarenbach CF, Costello RW, Donaire-Gonzalez D, Durr S, Garcia-Aymerich J, van Gestel AJR, Gramm M, Hernandes NA, Hill K, Hopkinson NS, Jarreta D, Kohler M, Kirsten AM, Leuppi JD, Magnussen H, Maltais F, Man WD-C, McKeough ZJ, Mesquita R, Miedinger D, Pitta F, Singh SJ, Smeenk FWJM, Tal-Singer R, Vagaggini B, Waschki B, Watz H, Wouters EFM, Zogg S, den Brinker ACet al., 2017, Analysis of nocturnal actigraphic sleep measures in patients with COPD and their association with daytime physical activity, THORAX, Vol: 72, Pages: 694-701, ISSN: 0040-6376

JOURNAL ARTICLE

Mesquita R, Spina G, Pitta F, Donaire-Gonzalez D, Deering BM, Patel MS, Mitchell KE, Alison J, van Gestel AJR, Zogg S, Gagnon P, Abascal-Bolado B, Vagaggini B, Garcia-Aymerich J, Jenkins SC, Romme EAPM, Kon SSC, Albert PS, Waschki B, Shrikrishna D, Singh SJ, Hopkinson NS, Miedinger D, Benzo RP, Maltais F, Paggiaro P, McKeough ZJ, Polkey MI, Hill K, Man WD-C, Clarenbach CF, Hernandes NA, Savi D, Wootton S, Furlanetto KC, Ng LWC, Vaes AW, Jenkins C, Eastwood PR, Jarreta D, Kirsten A, Brooks D, Hillman DR, Sant'Anna T, Meijer K, Durr S, Rutten EPA, Kohler M, Probst VS, Tal-Singer R, Garcia Gil E, den Brinker AC, Leuppi JD, Calverley PMA, Smeenk FWJM, Costello RW, Gramm M, Goldstein R, Groenen MTJ, Magnussen H, Wouters EFM, ZuWallack RL, Amft O, Watz H, Spruit MAet al., 2017, Physical activity patterns and clusters in 1001 patients with COPD, CHRONIC RESPIRATORY DISEASE, Vol: 14, Pages: 256-269, ISSN: 1479-9723

JOURNAL ARTICLE

Polkey MI, Man WD-C, 2017, Should We Get Sniffy About Maximal Inspiratory Pressure?, CHEST, Vol: 152, Pages: 6-7, ISSN: 0012-3692

JOURNAL ARTICLE

Maddocks M, Delogu V, Jones SE, Polkey MI, Man WD-Cet al., 2017, Exercise Training Versus Neuromuscular Stimulation in Severe Chronic Obstructive Pulmonary Disease, ARCHIVOS DE BRONCONEUMOLOGIA, Vol: 53, Pages: 357-359, ISSN: 0300-2896

JOURNAL ARTICLE

Kon SSC, Jolley CJ, Shrikrishna D, Montgomery HE, Skipworth JRA, Puthucheary Z, Moxham J, Polkey MI, Man WD-C, Hopkinson NSet al., 2017, ACE and response to pulmonary rehabilitation in COPD: two observational studies, BMJ OPEN RESPIRATORY RESEARCH, Vol: 4, ISSN: 2052-4439

JOURNAL ARTICLE

Steiner MC, Lowe D, Beckford K, Blakey J, Bolton CE, Elkin S, Man WD-C, Roberts CM, Sewell L, Walker P, Singh SJet al., 2017, Socioeconomic deprivation and the outcome of pulmonary rehabilitation in England and Wales, THORAX, Vol: 72, Pages: 530-537, ISSN: 0040-6376

JOURNAL ARTICLE

Maddocks M, Nolan CM, Man WD-C, 2017, Simple functional tests in COPD: stand up and be counted!, Eur Respir J, Vol: 49

JOURNAL ARTICLE

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