Imperial College London

Dr Keir Philip

Faculty of MedicineNational Heart & Lung Institute

Clinical Lecturer
 
 
 
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Contact

 

k.philip

 
 
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Location

 

Guy Scadding BuildingRoyal Brompton Campus

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Summary

 

Publications

Publication Type
Year
to

80 results found

Philip K, Buttery S, Lewis A, Alghamdi SM, Williams PJ, Alasmari AM, Alsulayyim A, Orton CM, Conway F, Chan L, Vijayakumar B, Tana A, Tonkin J, Perkins A, Garner J, Srikanthan K, Sadaka A, Pavitt M, Banya W, Lound A, Elkin S, Polkey MI, Man W, Lewis K, Cave P, Fancourt D, Hopkinson NSet al., 2024, Singing for Lung Health in COPD: a multicentre randomised controlled trial of online delivery, BMJ Open Respiratory Research, ISSN: 2052-4439

Journal article

Williams P, Bachir L, Cumella A, Philip KEJ, Polkey M, Laverty AA, Hopkinson Net al., 2024, Impact of omitting annual reviews for COPD on patient reported care quality – outcomes from the Asthma + Lung COPD patient passport., BMJ Open, ISSN: 2044-6055

Journal article

Williams P, Philip K, Buttery S, Perkins A, Chan L, Bartlett E, Devaraj A, Kemp S, Addis J, Derbyshire J, Chen M, Polkey M, Laverty AA, Hopkinson Net al., 2024, Immediate smoking cessation support during lung cancer screening: long-term outcomes from two randomised controlled trials, Thorax, Vol: 79, Pages: 269-273, ISSN: 0040-6376

Background: Immediate smoking cessation interventions delivered alongside targeted lung health checks (TLHC) to screen for lung cancer increase self-reported abstinence at three months. The impact on longer-term, objectively confirmed quit rates remains to established. Methods: We followed up participants from two clinical trials in people aged 55-75 years who smoked and took part in a TLHC. These randomised participants in the TLHC by day of attendance to either usual care (signposting to smoking cessation services) or an offer of immediate smoking cessation support including pharmacotherapy. In the QuLIT1 trial this was delivered face to face, in QuLIT2 it was delivered remotely. Follow up was conducted 12 months after the TLHC by telephone interview with subsequent biochemical verification of smoking cessation using exhaled CO. Results: 430 people were enrolled initially (115 in QuLIT1 315 in QuLIT2), with 4 deaths before 12 months leaving 426 [62.1±5.27 years old and 48% female] participants for analysis. At 12 months, those randomised to attend on smoking cessation support intervention days had higher quit rates compared to usual care adjusted for age, gender, deprivation, and which trial they had been in; self-reported 7-day point prevalence (20.0% vs 12.8%; AOR=1.78 95% CI, 1.04-2.89) and CO verified quits (12.1% vs 4.7%; AOR=2.97 95% CI, 1.38-6.90). Those in the intervention arm were also more likely to report having made a quit attempt (30.2% vs UC 18.5%; AOR 1.90 95% CI 1.15-3.15). Conclusion: Providing immediate smoking cessation support alongside TLHC increases long term, biochemically confirmed smoking abstinence.

Journal article

Alasmari AM, Alsulayyim AS, Alghamdi SM, Philip KEJ, Buttery SC, Banya WAS, Polkey MI, Armstrong PC, Rickman MJ, Warner TD, Mitchell JA, Hopkinson NSet al., 2024, Oral nitrate supplementation improves cardiovascular risk markers in COPD: ON-BC, a randomised controlled trial, European Respiratory Journal, Vol: 63, ISSN: 0903-1936

BACKGROUND: Short-term studies suggest that dietary nitrate (NO3 -) supplementation may improve the cardiovascular risk profile, lowering blood pressure (BP) and enhancing endothelial function. It is not clear if these beneficial effects are sustained and whether they apply in people with COPD, who have a worse cardiovascular profile than those without COPD. Nitrate-rich beetroot juice (NR-BRJ) is a convenient dietary source of nitrate. METHODS: The ON-BC trial was a randomised, double-blind, placebo-controlled parallel group study in stable COPD patients with home systolic BP (SBP) measurement ≥130 mmHg. Participants were randomly allocated (1:1) using computer-generated, block randomisation to either 70 mL NR-BRJ (400 mg NO3 -) (n=40) or an otherwise identical nitrate-depleted placebo juice (0 mg NO3 -) (n=41), once daily for 12 weeks. The primary end-point was between-group change in home SBP measurement. Secondary outcomes included change in 6-min walk distance (6MWD) and measures of endothelial function (reactive hyperaemia index (RHI) and augmentation index normalised to a heart rate of 75 beats·min-1 (AIx75)) using an EndoPAT device. Plasma nitrate and platelet function were also measured. RESULTS: Compared with placebo, active treatment lowered SBP (Hodges-Lehmann treatment effect -4.5 (95% CI -5.9- -3.0) mmHg), and improved 6MWD (30.0 (95% CI 15.7-44.2) m; p<0.001), RHI (0.34 (95% CI 0.03-0.63); p=0.03) and AIx75 (-7.61% (95% CI -14.3- -0.95%); p=0.026). CONCLUSIONS: In people with COPD, prolonged dietary nitrate supplementation in the form of beetroot juice produces a sustained reduction in BP, associated with an improvement in endothelial function and exercise capacity.

Journal article

Hopkinson N, Buttery S, Polkey M, Philip Ket al., 2023, Investigating the prognostic value of digital mobility outcomes in patients with Chronic Obstructive Pulmonary Disease: a systematic literature review and meta-analysis, European Respiratory Review, Vol: 32, ISSN: 0905-9180

Background: Reduced mobility is a central feature of COPD. Assessment of mobility outcomes that can be measured digitally (digital mobility outcomes (DMOs)) in daily life such as gait speed and steps per day is increasingly possible using devices such as pedometers and accelerometers, but the predictive value of these measures remains unclear in relation to key outcomes such as hospital admission and survival.Methods: We conducted a systematic review, nested within a larger scoping review by the MOBILISE-D consortium, addressing DMOs in a range of chronic conditions. Qualitative and quantitative analysis considering steps per day and gait speed and their association with clinical outcomes in COPD patients was performed.Results: 21 studies (6076 participants) were included. Nine studies evaluated steps per day and 11 evaluated a measure reflecting gait speed in daily life. Negative associations were demonstrated between mortality risk and steps per day (per 1000 steps) (hazard ratio (HR) 0.81, 95% CI 0.75–0.88, p<0.001), gait speed (<0.80 m·s−1) (HR 3.55, 95% CI 1.72–7.36, p<0.001) and gait speed (per 1.0 m·s−1) (HR 7.55, 95% CI 1.11–51.3, p=0.04). Fewer steps per day (per 1000) and slow gait speed (<0.80 m·s−1) were also associated with increased healthcare utilisation (HR 0.80, 95% CI 0.72–0.88, p<0.001; OR 3.36, 95% CI 1.42–7.94, p=0.01, respectively). Available evidence was of low-moderate quality with few studies eligible for meta-analysis.Conclusion: Daily step count and gait speed are negatively associated with mortality risk and other important outcomes in people with COPD and therefore may have value as prognostic indicators in clinical trials, but the quantity and quality of evidence is limited. Larger studies with consistent methodologies are called for.

Journal article

Matsumoto K, Read N, Philip KEJ, Allinson JPet al., 2023, Exacerbations in Chronic Obstructive Pulmonary Disease: Clinical, Genetic, and Mycobiome Risk Factors, AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Vol: 208, Pages: 487-489, ISSN: 1073-449X

Journal article

Harrison J, Saccente-Kennedy B, Orton CM, McCarthy LP, Archer J, Symons HE, Szczepanska A, Watson NA, Browne WJ, Moseley B, Philip KEJ, Hull JH, Calder JD, Costello D, Shah PL, Epstein R, Reid JP, Bzdek BRet al., 2023, Emission rates, size distributions, and generation mechanism of oral respiratory droplets, AEROSOL SCIENCE AND TECHNOLOGY, Vol: 57, Pages: 187-199, ISSN: 0278-6826

Journal article

Williams PJ, Philip KEJ, Gill NK, Flannery D, Buttery S, Bartlett EC, Devaraj A, Kemp SV, Addis J, Derbyshire J, Chen M, Morris K, Laverty AA, Hopkinson NSet al., 2023, Immediate, remote smoking cessation intervention in participants undergoing a targeted lung health check: quit smoking lung health intervention trial, a randomized controlled trial, Chest, Vol: 163, Pages: 455-463, ISSN: 0012-3692

BACKGROUND: Lung cancer screening programs provide an opportunity to support people who smoke to quit, but the most appropriate model for delivery remains to be determined. Immediate face-to-face smoking cessation support for people undergoing screening can increase quit rates, but it is not known whether remote delivery of immediate smoking cessation counselling and pharmacotherapy in this context also is effective. RESEARCH QUESTION: Does an immediate telephone smoking cessation intervention increase quit rates compared with usual care among a population enrolled in a targeted lung health check (TLHC)? STUDY DESIGN AND METHODS: In a single-masked randomized controlled trial, people 55 to 75 years of age who smoke and attended a TLHC were allocated by day of attendance to receive either immediate telephone smoking cessation intervention (TSI) support (starting immediately and lasting for 6 weeks) with appropriate pharmacotherapy or usual care (UC; very brief advice to quit and signposting to smoking cessation services). The primary outcome was self-reported 7-day point prevalence smoking abstinence at 3 months. Differences between groups were assessed using logistic regression. RESULTS: Three hundred fifteen people taking part in the screening program who reported current smoking with a mean ± SD age of 63 ± 5.4 years, 48% of whom were women, were randomized to TSI (n = 152) or UC (n = 163). The two groups were well matched at baseline. Self-reported quit rates were higher in the intervention arm, 21.1% vs 8.9% (OR, 2.83; 95% CI, 1.44-5.61; P = .002). Controlling for participant demographics, neither baseline smoking characteristics nor the discovery of abnormalities on low-dose CT imaging modified the effect of the intervention. INTERPRETATION: Immediate provision of an intensive telephone-based smoking cessation intervention, delivered within a targeted lung screening context, is associated with incr

Journal article

Philip K, 2023, Digital delivery and assessment of holistic interventions for breathlessness

Breathlessness is a common and important symptom, resulting from the interaction between multiple physical, psychological and social factors, and causes substantial negative impacts to health-related quality of life. Interest has grown in therapeutic potential of holistic participatory arts-in-health activities using singing and dance for people with breathlessness, within the broader context of social prescribing. A small body of research has indicated such interventions might be effective, however properly conducted studies investigating impact, and mechanisms of impact, are lacking. Additionally, advances in digital health have expanded remote healthcare delivery, a trend accelerated by the COVID-19 pandemic, creating novel opportunities and challenges.This thesis aims to assess the impact, potential mechanisms, and possible future approaches, of digitally delivered holistic arts-in-health interventions for people with breathlessness. I present six results chapters addressing current research gaps. First, an observational study comparing the physiological demands of Singing for Lung Health (SLH) with treadmill walking, to investigate potential mechanisms of impact. Second, I present data from the first group of a planned larger randomised controlled trial (RCT) investigating the impact of face-to-face SLH. This group transferred to online SLH halfway through the intervention due to the COVID-19 pandemic, but viewed as a convenience pilot study, the findings provide valuable insights into digital adaptation of complex interventions. Third, a digitally delivered, remotely assessed, RCT comparing online SLH to usual care in COPD. Fourth, a digitally delivered and assessed RCT comparing the English National Opera’s Breathe programme to usual care in people with Long COVID and breathlessness. The fifth and sixth results chapters are qualitative studies investigating the experience of dance group participants for people with breathlessness in England and Uganda.T

Thesis dissertation

Hopkinson N, Polkey M, Alghamdi S, Alsulayyim A, Philip K, Buttery Set al., 2023, Oscillatory positive expiratory pressure therapy in COPD (O-COPD): a randomised controlled trial, Thorax, Vol: 78, Pages: 136-143, ISSN: 0040-6376

Background: Oscillatory Positive Expiratory Pressure (OPEP) devices are intended to facilitate sputum clearance and reduce cough, but there is limited evidence for their effectiveness in COPD, or to guide patient selection. We aimed to assess the impact of OPEP therapy on quality of life and objective measures of cough and sleep disturbance in COPD patients with regular sputum production.Methods: We enrolled stable COPD patients, who reported sputum production every day or most days, into an assessor-blind, parallel group, randomised controlled trial comparing three months of using an Acapella device against usual care (including use of the active cycle of breathing technique (ACBT)). The primary outcome was cough-related quality of life measured using the Leicester Cough Questionnaire (LCQ). Secondary outcomes included fatigue (FACIT score) and generic quality of life(EQ-5D). In a sub study(n=45), objective monitoring of cough and disturbance/movement during sleep were also available.Results: 122 participants (61/61 OPEP/control) were recruited, 40% female, 17% smokers, FEV1 38(25-56)% predicted, and age 62±10 years. 103 completed the study (55/48 OPEP/control). Use of OPEP was associated with an improvement in LCQ compared to controls; MD [95% CI] +1.03[0.71 to 2.10]; (p=0.03), FACIT score +4.68[1.34 to 8.02];(p<0.001) and EQ-5D +4.00[0.49 to 19.75];(p=0.04). There was also an improvement in cough frequency -60[-43 to -95] coughs/24 hours (P<0.001), but no statistically significant effect on sleep disturbance was identified.Conclusions: Regular use of an Acapella device improves symptoms and quality of life in people with COPD who produce sputum daily or most days.

Journal article

Williams P, Philip K, Alghamdi S, Perkins A, Buttery S, Polkey M, Laverty A, Hopkinson Net al., 2023, Strategies to deliver smoking cessation interventions during targeted lung health screening - a systematic review and meta-analysis, Chronic Respiratory Disease, Vol: 20, Pages: 1-14, ISSN: 1479-9723

IntroductionLung cancer screening presents an important teachable moment to promote smoking cessation, but the most effective strategy to deliver support in this context remains to be established.MethodsWe undertook a systematic review and meta-analysis of smoking cessation interventions delivered during lung health screening, published prior to 20/07/2022 MEDLINE, PsychINFO, CENTRAL, EMBASE, CINAHL and Scopus databases. Two reviewers screened titles, and abstracts, four reviewed each full text using prespecified criteria, extracted relevant data, assessed risk of bias and confidence in findings using the GRADE criteria. The review was registered prospectively on PROSPERO (CRD42021242431).Results10 randomised controlled trials and three observational studies with a control group were identified. Meta-analysis of nine RCTs demonstrated that smoking cessation interventions delivered during lung screening programmes increased quit rates compared to usual care (odds ratios: 2.01, 95%: 1.49–2.72 p < 0.001). Six RCTs using intensive (≥3 behavioural counselling sessions) interventions demonstrated greater quit rates compared to usual care (OR: 2.11, 95% CI 1.53–2.90, p < 0.001). A meta-analysis of two RCTs found intensive interventions were more effective than non-intensive (OR: 2.07, 95%CI 1.26–3.40 p = 0.004), Meta-analysis of two RCTs of non-intensive interventions (≤2 behavioural counselling sessions or limited to online information audio take home materials such as pamphlets) did not show a higher quit rate than usual care (OR: 0.90, 95% CI 0.39–2.08 p = 0.80).DiscussionModerate quality evidence supports smoking cessation interventions delivered within a lung screening setting compared to usual care, with high-quality evidence that more intensive interventions are likely to be most effective.

Journal article

Philip K, Owles H, McVey S, Pagnuco T, Bruce K, Harry B, Banya W, Mollica J, Lound A, Zumpe S, Abrahams A, Padmanaban V, Hardy T, Lewis A, Lalvani A, Elkin S, Hopkinson Net al., 2022, Impact of an online breathing and wellbeing programme (ENO Breathe) in people with persistent symptoms following COVID-19: a randomised controlled trial, European Respiratory Journal, Vol: 60, ISSN: 0903-1936

Aims: ENO Breathe is an online breathing and wellbeing programme for people with Long COVID focusing on breathing re-training using singing techniques.Aim: to assess whether ENO Breathe improves health related quality-of-life (HRQoL) in people with persistent breathlessness following COVID-19.Method:A parallel-group, single-blind, RCT, comparing ENO Breathe(6 weeks) with usual care in adults, with persisting breathlessness +/− anxiety, following assessment at an NHS Long COVID clinic.Primary outcome: change in HRQoL using the RAND SF-36 Mental(MHC) and Physical(PHC) Health Composite Scores.Secondary outcomes: CAT, VAS for breathlessness (rest, walking, stairs, and running), Dysp-12, GAD-7. Participant experience was assessed using focus groups and free-text responses.Results: 150 participants (mean(SD) 49(12)years, 81% female, 320(127) days symptomatic; ENO Breathe(n=74), Control(n=76). ENO Breathe was associated with improvement in MHC of 2.42 points (95%CI 0.03 to 4.80, p=0.045), but not PHC 0.6 (-1.33 to 2.52, p=0.541). VAS breathlessness (running) favoured ENO Breathe -10.48(-17.23 to -3.73, p=0.003). Three participant experience themes were identified 1) improvements in symptoms; 2) feeling that the programme was complementary to standard care; 3) the particular suitability of singing and music to address their needs.Conclusion: An online breathing and wellbeing programme can improve the mental component of HRQoL and elements of breathlessness in people with persisting symptoms after COVID-19. Mind-body and music-based approaches, including practical, enjoyable symptom-management techniques may have a role supporting recovery.

Journal article

Philip KEJ, Bu F, Polkey M, Brown J, Steptoe A, Hopkinson N, Fancourt Det al., 2022, Relationship of smoking with current and future social isolation and loneliness: 12-year follow-up of 8,780 older adults in England, Publisher: EUROPEAN RESPIRATORY SOC JOURNALS LTD, ISSN: 0903-1936

Conference paper

Philip KEJ, Owles H, McVey S, Pagnuco T, Bruce K, Brunjes H, Banya W, Mollica J, Lound A, Zumpe S, Abrahams AM, Padmanaban V, Hardy TH, Lewis A, Lalvani A, Elkin S, Hopkinson NSet al., 2022, An online breathing and wellbeing programme (ENO Breathe) for people with persistent symptoms following COVID-19: a parallel-group, single-blind, randomised controlled trial, The Lancet Respiratory Medicine, Vol: 10, Pages: 851-862, ISSN: 2213-2600

BACKGROUND: There are few evidence-based interventions for long COVID; however, holistic approaches supporting recovery are advocated. We assessed whether an online breathing and wellbeing programme improves health related quality-of-life (HRQoL) in people with persisting breathlessness following COVID-19. METHODS: We conducted a parallel-group, single-blind, randomised controlled trial in patients who had been referred from one of 51 UK-based collaborating long COVID clinics. Eligible participants were aged 18 years or older; were recovering from COVID-19 with ongoing breathlessness, with or without anxiety, at least 4 weeks after symptom onset; had internet access with an appropriate device; and were deemed clinically suitable for participation by one of the collaborating COVID-19 clinics. Following clinical assessment, potential participants were given a unique online portal code. Participants were randomly assigned (1:1) to either immediate participation in the English National Opera (ENO) Breathe programme or to usual care. Randomisation was done by the research team using computer-generated block randomisation lists, with block size 10. The researcher responsible for randomisation was masked to responses. Participants in the ENO Breathe group participated in a 6-week online breathing and wellbeing programme, developed for people with long COVID experiencing breathlessness, focusing on breathing retraining using singing techniques. Those in the deferred group received usual care until they exited the trial. The primary outcome, assessed in the intention-to-treat population, was change in HRQoL, assessed using the RAND 36-item short form survey instrument mental health composite (MHC) and physical health composite (PHC) scores. Secondary outcome measures were the chronic obstructive pulmonary disease assessment test score, visual analogue scales (VAS) for breathlessness, and scores on the dyspnoea-12, the generalised anxiety disorder 7-item scale, and the short

Journal article

Buttery S, Philip K, Alghamdi S, Williams P, Quint J, Hopkinson Net al., 2022, Reporting of data on participant ethnicity and socioeconomic status in high-impact medical journals: A targeted literature review, BMJ Open, Vol: 12, ISSN: 2044-6055

Objectives: To assess the frequency of reporting of ethnicity (or ‘race’) and socioeconomic status (SES) indicators in high-impact journals.Design: Targeted literature reviewData sources: The 10 highest ranked general medical journals using Google scholar h5 index.Eligibility criteria: Inclusion criteria were, human research, reporting participant level data. Exclusion criteria were non-research article, animal/other non-human participant/subject; or no participant characteristics reported.Data extraction and synthesis: Working backwards from 19/04/2021 in each journal, two independent reviewers selected the 10 most recent articles meeting inclusion/exclusion criteria, to create a sample of 100 articles.Data on the frequency of reporting of ethnicity (or ‘race’) and SES indicators were extracted and presented using descriptive statistics.Results: Of one hundred research articles included, 35 reported ethnicity and 13 SES. By contrast, 99 reported age, and 97 reported sex or gender. Among the articles not reporting ethnicity only 3 (5%) highlighted this as a limitation, and only 6 (7%) where SES data were missing. Median number of articles reporting ethnicity per journal was 2.5/10 (range 0 to 9). Only 2 journals explicitly requested reporting of ethnicity (or race), and 1 requested SES. Conclusions: The majority of research published in high-impact medical journals does not include data on the ethnicity and socioeconomic status of participants, and this omission is rarely acknowledged as a limitation. This situation persists despite the well-established importance of this issue and ICMJE recommendations to include relevant demographic variables to ensure representative samples. Standardized explicit minimum standards are required.Strengths and Limitations of this study - This study included recent studies from a range of the highest impact general medical journals.- Different inclusion/exclusion criteria for articles could be justifiably use

Journal article

Orton CM, Symons HE, Moseley B, Archer J, Watson NA, Philip KEJ, Sheikh S, Saccente-Kennedy B, Costello D, Browne WJ, Calder JD, Bzdek BR, Hull JH, Reid JP, Shah PLet al., 2022, A comparison of respiratory particle emission rates at rest and while speaking or exercising, COMMUNICATIONS MEDICINE, Vol: 2, ISSN: 2730-664X

Journal article

Williams P, Cumella A, Philip K, Laverty A, Nicholas Het al., 2022, Smoking and socio-economic factors linked to acute exacerbations of COPD: analysis from an Asthma + Lung UK survey, BMJ Open Respiratory Research, Vol: 9, ISSN: 2052-4439

Background: Understanding the factors driving acute exacerbations of COPD is key to reducing their impact on human health and wellbeing. Methods: 5997 patients, mean 66 years, 64% female, completed an online survey between December 2020 and May 2021 about living with COPD developed by the charity Asthma+Lung UK.Results: The 3731(62.2%) survey participants reporting frequent(>2/year) exacerbations were more likely to smoke (AOR 1.70, 95%CI 1.470-1.98), have lower annual household income (<£20,000, (AOR: 1.72, 1.36-2.17), live in a cold and damp home (AOR: 1.78, 1.50-2.11), and report previous occupational exposure to dust, fumes, and chemicals. Smokers were more likely to report attending hospital to manage their most recent AECOPD compared to ex-smokers (AOR: 1.25, 95% CI 0.99- 1.59).

Journal article

Alghamdi SM, Alasmari AM, Alsulayyim AS, Philip KE, Birring SS, Polkey MI, Hopkinson NSet al., 2022, Impact of Oscillatory Positive Expiratory Pressure (OPEP) Therapy on Objectively Determined Cough and Sleep Disturbance in COPD: A Sub-Study from the O-COPD Trial, International Conference of the American-Thoracic-Society, Publisher: AMER THORACIC SOC, ISSN: 1073-449X

Conference paper

Alghamdi SM, Philip KE, Alsulayyim AS, Alasmari AM, Buttery SC, Birring SS, Polkey MI, Hopkinson NSet al., 2022, Cough Frequency in Chronic Obstructive Pulmonary Disease (COPD) with Frequent Sputum Production, International Conference of the American-Thoracic-Society, Publisher: AMER THORACIC SOC, ISSN: 1073-449X

Conference paper

Alghamdi SM, Alasmari AM, Alsulayyim AS, Philip KE, Buttery SC, Williams P, Orton C, Birring SS, Polkey MI, Hopkinson NSet al., 2022, Oscillatory Positive Expiratory Pressure (OPEP) Therapy in Chronic Obstructive Pulmonary Disease (COPD): The O-COPD Trial, International Conference of the American-Thoracic-Society, Publisher: AMER THORACIC SOC, ISSN: 1073-449X

Conference paper

Vijayakumar B, Tonkin J, Devaraj A, Philip KEJ, Orton CM, Desai SR, Shah PLet al., 2022, CT Lung Abnormalities after COVID-19 at 3 Months and 1 Year after Hospital Discharge, RADIOLOGY, Vol: 303, ISSN: 0033-8419

Journal article

Hurst JR, Cumella A, Niklewicz CN, Philip KEJ, Singh V, Hopkinson NSet al., 2022, Acceptability of hygiene, face covering and social distancing interventions to prevent exacerbations in people living with airways diseases, THORAX, Vol: 77, Pages: 505-507, ISSN: 0040-6376

Journal article

Williams PJ, Cumella A, Philip KEJ, Laverty AA, Hopkinson NSet al., 2022, Smoking and socio-economic factors linked to acute exacerbations of COPD: analysis from an Asthma + Lung UK survey

<jats:title>ABSTRACT</jats:title><jats:p>Understanding the factors driving acute exacerbations of COPD is key to reducing their impact on human health and wellbeing. 5997 patients, mean 66 years, 64% female, completed an online survey between December 2020 and May 2021 about living with COPD developed by the charity Asthma+Lung UK. The 3731(62.2%) reporting frequent(≥2/year) exacerbations were more likely to smoke (AOR 1.70, 95%CI 1.470-1.98), have lower annual household income (≤£20,000, (AOR: 1.72, 1.36-2.17), live in a cold and damp home (AOR: 1.78, 1.50-2.11), and report previous occupational exposure to dust, fumes, and chemicals. Strategies to improve COPD outcomes must address issues of social justice.</jats:p>

Working paper

Williams PJ, Philip KEJ, Gill NK, Flannery D, Buttery S, Bartlett EC, Devaraj A, Kemp SV, Addis J, Derbyshire J, Chen M, Morris K, Laverty AA, Hopkinson NSet al., 2022, Immediate, remote smoking cessation intervention in participants undergoing a targeted lung health check: QuLIT2 a randomised controlled trial

<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Lung cancer screening programs provide an opportunity to support smokers to quit, but the most appropriate model for delivery remains to be determined. Immediate face to face smoking cessation support for people undergoing screening can increase quit rates, but it is not known whether remote delivery of immediate smoking cessation counselling and pharmacotherapy in this context is also effective.</jats:p></jats:sec><jats:sec><jats:title>Materials and Methods</jats:title><jats:p>In a single-blind randomised controlled trial, smokers aged 55-75 years attending a Targeted Lung Health Check (TLHC) were allocated by day of attendance to receive either immediate telephone smoking cessation support (TSI) (starting immediately and lasting for 6 weeks) with appropriate pharmacotherapy, or usual care (very brief advice to quit and signposting to smoking cessation services) (UC). The primary outcome was self-reported 7-day point prevalence smoking abstinence at three months. Differences between groups were assessed using logistic regression.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>315 current smokers taking part in the screening programme, mean (SD) age 63(5.4) years, 48% female, were randomised to telephone smoking cessation (n=152) or usual care (n=163). The two groups were well-matched at baseline. Self-reported quit rates were higher in the intervention arm, 21.1% vs 8.9% (odds ratio [OR]: 2.83, 95% CI 1.44-5.61, p=0.002). Controlling for participant demographics, baseline smoking characteristics or the discovery of abnormalities on low dose CT scanning did not modify the effect of the intervention.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Immediate provision of an intensive telephone-bas

Working paper

Archer J, McCarthy LP, Symons HE, Watson NA, Orton CM, Browne WJ, Harrison J, Moseley B, Philip KEJ, Calder JD, Shah PL, Bzdek BR, Costello D, Reid JPet al., 2022, Comparing aerosol number and mass exhalation rates from children and adults during breathing, speaking and singing, Interface Focus, Vol: 12, Pages: 1-15, ISSN: 2042-8901

Aerosol particles of respirable size are exhaled when individuals breathe, speak and sing and can transmit respiratory pathogens between infected and susceptible individuals. The COVID-19 pandemic has brought into focus the need to improve the quantification of the particle number and mass exhalation rates as one route to provide estimates of viral shedding and the potential risk of transmission of viruses. Most previous studies have reported the number and mass concentrations of aerosol particles in an exhaled plume. We provide a robust assessment of the absolute particle number and mass exhalation rates from measurements of minute ventilation using a non-invasive Vyntus Hans Rudolf mask kit with straps housing a rotating vane spirometer along with measurements of the exhaled particle number concentrations and size distributions. Specifically, we report comparisons of the number and mass exhalation rates for children (12–14 years old) and adults (19–72 years old) when breathing, speaking and singing, which indicate that child and adult cohorts generate similar amounts of aerosol when performing the same activity. Mass exhalation rates are typically 0.002–0.02 ng s−1 from breathing, 0.07–0.2 ng s−1 from speaking (at 70–80 dBA) and 0.1–0.7 ng s−1 from singing (at 70–80 dBA). The aerosol exhalation rate increases with increasing sound volume for both children and adults when both speaking and singing.

Journal article

Burton A, Aughterson H, Fancourt D, Philip KEJet al., 2022, Factors shaping the mental health and well-being of people experiencing persistent COVID-19 symptoms or 'long COVID': qualitative study, BJPSYCH OPEN, Vol: 8, ISSN: 2056-4724

Journal article

Philip K, Bu F, Polkey M, Brown J, Steptoe A, Hopkinson N, Fancourt Det al., 2022, Relationship of smoking with current and future social isolation and loneliness: 12-year follow-up of older adults in England, The Lancet Regional Health Europe, Vol: 14, ISSN: 2666-7762

BackgroundSmoking is often colloquially considered “social”. However, the actual relationship of smoking with current and future social isolation and loneliness is unclear. We therefore examined these relationships over a 12-year follow-up.MethodsIn this cohort study, we used a nationally representative sample of community dwelling adults aged 50 years and over from the English Longitudinal Study of Ageing (N=8780) (45% male, mean(SD) age 67(10) years. We examined associations of self-reported smoking status at baseline assessment, with social isolation (low social contact, social disengagement, domestic isolation), and loneliness (3-item UCLA loneliness scale), measured at baseline, and follow-up at 4, 8 and 12 years, using ordinary least squares regression models.FindingsAt baseline, smokers were more likely to be lonely (coef.=0·111, 95% CI 0·025 – 0·196) and socially isolated than non-smokers, having less frequent social interactions with family and friends (coef.= 0·297, 95%CI 0·148 – 0·446), less frequent engagement with community and cultural activities (coef.= 0·534, 95%CI 0·421 – 0·654), and being more likely to live alone (Odds Ratio =1·400, 95%CI 1·209 – 1·618). Smoking at baseline was associated with larger reductions in social contact (coef.=0·205, 95%CI 0·053 – 0·356, to 0·297, 95%CI 0·140 – 0·455), increases in social disengagement (coef.=0·168, 95%CI 0·066 – 0·270, to coef.=0·197, 95%CI 0·087 – 0·307), and increases in loneliness (coef.=0·105, 95%CI 0·003 – 0·207), at 4-year follow-up) over time. No association was found between smoking and changes in cohabitation status. Findings were independent of all identified confounders, including age, sex, social class and the presence of physical and mental

Journal article

Williams P, Buttery S, Mweseli R, Phillip KEJ, Sadaka A, Bartlett E, Devaraj A, Kemp S, Addis J, Derbyshire J, Chen M, Morris K, Laverty A, Hopkinson Net al., 2022, Immediate smoking cessation support vs usual care in smokers attending a targeted lung health check; the QuLIT trial, BMJ Open Respiratory Research, Vol: 9, ISSN: 2052-4439

Objectives: Lung cancer screening programmes offer an opportunity to address tobacco dependence in current smokers. The effectiveness of different approaches to smoking cessation in this context has not yet been established. We investigated if immediate smoking cessation support, including pharmacotherapy, offered as part of a lung cancer screening programme, increases quit rates compared to usual care (Very Brief Advice to quit and signposting to smoking cessation services).Materials and Methods: We conducted a single-blind randomised controlled trial of current smokers aged 55-75 years attending a Targeted Lung Health Check (TLHC). On randomly allocated days smokers received either (1) immediate support from a trained smoking cessation counsellor with appropriate pharmacotherapy or (2) usual care. The primary outcome was self-reported quit rate at three months. We performed thematic analysis of participant interview responses.Results: Of 412 people attending between January and March 2020, 115(27.9%) were current smokers; 46% female, mean(SD) 62.4(5.3) years. Follow up data were available for 84 smokers. At 3 months quit rates in the intervention group were higher 14/48(29.2%) versus 4/36(11%) (2 3.98, p=0.04). Participant interviews revealed four smoking-cessation related themes; 1) Stress and anxiety, 2) Impact of the COVID-19 pandemic, 3) Computerised tomography scans influencing desire to quit, 4) Individual beliefs about stopping smoking. Conclusion: The provision of immediate smoking cessation support is associated with a substantial increase in quit rates at three months. Further research is needed to investigate longer term outcomes and to refine future service delivery.

Journal article

Philip K, Buttery S, Williams P, Vijayakumar B, Tonkin J, Cumella A, Lottie R, Ogden L, Quint J, Johnston S, Polkey M, Hopkinson Net al., 2022, Impact of COVID-19 on people with asthma: A mixed methods analysis from a UK wide survey, BMJ Open Respiratory Research, Vol: 9, ISSN: 2052-4439

Introduction: The impact of acute COVID-19 on people with asthma appears complex, being moderated by multiple interacting disease-specific, demographic and environmental factors. Research regarding longer-term effects in this group is limited. We aimed to assess impacts of COVID-19 and predictors of persistent symptoms, in people with asthma.Methods: Using data from an online UK-wide survey of 4500 people with asthma (median age 50–59 years, 81% female), conducted in October 2020, we undertook a mixed methods analysis of the characteristics and experience of those reporting having had COVID-19.Results: The COVID-19 group (n=471, 10.5%) reported increased inhaler use and worse asthma management, compared with those not reporting COVID-19, but did not differ by gender, ethnicity or household income. Among the COVID-19 group, 56.1% reported having long COVID, 20.2% were ‘unsure’. Those with long COVID were more likely than those without long COVID to describe: their breathing as worse or much worse after their initial illness (73.7% vs 34.8%, p<0.001), increased inhaler use (67.8% vs 34.8%, p<0.001) and worse or much worse asthma management (59.6% vs 25.6%, p<0.001). Having long COVID was not associated with age, gender, ethnicity, UK nation or household income.Analysis of free text survey responses identified three key themes: (1) variable COVID-19 severity, duration and recovery; (2) symptom overlap and interaction between COVID-19 and asthma; (3) barriers to accessing healthcare.Conclusions: Persisting symptoms are common in people with asthma following COVID-19. Measures are needed to ensure appropriate healthcare access including clinical evaluation and investigation, to distinguish between COVID-19 symptoms and asthma.

Journal article

Buttery S, Philip K, Williams P, Fallas A, West B, Curnella A, Walker S, Quint J, Polkey M, Hopkinson Net al., 2021, Patient symptoms and experience following COVID-19: results from a UK-wide survey, BMJ Open Respiratory Research, Vol: 8, ISSN: 2052-4439

Objectives: To investigate the experience of people who continue to be unwell after acute COVID-19, often referred to as ‘long COVID’, both in terms of their symptoms and their interactions with healthcare.Design: We conducted a mixed-methods analysis of responses to a survey accessed through a UK online post-COVID support and information hub between April and December 2020 about people’s experiences after having acute COVID-19.Participants: 3290 respondents, 78% female 92.1% white ethnicity and median age range 45-54 years; 12.7% had been hospitalised. 494(16.5%) completed the survey between 4 and 8 weeks of the onset of their symptoms, 641(21.4%) between 8 and 12 weeks and 1865(62.1%) >12 weeks after.Results: The ongoing symptoms most frequently reported were; breathing problems (92.1%), fatigue (83.3%), muscle weakness or joint stiffness (50.6%), sleep disturbances (46.2%), problems with mental abilities (45.9%) changes in mood, including anxiety and depression (43.1%) and cough (42.3%). Symptoms did not appear to be related to the severity of the acute illness or to the presence of pre-existing medical conditions. Analysis of free text responses revealed three main themes (1) Experience of living with COVID-19 – physical and psychological symptoms that fluctuate unpredictably; (2) Interactions with healthcare that were unsatisfactory; (3) Implications for the future – their own condition, society and the healthcare system, and the need for researchConclusion: Consideration of patient perspective and experiences will assist in the planning of services to address problems persisting in people who remain symptomatic after the acute phase of COVID-19.

Journal article

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