Imperial College London

ProfessorNickHopkinson

Faculty of MedicineNational Heart & Lung Institute

Professor of Respiratory Medicine
 
 
 
//

Contact

 

n.hopkinson

 
 
//

Location

 

Muscle LabSouth BlockRoyal Brompton Campus

//

Summary

 

Publications

Publication Type
Year
to

512 results found

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

Hopkinson NS, 2024, Smoking and lung cancer-70 long years on., BMJ, Vol: 384

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

Williams P, Buttery SC, Hopkinson N, Laverty AAet al., 2024, Lung disease and social justice - COPD as a manifestation of structural violence., American Journal of Respiratory and Critical Care Medicine, ISSN: 1073-449X

Lung health, the development of lung disease, and how well a person with lung disease is able to live, all depend on a wide range of societal factors. These systemic factors that adversely affect people and cause injustice, can be thought of as “structural violence”. To make the causal processes relating to COPD more apparent, and the responsibility to interrupt or alleviate them clearer, we have developed a taxonomy to describe this. It contains five domains: 1)Avoidable lung harms: (i)processes impacting on lung development (ii)processes which disadvantage lung health in particular groups across the life course. 2)Diagnostic Delay: (i)healthcare factors (ii)norms and attitudes that mean that COPD is not diagnosed in a timely way, denying people with COPD effective treatment. 3)Inadequate COPD Care: ways in which the provision of care for people with COPD falls short of what is needed to ensure that they are able to enjoy the best possible health, considered as (i)healthcare resource allocation (ii)norms and attitudes influencing clinical practice. 4)Low status of COPD: ways both COPD as a condition and people with COPD are held in less regard and considered less of a priority than other comparable health problems. 5)Lack of Support: factors that make living with COPD more difficult than it should be (i)socioenvironmental factors (ii)factors that promote social isolation. This model has relevance for policymakers, healthcare professionals and the public as an educational resource, to change clinical practices and priorities and to stimulate advocacy and activism with the goal of the elimination of COPD.

Journal article

Buttery S, Lewis A, Alzetani A, Curtis KJ, Dodd J, Habib AM, Hussain A, Havelock T, Jordan S, Kallis C, Kemp SV, Lawson RA, Mahadeva R, Munavvar M, Naidu B, Rathinan S, Shackcloth M, Shah PL, Tenconi S, Hopkinson NSet al., 2024, Survival following Lung Volume Reduction procedures - results from the UK Lung Volume Reduction (UKLVR) Registry, BMJ Open Respiratory Research, ISSN: 2052-4439

Journal article

Delgado-Ortiz L, Ranciati S, Arbillaga-Etxarri A, Balcells E, Buekers J, Demeyer H, Frei A, Gimeno-Santos E, Hopkinson NS, de Jong C, Karlsson N, Louvaris Z, Palmerini L, Polkey MI, Puhan MA, Rabinovich RA, Rodríguez Chiaradia DA, Rodriguez-Roisin R, Toran-Montserrat P, Vogiatzis I, Watz H, Troosters T, Garcia-Aymerich Jet al., 2024, Real-world walking cadence in people with COPD, ERJ Open Research, Pages: 00673-2023

<jats:sec><jats:title>Introduction</jats:title><jats:p>The clinical validity of real-world walking cadence in people with chronic obstructive pulmonary disease (COPD) is unsettled. Objective: to assess the levels, variability and association with clinically relevant COPD characteristics and outcomes of real-world walking cadence.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We assessed walking cadence (steps per minute during walking bouts &gt;10 s) from 7-days accelerometer data in 593 individuals with COPD from five European countries, and clinical and functional characteristics from validated questionnaires and standardised tests. Severe exacerbations during 12-months follow-up were recorded from patient reports and medical registries.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Participants were mostly male (80%) and had mean (<jats:sc>sd</jats:sc>) age 68 (8) years, post-bronchodilator FEV<jats:sub>1</jats:sub>57 (19)%, and 6880 (3926) steps/day. Mean walking cadence was 88 steps/min, followed a normal distribution (<jats:sc>sd</jats:sc>=9), and was highly stable within-person (ICC 0.92 (95%CI 0.90–0.93)). After adjusting for age, sex, height and number of walking bouts in fractional polynomial or linear regressions, walking cadence was positively associated with FEV<jats:sub>1,</jats:sub>6-min walk distance, physical activity (steps/day, time in moderate-to-vigorous physical activity, vector magnitude units, walking time, intensity during locomotion), physical activity experience and health-related quality of life; and negatively associated with breathlessness and depression (all p&lt;0.05). These associations remained after further adjustment for daily steps. In negative binomial regression adjusted for multiple confounders, walking cadence related to lowe

Journal article

Hopkinson NS, 2024, Reply to Gallego and Farber, and to Young, et al. and to Aslan., Am J Respir Crit Care Med

Journal article

Jones AW, King BE, Cumella A, Hopkinson NS, Hurst JR, Holland AEet al., 2024, Use of infection control measures in people with chronic lung disease: mixed methods study, ERJ Open Research, Vol: 10, ISSN: 2312-0541

BACKGROUND: The introduction of community infection control measures during the COVID-19 pandemic was associated with a reduction in acute exacerbations of lung disease. We aimed to understand the acceptability of continued use of infection control measures among people with chronic lung disease and to understand the barriers and facilitators of use. METHODS: Australian adults with chronic lung disease were invited to an online survey (last quarter of 2021) to specify infection control measures they would continue themselves post-pandemic and those they perceived should be adopted by the community. A subset of survey participants were interviewed (first quarter of 2022) with coded transcripts deductively mapped to the COM-B model and Theoretical Domains Framework. RESULTS: 193 people (COPD 84, bronchiectasis 41, interstitial lung disease 35, asthma 33) completed the survey. Physical distancing indoors (83%), handwashing (77%), and avoidance of busy places (71%) or unwell family and friends (77%) were measures most likely to be continued. Policies for the wider community that received most support were those during the influenza season including hand sanitiser being widely available (84%), wearing of face coverings by healthcare professionals (67%) and wearing of face coverings by the general population on public transport (66%). Barriers to use of infection control measures were related to physical skills, knowledge, environmental context and resources, social influences, emotion, beliefs about capabilities and beliefs about consequences. CONCLUSIONS: Adults with chronic lung diseases in Australia are supportive of physical distancing indoors, hand hygiene, and avoidance of busy places or unwell family and friends as long-term infection control measures.

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

Hopkinson N, 2023, Dig where you stand: a book that investigates the hidden history of work and occupational health, BMJ: British Medical Journal, Vol: 383, Pages: 2961-2961, ISSN: 0959-535X

Journal article

McKee M, Hopkinson NS, 2023, New Zealand reverses landmark tobacco controls, BMJ: British Medical Journal, Vol: 383, ISSN: 0959-535X

Journal article

Hopkinson NS, 2023, E-Cigarettes as a Smoking Cessation Aid - Toward Common Ground and a Rational Approach, AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Vol: 208, Pages: 1007-1009, ISSN: 1073-449X

Journal article

Doe G, Taylor SJC, Topalovic M, Russell R, Evans RA, Maes J, Van Orshovon K, Sunjaya A, Scott D, Prevost AT, El-Emir E, Harvey J, Hopkinson NS, Kon SS, Patel S, Jarrold I, Spain N, Man WD-C, Hutchinson Aet al., 2023, Spirometry services in England post-pandemic and the potential role of AI support software: a qualitative study of challenges and opportunities, BRITISH JOURNAL OF GENERAL PRACTICE, ISSN: 0960-1643

Journal article

Vrinten C, Parnham J, Filippidis F, Creese H, Hopkinson N, Laverty Aet al., 2023, Patterns of cigarette and e-cigarette use among UK adolescents: a latent class analysis of the Millennium Cohort Study, European Journal of Public Health, Vol: 33, Pages: 857-863, ISSN: 1101-1262

Background Patterning of cigarette and e-cigarette use among young people remains poorlycharacterised. We aimed to describe these patterns in the UK Millennium Cohort Study atage 14 and 17 years.Methods Data on cigarette and e-cigarette use come from 9,731 adolescents. Latent class analysisassigned participants to membership of classes of product use and multinomial logisticregression analyses assessed differences in the likelihood of belonging to classes bysociodemographic (age, gender, ethnicity, household income, maternal education, countryof residence) and smoking-related social factors (caregiver tobacco use, caregiver ecigarette use, and peer smoking).ResultsWe identified four classes of use: 45.8% of adolescents continued to abstain from cigarettesor e-cigarettes; 21.3% experimented (used once or in the past but not currently) withcigarettes and/or e-cigarettes by age 17 but were not current users; 19.0% were lateadopters, characterised by low levels of use at age 14 but high levels of experimentation andcurrent use at age 17; and 13.9% were early adopters, characterised by high levels ofexperimentation and current use at ages 14 and 17. At age 17, 70.4% of early adopterssmoked cigarettes regularly plus an additional 27.3% experimented with cigarettes.Corresponding percentages for e-cigarettes were 37.9% and 58.9%. Tobacco and ecigarette use by caregivers, and cigarette use by peers, were associated with being both lateadopters and early adopters. ConclusionApproximately one in seven adolescents in the UK are early adopters of nicotine products.This highlights the need to develop and implement effective policies to prevent nicotine useuptake.

Journal article

Alghamdi SM, Alzahrani A, Alshahrani YM, Al Ruwaithi AA, Aldhahir AM, Alsulayyim AS, Siraj RA, Almansour AH, Alasmari AM, Alqahtani JS, Alanazi AM, Jaishi ST, Allehyani BA, Hopkinson NSet al., 2023, Perception and clinical practice regarding mucus clearance devices with chronic obstructive pulmonary disease: a cross-sectional study of healthcare providers in Saudi Arabia, BMJ Open, Vol: 13, Pages: 1-7, ISSN: 2044-6055

OBJECTIVES: Clearing secretions from the airway can be difficult for people with chronic obstructive pulmonary disease (COPD). Mucus clearance devices (MCDs) are an option in disease management to help with this, but healthcare provider awareness and knowledge about them as well as current clinical practice in Saudi Arabia are not known. DESIGN: A cross-sectional online survey consisting of four themes; demographics, awareness, recommendations and clinical practice, for MCDs with COPD patients. SETTING: Saudi Arabia. PARTICIPANTS: 1188 healthcare providers including general practitioners, family physicians, pulmonologists, nursing staff, respiratory therapists and physiotherapists. PRIMARY OUTCOME MEASURES: Healthcare providers' level of awareness about MCDs, and the identification of current clinical practices of COPD care in Saudi Arabia. RESULTS: 1188 healthcare providers (44.4% female) completed the survey. Regarding devices, 54.2% were aware of the Flutter, 23.8% the Acapella and 5.4% the positive expiratory pressure mask. 40.7% of the respondents identified the Acapella, and 22.3% the Flutter as first choice for COPD management. 75% would usually or always consider their use in COPD patients reporting daily difficulty clearing mucus, whereas 55.9% would sometimes or usually consider the use of MCDs with COPD patients who produced and were able to clear mucus with cough. In clinical practice, 380 (32%) of the respondents would prescribe MCDs, 378 (31.8%) would give MCDs without prescriptions, 314 (26.4%) would not provide them at all and 116 (9.8%) would only advise patients about them. CONCLUSION: Healthcare providers are aware of the existence of MCDs and their benefits for sputum clearance and believe that MCDs are beneficial for sputum clearance in some COPD patients. TRIAL REGISTRATION NUMBER: ISRCTN44651852.

Journal article

Buekers J, Megaritis D, Koch S, Alcock L, Ammour N, Becker C, Bertuletti S, Bonci T, Brown P, Buckley E, Buttery SC, Caulfied B, Cereatti A, Chynkiamis N, Demeyer H, Echevarria C, Frei A, Hansen C, Hausdorff JM, Hopkinson NS, Hume E, Kuederle A, Maetzler W, Mazza C, Mico-Amigo EM, Mueller A, Palmerini L, Salis F, Scott K, Troosters T, Vereijken B, Watz H, Rochester L, Del Din S, Vogiatzis I, Garcia-Aymerich Jet al., 2023, Laboratory and free-living gait performance in adults with COPD and healthy controls, ERJ Open Research, Vol: 9, ISSN: 2312-0541

Background Gait characteristics are important risk factors for falls, hospitalisations and mortality in older adults, but the impact of COPD on gait performance remains unclear. We aimed to identify differences in gait characteristics between adults with COPD and healthy age-matched controls during 1) laboratory tests that included complex movements and obstacles, 2) simulated daily-life activities (supervised) and 3) free-living daily-life activities (unsupervised).Methods This case–control study used a multi-sensor wearable system (INDIP) to obtain seven gait characteristics for each walking bout performed by adults with mild-to-severe COPD (n=17; forced expiratory volume in 1 s 57±19% predicted) and controls (n=20) during laboratory tests, and during simulated and free-living daily-life activities. Gait characteristics were compared between adults with COPD and healthy controls for all walking bouts combined, and for shorter (≤30 s) and longer (>30 s) walking bouts separately.Results Slower walking speed (−11 cm·s−1, 95% CI: −20 to −3) and lower cadence (−6.6 steps·min−1, 95% CI: −12.3 to −0.9) were recorded in adults with COPD compared to healthy controls during longer (>30 s) free-living walking bouts, but not during shorter (≤30 s) walking bouts in either laboratory or free-living settings. Double support duration and gait variability measures were generally comparable between the two groups.Conclusion Gait impairment of adults with mild-to-severe COPD mainly manifests during relatively long walking bouts (>30 s) in free-living conditions. Future research should determine the underlying mechanism(s) of this impairment to facilitate the development of interventions that can improve free-living gait performance in adults with COPD.

Journal article

Parnham JC, Vrinten C, Cheeseman H, Bunce L, Hopkinson NS, Filippidis FT, Laverty AAet al., 2023, Changing awareness and sources of tobacco and e-cigarettes among children and adolescents in Great Britain, TOBACCO CONTROL, ISSN: 0964-4563

Journal article

Hopkinson NS, Stokes-Lampard H, Clarke S, James A, Hawthorne K, Thakar R, Fenton K, Strain D, Walton G, Cullen P, Black C, Wiseman A, Dixon J, Griffiths C, Walker I, Bauld Let al., 2023, Meagre spending on tobacco control is costing the economy billions, BMJ: British Medical Journal, Vol: 381, Pages: 876-876, ISSN: 0959-535X

Journal article

Buttery SC, Banya W, Bilancia R, Boyd E, Buckley J, Greening NJ, Housley K, Jordan S, Kemp SV, Kirk AJB, Latimer L, Lau K, Lawson R, Lewis A, Moxham J, Rathinam S, Steiner MC, Tenconi S, Waller D, Shah PL, Hopkinson NS, CELEB investigatorset al., 2023, Lung volume reduction surgery versus endobronchial valves: a randomised controlled trial, European Respiratory Journal, Vol: 61, Pages: 1-14, ISSN: 0903-1936

BACKGROUND: Lung volume reduction surgery (LVRS) and bronchoscopic lung volume reduction (BLVR) with endobronchial valves can improve outcomes in appropriately selected patients with emphysema. However, no direct comparison data exist to inform clinical decision making in people who appear suitable for both procedures. Our aim was to investigate whether LVRS produces superior health outcomes when compared with BLVR at 12 months. METHODS: This multicentre, single-blind, parallel-group trial randomised patients from five UK hospitals, who were suitable for a targeted lung volume reduction procedure, to either LVRS or BLVR and compared outcomes at 1 year using the i-BODE score. This composite disease severity measure includes body mass index, airflow obstruction, dyspnoea and exercise capacity (incremental shuttle walk test). The researchers responsible for collecting outcomes were masked to treatment allocation. All outcomes were assessed in the intention-to-treat population. RESULTS: 88 participants (48% female, mean±sd age 64.6±7.7 years, forced expiratory volume in 1 s percent predicted 31.0±7.9%) were recruited at five specialist centres across the UK and randomised to either LVRS (n=41) or BLVR (n=47). At 12 months follow-up, the complete i-BODE was available in 49 participants (21 LVRS/28 BLVR). Neither improvement in the i-BODE score (LVRS -1.10±1.44 versus BLVR -0.82±1.61; p=0.54) nor in its individual components differed between groups. Both treatments produced similar improvements in gas trapping (residual volume percent predicted: LVRS -36.1% (95% CI -54.6- -10%) versus BLVR -30.1% (95% CI -53.7- -9%); p=0.81). There was one death in each treatment arm. CONCLUSION: Our findings do not support the hypothesis that LVRS is a substantially superior treatment to BLVR in individuals who are suitable for both treatments.

Journal article

Hopkinson NS, 2023, Secondary prevention must include treating tobacco dependence., BMJ: British Medical Journal, Vol: 380, Pages: 1-1, ISSN: 0959-535X

Journal article

Jeyin N, Desai SR, Padley SPG, Wechalekar K, Gregg S, Sousa T, Shah PL, Allinson JP, Hopkinson NS, Begum S, Jordan S, Kemp SV, Ridge CAet al., 2023, Dual-energy computed tomographic pulmonary angiography accurately estimates lobar perfusion before lung volume reduction for severe emphysema, Journal of Thoracic Imaging, Vol: 38, Pages: 104-112, ISSN: 0883-5993

PURPOSE: To assess if dual-energy computed tomographic pulmonary angiography (DECTPA) derived lobar iodine quantification can provide an accurate estimate of lobar perfusion in patients with severe emphysema, and offer an adjunct to single-photon emission CT perfusion scintigraphy (SPECT-PS) in assessing suitability for lung volume reduction (LVR). MATERIALS AND METHODS: Patients with severe emphysema (forced expiratory volume in 1 s <49% predicted) undergoing evaluation for LVR between May 2018 and April 2020 imaged with both SPECT-PS and DECTPA were included in this retrospective study. DECTPA perfused blood volume maps were automatically segmented and lobar iodine mass was estimated and compared with lobar technetium (Tc99m) distribution acquired with SPECT-PS. Pearson correlation and Bland-Altman analysis were used for intermodality comparison between DECTPA and SPECT-PS. Univariate and adjusted multivariate linear regression were modelled to ascertain the effect sizes of possible confounders of disease severity, sex, age, and body mass index on the relationship between lobar iodine and Tc99m values. Effective radiation dose and adverse reactions were recorded. RESULTS: In all, 123 patients (64.5±8.8 y, 71 men; mean predicted forced expiratory volume in 1 s 32.1 ±12.7%,) were eligible for inclusion. There was a linear relationship between lobar perfusion values acquired using DECTPA and SPECT-PS with statistical significance (P<0.001). Lobar relative perfusion values acquired using DECTPA and SPECT-PS had a consistent relationship both by linear regression and Bland-Altman analysis (mean bias, -0.01, mean r2 0.64; P<0.0001). Individual lobar comparisons demonstrated moderate correlation (r=0.79, 0.78, 0.84, 0.78, 0.8 for the right upper, middle, lower, left upper, and lower lobes, respectively, P<0.0001). The relationship between lobar iodine and Tc99m values was not significantly altered after controlling for conf

Journal article

Patel S, Jones SE, Barker RE, Polgar O, Maddocks M, Hopkinson NS, Nolan CM, Man WD-Cet al., 2023, The six-minute step test as an exercise outcome in chronic obstructive pulmonary disease, Annals of the American Thoracic Society, Vol: 20, Pages: 476-479, ISSN: 1546-3222

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

Williams P, Cheeseman H, Arnott D, Bunce L, Hopkinson N, Laverty Aet al., 2023, Use of tobacco and e-cigarettes among youth in Great Britain in 2022: analysis of a cross sectional survey, Tobacco Induced Diseases, Vol: 21, ISSN: 1617-9625

Introduction:Although e-cigarettes can be an effective form of nicotine substitution for adults attempting to quit smoking, their use among children and young people is a concern. Accurate data about this are needed to inform debates over policy and regulation in the UK and elsewhere.Methods:Using data from an online survey of 2613 youth aged 11–18 years, conducted by the market research company YouGov in March 2022, we present prevalence estimates of e-cigarette and tobacco use. We use logistic regression models to assess differences in e-cigarette use, tobacco use and use of disposable e-cigarettes across a range of covariates including age, sex, tobacco smoking status, social class, and country.Results:Among the 18.0% of those surveyed who reported ever having smoked a cigarette, 83.9% were not regular (at least once per week) smokers and 16.1% were (15.1% and 2.9% of the total sample, respectively). Among the 19.2% of those surveyed who had ever used an e-cigarette, 79.2% were not regular users, while 20.8% were (15.2% and 4.0% of the total sample, respectively). Regular e-cigarette use was more common than regular tobacco smoking (4.0% vs 2.9%). E-cigarette use was more common among those who also smoked tobacco, with 9.0% of never e-cigarette users ever smoking tobacco, compared with 89.4% of regular e-cigarette users. Both smoking and e-cigarette use were associated with increasing age and use by others within the home, but not with social class. Use of disposable e-cigarettes was reported by 53.8% of those who have ever used an e-cigarette, and more common among females than males.Conclusions:Regular e-cigarette use is now more common than smoking in children and youth, though the majority of this is among those who have also smoked tobacco. Measures to reduce the appeal of both e-cigarettes and tobacco to children and young people are warranted.

Journal article

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

Hopkinson N, Buttery S, Williams P, 2023, Development and implementation of the lung volume reduction pulmonary rehabilitation tool to identify eligibility for lung volume reduction in people with chronic obstructive pulmonary disease during pulmonary rehabilitation, Chronic Respiratory Disease, Vol: 20, ISSN: 1479-9723

BackgroundCompletion of pulmonary rehabilitation is recognised in chronic obstructive pulmonary disease (COPD) guidelines as a key opportunity to consider systematically whether a respiratory review to assess potential suitability for a lung volume reduction (LVR) procedure might be appropriate. We describe the development of a simple decision-support tool (the LVR-PR tool) to aid clinicians working in pulmonary rehabilitation, to operationalise this process.MethodsWe took an iterative mixed methods approach, which was partnership-based and involved an initial consensus survey, focus groups and an observational study cohort at multiple pulmonary rehabilitation centres.ResultsDiagnosis (97%), exercise capacity (84%), breathlessness (78%) and co-morbidities (76%) were acknowledged to be essential items for assessing basic LVR eligibility. Collating prior investigations and assessing patient understanding were considered useful but not essential. Clinician concerns included; streamlining the tool; access to clinical information and investigations; and care needed around introducing LVR therapies to patients in a PR setting. Access to clearer information about LVR procedures, the clinician’s role in considering eligibility and how educational resources should be delivered were identified as important themes from patient group discussions. The LVR-PR tool was considered to be feasible and valid for implementation in a variety of PR services across the UK subject to the provision of appropriate health professional training. Clinicians working in specialist LVR centres across the UK who were not otherwise involved in the development process confirmed the tool’s validity using the content validity index (CVI).InterpretationThe LVR-PR tool appears to be an acceptable tool that can be feasibly implemented in PR services subject to good quality educational resources for both patients and healthcare professionals.

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

Vrinten C, Parnham JC, Filippidis FT, Hopkinson NS, Laverty AAet al., 2022, Risk factors for adolescent smoking uptake: an analysis of prospective data from the Millennium Cohort Study., The Lancet, Vol: 400, Pages: S57-S57, ISSN: 0140-6736

BACKGROUND: Preventing smoking uptake among adolescents is essential to achieve a smoke-free generation. The aim of this study was to assess risk factors for smoking in late adolescence and smoking uptake between early and late adolescence, using data from the Millennium Cohort Study. We also present estimates of numbers of smokers and smoking uptake. METHODS: Adolescents aged 14-17 years were included in the analysis. In separate logistic regression models, we assessed associations between age, sex, ethnicity, household income, country of residence, current smoking of a caregiver, current smoking of peers and use of social media, and regular smoking (defined as smoking at least one cigarette per week) at the age of 17 years and smoking uptake between the ages of 14 and 17 years (defined as being a never-smoker at the age of 14 years and a regular smoker at the age of 17 years). We also estimated numbers of regular smoking and smoking uptake using the Office for National Statistics 2018-19 population estimates. FINDINGS: Data from 8944 adolescents aged 14-17 years with smoking data available were included, 948 (10·6%) of which were regular tobacco smokers at the age of 17 years. 488 (51·5%) of these 948 started smoking between the ages of 14 years and 17 years. Smoking uptake was more common among adolescents reporting caregiver smoking (162 [13·6%] of 1188 vs 324 [5·0%] of 6538 with non-smoking caregivers; p<0·0001); peers smoking (223 [12·6%] of 1764 vs 229 [4·3%] of 5350 without smoking peers; p<0·0001), and those reporting higher (at least 5 h/weekday) social media use (115 [9·8%] of 1176 vs 120 [4·1%] of 2947 with lower [less than 1 h/weekday] social media use; p=0·0059), among 7786 adolescents who did not smoke at age 14. We estimated that 164 313 (95% CI 146 815-181 811) adolescents were regular smokers by the age of 17 years, of whom 101 715 (85 994-117 435) took up the habit

Journal article

Philip KEJ, Buttery SC, Bowen S, Lewis A, Alghamdi SM, Williams PJ, Alasmari AM, Alsulayyim AS, Orton CM, Conway F, Chan L, Vijayakurnar 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, Fancourt D, Hopkinson NSet al., 2022, A SINGLE-BLIND, MULTICENTRE, MULTINATIONAL, RANDOMISED CONTROLLED TRIAL OF ONLINE SINGING FOR LUNG HEALTH (SLH) VS USUAL CARE FOR PEOPLE WITH COPD: THE SINGING FOR HEALTH, IMPROVING EXPERIENCES OF LUNG DISEASE (SHIELD) TRIAL, Winter Meeting of the British-Thoracic-Society (BTS), Publisher: BMJ PUBLISHING GROUP, Pages: A53-A53, ISSN: 0040-6376

Conference paper

Vrinten C, Parnham JC, Filippidis FT, Hopkinson NS, Laverty AAet al., 2022, Risk factors for adolescent smoking uptake: an analysis of prospective data from the Millennium Cohort Study, Publisher: ELSEVIER SCIENCE INC

Working paper

This data is extracted from the Web of Science and reproduced under a licence from Thomson Reuters. You may not copy or re-distribute this data in whole or in part without the written consent of the Science business of Thomson Reuters.

Request URL: http://wlsprd.imperial.ac.uk:80/respub/WEB-INF/jsp/search-html.jsp Request URI: /respub/WEB-INF/jsp/search-html.jsp Query String: respub-action=search.html&id=00340756&limit=30&person=true