DrLouise Fleming
Professor of Practice in Paediatric Respiratory Medicine
National Heart & Lung Institute - Faculty of Medicine
Orcid identifier0000-0002-7268-7433 (opens in a new tab)
- Professor of Practice in Paediatric Respiratory MedicineNational Heart & Lung Institute - Faculty of Medicine
- 020 7352 8121 Ext.2938 (Work)
- Department of Respiratory Paedia, Royal Brompton, Royal Brompton Campus, United Kingdom
RESEARCH
Novel approaches to treatment and assessment of treatment response
• There is a growing body of evidence of the harmful effects of excessive use of short acting beta agonists (SABA) particularly if not taken with inhaled corticosteroids (ICS). Recent studies in adolescents and adults have led to significant changes in asthma management and the use of anti-inflammatory relievers (which contain inhaled corticosteroids). There is paucity of data in children. I am leading a ground breaking £2.4million HTA funded study that will enrol 1352 children with a range of asthma severities and compare standard care with the an anti-inflammatory reliever
• This study will have the potential to lead to a paradigm shift in asthma management, particularly in the UK, where excessive SABA use is widely accepted by medical professionals and patients alike.
• Predicting response to biological treatments – most data on treatment response is based on adult studies. I am involved in both clinical trials and real-world data collection to better characterise and understand paediatric responses.
• Medications, particularly inhaled corticosteroids, can also have unwanted effects and can lead to adrenal suppression. However, these responses are apparently idiosyncratic. Recent work includes exploring the relationship between adrenal suppression, steroid resistance, airway inflammation, airflow obstruction and adherence.
Harnessing digital technologies to improve asthma management
• Currently much of asthma diagnosis and management is based on subjective symptom reporting. Innovations in digital technology have opened the possibilities for objective real time monitoring to better inform the decision-making process.
• Adherence monitoring is a key research theme – this includes improved monitoring strategies to monitor both inhalation and actuation; testing novel devices (using both qualitative and quantitative data) and adherence interventions.
• Developing digital technologies to better predict asthma attacks – this includes physiological measurements such as home spirometry and peak flow and nocturnal monitoring including respiratory rate and pattern and environmental data.
• Use of home spirometry to diagnose and characterise asthma.
Child and Family Factors
• Better understanding of patient factors and how they impact on health behaviour can help to target interventions, including adherence. Recent and current work includes determinants of adherence in children, implementation of behavioural change techniques, including financial incentives and challenging health beliefs.
• Other work includes exploring patient factors in fatal and near fatal asthma and the impact of these events on families.
Charactering asthma and pre school wheeze
• Data from severe asthma and preschool wheeze (PSW) clinical cohorts has provided novel insights into the pathobiology & treatment targets for asthma. Ongoing studies include use of biomarkers in pre-school asthma and progression and outcome of pre-school wheeze
• There is a growing body of evidence of the harmful effects of excessive use of short acting beta agonists (SABA) particularly if not taken with inhaled corticosteroids (ICS). Recent studies in adolescents and adults have led to significant changes in asthma management and the use of anti-inflammatory relievers (which contain inhaled corticosteroids). There is paucity of data in children. I am leading a ground breaking £2.4million HTA funded study that will enrol 1352 children with a range of asthma severities and compare standard care with the an anti-inflammatory reliever
• This study will have the potential to lead to a paradigm shift in asthma management, particularly in the UK, where excessive SABA use is widely accepted by medical professionals and patients alike.
• Predicting response to biological treatments – most data on treatment response is based on adult studies. I am involved in both clinical trials and real-world data collection to better characterise and understand paediatric responses.
• Medications, particularly inhaled corticosteroids, can also have unwanted effects and can lead to adrenal suppression. However, these responses are apparently idiosyncratic. Recent work includes exploring the relationship between adrenal suppression, steroid resistance, airway inflammation, airflow obstruction and adherence.
Harnessing digital technologies to improve asthma management
• Currently much of asthma diagnosis and management is based on subjective symptom reporting. Innovations in digital technology have opened the possibilities for objective real time monitoring to better inform the decision-making process.
• Adherence monitoring is a key research theme – this includes improved monitoring strategies to monitor both inhalation and actuation; testing novel devices (using both qualitative and quantitative data) and adherence interventions.
• Developing digital technologies to better predict asthma attacks – this includes physiological measurements such as home spirometry and peak flow and nocturnal monitoring including respiratory rate and pattern and environmental data.
• Use of home spirometry to diagnose and characterise asthma.
Child and Family Factors
• Better understanding of patient factors and how they impact on health behaviour can help to target interventions, including adherence. Recent and current work includes determinants of adherence in children, implementation of behavioural change techniques, including financial incentives and challenging health beliefs.
• Other work includes exploring patient factors in fatal and near fatal asthma and the impact of these events on families.
Charactering asthma and pre school wheeze
• Data from severe asthma and preschool wheeze (PSW) clinical cohorts has provided novel insights into the pathobiology & treatment targets for asthma. Ongoing studies include use of biomarkers in pre-school asthma and progression and outcome of pre-school wheeze