Chronic obstructive pulmonary disease (COPD) and asthma are common lung conditions and patients are at risk of severe episodes of deterioration - 'exacerbations'. Exacerbations are the second commonest cause of adult emergency medical hospital admission in the UK and are associated with shortened lives and decreased quality of life. Changes in temperature, humidity and air pollution are related to exacerbations, but these are not well characterised due, in part, to insufficiently detailed environmental exposure estimates in studies, and in part to the difficulty in estimating complex patterns of risks involving exposures varying in time and multiple exacerbations events. This study will investigate the role of environmental factors such as pollution and temperature on exacerbations in COPD and asthma by using linked electronic health records and environmental data, and by applying novel study designs and statistical techniques. Findings from this study will be of benefit to both patients and health care providers by helping to improve the organisation of health care resources, particularly in the winter and highlight times when patients should be aware of increased risk of exacerbations.
Changes in temperature, humidity and air pollution are related to exacerbations for chronic obstructive pulmonary disease (COPD) and asthma. However, these health associations are not well characterised due, in part, to insufficiently detailed environmental exposure estimates in studies, and in part to the difficulty in estimating complex temporal patterns of risks involving exposures varying in time and multiple exacerbations events. This study will use linked patient data via General Practices contributing to CPRD, and relevant daily atmospheric data held by DEFRA and BADC monitoring stations as the best available proxy for environmental data in the locality of a given practice. The analysis will be performed by applying the case time series design, a novel analytical method to investigate transient effects of time-varying factors in a longitudinal setting. This is a novel approach that combines design features from time series analysis with individual-level case-only methods, and allow the assessment of complex temporal effects of exposures with multiple health events while controlling by design for time-invariant confounders. Findings from this study will be of benefit to both patients and health care providers by helping to improve the organisation of health care resources, particularly in the winter and highlight times when patients should be aware of increased risk of exacerbations.
COPD exacerbations
Asthma exacerbations
Jennifer Quint - Chief Investigator - Imperial College London
Jennifer Quint - Corresponding Applicant - Imperial College London
Ana Maria Vicedo-Cabrera - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Antonio Gasparrini - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
Francesco Sera - Collaborator - London School of Hygiene & Tropical Medicine ( LSHTM )
HES Admitted Patient Care;ONS Death Registration Data;Practice Level Index of Multiple Deprivation;Non-standard