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Professors Jennifer Alison and Carol Armour lead the Respiratory Stream at Sydney Health Partners. Here they overview what their team is trying to achieve and how their work can help people with various respiratory diseases, which are under-recognised in the general community and, as a result, under-managed.
What are you working on?
The Respiratory Stream of Sydney Health Partners is organised into four themes: 1. asthma, 2. COPD, 3. pulmonary fibrosis and pulmonary vascular disease 4. Cystic Fibrosis and bronchiectasis. The membership of the Respiratory Stream is multidisciplinary, to represent the team needed to manage people with these diseases.
Why are you undertaking this research?
The burden respiratory diseases place on the health system is enormous. For example, COPD (emphysema and chronic bronchitis) affects one-in-seven Australians over the age of 40 and almost one-in-three over 75 years. COPD costs the health system in excess of a billion dollars a year and is the second- highest cause of avoidable hospital admissions. In 7.5% of Australians 40 years old or over, COPD has progressed to the point where symptoms may already be present and affecting daily life. Half of these people will not have been diagnosed as having COPD, which reduces the opportunity for early intervention and management.
Another huge challenge for the health system is asthma, which affects one-in-ten people or 2.5 million Australians. Almost 17 per cent of infants experience asthma or wheeze in the first three years of life and, of all the children presenting to emergency departments with asthma, 43 % are admitted.
Who are you trying to help?
Our first aim is to achieve optimal care for everyone burdened with respiratory disease by introducing evidence-based interventions across Sydney Health Partners.
Our second aim is to achieve earlier identification and diagnosis of people suffering respiratory disease. This applies to COPD as well as pulmonary fibrosis and pulmonary vascular disease which are not are not as common as asthma and COPD, yet they represent a huge problem in terms of diagnosis and treatment. It may be many months before a person is diagnosed and receives appropriate treatment since the symptoms can be non-specific breathlessness.
Cystic fibrosis (CF) and bronchiectasis also represent major challenges in diagnosis and management. CF is well-recognised early in life and managed well at specialist centres. However, as people with CF reach adulthood, their management changes and their care can become complex. For bronchiectasis, the burden of disease and the best management strategies are not well understood and require further research.
How does being part of a collaborative partnership like Sydney Health Partners help you to achieve more than you would be able to individually?
Sydney Health Partners assists our researchers to engage beyond a single Local Health District. By working collaboratively across traditional boundaries we bring together the best minds in research and clinical care to benefit more people with respiratory disease. An example is the establishment of a Breathlessness Clinic for patients with complicated or hard to diagnose cardiorespiratory conditions.
What potential do you see for scaling up the results of your research? How can it reach more people in the health system?
The Sydney region is recognised nationally and internationally for its excellence in research and treatment of respiratory diseases. Sydney Health Partners member organisations cover areas of health responsibility of 2.6 million people or 10 per cent of Australia’s population.
Our research on improving management of respiratory disease will be disseminated through Sydney Health Partners, then through NSW and, via the other advanced translational networks, to Australia.