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Research Strategy

The role of the UKRRF
The IPCRG has established the UK Respiratory Research Foundation (UKRRF) to harness the very best in UK experience, data and systems. Consultation with UKRRF members and leading UK primary care experts has led to the development of a much-needed comprehensive research strategy for primary care respiratory medicine. The strategy not only provides a framework for the development of the Foundation’s own research programme, but also highlights priority areas in respiratory primary care medicine for research for potential researchers and funders.

The UKRRF focuses on research in chronic respiratory diseases commonly diagnosed and managed in primary care, including: child and adult asthma; smoking dependence; allergic rhinitis; chronic obstructive pulmonary disease (COPD), and comorbidities. To a lesser extent, it also addresses infectious respiratory diseases handled in the primary care setting, including lower respiratory tract infections (LRTIs), infection trends, and pandemic flu.

Many of the studies that have focused on chronic respiratory diseases have been carried out in secondary care, frequently in patients unrepresentative of the primary care respiratory population. The studies often excluded the “typical” patients seen in real-life primary practice – those people with asthma who keep pets or smoke, those with comorbidities (e.g. heart failure or diabetes), and those with low levels of health literacy.

The limited nature of the current evidence base in respiratory medicine presents challenges when applying findings in the primary care settings. Primary care practitioners require assistance in identifying which of their patients are accurately represented by, and therefore in which patients management and care decisions can be guided by, studies undertaken so far.

Primary care practice benefits from: symptom- rather than diagnosis-based guidance; practical interventions that can be applied in the primary care setting, and outcomes that are meaningful across all levels of primary care services and not limited to those with additional services or to secondary care centres. The UKRRF is underpinned by the belief that an important element of providing the necessary support for primary care physicians is making sure future research is designed to answer questions that relate to real-life primary care, and that test new methodologies and approaches.

Within the UK, the increasing differences between the four home nation’s healthcare systems (in terms of both service delivery and funding) provide plenty of scope for comparative research. However, as a branch of the IPCRG, the UKRRF also considers the implications of its research at an international level and recognizes it has a role to play in setting and raising standards in international primary care respiratory medicine. The UK’s ethnically-diverse urban populations present one means by which the Foundation can be informed by international colleagues about health beliefs, behaviours and practice in other countries, while the IPCRG’s established connections with Bangladesh and Pakistan offer further scope for reflecting international practices in the Foundation’s research.

UKRRF research
UKRRF-funded research must be carried out in the UK and focus on the following key areas:
  • Questionnaires to assess patients’ and physicians’ understanding of respiratory problems;
  • Questionnaires designed to be simple to administer and to complete;
  • Questionnaires that aid diagnosis;
  • Practical methods to explore the identity, health beliefs and behaviours of patients and clinicians to improve concordance;
  • Creation and testing of educational interventions for patients and clinicians (e.g. evaluation of improvements in asthma control, smoking cessation benefits, interpretation of spirometry and implementation of guidelines);
  • Tailoring care to individual patients to improve adherence; 
  • Systematization of care to reduce variations in the application of the evidence-base;
  • The evaluation of the effectiveness and cost-effectiveness of:
    • pharmacological and non-pharmacological (e.g. exercise and breathing retraining) interventions
    • management systems for the treatment of chronic respiratory diseases and respiratory infections;
    • use of novel therapies and approaches that may improve concordance;
  • Optimal use of spirometry and practical alternatives for primary care that could improve the validity of findings;
  • Appropriate prescribing of antibiotics for lower respiratory tract infection (LRTI) following (UK-based, IPCRG-funded) research demonstrating a link between not prescribing antibiotics and death from pneumonia.
Click here to read the UKRRF Research Needs Statements.

Realization of the research strategy
At this time, there are two ongoing studies (TAKL and HARP), one study (HEALTH) that was finished early due to recruitment difficulties and one completed project that have received UKRRF support.

UKRRF funding
Research funds are currently being raised through IPCRG educational and fund-raising activities. Additional funding streams are also being sought from other charities, the Department of Health in England and from pharmaceutical and device companies. Work is ongoing to develop and extend funding partnerships across the UK’s four home nations.

Pharmaceutical industry support is considered appropriate as pharmacological therapies form the backbone of interventions in the UK for asthma, allergic rhinitis, smoking cessation and respiratory tract infections. It is important, however, that wherever possible (and appropriate) trials are carried out independently, in real-life settings, involving products from multiple companies and, preferably in conjunction with non-pharmacological interventions. While the UKRFF does not conduct cellular or animal research, it upholds Association of Medical Research Charities’ (AMRC) statement on animal research.

UKRRF funding will aim to cover 50%–100% of research costs, depending on how well the profile of the research reflects the Foundation’s identified research priorities, and on the availability of funds at that time. Details of eligibility for UKRRF funding are detailed on the Research Policy page.

Strategy review
To ensure the relevance of its work, the UKRRF will revise and adapt its research priorities and needs statements as new evidence emerges. Wherever possible, the UKRRF will work with its academic and charitable partners to maximize synergies and help build on their thinking about the research agenda so as to optimize use of the available resources. The research priorities published on this website will be revised to reflect any resulting changes in position and research direction.

Contributions to the research agenda are welcomed, as are research proposals, and can be submitted to the UKRRF Research Editor (submission instructions are detailed on the relevant forms).

Click here to make your suggestion for the research agenda, or here to apply for UKRRF support.

Siân Williams
May 2009

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