Date: 27 December 2017
Professor Mona Bafadhel is an associate professor of Respiratory Medicine at the University of Oxford’s Nuffield Department of Medicine. She was the chief investigator on the COPD STARR study, which looks into taking blood samples from patients with chronic obstructive pulmonary disease (COPD) - an umbrella term used to describe lung diseases - to tailor specific antibiotic and steroid treatments based on their white blood cell counts. She is now the chief investigator on a follow-up study, COPD STARR 2, which involves trialling tailored treatments, based on the results of COPD STARR.
What does your role as a chief investigator involve?
“My role as a chief investigator involves overall responsibility for the study. This includes the idea design, putting it together, making sure we have got ethical approval and funding, and recruiting the staff to work on the study. Once patient recruitment has finished, it involves analysing the data and ensuring that we can announce the results to patients, clinicians and the scientific community.”
How would you define COPD to someone who has never heard of it?
“COPD is an umbrella term for chronic bronchitis and emphysema and, in some cases, chronic asthma. It is largely caused by exposure to cigarette smoke and/or pollutants. Patients mainly report they are breathless, have an increase in cough, and also complain that they are producing a lot of phlegm.”
What was the aim of the COPD STARR study?
“Sometimes the symptoms of COPD can get worse and the symptoms such as the coughing and breathlessness also get worse. These periods of worsening are called exacerbations or lung attacks. At the moment we treat lung attacks the same way, with antibiotics and steroids. What STARR is aiming to do is to see if we can use a simple blood test on patients to analyse their white blood cells and demonstrate if we can use this information to give each patient the right treatment at the right time. Our aim is to show this is better than treating everyone with the same steroid and antibiotic treatment.”
What was the most interesting part of this study for you?
“It was seeing how many patients with COPD are willing and interested in taking part in research. It’s also interesting to look at the patterns of inflammation, blood cells and breathing test results in the individuals and being able to see the similarities or differences between the patients. It’s most interesting to see that it’s a very common disease that we can try to make an impact on.”
What does taking part in COPD STARR 2 involve?
“The STARR nurses, Joanne Davies and Helen Jeffers, will see participants at the GP surgery and they’ll be given questionnaires and a blood test and we will record that data. They are then given a contact card and asked to contact Helen and Joanne when they feel they are getting worse. We will then see participants at the GP surgery and following tests with finger-prick blood tests, questionnaires and breathing tests, we will allocate them into one of two groups. Group one will receive the standard antibiotic and steroid combination. Group two will receive antibiotic and a choice of steroids or a placebo, depending on what the blood tests show. We will then see everyone at check-up visits at 14 days, 30 days and 90 days after their treatment. This will be to assess what the response has been like.”
What impact do you think this will have on the treatment of COPD?
“If the study is successful and demonstrates we can safely reduce the amount of steroids given to patients to improve their symptoms by giving them the right treatment at the right time, this study is likely to impact a change in clinical practice. Both nationally and internationally, there is excitement about this study and the results that could be generated.”
What is the most exciting part of research for you?
“For me, I find the most exciting part of research is trying to answer questions that I think are important to help my patients. I try to answer these questions with the help of my patients and the help of dedicated research staff, such as nurses and GPs. The exciting part is having that question, putting it down on a piece of paper and trying to answer it at the end.”
What would you say to patients interested in getting involved in research?
“There are plenty of opportunities to do so. That includes getting in touch with the Respiratory Medicine Unit at the University of Oxford. We have web addresses for individual studies and for individual research team members. There are plenty of different studies of different intensities that can be accessed.”
For more information visit http://www.ndmrb.ox.ac.uk/respiratory-medicine-unit
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