| Key areas of research | Key contributions to clinical practice | Key areas for future research |
| Investigating innovative ways to ensure regular professional review of people with asthma | National guidelines now recommend that telephone reviews can contribute to the provision of flexible support for people with asthma. A key advantage is the opportunity for clinicians to initiate reviews with patients who do not respond to invitations | How can other forms of remote and/or asynchronous consultation (eg, e-mail, text messaging and videophones) contribute to the care of people with asthma and other long-term conditions? |
| Understanding and evaluating the use of technology to support patient self-care in asthma and COPD | Qualitative work and pilot studies suggest that tele-monitoring is welcomed by many patients, and has the potential to support the care of people with respiratory disease | Ongoing trials will generate an evidence base to inform effective and safe development of monitoring technologies. Under what circumstances, and for which patient groups, does such technology provide most benefit? |
| Exploring aspects of the shift of services for long-term conditions from secondary to primary care, including the role of GPwSI | GPwSIs can contribute positively to the development of respiratory care in their locality. Effective pulmonary rehabilitation can be provided in the community by a primary health care team | What is the impact of initiatives that aim to increase clinical involvement with service development (such as Managed Clinical Networks and Practice-based Commissioning) on local respiratory care provision? There is a need to develop interventions and test new models of care for people with severe COPD |
| Investigating primary care prescribing using computerised databases of anonymised medical records from general practice | There are concerns about a significant minority of adults and children with asthma who are prescribed inhaled doses in excess of guideline recommendations. Correlation between an increase in pneumonia deaths and the reduction in antibiotic prescribing raises concerns about how GPs determine the need for antibiotics | Effective implementation of guidelines remains a challenge, and better evidence-based strategies are required. How can GPs target antibiotics to those most likely to benefit, thereby allowing them to reduce antibiotic prescribing safely? |
| Tackling inequalities in healthcare and the provision of care for ethnic minorities | Both qualitative studies and trials highlight that effective interventions do not translate directly across ethnic boundaries. Practice-based screening for TB increases the detection of active disease | How to develop models of care to meet the needs of ethnic minorities remains an unresolved issue |
COPD, chronic obstructive pulmonary disease; GP, general practitioner; GpwSI, GP with special interest; TB, tuberculosis.