Respiratory diseases remain a significant cause of global morbidity and mortality and primary care plays a central role in their prevention, diagnosis and management. An e-Delphi process was employed to identify and prioritise the current respiratory research needs of primary care health professionals worldwide. One hundred and twelve community-based physicians, nurses and other healthcare professionals from 27 high-, middle- and low-income countries suggested 608 initial research questions, reduced after evidence review by 27 academic experts to 176 questions covering diagnosis, management, monitoring, self-management and prognosis of asthma, COPD and other respiratory conditions (including infections, lung cancer, tobacco control, sleep apnoea). Forty-nine questions reached 80% consensus for importance. Cross-cutting themes identified were: a need for more effective training of primary care clinicians; evidence and guidelines specifically relevant to primary care, adaption for local and low-resource settings; empowerment of patients to improve self-management; and the role of the multidisciplinary healthcare team.
Bibliographical noteFunding Information:
P.A. holds grants related to respiratory epidemiology from the NIHR. She chairs the NIHR Public Health Research Funding Committee. Jv.B. has received consultancy fees, honorarium and research funding from AstraZeneca, Boehringer Ingelheim, Chiesi, Menarini, Novartis, Nutricia, Pill Connect, Teva and Trudell Medical to consult, give lectures, provide advice and conduct independent research, all paid to his institution. J.C.S. has in the last 3 years received payment for participating in educational activities from Boheringer Ingelheim, GlaxoSmithKline, AstraZeneca, Novartis and Mundipharma. R.J. reports grants from the NIHR and participation in a Boehringer Ingelheim primary care advisory board during this project. J.K. reports grants, personal fees and non-financial support from AstraZeneca, grants, personal fees and non-financial support from Boehringer Ingelheim, grants and personal fees from Chiesi Pharmaceuticals, grants, personal fees and non-financial support from GSK, grants and personal fees from Novartis, grants from MundiPharma, grants from TEVA, outside the submitted work, all paid to his institution; and J.K. holds 72.5% of shares in the General Practitioners Research Institute. K.L. has received personal fees for lectures and educational activities from AstraZeneca, Novartis, Boehringer Ingelheim and Chiesi and served on advisory boards arranged by AstraZeneca, GlaxoSmithKline, Novartis and Boehringer Ingelheim. L.M. has received payment for participating in educational activities, consultancy, or support to attend clinical meetings from Hero España, Merck-Allergopharma, ALK-Abelló, Laboratorios Jofre-Roig, Laboratorios Leti, Faes Farma, Novartis, Inmunotek, GSK, and Alter. D.P. has board membership with Amgen, AstraZeneca, Boehringer Ingelheim, Chiesi, Circassia, Mylan, Mundipharma, Novartis, Regeneron Pharmaceuticals, Sanofi Genzyme, Teva Pharmaceuticals, Thermofisher; consultancy agreements with Amgen, AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Mylan, Mundipharma, Novartis, Pfizer, Teva Pharmaceuticals, Theravance; grants and unrestricted funding for investigator-initiated studies (conducted through Observational and Pragmatic Research Institute Pte Ltd) from AstraZeneca, Boehringer Ingelheim, Chiesi, Circassia, Mylan, Mundi-pharma, Novartis, Pfizer, Regeneron Pharmaceuticals, Respiratory Effectiveness Group, Sanofi Genzyme, Teva Pharmaceuticals, Theravance, UK National Health Service; payment for lectures/speaking engagements from AstraZeneca, Boehringer Ingelheim, Chiesi, Cipla, GlaxoSmithKline, Kyorin, Mylan, Mundipharma, Novartis, Regeneron Pharmaceuticals, Sanofi Genzyme, Teva Pharmaceuticals; payment for the development of educational materials from Mundipharma, Novartis; payment for travel/accommodation/meeting expenses from AstraZeneca, Boehringer Ingelheim, Mundipharma, Mylan, Novartis, Thermofisher; funding for patient enrolment or completion of research from Novartis; stock/stock options from AKL Research and Development Ltd which produces phytopharmaceuticals; owns 74% of the social enterprise Optimum Patient Care Ltd (Australia and UK) and 74% of Observational and Pragmatic Research Institute Pte Ltd (Singapore); 5% shareholding in Timestamp which develops adherence monitoring technology; is peer reviewer for grant committees of the Efficacy and Mechanism Evaluation programme, and Health Technology Assessment; and was an expert witness for GlaxoSmithKline. H.P. in the last 3 years was paid by Teva to write a piece on supported self-management for their website. Organisations with which she is involved, or conferences/meetings at which she has spoken receive multi-company sponsorship. D.R. has in the last 3 years received payment for participating in educational activities, consultancy or support to attend clinical meetings from: AZ,BI, GSK, Chiesi, Novartis, Trudell, Meda, Regeneron and Medscape. He is a board member of the Primary care and allied health section of the European Academy of Allergy and clinical Immunology and vice president of the Respiratory Effectiveness Group. B.S. has received honoraria for educational activities and lectures from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Novartis, MEDA and TEVA and has served on advisory boards arranged by AstraZeneca, Novartis, GlaxoSmithKline, Boehringer Ingelheim and MEDA. S.S. has served as a consultant for Boehringer Ingelheim, Genentech, GlaxoSmithKline, AstraZeneca, Propeller Health, Sanofi, and Regeneron; and received a grant from Propeller Health. All payments were made to his university. A.T. has grants for respiratory research from AstraZeneca, Chiesi and CSL Behring, and has additional consultancy or honoraria for educational work for GSK and Boehringer Ingelheim. S.T. holds grants related to COPD and asthma from the NIHR. I.T. has in the last 3 years received payment for participating in educational activities, consultancy or received grants from: AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Novartis and ELPEN. She is the Editor in Chief of the npjPCRM. O.Y. holds a grant related to respiratory health from the NIHR. A.B., R.A., A.A.A., D.A., I.B., N.C., A.D., M.E., Fv.G., S.H., A.K., B.K., D.K., E.M., C.Mc., C.N., S.P., S.J.S., D.W., S.W. and A.K.T. declare no competing interests.
© 2022, The Author(s).
- primary care
- research priorities
- respiratory disease
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
- Family Practice
- Pulmonary and Respiratory Medicine