Profile Image

Professor Vanessa McDonald

Professor

School of Nursing and Midwifery (Nursing)

Rethinking chronic lung disease

Falling under the umbrella term of 'multidimensional assessment and individualised management,' Professor Vanessa McDonald's clinical research is helping to engineer a shift in the way patients with long-term respiratory problems are diagnosed and treated.

Associate Professor Vanessa McDonald

By all measures, McDonald is a prolific performer. Though just a few years out of her doctoral studies, the early career researcher has already procured a number of competitive grants, fellowships and scholarships, as well as a publication catalogue worthy of senior academics. She's also achieved marked success closer to home, winning the Vice-Chancellor's Researcher of the Year Award for 2014.

For a long time however, this wasn't the plan. McDonald took an unusual academic pathway to get to where she is at the Hunter Medical Research Institute, spending years as a clinical nurse consultant in respiratory medicine before deciding to undertake a PhD in the late 2000s.

'It was this first role that inspired the second one,' she reveals.

'Problems with approaches to management sparked my research interest in patients with lung disease.'

Still working clinically to 'maintain creativity and currency in terms of generating research ideas,' the esteemed educator and investigator is a master of many trades. She's working with and for patients suffering from complex respiratory conditions in all of these endeavours, focusing principally on chronic obstructive pulmonary disease (COPD), and the overlap of asthma and COPD in older populations, and bronchiectasis. McDonald is also especially interested in advancing care options for those with severe asthma.

There's a small group of patients with severe asthma who are refractory to treatment – we can throw as much traditional asthma medication at them as we like, but they're not going to respond.

'These are the people who have a huge but often preventable healthcare burden, yet little research has been done on management approaches for them.'

McDonald is examining respiratory problems from multiple perspectives in her research, concentrating on the pathophysiological components, functional and psychosocial needs of individual patients. This inventive quadrant approach, which encompasses comorbidity, risk factors, self-management and management of the airways, similarly serves to improve outcomes and help translate findings into scalable and fundable practice.

'Most clinical trials tend to recruit people with pure asthma for asthma studies, and pure COPD for COPD studies, but in the real world when we sit down with a patient, often their diagnosis is impure,' she explains.

'There's usually overlap.'

'Clinical trials generate evidence that informs us on how to manage health conditions, but due to strict inclusion and exclusion criteria they often don't translate to the person sitting in front of us.'

All angles

McDonald characterised asthma and COPD overlap in the older person during her PhD candidature, focusing on the 'usually excluded' population with support from a National Health and Medical Research Council Centre for Respiratory and Sleep Medicine Scholarship. This research area involved collecting data from several sources to inform an intervention for a randomised control trial.

'I undertook qualitative analyses to develop insight into patient needs and healthcare experiences, as well as a cross-sectional study to understand what the population looks like,' she states.

'I then developed an intervention that was piloted in a clinical trial.'

This multidimensional assessment and individualised management study delivered targeted treatments to the individual problems identified, including inflammatory phenotypes, comorbidities and risk factors.

'For example if participants had airway inflammation, the pharmacotherapy was individualised to that phenotype,' she advises.

'If they showed signs of anxiety or depression they underwent cognitive behaviour therapy, and if they were nicotine-dependent they underwent a smoking intervention.'

With results deemed 'quite outstanding' in terms of their impact on health status, McDonald's PhD was published in a top respiratory journal, Thorax, in early 2013.

'The findings demonstrated an improvement in health status that were three times the minimally clinically important difference,' she asserts.

'The intervention also improved the inflammatory processes and the number of exacerbations the patients experienced.'

The principal researcher in the University of Newcastle's Priority Research Centre for Asthma and Respiratory Disease has since followed up on this research, undertaking new studies to see whether the model is transferrable to a 'generally younger' severe asthma population.

A closer look at COPD

McDonald is continuing to develop a large and impressive body of work out of her PhD thesis.  She's the current recipient of the Lung Foundation of Australia's Research Fellowship, awarded annually to one academic from any medical, scientific or allied health background, and is currently using it to fund a study on medication options for patients with COPD.

'We are examining the inflammatory phenotypes of individual patients and targeting pharmacotherapy to these processes,' she clarifies.

'Drugs are used to control eosinophilic and neutrophilic airway inflammation.'

'Medication typically used in cardiovascular diseases, but which we know reduces the degree of systemic inflammation and improves outcomes in COPD, are also being used.'

The co-convenor of the Thoracic Society Australia and New Zealand Special Interest Group has devised a randomised control trial to test this approach, with the intervention group receiving active drugs to match their number of inflammatory phenotypes, and the control group receiving a placebo. Having established a national profile and an emerging international profile, McDonald is also evaluating the health status assessment of COPD patients with St George's London Hospital Professor of Medicine, Paul Jones.

In another offshoot of her PhD, McDonald is undertaking evaluations of a weight loss trial in COPD patients.

'We know that obesity has deleterious health effects, but there's an interesting paradox that exists in COPD where obese patients have better survival than those who are normal or underweight or even just a little overweight,' she discloses.

'It could be that maintenance of muscle mass plays a key role in this, though we're not certain.'

'At present there are no treatment recommendations for this population and advising COPD patients to lose weight could actually be doing harm.'

Coupled with a resistance-training program, the weight loss intervention was found to be successful in both achieving weight loss and maintaining muscle mass. It also resulted in improvements in health status, lung function and ability to carry out daily tasks.

'This pilot study is a proof of concept,' she explains.

'Now we're publishing the data and looking at obtaining an external grant to conduct a larger study and test its true efficacy.'

The energetic academic is simultaneously involved in several current and interdisciplinary collaborations. She's working on a national University of Adelaide-led study on opioids and their potential to improving the exercise capacity of COPD patients within pulmonary rehabilitation programs, and with Laureate Professor Rob Sanson-Fisher from Public Health on a grant for a COPD self-management intervention using online tools.

An equity imperative

Observing 'limited evidence' for COPD treatment guidelines and recommendations for the management of comorbidity, McDonald is also supervising a PhD student to better understand the disease and its comorbidities.

'There's a whole gamut – obesity, anxiety and depression, skeletal muscle dysfunction, and cardiovascular disease,' she declares.

'So we're looking at measurement tools, comorbidity mechanisms, how they relate with each other and their impact on outcomes.'

'This will help us develop novel approaches to comorbidity management in COPD.'

Juggling many projects at once, McDonald and her colleagues are developing a new research area with another PhD student. This time around, the team is exploring sedentary behaviours in people with severe asthma and bronchiectasis.

McDonald is in the process of recruiting patients for the study, which aims to get snapshots of severe asthma and bronchiectasis by 'objectively measuring' how much sufferers exercise throughout the day and how much of the time they are sedentary. The Australian Pulmonary Rehab Guidelines Committee member will then relate data collected from the individual activity monitors to disease phenotypes and outcomes, such as inflammation and health status.

Recognising the futility of applying general population interventions to people with bronchiectasis and severe asthma, McDonald's team will use all of this information to develop and trial a tailor-made behavioural change intervention.

'We want patients to be more active, but we also need to accept that they're often limited by breathlessness, muscle wasting and other comorbid factors.'

Beyond the here and now

Similarly recognising the futility of only undertaking short-term research in this field, McDonald is leading a longitudinal study of patients with bronchiectasis.

'There are few long-term data of this population and determinants of decline,' she admits.

'So I'm following up patients every year for five years to track their progress.'

More recently, McDonald was part of the team that received a $2.5 million National Health and Medical Research Council grant to establish a Centre of Research Excellence in Severe Asthma. It's part of a collaboration led by Professor Peter Gibson involving national researchers from Brisbane, Sydney, Melbourne, and Perth.

'We will seek to improve knowledge of severe asthma and its management and focus on training a new group of severe asthma researchers,' she conveys.

'We will also develop an implementation framework to translate this new knowledge into practice.'

Associate Professor Vanessa McDonald

Rethinking chronic lung disease

Associate Professor Vanessa McDonald is examining respiratory problems from multiple perspectives, concentrating on the pathophysiological components, function

Read more

Career Summary

Biography

Professor Vanessa McDonald is co-director of the NHMRC CRE in Severe Asthma, deputy director and research leader in the Priority Research Centre for Healthy Lungs and an academic clinician in the Department of Respiratory and Sleep Medicine. She also leads the Chronic Disease and Older Person Research group within the School of Nursing and Midwifery.

Professor McDonald joined the University of Newcastle in 2011, following the completion of her PhD.  Prior to this, she worked clinically within the Hunter New England Local Health District as a Respiratory Clinical Nurse Consultant.  She has been a nurse for over 20 years and it is her clinical background and experience that drives her innovation in research.  

Vanessa’s research programme is centred around the development of innovative approaches to the management of chronic diseases.  Her translational research programme links biomedicine, clinical effectiveness and health policy development.   

At 6 years post-doctoral, Professor Vanessa McDonald has established a productive track record publishing over 80 peer reviewed journal articles.  Her work is published in high impact journals including the Lancet, the AJRCCM, Thorax and the Eur Resp J.  Complimenting her publication catalogue is a suite of other outputs. She has authored 7 book chapters, 5 separate national clinical practice guidelines for asthma and COPD, national reports, multimedia resources, and national patient education publications.


Qualifications

  • PhD (Medicine), University of Newcastle
  • Diploma in Health Science (Nursing), University of Newcastle
  • Bachelor of Nursing, University of Newcastle

Keywords

  • Asthma
  • COPD
  • Chronic Disease Management
  • Clinical Management
  • Cystic Fibrosis
  • Nursing
  • Obstructive Airways Disease
  • Older People
  • Self Management
  • Severe Asthma

Fields of Research

Code Description Percentage
110203 Respiratory Diseases 70
111099 Nursing not elsewhere classified 30

Professional Experience

UON Appointment

Title Organisation / Department
Professor University of Newcastle
School of Nursing and Midwifery
Australia

Academic appointment

Dates Title Organisation / Department
1/04/2014 -  Committee Member - COPD Evaluation Committee The Lung Foundation of Australia
Australia
1/01/2014 -  Writing Committee Member The Lung Foundation of Australia
Australia
1/07/2013 -  Writing Committee Member Therapeutic Guidelines - Respiratory
Australia
1/06/2013 - 1/06/2015 Fellow University of Newcastle
School of Nursing and Midwifery
Australia
1/03/2013 -  Co-Convenor - COPD SIG The Thoracic Society of Australia and New Zealand
Australia
1/01/2013 -  Membership - American Thoracic Society American Thoracic Society
United States
1/03/2011 -  Membership - Research subcommittee The Thoracic Society of Australia and New Zealand
Australia
1/04/2007 -  Committee Member - National COPD Coordinating Committee The Lung Foundation of Australia
Australia
1/01/2007 -  Membership - European Respiratory Society European Respiratory Society
United Kingdom
1/01/2000 -  Clinical Nurse Consultant John Hunter Hospital, Newcastle
Australia
1/01/2000 -  Membership - Thoracic Society of Australia and New Zealand Thoracic Society of Australia and New Zealand

Membership

Dates Title Organisation / Department
1/01/2015 - 22/12/2017 APSR International Conference Local Organising Committee The Thoracic Society of Australia and New Zealand
Australia

Professional appointment

Dates Title Organisation / Department
22/08/2015 - 22/09/2015 American Thoracic Society Nursing Assembly Programme Committee American Thoracic Society
United States
1/01/2015 - 23/12/2015 NHMRC Grant Review Panel Member NHMRC (National Health & Medical Research Council)

Awards

Award

Year Award
2014 Vice Chancellor's Award for Research Excellence
The University of Newcastle
2014 The University of Newcastle Researcher of the Year
The University of Newcastle

Distinction

Year Award
2017 Fellow of the Thoracic Society of Australia and New Zealand
The Thoracic Society of Australia & New Zealand
2017 Honorary Visiting Professor Sichuan University
Sichuan University, China
1998 Hunter Valley Chapter Prize
Unknown

Prize

Year Award
2016 Asthma Australia Mid Career Travel Award
Asthma Australia

Research Award

Year Award
2014 TSANZ Dr Janet Elder International Travel Award
Thoracic Society of Australia and New Zealand
2013 Japanese Respiratory Society Early Career Development Awards
Unknown
2013 HMRI EARY CAREER RESEARCHER
Hunter Medical Research Institute
2012 Best COPD Oral Presentation
Thoracic Society of Australia and New Zealand
2012 The Dr Janet Elder International Travel Award
Thoracic Society of Australia and New Zealand
2011 Best Oral Presentation - TSANZ COPD Award
Thoracic Society of Australia and New Zealand
2011 Pulse Early Career Research Prize
Unknown
2008 Best Oral Presentation - Nrurses Award
Thoracic Society of Australia and New Zealand
2002 Best Oral Presentation - Nurses Award
Thoracic Society of Australia and New Zealand
2000 Best Poster Presentation - Nurses Award
Thoracic Society of Australia and New Zealand
Edit

Publications

For publications that are currently unpublished or in-press, details are shown in italics.


Book (1 outputs)

Year Citation Altmetrics Link
2015 McDonald VM, Respiratory Expert Group, Therapeutic guidelines: Respiratory, Therapeutic Guidelines Limited, Melbourne (2015) [A4]

Chapter (6 outputs)

Year Citation Altmetrics Link
2017 Wilson AJ, Hoffman K, McDonald V, 'Chapter 4: Caring for a person with a respiratory condition', Clinical Reasoning 2nd edition, Pearson, Sydney (2017)
Co-authors Amanda Wilson
2016 Johnson M, Carlo B, Currow D, Maddocks M, McDonald VM, Mahadeva R, Mason M, 'Management of chronic breathlessness: non- pharmacological and pharmacological interventions.', Palliative Care in Respiratory Disease, European Respiratory Society, Sheffield, England 153-171 (2016) [B1]
DOI 10.1183/2312508X.10011915
2015 McDonald VM, Penola D, 'Alterations of Pulmonary Function Across the Lifespan', Understanding Pathophysiology, Elsevier, Sydney 683-731 (2015) [B2]
2014 Penola D, McDonald VM, 'The structure and function of the pulmonary system.', Understanding Pathophysiology, Elsevier, Sydney 665-682 (2014) [B2]
2014 McDonald VM, Gibson PG, 'Asthma Education', Clinical Asthma, CRC Press, Bosa Roca/US 127-137 (2014) [B2]
DOI 10.1201/b16468-18
Co-authors Peter Gibson
2009 McDonald VM, Gibson PG, 'Asthma patient education', Allergy Frontiers: Diagnosis and Health Economics, Springer, Berlin 475-489 (2009) [B1]
DOI 10.1007/978-4-431-98349-1_26
Co-authors Peter Gibson
Show 3 more chapters

Journal article (70 outputs)

Year Citation Altmetrics Link
2017 Alison JA, McKeough ZJ, Johnston K, McNamara RJ, Spencer LM, Jenkins SC, et al., 'Australian and New Zealand Pulmonary Rehabilitation Guidelines', Respirology, 22 800-819 (2017)

© 2017 The Authors. Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Respirology Background and objective: The aim of the Pulmona... [more]

© 2017 The Authors. Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Respirology Background and objective: The aim of the Pulmonary Rehabilitation Guidelines (Guidelines) is to provide evidence-based recommendations for the practice of pulmonary rehabilitation (PR) specific to Australian and New Zealand healthcare contexts. Methods: The Guideline methodology adhered to the Appraisal of Guidelines for Research and Evaluation (AGREE) II criteria. Nine key questions were constructed in accordance with the PICO (Population, Intervention, Comparator, Outcome) format and reviewed by a COPD consumer group for appropriateness. Systematic reviews were undertaken for each question and recommendations made with the strength of each recommendation based on the GRADE (Gradings of Recommendations, Assessment, Development and Evaluation) criteria. The Guidelines were externally reviewed by a panel of experts. Results: The Guideline panel recommended that patients with mild-to-severe COPD should undergo PR to improve quality of life and exercise capacity and to reduce hospital admissions; that PR could be offered in hospital gyms, community centres or at home and could be provided irrespective of the availability of a structured education programme; that PR should be offered to patients with bronchiectasis, interstitial lung disease and pulmonary hypertension, with the latter in specialized centres. The Guideline panel was unable to make recommendations relating to PR programme length beyond 8 weeks, the optimal model for maintenance after PR, or the use of supplemental oxygen during exercise training. The strength of each recommendation and the quality of the evidence are presented in the summary. Conclusion: The Australian and New Zealand Pulmonary Rehabilitation Guidelines present an evaluation of the evidence for nine PICO questions, with recommendations to provide guidance for clinicians and policymakers.

DOI 10.1111/resp.13025
Citations Scopus - 1
2017 Baines KJ, Fu J-J, McDonald VM, Gibson PG, 'Airway gene expression of IL-1 pathway mediators predicts exacerbation risk in obstructive airway disease', INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE, 12 541-550 (2017)
DOI 10.2147/COPD.S119443
2017 Gibson PG, McDonald VM, 'Management of severe asthma: targeting the airways, comorbidities and risk factors', Internal Medicine Journal, 47 623-631 (2017)

© 2017 Royal Australasian College of Physicians Severe asthma is a complex heterogeneous disease that is refractory to standard treatment and is complicated by multiple comorbidi... [more]

© 2017 Royal Australasian College of Physicians Severe asthma is a complex heterogeneous disease that is refractory to standard treatment and is complicated by multiple comorbidities and risk factors. In mild to moderate asthma, the burden of disease can be minimised by inhaled corticosteroids, bronchodilators and self-management education. In severe asthma, however, management is more complex. When patients with asthma continue to experience symptoms and exacerbations despite optimal management, severe refractory asthma (SRA) should be suspected and confirmed, and other aetiologies ruled out. Once a diagnosis of SRA is established, patients should undergo a systematic and multidimensional assessment to identify inflammatory endotypes, risk factors and comorbidities, with targeted and individualised management initiated. We describe a practical approach to assessment and management of patients with SRA.

DOI 10.1111/imj.13441
Co-authors Peter Gibson
2017 Chu G, Choi P, McDonald VM, 'Sleep disturbance and sleep-disordered breathing in hemodialysis patients.', Semin Dial, (2017)
DOI 10.1111/sdi.12617
2017 Baines KJ, Fu JJ, McDonald VM, Gibson PG, 'Airway gene expression of IL-1 pathway mediators predicts exacerbation risk in obstructive airway disease', International Journal of COPD, 12 541-550 (2017) [C1]

© 2017 Baines et al. Background: Exacerbations of asthma and COPD are a major cause of morbidity and mortality and are responsible for significant health care costs. This study f... [more]

© 2017 Baines et al. Background: Exacerbations of asthma and COPD are a major cause of morbidity and mortality and are responsible for significant health care costs. This study further investigates interleukin (IL)-1 pathway activation and its relationship with exacerbations of asthma and COPD. Methods: In this prospective cohort study, 95 participants with stable asthma (n=35) or COPD (n=60) were recruited and exacerbations recorded over the following 12 months. Gene expressions of IL-1 pathway biomarkers, including the IL-1 receptors (IL1R1, IL1R2, and IL1RN), and signaling molecules (IRAK2, IRAK3, and PELI1), were measured in sputum using real-time quantitative polymerase chain reaction. Mediators were compared between the frequent (2 exacerbations in the 12 months) and infrequent exacerbators, and the predictive relationships investigated using receiver operating characteristic curves and area under the curve (AUC) values. Results: Of the 95 participants, 89 completed the exacerbation follow-up, where 30 participants (n=22 COPD, n=8 asthma) had two or more exacerbations. At the baseline visit, expressions of IRAK2, IRAK3, PELI1, and IL1R1 were elevated in participants with frequent exacerbations of both asthma and COPD combined and separately. In the combined population, sputum gene expression of IRAK3 (AUC=75.4%; P,0.001) was the best predictor of future frequent exacerbations, followed by IL1R1 (AUC=72.8%; P,0.001), PELI1 (AUC=71.2%; P,0.001), and IRAK2 (AUC=68.6; P=0.004). High IL-1 pathway gene expression was associated with frequent prior year exacerbations and correlated with the number and severity of exacerbations. Conclusion: The upregulation of IL-1 pathway mediators is associated with frequent exacerbations of obstructive airway disease. Further studies should investigate these mediators as both potential diagnostic biomarkers predicting at-risk patients and novel treatment targets.

DOI 10.2147/COPD.S119443
Co-authors Peter Gibson, Katherine Baines
2017 McDonald VM, Gibson PG, '"To define is to limit": perspectives on asthma-COPD overlap syndrome and personalised medicine', EUROPEAN RESPIRATORY JOURNAL, 49 (2017)
DOI 10.1183/13993003.00336-2017
Co-authors Peter Gibson
2017 Baines KJ, Fu J-J, McDonald VM, Gibson PG, 'Airway gene expression of IL-1 pathway mediators predicts exacerbation risk in obstructive airway disease', INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE, 12 541-550 (2017)
DOI 10.2147/COPD.S119443
2017 Maltby S, Gibson PG, Powell H, McDonald VM, 'Omalizumab Treatment Response in a Population With Severe Allergic Asthma and¿Overlapping COPD', Chest, 151 78-89 (2017)

© 2016 American College of Chest Physicians Background Asthma and COPD are common airway diseases. Individuals with overlapping asthma and COPD experience increased health impair... [more]

© 2016 American College of Chest Physicians Background Asthma and COPD are common airway diseases. Individuals with overlapping asthma and COPD experience increased health impairment and severe disease exacerbations. Efficacious treatment options are required for this population. Omalizumab (anti-IgE) therapy is effective in patients with severe persistent asthma, but limited data are available on efficacy in populations with overlapping asthma and COPD. Methods Data from the Australian Xolair Registry were used to compare treatment responses in individuals with asthma-COPD overlap with responses in patients with severe asthma alone. Participants were assessed at baseline and after 6¿months of omalizumab treatment. We used several different definitions of asthma-COPD overlap. First, we compared participants with a previous physician diagnosis of COPD to participants with no COPD diagnosis. We then made¿comparisons based on baseline lung function, comparing participants with an FEV 1 < ¿80%¿predicted to those with an FEV 1 > 80%¿predicted after bronchodilator use. In the population with an FEV 1 < 80%, analysis was further stratified based on smoking history. Results Omalizumab treatment markedly improved asthma control and health-related quality of life in all populations assessed based on the Asthma Control Questionnaire and Asthma Quality of Life Questionnaire scores. Omalizumab treatment did not improve lung function (FEV 1 , FVC, or FEV 1 /FVC ratio) in populations that were enriched for asthma-COPD overlap (diagnosis of COPD or FEV 1 ¿ < 80%/ever smokers). Conclusions Our study suggests that omalizumab improves asthma control and health-related quality of life in individuals with severe allergic asthma and overlapping COPD. These findings provide real-world efficacy data for this patient population and suggest that omalizumab is useful in the management of severe asthma with COPD overlap.

DOI 10.1016/j.chest.2016.09.035
Citations Scopus - 4Web of Science - 7
Co-authors Steven Maltby, Peter Gibson
2017 McDonald VM, Maltby S, Reddel HK, King GG, Wark PAB, Smith L, et al., 'Severe asthma: Current management, targeted therapies and future directionsA roundtable report', RESPIROLOGY, 22 53-60 (2017)
DOI 10.1111/resp.12957
Citations Scopus - 2Web of Science - 1
Co-authors Peter Gibson, Steven Maltby, Peter Wark
2017 Clark VL, Gibson PG, Genn G, Hiles SA, Pavord ID, Mcdonald VM, 'Multidimensional assessment of severe asthma: A systematic review and meta-analysis', Respirology, (2017)

© 2017 Asian Pacific Society of Respirology. The management of severe asthma is complex. Multidimensional assessment (MDA) of specific traits has been proposed as an effective st... [more]

© 2017 Asian Pacific Society of Respirology. The management of severe asthma is complex. Multidimensional assessment (MDA) of specific traits has been proposed as an effective strategy to manage severe asthma, although it is supported by few prospective studies. We aimed to systematically review the literature published on MDA in severe asthma, to identify the traits included in MDA and to determine the effect of MDA on asthma-related outcomes. We identified 26 studies and classified these based on study type (cohort/cross-sectional studies; experimental/outcome studies; and severe asthma disease registries). Study type determined the comprehensiveness of the assessment. Assessed traits were classified into three domains (airways, co-morbidities and risk factors). The airway domain had the largest number of traits assessed (mean±SD=4.2±1.7) compared with co-morbidities (3.6±2.2) and risk factors (3.9±2.1). Bronchodilator reversibility and airflow limitation were assessed in 92% of studies, whereas airway inflammation was only assessed in 50%. Commonly assessed co-morbidities were psychological dysfunction, sinusitis (both 73%) and gastro-oesophageal reflux disease (GORD; 69%). Atopic and smoking statuses were the most commonly assessed risk factors (85% and 86%, respectively). There were six outcome studies, of which five concluded that MDA is effective at improving asthma-related outcomes. Among these studies, significantly more traits were assessed than treated. MDA studies have assessed a variety of different traits and have shown evidence of improved outcomes. This promising model of care requires more research to inform which traits should be assessed, which traits should be treated and what effect MDA has on patient outcomes.

DOI 10.1111/resp.13134
Co-authors Vanessa Clark, Sarah Hiles, Peter Gibson
2017 McDonald VM, Wood LG, Holland AE, Gibson PG, 'Obesity in COPD: to treat or not to treat?', EXPERT REVIEW OF RESPIRATORY MEDICINE, 11 81-83 (2017)
DOI 10.1080/17476348.2017.1267570
Co-authors Lisa Wood, Peter Gibson
2016 Gibson PG, Reddel H, McDonald VM, Marks G, Jenkins C, Gillman A, et al., 'Effectiveness and response predictors of omalizumab in a severe allergic asthma population with a high prevalence of comorbidities: the Australian Xolair Registry', INTERNAL MEDICINE JOURNAL, 46 1054-1062 (2016)
DOI 10.1111/imj.13166
Citations Web of Science - 8
Co-authors Peter Wark, Peter Gibson
2016 Wang G, Baines KJ, Fu JJ, Wood LG, Simpson JL, McDonald VM, et al., 'Sputum mast cell subtypes relate to eosinophilia and corticosteroid response in asthma', European Respiratory Journal, 47 1123-1133 (2016) [C1]

Copyright © ERS 2016. Mast cells are a resident inflammatory cell of the airways, involved in both the innate and adaptive immune response. The relationship between mast cells an... [more]

Copyright © ERS 2016. Mast cells are a resident inflammatory cell of the airways, involved in both the innate and adaptive immune response. The relationship between mast cells and inflammatory phenotypes and treatment response of asthma is not clear. Clinical characteristics of subjects with stable asthma (n=55), inflammatory cell counts and gene expression microarrays in induced sputum were analysed. Sputum mast cell subtypes were determined by molecular phenotyping based on expression of mast cell biomarkers (tryptase (TPSAB1), chymase (CMA1) and carboxypeptidase A3 (CPA3)). Effects of mast cell subtypes on steroid response were observed in a prospective cohort study (n=50). MCT (n=18) and MCT/CPA3 (mRNA expression of TPSAB1 and CPA3; n=29) subtypes were identified, as well as a group without mast cell gene expression (n=8). The MCT/CPA3 subtype had elevated exhaled nitric oxide fraction, sputum eosinophils, bronchial sensitivity and reactivity, and poorer asthma control. This was accompanied by upregulation of 13 genes. Multivariable logistic regression identified CPA3 (OR 1.21, p=0.004) rather than TPSAB1 (OR 0.92, p=0.502) as a determinant of eosinophilic asthma. The MCT/CPA3 subtype had a better clinical response and reduced signature gene expression with corticosteroid treatment. Sputum mast cell subtypes of asthma can be defined by a molecular phenotyping approach. The MCT/CPA3 subtype demonstrated increased bronchial sensitivity and reactivity, and signature gene expression, which was associated with airway eosinophilia and greater corticosteroid responsiveness.

DOI 10.1183/13993003.01098-2015
Citations Scopus - 6Web of Science - 6
Co-authors Katherine Baines, Jodie Simpson, Lisa Wood, Peter Gibson
2016 Fu JJ, Min J, Yu PM, McDonald VM, Mao B, 'Study design for a randomised controlled trial to explore the modality and mechanism of Tai Chi in the pulmonary rehabilitation of chronic obstructive pulmonary disease', BMJ Open, 6 (2016) [C1]

© 2016, BMJ Publishing Group. All rights reserved. Introduction: Although pulmonary rehabilitation (PR) is associated with significant clinical benefits in chronic obstructive pu... [more]

© 2016, BMJ Publishing Group. All rights reserved. Introduction: Although pulmonary rehabilitation (PR) is associated with significant clinical benefits in chronic obstructive pulmonary disease (COPD) and has been recommended by guidelines, PR with conventional exercise training has not been widely applied in the clinic because of its inherent limitations. Alternative exercise such as Tai Chi has been investigated and the results are promising. However, the strengths and weaknesses of the exercise modality of Tai Chi, conventional PR and a combination of Tai Chi and conventional PR and the possible mechanisms underlying Tai Chi exercise remain unclear. This study aims to address the above research gaps in a well-designed clinical trial. Methods and analysis: This study is a single-blind, randomised controlled trial. Participants with stable COPD will be recruited and randomly assigned to one of four groups receiving Tai Chi exercise, conventional PR using a total body recumbent stepper (TBRS), combined Tai Chi and TBRS, or usual care (control) in a 1:1:1:1 ratio. Participants will perform 30 min of supervised ex ercise three times a week for 8 weeks; they will receive sequential follow-ups until 12 months after recruitment. The primary outcome will be health-related quality of life as measured by the St George's Respiratory Questionnaire. Secondary outcomes will include 6 min walking distance, pulmonary function, the modified Medical Research Council Dyspnoea Scale, the COPD Assessment Test, the Hospital Anxiety and Depression Scale, the Berg Balance Scale, exacerbation frequency during the study period, and systemic inflammatory and immune markers. Ethics and dissemination: Ethics approval has been granted by the Clinical Trial and Biomedical Ethics Committee of West China Hospital of Sichuan University (No TCM-2015-82). Written informed consent will be obtained from each participant before any procedures are performed. The study findings will be published in peer-reviewed journals and presented at national and international conferences. Trial registration number: ChiCTR-IOR-15006874; Pre-results.

DOI 10.1136/bmjopen-2016-011297
Citations Scopus - 1
2016 Simpson JL, Baines KJ, Horvat JC, Essilfie AT, Brown AC, Tooze M, et al., 'COPD is characterized by increased detection of Haemophilus influenzae, Streptococcus pneumoniae and a deficiency of Bacillus species', Respirology, 21 697-704 (2016) [C1]

© 2016 Asian Pacific Society of Respirology. Background and objective Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow limitation and inflamma... [more]

© 2016 Asian Pacific Society of Respirology. Background and objective Chronic obstructive pulmonary disease (COPD) is characterized by progressive airflow limitation and inflammation. Airway bacterial colonization is increased in COPD; however, the role of potentially pathogenic and non-pathogenic bacteria in the pathogenesis of disease is unclear. This study characterized the presence of bacteria in a well-characterized cohort of adults with COPD and healthy controls. Methods Adults with COPD (n = 70) and healthy controls (n = 51) underwent clinical assessment and sputum induction. Sputum was dispersed, and total and differential cell counts were performed. Bacteria were cultured, identified and enumerated. Supernatants were assessed for neutrophil elastase (NE) and IL-1ß. Common respiratory pathogens were also determined using real-time PCR. Results Participants with COPD had a typical neutrophilic inflammatory profile. The total load of bacteria was incr eased in COPD and was associated with poorer respiratory health status, as measured by the St George's Respiratory Questionnaire (Spearman's r = 0.336, P = 0.013). Significantly lower levels of culturable Bacillus species were identified compared with healthy controls. PCR analyses revealed increased rates of detection of potentially pathogenic bacteria with Haemophilus influenzae detection associated with higher sputum levels of NE and IL-1ß, while Streptococcus pneumoniae was more common in male ex-smokers with emphysema and a deficit in diffusion capacity. Conclusion Non-pathogenic and pathogenic bacteria were altered in the sputum of patients with COPD. These observations highlight the potential to identify treatment and management strategies that both target specific bacterial pathogens and restore the microbial balance, which may lead to reductions in inflammation and subsequent improvements in lung health.

DOI 10.1111/resp.12734
Citations Scopus - 6Web of Science - 7
Co-authors Jodie Simpson, Jay Horvat, Peter Gibson, Philip Hansbro, Katherine Baines
2016 Maltby S, Gibson P, Mattes J, McDonald VM, 'How to treat Severe Asthma ¿ Part 2 Management.', Australian Doctor, (2016)
Co-authors Peter Gibson, Joerg Mattes, Steven Maltby
2016 Maltby S, Gibson P, Mattes J, McDonald VM, 'How to treat Severe Asthma ¿ Part 1 Diagnosis', Australian Doctor, (2016)
Co-authors Joerg Mattes, Peter Gibson, Steven Maltby
2016 McDonald VM, Gibson PG, 'Phenotyping Asthma and Chronic Obstructive Pulmonary Disease (COPD)', BRN Reviews, 2 239-252 (2016) [C1]
Co-authors Peter Gibson
2016 Cousins JL, Wark PAB, McDonald VM, 'Acute oxygen therapy: A review of prescribing and delivery practices', International Journal of COPD, 11 1067-1075 (2016) [C1]

© 2016 Cousins et al. Oxygen is a commonly used drug in the clinical setting and like other drugs its use must be considered carefully. This is particularly true for those patien... [more]

© 2016 Cousins et al. Oxygen is a commonly used drug in the clinical setting and like other drugs its use must be considered carefully. This is particularly true for those patients who are at risk of type II respiratory failure in whom the risk of hypercapnia is well established. In recent times, several international bodies have advocated for the prescription of oxygen therapy in an attempt to reduce this risk in vulnerable patient groups. Despite this guidance, published data have demonstrated that there has been poor uptake of these recommendations. Multiple interventions have been tested to improve concordance, and while some of these interventions show promise, the sustainability of these interventions are less convincing. In this review, we summarize data that have been published on the prevalence of oxygen prescription and the accurate and appropriate administration of this drug therapy. We also identify strategies that have shown promise in facilitating changes to oxygen prescription and delivery practice. There is a clear need to investigate the barriers, facilitators, and attitudes of clinicians in relation to the prescription of oxygen therapy in acute care. Interventions based on these findings then need to be designed and tested to facilitate the application of evidence-based guidelines to support sustained changes in practice, and ultimately improve patient care.

DOI 10.2147/COPD.S103607
Citations Scopus - 1Web of Science - 1
Co-authors Peter Wark
2016 Wright TK, Gibson PG, Simpson JL, McDonald VM, Wood LG, Baines KJ, 'Neutrophil extracellular traps are associated with inflammation in chronic airway disease', Respirology, 21 467-475 (2016) [C1]

© 2016 Asian Pacific Society of Respirology. Background and objective Neutrophil extracellular traps (NETs) are web-like structures comprising DNA and antimicrobial proteins, exp... [more]

© 2016 Asian Pacific Society of Respirology. Background and objective Neutrophil extracellular traps (NETs) are web-like structures comprising DNA and antimicrobial proteins, expelled from neutrophils during NETosis. Persistence of NETs can be pro-inflammatory, yet their role in respiratory disease remains unclear. This study aimed to investigate the presence of NETs in sputum from patients with asthma and COPD, and the relationship of NETs with inflammatory phenotype and disease severity. Methods Induced sputum was collected from healthy controls, asthma and COPD patients. Extracellular DNA (eDNA) was quantified by PicoGreen. LL-37, a-defensins1-3, NE, IL-1ß and CXCL8 were quantified by ELISA. PAD4 and NLRP3 gene expression was performed using qPCR. NETs were imaged in sputum smears using immunofluorescence microscopy. Results Sputum eDNA and NET neutrophil antimicrobial proteins were significantly elevated in asthma and COPD compared with healthy controls. Levels of eDNA and NET components were significantly higher in neutrophilic versus non-neutrophilic asthma and COPD. NETs were clearly visualized in sputum smears. PAD4 mRNA was upregulated in neutrophilic COPD. The level of eDNA was higher in severe asthma. High eDNA levels were associated with heightened innate immune responses, including elevated CXCL8 and IL-1ß, and NLRP3 gene expression in both COPD and asthma. Antimicrobial proteins and eDNA were positively correlated with airway neutrophils, and negatively correlated with lung function and symptoms. Conclusion NETs are present in the airways o f subjects with asthma and COPD. Accumulation of excessive NETs was associated with activation of innate immune responses contributing to disease pathogenesis in chronic airway disease.

DOI 10.1111/resp.12730
Citations Scopus - 15Web of Science - 13
Co-authors Lisa Wood, Jodie Simpson, Katherine Baines, Peter Gibson
2016 Hew M, Gillman A, Sutherland M, Wark P, Bowden J, Guo M, et al., 'Real-life effectiveness of omalizumab in severe allergic asthma above the recommended dosing range criteria', Clinical and Experimental Allergy, 46 1407-1415 (2016) [C1]

© 2016 John Wiley & Sons Ltd Background: Omalizumab (Xolair) dosing in severe allergic asthma is based on serum IgE and bodyweight. In Australia, patients eligible for omalizum... [more]

© 2016 John Wiley & Sons Ltd Background: Omalizumab (Xolair) dosing in severe allergic asthma is based on serum IgE and bodyweight. In Australia, patients eligible for omalizumab but exceeding recommended ranges for IgE (30¿1500 IU/mL) and bodyweight (30¿150 kg) may still receive a ceiling dose of 750 mg/4 weeks. About 62% of patients receiving government-subsidized omalizumab are enrolled in the Australian Xolair Registry (AXR). Objectives: To determine whether AXR participants above the recommended dosing ranges benefit from omalizumab and to compare their response to within-range participants. Methods: Data were stratified according to dose range status (above-range or within-range). Further sub-analyses were conducted according to the reason for being above the dosing range (IgE only vs. IgE and weight). Results: Data for 179 participants were analysed. About 55 (31%) were above recommended dosing criteria; other characteristics were similar to within-range participants. Above-range participants had higher baseline IgE [812 (IQR 632, 1747) IU/mL vs. 209 (IQR 134, 306) IU/mL] and received higher doses of omalizumab [750 (IQR 650, 750) mg] compared to within-range participants [450 (IQR, 300, 600) mg]. At 6 months, improvements in Juniper 5-item Asthma Control Questionnaire (ACQ-5, 3.61 down to 2.01 for above-range, 3.47 down to 1.93 for within-range, P < 0.0001 for both) and Asthma Quality of Life Questionnaire (AQLQ mean score (3.22 up to 4.41 for above-range, 3.71 up to 4.88 for within-range, P < 0.0001) were observed in both groups. Forced expiratory volume in one second (FEV 1 ) improved among above-range participants. There was no difference in response between above-range and within-range participants. Above-range participants due to either IgE alone or IgE and weight had similar improvements in ACQ-5, AQLQ and FEV 1 . Conclusions and Clinical Relevance: Patients with severe allergic asthma above recommended dosing criteria for omalizumab have significantly improved symptom control, quality of life and lung function to a similar degree to within-range participants, achieved without dose escalation above 750 mg.

DOI 10.1111/cea.12774
Citations Scopus - 6Web of Science - 5
Co-authors Peter Gibson, Peter Wark
2016 Gibson PG, Reddel H, McDonald VM, Marks G, Jenkins C, Gillman A, et al., 'Effectiveness and response predictors of omalizumab in a severe allergic asthma population with a high prevalence of comorbidities: the Australian Xolair Registry', INTERNAL MEDICINE JOURNAL, 46 1054-1062 (2016) [C1]
DOI 10.1111/imj.13166
Citations Web of Science - 7
Co-authors Peter Gibson, Peter Wark
2016 Negewo NA, McDonald VM, Baines KJ, Wark PAB, Simpson JL, Jones PW, Gibson PG, 'Peripheral blood eosinophils: A surrogate marker for airway eosinophilia in stable COPD', International Journal of COPD, 11 1495-1504 (2016) [C1]

© 2016 Negewo et al. Introduction: Sputum eosinophilia occurs in approximately one-third of stable chronic obstructive pulmonary disease (COPD) patients and can predict exacerbat... [more]

© 2016 Negewo et al. Introduction: Sputum eosinophilia occurs in approximately one-third of stable chronic obstructive pulmonary disease (COPD) patients and can predict exacerbation risk and response to corticosteroid treatments. Sputum induction, however, requires expertise, may not always be successful, and does not provide point-of-care results. Easily applicable diagnostic markers that can predict sputum eosinophilia in stable COPD patients have the potential to progress COPD management. This study investigated the correlation and predictive relationship between peripheral blood and sputum eosinophils. It also examined the repeatability of blood eosinophil counts. Methods: Stable COPD patients (n=141) were classified as eosinophilic or noneosinophilic based on their sputum cell counts (=3%), and a cross-sectional analysis was conducted comparing their demographics, clinical characteristics, and blood cell counts. Receiver operating characteristic curve analysis was used to assess the predictive ability of blood eosinophils for sputum eosinophilia. Intraclass correlation coefficient was used to examine the repeatability of blood eosinophil counts. Results: Blood eosinophil counts were significantly higher in patients with sputum eosinophilia (n=45) compared to those without (0.3×10 9 /L vs 0.15×10 9 /L; P < 0.0001). Blood eosinophils correlated with both the percentage (¿=0.535; P < 0.0001) and number of sputum eosinophils (¿=0.473; P < 0.0001). Absolute blood eosinophil count was predictive of sputum eosinophilia (area under the curve =0.76, 95% confidence interval [CI] =0.67¿0.84; P < 0.0001). At a threshold of =0.3×10 9 /L (specificity =76%, sensitivity =60%, and positive likelihood ratio =2.5), peripheral blood eosinophil counts enabled identification of the presence or absence of sputum eosinophilia in 71% of the cases. A threshold of =0.4×10 9 /L had similar classifying ability but better specificity (91.7%) and higher positive likelihood ratio (3.7). In contrast, =0.2×10 9 /L offered a better sensitivity (91.1%) for ruling out sputum eosinophilia. There was a good agreement between two measurements of blood eosinophil count over a median of 28 days (intraclass correlation coefficient =0.8; 95% CI =0.66¿0.88; P < 0.0001). Conclusion: Peripheral blood eosinophil counts can help identify the presence or absence of sputum eosinophilia in stable COPD patients with a reasonable degree of accuracy.

DOI 10.2147/COPD.S100338
Citations Scopus - 10Web of Science - 2
Co-authors Peter Wark, Katherine Baines, Peter Gibson, Jodie Simpson
2016 McDonald VM, Gibson PG, Scott HA, Baines PJ, Hensley MJ, Pretto JJ, Wood LG, 'Should we treat obesity in COPD? The effects of diet and resistance exercise training', Respirology, 21 875-882 (2016) [C1]

© 2016 Asian Pacific Society of Respirology Background and objective: Obesity is an established risk factor for poor health outcomes, but paradoxically in chronic obstructive pul... [more]

© 2016 Asian Pacific Society of Respirology Background and objective: Obesity is an established risk factor for poor health outcomes, but paradoxically in chronic obstructive pulmonary disease (COPD), it is associated with improved survival and lung function. A major evidence gap exisits to inform treatment recommendations for patients with COPD who are obese. We aimed to determine the effect of weight reduction involving a low-energy diet utilizing a partial meal replacement plan, coupled with resistance exercise training in obese COPD patients. Methods: In a proof of concept before¿after clinical trial, obese (body mass index =30 kg/m 2 ) COPD patients received a 12 week weight reduction programme involving meal replacements, dietary counselling by a dietitian and resistance exercise training prescribed and supervised by a physiotherapist. Patients were reviewed face to face by the dietitian and physiotherapist every 2 weeks for counselling. Results: Twenty-eight participants completed the intervention. Mean (standard deviation) body mass index was 36.3 kg/m 2 (4.6) at baseline and reduced by 2.4 kg/m 2 ((1.1) P < 0.0001) after the intervention. Importantly, skeletal muscle mass was maintained. Clinical outcomes improved with weight loss including exercise capacity, health status, dyspnea, strength and functional outcomes. There was also a significant reduction in the body mass index, obstruction, dyspnea and exercise score (BODE). Systemic inflammation measured by C-reactive protein however did not change. Conclusion: In obese COPD patients, dietary energy restriction coupled with resistance exercise training results in clinically significant improvements in body mass index, exercise tolerance and health status, whilst preserving skeletal muscle mass. This novel study provides a framework for development of guidelines for the management of obese COPD patients and in guiding future research.

DOI 10.1111/resp.12746
Citations Scopus - 7Web of Science - 8
Co-authors Michael Hensley, Lisa Wood, Hayley Scott, Peter Gibson
2016 Gibson PG, Reddel H, McDonald VM, Marks G, Jenkins C, Gillman A, et al., 'Effectiveness and response predictors of omalizumab in a severe allergic asthma population with a high prevalence of comorbidities: the Australian Xolair Registry', Internal Medicine Journal, 46 1054-1062 (2016) [C1]

© 2016 Royal Australasian College of Physicians Background: Severe asthma is a high impact disease. Omalizumab targets the allergic inflammatory pathway; however, effectiveness d... [more]

© 2016 Royal Australasian College of Physicians Background: Severe asthma is a high impact disease. Omalizumab targets the allergic inflammatory pathway; however, effectiveness data in a population with significant comorbidities are limited. Aims: To describe severe allergic asthma, omalizumab treatment outcomes and predictors of response among the Australian Xolair Registry participants. Methods: A web-based post-marketing surveillance registry was established to characterise the use, effectiveness and adverse effects of omalizumab (Xolair) for severe allergic asthma. Results: Participants (n = 192) (mean age 51 years, 118 female) with severe allergic asthma from 21 clinics in Australia were assessed, and 180 received omalizumab therapy. They had poor asthma control (Asthma Control Questionnaire, ACQ-5, mean score 3.56) and significant quality of life impairment (Asthma-related Quality of Life Questionnaire score 3.57), and 52% were using daily oral corticosteroid (OCS). Overall, 95% had one or more comorbidities (rhinitis 48%, obesity 45%, cardiovascular disease 23%). The omalizumab responder rate, assessed by an improvement of at least 0.5 in ACQ-5, was high at 83%. OCS use was significantly reduced. The response in participants with comorbid obesity and cardiovascular disease was similar to those without these conditions. Baseline ACQ-5 = 2.0 (P = 0.002) and older age (P = 0.05) predicted the magnitude of change in ACQ-5 in response to omalizumab. Drug-related adverse events included anaphylactoid reactions (n = 4), headache (n = 2) and chest pains (n = 1). Conclusion: Australian patients with severe allergic asthma report a high disease burden and have extensive comorbidity. Symptomatic response to omalizumab was high despite significant comorbid disease. Omalizumab is an effective targeted therapy for severe allergic asthma with comorbidity in a real-life setting.

DOI 10.1111/imj.13166
Citations Scopus - 9
Co-authors Peter Wark, Peter Gibson
2016 Wark PAB, Hew M, Maltby S, McDonald VM, Gibson PG, 'Diagnosis and investigation in the severe asthma clinic.', Expert Rev Respir Med, 10 491-503 (2016) [C1]
DOI 10.1586/17476348.2016.1165096
Citations Scopus - 4Web of Science - 5
Co-authors Steven Maltby, Peter Gibson, Peter Wark
2015 McDonald VM, 'Inhaled medications in COPD: devices and medications', Medicine Today: the peer reviewed journal of clinical practice, July 21-27 (2015) [C1]
2015 Wark PAB, McDonald VM, Gibson PG, 'Adjusting prednisone using blood eosinophils reduces exacerbations and improves asthma control in difficult patients with asthma.', Respirology, 20 1282-1284 (2015) [C1]
DOI 10.1111/resp.12602
Citations Scopus - 11Web of Science - 12
Co-authors Peter Gibson, Peter Wark
2015 Fu J-J, McDonald VM, Baines KJ, Gibson PG, 'Airway IL-1 beta and Systemic Inflammation as Predictors of Future Exacerbation Risk in Asthma and COPD', CHEST, 148 618-629 (2015) [C1]
DOI 10.1378/chest.14-2337
Citations Scopus - 20Web of Science - 19
Co-authors Peter Gibson, Katherine Baines
2015 Negewo NA, Gibson PG, McDonald VM, 'COPD and its comorbidities: Impact, measurement and mechanisms', RESPIROLOGY, 20 1160-1171 (2015) [C1]
DOI 10.1111/resp.12642
Citations Scopus - 12Web of Science - 12
Co-authors Peter Gibson
2015 Gibson PG, McDonald VM, 'Asthma-COPD overlap 2015: Now we are six', Thorax, 70 683-691 (2015) [C1]

Background: The overlap between asthma and COPD is increasingly recognised. This review examines the new insights, treatment and remaining knowledge gaps for asthma-COPD overlap. ... [more]

Background: The overlap between asthma and COPD is increasingly recognised. This review examines the new insights, treatment and remaining knowledge gaps for asthma-COPD overlap. Method: A systematic literature review of cluster analyses of asthma and COPD was performed. Articles from 2009 to the present dealing with prevalence, morbidity and treatment of asthma-COPD overlap were identified and reviewed. Results: Asthma-COPD overlap was consistently recognised in studies using a variety of different study designs and sampling. The prevalence was approximately 20% in patients with obstructive airways diseases. Asthma-COPD overlap was associated with increased morbidity and possibly an increased mortality and comorbidity. There was evidence of a heterogeneous pattern of airway inflammation that included eosinophilic (in adult asthma), neutrophilic or mixed patterns (in severe asthma and COPD). Systemic inflammation was present in asthma-COPD overlap and resembled that of COPD. Within asthma-COPD overlap, there is evidence of different subgroups, and recognition us ing bronchodilator responsiveness has not been successful. Guidelines generally recommend a serial approach to assessment, with treatment recommendations dominated by an asthma paradigm. Research is needed into key clinical features that impact outcome, mechanisms and treatment approaches in asthma-COPD overlap. Identifying and treating disease components by multidimensional assessment shows promise. Conclusions: Asthma-COPD overlap has drawn attention to the significant heterogeneity that exists within obstructive airway diseases. It should be replaced by novel approaches that identify and manage the components of this heterogeneity, such as multidimensional assessment and treatment. Future research is needed to test these novel and personalised approaches.

DOI 10.1136/thoraxjnl-2014-206740
Citations Scopus - 51Web of Science - 50
Co-authors Peter Gibson
2015 Baines KJ, Wright TK, Simpson JL, McDonald VM, Wood LG, Parsons KS, et al., 'Airway beta-Defensin-1 Protein Is Elevated in COPD and Severe Asthma', MEDIATORS OF INFLAMMATION, (2015) [C1]
DOI 10.1155/2015/407271
Citations Scopus - 5Web of Science - 4
Co-authors Peter Gibson, Peter Wark, Jodie Simpson, Lisa Wood, Katherine Baines
2014 Fu J-J, Mcdonald VM, Wang G, Gibson PG, 'Asthma control: How it can be best assessed?', Current Opinion in Pulmonary Medicine, 20 1-7 (2014) [C1]
DOI 10.1097/MCP.0000000000000003
Citations Scopus - 5Web of Science - 4
Co-authors Peter Gibson
2014 Abramson MJ, Perret JL, Dharmage SC, McDonald VM, McDonald CF, 'Distinguishing adult-onset asthma from COPD: A review and a new approach', International Journal of COPD, 9 945-962 (2014) [C1]

© 2014 Abramson et al. Adult-onset asthma and chronic obstructive pulmonary disease (COPD) are major public health burdens. This review presents a comprehensive synopsis of their... [more]

© 2014 Abramson et al. Adult-onset asthma and chronic obstructive pulmonary disease (COPD) are major public health burdens. This review presents a comprehensive synopsis of their epidemiology, pathophysiology, and clinical presentations; describes how they can be distinguished; and considers both established and proposed new approaches to their management. Both adult-onset asthma and COPD are complex diseases arising from gene¿environment interactions. Early life exposures such as childhood infections, smoke, obesity, and allergy influence adult-onset asthma. While the established environmental risk factors for COPD are adult tobacco and biomass smoke, there is emerging evidence that some childhood exposures such as maternal smoking and infections may cause COPD. Asthma has been characterized predominantly by Type 2 helper T cell (Th2) cytokine-mediated eosinophilic airway inflammation associated with airway hyperresponsiveness. In established COPD, the inflammatory cell infiltrate in small airways comprises predominantly neutrophils and cytotoxic T cells (CD8 positive lymphocytes). Parenchymal destruction (emphysema) in COPD is associated with loss of lung tissue elasticity, and small airways collapse during exhalation. The precise definition of chronic airflow limitation is affected by age; a fixed cut-off of forced expiratory volume in 1 second/forced vital capacity leads to overdiagnosis of COPD in the elderly. Traditional approaches to distinguishing between asthma and COPD have highlighted age of onset, variability of symptoms, reversibility of airflow limitation, and atopy. Each of these is associated with error due to overlap and convergence of clinical characteristics. The management of chronic stable asthma and COPD is similarly convergent. New approaches to the management of obstructive airway diseases in adults have been proposed based on inflammometry and also multidimensional assessment, which focuses on the four domains of the airways, comorbidity, self-management, and risk factors. Short-acting beta-agonists provide effective symptom relief in airway diseases. Inhalers combining a long-acting beta-agonist and corticosteroid are now widely used for both asthma and COPD. Written action plans are a cornerstone of asthma management although evidence for self-management in COPD is less compelling. The current management of chronic asthma in adults is based on achieving and maintaining control through step-up and step-down approaches, but further trials of back-titration in COPD are required before a similar approach can be endorsed. Long-acting inhaled anticholinergic medications are particularly useful in COPD. Other distinctive features of management include pulmonary rehabilitation, home oxygen, and end of life care.

DOI 10.2147/COPD.S46761
Citations Scopus - 34
2014 Fu JJ, Gibson PG, Simpson JL, McDonald VM, 'Longitudinal changes in clinical outcomes in older patients with asthma, COPD and asthma-COPD overlap syndrome', Respiration, 87 63-74 (2014) [C1]

Background: The progression of obstructive airway diseases (OADs) including asthma, chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap syndrome in older adults i... [more]

Background: The progression of obstructive airway diseases (OADs) including asthma, chronic obstructive pulmonary disease (COPD) and asthma-COPD overlap syndrome in older adults is not well understood. Objective: To examine the prognosis of OADs and to identify potential determinants for longitudinal changes in clinical outcomes. Methods: We consecutively recruited 99 older adults ( > 55 years) with OADs who underwent a multidimensional assessment at baseline and 4 years which involved spirometry, 6-min walk distance (6MWD), assessments of health status (Saint George's Respiratory Questionnaire, SGRQ), comorbidity, and serum and sputum biomarkers. All-cause mortality and respiratory hospitalisation during the follow-up period were recorded. Clinical outcomes were compared between basal and final visits, and changes in clinical outcomes were compared among asthma, COPD and asthma-COPD overlap groups. Associations between clinical parameters, biomarkers and prognosis were examined. Results: After a median follow-up of 4.2 years, outcome data were available for 75 (75.8%) patients. There were 16 (16.2%) deaths. The BODE index predicted all-cause mortality in older people with OADs. While spirometry, 6MWD and SGRQ deteriorated significantly over the 4 years, there was significant heterogeneity in the longitudinal changes in these clinical outcomes. Participants with COPD had a significant decline in FEV 1 (p = 0.003), SGRQ (p = 0.030) and 6MWD [decline of 75.5 (93.4) m, p = 0.024]. The change in 6MWD was lower in the asthma-COPD overlap group. Airflow reversibility was associated with a reduced decline in 6MWD. Conclusion: COPD patients had a poor prognosis compared with asthma and asthma-COPD overlap patients. The BODE index is a useful prognostic indicator in older adults with OADs. Both airway disease diagnosis and BODE index warrant specific attention in clinical practice. © 2013 S. Karger AG, Basel.

DOI 10.1159/000352053
Citations Scopus - 43Web of Science - 40
Co-authors Jodie Simpson, Peter Gibson
2014 Oreo KM, Gibson PG, Simpson JL, Wood LG, Mcdonald VM, Baines KJ, 'Sputum ADAM8 expression is increased in severe asthma and COPD', Clinical and Experimental Allergy, 44 342-352 (2014) [C1]

Background: Severe asthma and chronic obstructive pulmonary disease (COPD) are chronic inflammatory airway diseases in which the mechanisms are not fully understood. A disintegrin... [more]

Background: Severe asthma and chronic obstructive pulmonary disease (COPD) are chronic inflammatory airway diseases in which the mechanisms are not fully understood. A disintegrin and metalloproteinase domain 8 (ADAM8) is an enzyme expressed on most leucocytes and may be important for facilitating leucocyte migration in respiratory disease. Objective: To investigate ADAM8 mRNA and protein expression in asthma and COPD and its relationship between asthma severity and inflammatory phenotypes. Methods: Induced sputum was collected from 113 subjects with asthma (severe n = 31, uncontrolled n = 39 and controlled n = 35), 20 subjects with COPD and 21 healthy controls. Sputum ADAM8 mRNA expression was measured by qPCR, and soluble ADAM8 (sADAM8) protein was measured in the sputum supernatant by validated ELISA. Results: ADAM8 mRNA correlated with ADAM8 protein levels (r = 0.27, P < 0.01). ADAM8 mRNA (P = 0.004) and sADAM8 protein (P = 0.014) levels were significantly higher in both asthma and COPD compared with healthy controls. ADAM8 mRNA (P = 0.035) and sADAM8 protein (P = 0.002) levels were significantly higher in severe asthma compared with controlled asthma. Total inflammatory cell count (P < 0.01) and neutrophils (P < 0.01) were also elevated in severe asthmatic sputum. Although ADAM8 mRNA was significantly higher in eosinophilic and neutrophilic asthma (P < 0.001), sADAM8 did not differ between asthma inflammatory phenotypes. ADAM8 expression positively correlated with sputum total cell count and sputum neutrophils. Conclusions and Clinical Relevance: ADAM8 expression is increased in both severe asthma and COPD and associated with sputum total cell count and neutrophils. ADAM8 may facilitate neutrophil migration to the airways in severe asthma and COPD. © 2013 John Wiley & Sons Ltd.

DOI 10.1111/cea.12223
Citations Scopus - 8Web of Science - 8
Co-authors Lisa Wood, Jodie Simpson, Katherine Baines, Peter Gibson
2014 Fu JJ, McDonald VM, Gibson PG, Simpson JL, 'Systemic inflammation in older adults with asthma-COPD overlap syndrome', Allergy, Asthma and Immunology Research, 6 316-324 (2014) [C1]

Purpose: The role of systemic inflammation on asthma-COPD overlap syndrome is unknown. This study aimed to examine systemic inflammation in asthma-COPD overlap syndrome, and to id... [more]

Purpose: The role of systemic inflammation on asthma-COPD overlap syndrome is unknown. This study aimed to examine systemic inflammation in asthma-COPD overlap syndrome, and to identify associations between clinical characteristics and inflammatory mediators in asthma-COPD overlap syndrome. Methods: In 108 adults older than 55 years comprising healthy controls (n=29), asthma (n=16), COPD (n=21) and asthma-COPD overlap syndrome (n=42), serum high sensitivity C-reactive protein and Interleukin 6 (IL-6) were assayed. Spirometry, induced sputum, quality of life, comorbidities and medications were assessed, and their associations with asthma-COPD overlap syndrome were analyzed using logistic regression. Associations between systemic inflammatory mediators and clinical characteristics were tested in multivariate linear regression models. Results: Patients with asthma-COPD overlap syndrome had significantly elevated IL-6 levels compared with healthy controls and asthmatics. Age, comorbidity index and IL-6 l evel were independently associated with asthma-COPD overlap syndrome. FEV1% predicted was inversely associated with IL-6 level, and cardiovascular disease was associated with an increased IL-6 level. Systemic markers were not associated with airway inflammation. Conclusions: Systemic inflammation is commonly present in asthma-COPD overlap syndrome, and asthma-COPD overlap syndrome resembled COPD in terms of systemic inflammation. IL-6 is a pivotal inflammatory mediator that may be involved in airflow obstruction and cardiovascular disease and may be an independent treatment target. © Copyright The Korean Academy of Asthma, Allergy and Clinical Immunology.

DOI 10.4168/aair.2014.6.4.316
Citations Scopus - 38Web of Science - 32
Co-authors Jodie Simpson, Peter Gibson
2014 Gibson PG, McDonald VM, 'Why is COPD phenotyping like sorting diamonds?', Eur Respir J, 44 277-279 (2014) [C3]
DOI 10.1183/09031936.00091214
Citations Scopus - 3Web of Science - 3
Co-authors Peter Gibson
2014 Rossiter RC, Day J, McDonald VM, Hunter S, Jeong S, Van Der Riet P, et al., 'Redefining old: Optimising health and wellbeing', Hong Kong Journal of Mental Health, 40 59-72 (2014) [C1]
Co-authors Margaret Harris, Pamela Vanderriet, Rachel Rossiter, Sarah Jeong, Jenny Day, Isabel Higgins, Sharyn Hunter
2014 Negewo NA, McDonald VM, Gibson PG, 'Comorbidity in chronic obstructive pulmonary disease', Respiratory Investigation, (2014) [C1]

© 2015 The Japanese Respiratory Society. Patients with chronic obstructive pulmonary diseases (COPD) often experience comorbid conditions. The most common comorbidities that have... [more]

© 2015 The Japanese Respiratory Society. Patients with chronic obstructive pulmonary diseases (COPD) often experience comorbid conditions. The most common comorbidities that have been associated with COPD include cardiovascular diseases, lung cancer, metabolic disorder, osteoporosis, anxiety and depression, skeletal muscle dysfunction, cachexia, gastrointestinal diseases, and other respiratory conditions. Not only are comorbidities common but they also considerably influence disease prognosis and patients' health status, and are associated with poor clinical outcomes. However, perusal of literature indicates that little has been done so far to effectively assess, manage, and treat comorbidities in patients with COPD. The aim of this review is to comprehensively narrate the comorbid conditions that often coexist with COPD, along with their reported prevalence and their significant impacts in the disease management of COPD. A perspective on integrated disease management approaches for COPD is also discussed.

DOI 10.1016/j.resinv.2015.02.004
Citations Scopus - 7
Co-authors Peter Gibson
2013 McDonald V, Wood L, Baines P, Higgins I, Gibson P, 'Obesity and bone health in COPD', EUROPEAN RESPIRATORY JOURNAL, 42 (2013)
Co-authors Isabel Higgins, Lisa Wood, Peter Gibson
2013 McDonald VM, Higgins I, Wood LG, Gibson PG, 'Multidimensional assessment and tailored interventions for COPD: respiratory utopia or common sense?', THORAX, 68 691-694 (2013) [C1]
DOI 10.1136/thoraxjnl-2012-202646
Citations Scopus - 42Web of Science - 39
Co-authors Lisa Wood, Peter Gibson, Isabel Higgins
2013 McDonald VM, Higgins I, Gibson PG, 'Insight into Older Peoples' Healthcare Experiences with Managing COPD, Asthma, and Asthma-COPD Overlap', JOURNAL OF ASTHMA, 50 497-504 (2013) [C1]
DOI 10.3109/02770903.2013.790415
Citations Scopus - 6Web of Science - 6
Co-authors Peter Gibson, Isabel Higgins
2013 Simpson JL, McDonald VM, Baines KJ, Oreo KM, Wang F, Hansbro PM, Gibson PG, 'Influence of Age, Past Smoking, and Disease Severity on TLR2, Neutrophilic Inflammation, and MMP-9 Levels in COPD', MEDIATORS OF INFLAMMATION, (2013) [C1]
DOI 10.1155/2013/462934
Citations Scopus - 16Web of Science - 15
Co-authors Philip Hansbro, Peter Gibson, Katherine Baines, Jodie Simpson
2013 McDonald VM, Higgins I, Gibson PG, 'Managing Older Patients with Coexistent Asthma and Chronic Obstructive Pulmonary Disease Diagnostic and Therapeutic Challenges', DRUGS & AGING, 30 1-17 (2013) [C1]
DOI 10.1007/s40266-012-0042-z
Citations Scopus - 18Web of Science - 15
Co-authors Peter Gibson, Isabel Higgins
2013 Walters JAE, Crockett AJ, McDonald VM, 'COPD: Practical aspects of case finding, diagnosing and monitoring', Medicine Today, 14 32-39 (2013) [C2]
2013 Bryant J, McDonald VM, Boyes A, Sanson-Fisher R, Paul C, Melville J, 'Improving medication adherence in chronic obstructive pulmonary disease: A systematic review', Respiratory Research, 14 (2013) [C1]
DOI 10.1186/1465-9921-14-109
Citations Scopus - 41Web of Science - 29
Co-authors Chris Paul, Allison Boyes, Rob Sanson-Fisher
2013 Mcdonald VM, Simpson JL, Mcelduff P, Gibson PG, 'Older peoples' perception of tests used in the assessment and management of COPD and asthma', Clinical Respiratory Journal, 7 367-374 (2013) [C1]

Objectives: Outcome assessment is an important part of the management of airways disease, yet older adults may have difficulty with the burden of testing. This study evaluated the... [more]

Objectives: Outcome assessment is an important part of the management of airways disease, yet older adults may have difficulty with the burden of testing. This study evaluated the patient perception of tests used for the assessment of airways disease in older people. Data Source: Older adults ( > 55 years) with obstructive airway disease and healthy controls (N=56) underwent inhaler technique assessment, skin allergy testing, venepuncture, fractional exhaled nitric oxide (FENO) and gas diffusion measurement, exercise testing, sputum induction, and questionnaire assessment. They then completed an assessment burden questionnaire across five domains: difficulty, discomfort, pain, symptoms and test duration. Results: Test perception was generally favourable. Induced sputum had the greatest test burden perceived as being more difficult (mean 0.83, P=0.001), associated with more discomfort (mean 1.3, P < 0.001), more painful (0.46, P=0.019), longer test duration (0.84, P < 0.001) and worsening symptoms (0.55, P=0.001) than the questionnaires. FENO had a more favourable assessment but was assessed to be difficult to perform. Inhaler technique received the most favourable assessment. Conclusions: Older adults hold favourable perceptions to a range of tests that they might encounter in the course of their care for airway disease. The newer tests of sputum induction and FENO have some observed difficulties, in particular sputum induction. The results of this study can inform current practice by including details of the test and its associated adverse effects when conducting the test, as well as providing clear explanations of the utility of tests and how the results might aid in patient care. © 2013 John Wiley & Sons Ltd.

DOI 10.1111/crj.12017
Co-authors Jodie Simpson, Patrick Mcelduff, Peter Gibson
2012 O'Brien AP, McDonald VM, Maguire JM, 'Editorial: Nursing and midwifery research and scholarship in the Hunter New England Local Health District', HNE Handover, 5 2 (2012) [C3]
Co-authors Tony Obrien
2012 Sukkar MB, Wood LG, Tooze MK, Simpson JL, McDonald VM, Gibson PG, Wark PA, 'Soluble RAGE is deficient in neutrophilic asthma and COPD', European Respiratory Journal, 39 721-729 (2012) [C1]
Co-authors Peter Wark, Peter Gibson, Jodie Simpson, Lisa Wood
2012 Wark PA, Tooze M, Cheese L, Whitehead BF, Gibson PG, Wark K, McDonald VM, 'Viral infections trigger exacerbations of cystic fibrosis in adults and children', European Respiratory Journal, 40 510-512 (2012) [C1]
DOI 10.1183/09031936.00202311
Citations Scopus - 13Web of Science - 16
Co-authors Peter Wark, Peter Gibson
2012 McDonald VM, Gibson PG, 'Exacerbations of severe asthma', Clinical and Experimental Allergy, 42 670-677 (2012) [C1]
DOI 10.1111/j.1365-2222.2012.03981.x
Citations Scopus - 27Web of Science - 27
Co-authors Peter Gibson
2012 Pretto JJ, McDonald VM, Wark PA, Hensley MJ, 'Multicentre audit of inpatient management of acute exacerbations of chronic obstructive pulmonary disease: Comparison with clinical guidelines', Internal Medicine Journal, 42 380-387 (2012) [C1]
DOI 10.1111/j.1445-5994.2011.02475.x
Citations Scopus - 14Web of Science - 15
Co-authors Michael Hensley, Peter Wark
2011 McDonald VM, Higgins I, Simpson JL, Gibson PG, 'The importance of clinical management problems in older people with COPD and asthma: Do patients and physicians agree?', Primary Care Respiratory Journal, 20 389-395 (2011) [C1]

Background: COPD and asthma in older people are complex conditions associated with multiple clinical problems. The relative importance of these problems to both patients and physi... [more]

Background: COPD and asthma in older people are complex conditions associated with multiple clinical problems. The relative importance of these problems to both patients and physicians and the level of agreement between them is largely unknown. Methods: Older people with asthma and COPD underwent a multidimensional assessment to characterise the prevalence of clinical problems. Each individual's problems were then summarised and presented separately to the patient and physician to rate problem importance. Problems were scored using a 5-point Likert scale from unimportant to very important. Results: The highest-rated problems were dyspnoea, activity limitation and airway inflammation, and these areas had good patientphysician concordance. Poor concordance was found for inhaler technique adequacy, airflow obstruction and obesity. Good concordance was found for written action plans, but this was less important to both patients and physicians. Conclusions: In asthma and COPD, patients and their physicians agree about the importance of managing activity limitation, dyspnoea, and airway inflammation. Other areas of management had little concordance or were viewed as less important. Self-management skills were not rated as important by patients and this may hinder successful management. Eliciting problems and addressing their importance to treatment goals may improve care in COPD and asthma. © 2011 Primary Care Respiratory Society UK. All rights reserved.

Citations Scopus - 19Web of Science - 18
Co-authors Isabel Higgins, Jodie Simpson, Peter Gibson
2011 McDonald VM, Simpson JL, Higgins IJ, Gibson PG, 'Multidimensional assessment of older people with asthma and COPD: Clinical management and health status', Age and Ageing, 40 42-49 (2011) [C1]
DOI 10.1093/ageing/afq134
Citations Scopus - 38Web of Science - 31
Co-authors Isabel Higgins, Jodie Simpson, Peter Gibson
2011 Verrills NM, Irwin JA, He XY, Wood LG, Powell H, Simpson JL, et al., 'Identification of novel diagnostic biomarkers for asthma and chronic obstructive pulmonary disease', American Journal of Respiratory and Critical Care Medicine, 183 1633-1643 (2011) [C1]
DOI 10.1164/rccm.201010-1623OC
Citations Scopus - 53Web of Science - 50
Co-authors Jodie Simpson, Peter Gibson, Jennifer Irwin, Alistair Sim, Nikki Verrills, Lisa Wood
2011 McDonald VM, Vertigan AE, Gibson PG, 'How to set up a severe asthma service', Respirology, 16 900-911 (2011) [C1]
DOI 10.1111/j.1440-1843.2011.02012.x
Citations Scopus - 14Web of Science - 12
Co-authors Peter Gibson
2010 Gibson PG, McDonald VM, Marks GB, 'Asthma in older adults', The Lancet, 376 803-813 (2010) [C1]
DOI 10.1016/S0140-6736(10)61087-2
Citations Scopus - 186Web of Science - 154
Co-authors Peter Gibson
2010 Lasserson TJ, McDonald VM, 'School-based self-management educational interventions for asthma in children and adolescents (Protocol)', Cochrane Database of Systematic Reviews, CD008385 (2010) [C1]
DOI 10.1002/14651858.CD008385
2009 Wark PA, McDonald VM, 'Nebulised hypertonic saline for cystic fibrosis', Cochrane Database of Systematic Reviews, - CD001506 (2009) [C1]
DOI 10.1002/14651858.cd001506.pub3
Citations Scopus - 70Web of Science - 47
Co-authors Peter Wark
2008 McDonald VM, Gibson PG, 'Asthma mortality and management in older Australians: Time for a new approach?', Australasian Journal on Ageing, 27 215 (2008) [C3]
DOI 10.1111/j.1741-6612.2008.00322.x
Citations Scopus - 5Web of Science - 4
Co-authors Peter Gibson
2007 Gibson PG, Taramarcaz P, McDonald VM, 'Use of omalizumab in a severe asthma clinic', Respirology, 12 S35-S44 (2007) [C1]
DOI 10.1111/j.1440-1843.2007.01047.x
Citations Scopus - 7Web of Science - 4
Co-authors Peter Gibson
2006 Vm M, Gibson PG, 'Asthma self-management education', Chronic Respiratory Disease, 3 29-37 (2006) [C1]
DOI 10.1191/1479972306cd090ra
Citations Scopus - 27
Co-authors Peter Gibson
2005 McDonald VM, Gibson PG, 'Inhalation-device polypharmacy in asthma', Medical Journal of Australia, 182 250-251 (2005) [C3]
Citations Scopus - 8Web of Science - 8
Co-authors Peter Gibson
2005 Wark PAB, McDonald V, Jones AP, 'Nebulised hypertonic saline for cystic fibrosis', COCHRANE DATABASE OF SYSTEMATIC REVIEWS, (2005)
DOI 10.1002/14651858.CD001506.pub2
Citations Scopus - 38Web of Science - 1
Co-authors Peter Wark
2003 Wark PA, McDonald V, 'Nebulised hypertonic saline for cystic fibrosis.', Cochrane database of systematic reviews (Online), (2003)

BACKGROUND: The lung disease in cystic fibrosis is characterised by impaired mucociliary clearance. Hypertonic saline (HS) has been shown to enhance mucociliary clearance in-vitro... [more]

BACKGROUND: The lung disease in cystic fibrosis is characterised by impaired mucociliary clearance. Hypertonic saline (HS) has been shown to enhance mucociliary clearance in-vitro and this may act to lessen the destructive inflammatory process in the airways. OBJECTIVES: To investigate the effects of treatment with nebulised hypertonic saline on people with CF compared to placebo and or other treatments that enhance mucociliary clearance. SEARCH STRATEGY: 'We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group trials register which comprises references identified from comprehensive electronic database searches, handsearching relevant journals and handsearching abstract books of conference proceedings. Date of the most recent search of the Group's register: October 2001. SELECTION CRITERIA: All controlled trials (any language) assessing the effect of hypertonic saline compared to placebo or other mucolytic therapy, for any duration or dose regimen in people with cystic fibrosis of any age or severity. DATA COLLECTION AND ANALYSIS: All identified trials were independently reviewed by both reviewers & all data collected. Trial quality was assessed along with allocation concealment. MAIN RESULTS: Fourteen controlled trials were identified. Nine trials met the inclusion criteria; these involved 235 participants with an age range of 6 to 46 years. Two short-term trials of immediate effect on mucociliary clearance demonstrated that HS increased isotope clearance compared to control. Lung function as measured by improvement in Forced Expiratory Volume at one second (FEV1 l/min) was observed in four trials. When 3% to 7% saline was used in a volume of 10mls twice a day, in comparison to placebo, HS led to a significant increase in FEV1, WMD 12.20 (95%CI 4.30 to 20.10). In comparison to deoxyribonuclease (DNase) two trials used a similar concentration and volume of HS. Over a three week period the groups showed a similar increase in FEV1, WMD -1.60 (95%CI -11.16 to 7.96). However after 12 weeks treatment in participants with moderate to severe lung disease compared to DNase, HS 5mls twice a day showed less benefit to FEV1, WMD -13.00 (95%CI -22.46 to -3.54). No serious adverse events were noted. REVIEWER'S CONCLUSIONS: Nebulised hypertonic saline improves mucociliary clearance in short term clinical trials and appears to increase lung function compared to control. In comparison to DNase it may be less effective at improving lung function, after three months. At this stage there is insufficient evidence to support the use of hypertonic saline as routine treatment for people with cystic fibrosis.

Citations Scopus - 15
Co-authors Peter Wark
2000 Wark PA, McDonald V, 'Nebulised hypertonic saline for cystic fibrosis.', Cochrane database of systematic reviews (Online : Update Software), (2000)

BACKGROUND: The lung disease in cystic fibrosis is characterised by impaired mucociliary clearance, recurrent bronchial infection and airway inflammation. Hypertonic saline has be... [more]

BACKGROUND: The lung disease in cystic fibrosis is characterised by impaired mucociliary clearance, recurrent bronchial infection and airway inflammation. Hypertonic saline has been shown to enhance mucociliary clearance in-vitro and this may act to lessen the destructive inflammatory process in the airways. OBJECTIVES: To determine if nebulised hypertonic saline treatment improved lung function, exercise tolerance, quality of life and decreased the incidence of exacerbations of respiratory infections in patients with cystic fibrosis. SEARCH STRATEGY: Studies were identified from the Cochrane Cystic Fibrosis and Genetic Disorders Group trials register. Titles and abstracts were reviewed to identify all controlled trials. Review articles and bibliographies identified from this process were surveyed for additional citations & RCTs. Identification of unpublished work was obtained from abstract books from the three major Cystic Fibrosis conferences (International Cystic Fibrosis Conference, The European Cystic Fibrosis Conference and the North American Cystic Fibrosis Conference). Trial authors were contacted for additional information when only abstracts were available to review. Date of the most recent search of the Group's specialised register: November 1999. SELECTION CRITERIA: All controlled trials that assessed the effect of hypertonic saline compared to placebo or other mucolytic therapy, for any duration or dose regimen in subjects with cystic fibrosis of any age or severity were reviewed. Studies in languages other than English were included. DATA COLLECTION AND ANALYSIS: All identified trials were independently reviewed by both reviewers & all data collected. Trial quality was scored by the Cochrane assessment of allocation concealment & the Jadad scale of methodological quality. MAIN RESULTS: Twelve controlled trials of hypertonic saline were identified. Seven trials met the inclusion criteria; these involved 143 subjects with an age range of 6 to 46 years. Of these, six were published studies and one in abstract form. The durations of the trials were limited to immediate effects on mucociliary clearance to a maximum of three weeks. In two studies, involving thirty five subjects, a score for the feeling of cleared chest was made using visual analogue scales. This analysis showed a weighted mean difference of -0.98 (95% confidence Interval -1.6, -0.34), favouring hypertonic saline over isotonic saline. In two trials with 22 subjects hypertonic saline improved mucociliary clearance as measured by isotope clearance from the lungs in 90 minutes demonstrating a weighted mean difference of -11.3 (95% confidence Interval -18.6, -4.0), and as area under the clearance time curve; weighted mean difference of -212 (95%CI -272, -152), also favouring hypertonic saline over isotonic saline. Lung function as measured by improvement in FEV1 was observed in one study of 27 subjects. The percentage increase in FEV1 at two weeks increased by a mean 15.0% with hypertonic saline and 2.8% with isotonic saline (p=0.004). Adverse events were adequately described in only one trial and none were serious. REVIEWER'S CONCLUSIONS: Nebulised hypertonic saline improves mucociliary clearance immediately after administration which may have a longer term beneficial effect in cystic fibrosis. The maximum time data were recorded for was only three weeks. Most of the patients had mild to moderate lung disease and the effect on severe lung disease remains unclear. Further studies of hypertonic saline should be carried out to determine the effect on pulmonary function tests, quality of life, frequency of exacerbations of respiratory disease and efficacy comparisons with nebulised deoxyribonuclease, with larger numbers and for longer duration. At this stage there is insufficient evidence to support the use of hypertonic saline in routine treatment for patients with cystic fibrosis.

Citations Scopus - 1
Co-authors Peter Wark
2000 Wark PA, McDonald V, 'Nebulised hypertonic saline for cystic fibrosis.', Cochrane database of systematic reviews (Online), (2000)

BACKGROUND: The lung disease in cystic fibrosis is characterised by impaired mucociliary clearance, recurrent bronchial infection and airway inflammation. Hypertonic saline has be... [more]

BACKGROUND: The lung disease in cystic fibrosis is characterised by impaired mucociliary clearance, recurrent bronchial infection and airway inflammation. Hypertonic saline has been shown to enhance mucociliary clearance in-vitro and this may act to lessen the destructive inflammatory process in the airways. OBJECTIVES: To determine if nebulised hypertonic saline treatment improved lung function, exercise tolerance, quality of life and decreased the incidence of exacerbations of respiratory infections in patients with cystic fibrosis. SEARCH STRATEGY: Studies were identified from the Cochrane Cystic Fibrosis and Genetic Disorders Group trials register. Titles and abstracts were reviewed to identify all controlled trials. Review articles and bibliographies identified from this process were surveyed for additional citations & RCTs. Identification of unpublished work was obtained from abstract books from the three major Cystic Fibrosis conferences (International Cystic Fibrosis Conference, The European Cystic Fibrosis Conference and the North American Cystic Fibrosis Conference). Trial authors were contacted for additional information when only abstracts were available to review. Date of the most recent search of the Group's specialised register: November 1999. SELECTION CRITERIA: All controlled trials that assessed the effect of hypertonic saline compared to placebo or other mucolytic therapy, for any duration or dose regimen in subjects with cystic fibrosis of any age or severity were reviewed. Studies in languages other than English were included. DATA COLLECTION AND ANALYSIS: All identified trials were independently reviewed by both reviewers & all data collected. Trial quality was scored by the Cochrane assessment of allocation concealment & the Jadad scale of methodological quality. MAIN RESULTS: Twelve controlled trials of hypertonic saline were identified. Seven trials met the inclusion criteria; these involved 143 subjects with an age range of 6 to 46 years. Of these, six were published studies and one in abstract form. The durations of the trials were limited to immediate effects on mucociliary clearance to a maximum of three weeks. In two studies, involving thirty five subjects, a score for the feeling of cleared chest was made using visual analogue scales. This analysis showed a weighted mean difference of -0.98 (95% confidence Interval -1.6, -0.34), favouring hypertonic saline over isotonic saline. In two trials with 22 subjects hypertonic saline improved mucociliary clearance as measured by isotope clearance from the lungs in 90 minutes demonstrating a weighted mean difference of -11.3 (95% confidence Interval -18.6, -4.0), and as area under the clearance time curve; weighted mean difference of -212 (95%CI -272, -152), also favouring hypertonic saline over isotonic saline. Lung function as measured by improvement in FEV1 was observed in one study of 27 subjects. The percentage increase in FEV1 at two weeks increased by a mean 15.0% with hypertonic saline and 2.8% with isotonic saline (p=0.004). Adverse events were adequately described in only one trial and none were serious. REVIEWER'S CONCLUSIONS: Nebulised hypertonic saline improves mucociliary clearance immediately after administration which may have a longer term beneficial effect in cystic fibrosis. The maximum time data were recorded for was only three weeks. Most of the patients had mild to moderate lung disease and the effect on severe lung disease remains unclear. Further studies of hypertonic saline should be carried out to determine the effect on pulmonary function tests, quality of life, frequency of exacerbations of respiratory disease and efficacy comparisons with nebulised deoxyribonuclease, with larger numbers and for longer duration. At this stage there is insufficient evidence to support the use of hypertonic saline in routine treatment for patients with cystic fibrosis.

Citations Scopus - 20
Co-authors Peter Wark
1999 McDonald V, 'The characteristics of asthma education programs within New South Wales', Journal of Quality in Clinical Practice, 19 117-121 (1999)

The aim of the study was to examine the characteristics of asthma education programs within NSW. A cross-sectional questionnaire survey concerning the aims and characteristics of ... [more]

The aim of the study was to examine the characteristics of asthma education programs within NSW. A cross-sectional questionnaire survey concerning the aims and characteristics of 42 asthma education programs was administered to members of the Asthma Educators Association (AEA) of NSW. While most programs sought to improve asthma knowledge (78%), only a small number sought to improve asthma management skills (38%), asthma control (33%) and attitudes (10%). Most programs performed one-to-one (69%) education. Medical intervention was under-utilized by most programs and only 4% gave feedback to the referring doctor. Program evaluation was incompletely linked to program aims. There was incomplete evaluation of knowledge gain as an outcome. The study reviewed the characteristics of education programs within NSW. Existing programs appropriately employ a variety of educational methods and target a broad range of people with asthma. There remains a need to use a combined approach utilizing education and medical management, and to employ methods to evaluate programs.

DOI 10.1046/j.1440-1762.1999.00310.x
Citations Scopus - 5
1999 Wark P, McDonald V, 'The effectiveness of nebulised hypertonic saline on lung function, exercise tolerance and quality of life in cystic fibrosis', Respirology, 4 (1999)

Thick tenacious secretions that are difficult to expectorate and recurrent infection that leads to progressive end stage fibrotic disease typify lung disease in cystic fibrosis (C... [more]

Thick tenacious secretions that are difficult to expectorate and recurrent infection that leads to progressive end stage fibrotic disease typify lung disease in cystic fibrosis (CF). Mucolytic treatment can improve expectoration of sputum and lung function in CF. Our aim was to examine the efficacy of hypertonic saline (HS) in CF as an alternative or supplementary treatment. Methods: A meta-analysis of controlled trials was done. A search was carried out via the Cochrane Cystic Fibrosis Group specialist trials register. The titles and abstracts were reviewed to identify all potential controlled trials, articles were surveyed for additional citations. Identification of unpublished work was obtained from abstract books from (The International CF Conference, The European CF Conference and the North American CF Conference). All controlled trials that assessed the efficacy of Hypertonic Saline in subjects with cystic fibrosis were reviewed. The reviewers independently reviewed all trials. Data was analysed and compared using Revman. Results: A total of ten controlled trials were identified. Adequate data was available for analysis from seven of the studies, n = 166, age range (7-36years). Two studies showed that hypertonic saline (HS) improved lung function at two weeks by increasing the percentage change in FEV1. This showed a weighted mean difference (WMD) of +12.2 (95%CI +13.860, +10.540), favouring HS over isotonic saline (IS). An immediate effect on mucociliary clearance as measured by radioisotope was assessed in two trials. Analysis of isotope clearance at 90 mins found a WMD of +11.28 (95%CI +18.562, +3.998), favouring HS over IS. Measuring clearance as area under the curve showed a WMD of +212.059 (95%CI +271.641, +152.477), favouring HS over IS. Nebulised hypertonic saline appears to have a beneficial effect in cystic fibrosis, improving muco-ciliary clearance immediately after administration and lung function after two weeks of administration in combination with chest physiotherapy. Comparative data was not available to assess outcomes such as improvement in objective exercise testing, effect on symptom scores, quality of life measures or long term efficacy.

Co-authors Peter Wark
Show 67 more journal articles

Review (2 outputs)

Year Citation Altmetrics Link
2017 McDonald VM, Maltby S, Gibson PG, 'Severe asthma: Can we fix it? Prologue to seeking innovative solutions for severe asthma', RESPIROLOGY (2017)
DOI 10.1111/resp.12956
Citations Web of Science - 1
Co-authors Steven Maltby, Peter Gibson
2016 Grainge CL, Maltby S, Gibson PG, Wark PAB, McDonald VM, 'Targeted therapeutics for severe refractory asthma: monoclonal antibodies', EXPERT REVIEW OF CLINICAL PHARMACOLOGY (2016)
DOI 10.1586/17512433.2016.1172208
Citations Scopus - 3Web of Science - 3
Co-authors Peter Wark, Steven Maltby, Christopher Grainge, Peter Gibson

Conference (62 outputs)

Year Citation Altmetrics Link
2017 McDonald VM, Clark VL, Wark PAB, Baines KJ, Gibson PG, 'MULTIDIMENSIONAL ASSESSMENT AND TARGETED THERAPY OF SEVERE PERSISTENT ASTHMA: A RANDOMISED CONTROLLED TRIAL', RESPIROLOGY (2017)
Co-authors Peter Wark, Peter Gibson, Katherine Baines
2017 Cordova-Rivera L, Gibson PG, Gardiner PA, McDonald VM, 'PHYSICAL INACTIVITY AND SEDENTARY TIME IN SEVERE ASTHMA', RESPIROLOGY (2017)
Co-authors Peter Gibson
2017 Negewo NA, Gibson PG, Wark PAB, Simpson JL, Mcdonald VM, 'COMPLEX MEDICATION REGIMENS IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) ARE ASSOCIATED WITH DISEASE SEVERITY AND COMORBIDITIES', RESPIROLOGY (2017)
Co-authors Peter Wark, Peter Gibson, Jodie Simpson
2017 Maltby S, Gibson PG, Powell H, Mcdonald VM, 'OMALIZUMAB TREATMENT RESPONSE IN A SEVERE ALLERGIC ASTHMA POPULATION WITH OVERLAPPING COPD', RESPIROLOGY (2017)
Co-authors Steven Maltby, Peter Gibson
2016 Negewo N, Mcdonald V, Baines K, Wark P, Simpson J, Jones P, Gibson P, 'BLOOD EOSINOPHILS AS A SURROGATE MARKER FOR SPUTUM EOSINOPHILIA IN STABLE COPD', RESPIROLOGY (2016)
Co-authors Peter Gibson, Peter Wark, Jodie Simpson
2016 Harvey E, Gibson P, Bardin P, Peters M, Reynolds P, Upham J, et al., 'CHARACTERISATION OF SEVERE ASTHMA PHENOTYPES VIA A SEVERE ASTHMA REGISTRY: THE SEVERE ASTHMA WEB-BASED DATABASE', RESPIROLOGY (2016)
Co-authors Peter Gibson, Peter Wark
2016 Harvey E, Gibson P, Bardin P, Peters M, Reynolds P, Upham J, et al., 'SEVERE ASTHMA IS ASSOCIATED WITH WORK PRODUCTIVITY LOSS, ACTIVITY IMPAIRMENT AND REDUCED QUALITY OF LIFE', RESPIROLOGY (2016)
Co-authors Peter Wark, Peter Gibson
2016 Negewo N, Gibson, Wood, Baines, McDonald, 'Effect of weight loss on COPD-associated comorbidities in obese COPD' (2016)
DOI 10.1183/13993003.congress-2016.PA643
Co-authors Lisa Wood, Peter Gibson, Katherine Baines
2016 Negewo N, Gibson P, Wood L, Baines K, McDonald V, 'DOES WEIGHT LOSS COUPLED WITH RESISTANCE TRAINING IN OBESE COPD PATIENTS IMPROVE OTHER INTERRELATED COMORBIDITIES?', RESPIROLOGY (2016)
Co-authors Peter Gibson
2016 Samuel S, Wood-Baker R, Gibson P, Yang I, Hutchinson A, Sajkov D, Mcdonald V, 'COPD ASSESSMENT TEST (CAT) AS A PREDICTOR FOR MORTALITY AND READMISSION FOLLOWING HOSPITALISATION FOR ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD)', RESPIROLOGY (2016)
Co-authors Peter Gibson
2016 Hew M, Gillman A, Sutherland M, Wark P, Bowden J, McDonald V, et al., 'Clinical Effectiveness Of Omalizumab In Severe Allergic Asthma Above The Recommended Dosing Range: The Australian Xolair Registry', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE (2016)
Co-authors Peter Gibson, Peter Wark
2015 Baines K, Wright T, Simpson J, Mcdonald V, Wood L, Gibson P, 'EXCESSIVE NEUTROPHIL EXTRACELLULAR TRAPS ARE ASSOCIATED WITH INFLAMMATION IN CHRONIC AIRWAY DISEASE', RESPIROLOGY (2015) [E3]
Co-authors Peter Gibson, Lisa Wood, Jodie Simpson, Katherine Baines
2015 Wark P, Mcdonald V, Gibson P, 'A TREATMENT ALGORITHM ADJUSTING ORAL CORTICOSTEROID USING BLOOD EOSINOPHILS REDUCES EXACERBATIONS AND IMPROVES ASTHMA CONTROL, IN DIFFICULT ASTHMATICS', RESPIROLOGY (2015) [E3]
Co-authors Peter Gibson, Peter Wark
2015 Steven A, Gibson P, Wark P, Mcdonald V, 'THE USE OF AZOLES IN AIRWAYS DISEASE: A RETROSPECTIVE AUDIT', RESPIROLOGY (2015) [E3]
Co-authors Peter Gibson, Peter Wark
2015 McDonald V, Wark P, Baines K, Gibson P, 'A multidimensional assessment of severe asthma', American Journal of Respiratory and Critical Care Medicine (2015) [E3]
Co-authors Peter Wark, Peter Gibson, Katherine Baines
2015 Baines K, Wright T, Simpson J, McDonald V, Wood L, Gibson P, 'Accumulation of neutrophil extracellular traps is associated with inflammation in neutrophilic asthma and COPD', Am J Resp Crit Care Med (2015) [E3]
Co-authors Lisa Wood, Jodie Simpson, Peter Gibson, Katherine Baines
2015 McDonald V, Wark P, Baines K, Gibson P, 'The multidimensional components of severe asthma', Respirology (2015) [E3]
Co-authors Katherine Baines, Peter Gibson, Peter Wark
2015 Negewo N, McDonald V, Baines K, Wark P, Simpson J, Jones P, Gibson P, 'Can blood eosinophils predict sputum eosinophils in stable COPD?' (2015)
DOI 10.1183/13993003.congress-2015.PA3967
Co-authors Peter Wark, Jodie Simpson, Peter Gibson, Katherine Baines
2014 Fu J-J, McDonald VM, Baines KJ, Mao B, Gibson PG, 'Airway Il-1 Pathway Activation And Systemic Inflammation Predict Future Exacerbation Risk In Asthma And COPD', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE (2014)
Co-authors Katherine Baines, Peter Gibson
2014 Wright T, Gibson P, Simpson J, Mcdonald V, Wood L, Baines K, 'ALARMINS IN ASTHMA AND COPD: RELATIONSHIPS TO INFLAMMATORY PHENOTYPES AND DISEASE SEVERITY', RESPIROLOGY (2014) [E3]
Co-authors Katherine Baines, Jodie Simpson, Lisa Wood, Peter Gibson
2014 Mcdonald V, Gibson P, Scott H, Baines P, Hensley M, Pretto J, Wood L, 'SHOULD WE TREAT OBESITY IN COPD? THE EFFECTS OF WEIGHT LOSS AND RESISTANCE TRAINING IN OBESE COPD', RESPIROLOGY (2014) [E3]
Co-authors Hayley Scott, Lisa Wood, Michael Hensley, Peter Gibson
2014 Saleem TA, Mcdonald M, Sankaranarayanan A, Schofield P, Wark P, 'PREVALENCE AND IMPACT OF COGNITIVE IMPAIRMENT IN COPD', RESPIROLOGY (2014) [E3]
Co-authors Peter Wark, Peter Schofield
2013 Fu JJ, Mcdonald VM, Simpson JL, Higgins I, Mao B, Gibson PG, 'VALIDATION OF THE NEW GOLD COMBINED ASSESSMENT IN AN AUSTRALIAN COPD COHORT', RESPIROLOGY (2013) [E3]
Co-authors Jodie Simpson, Peter Gibson, Isabel Higgins
2013 Powell J, Walters JAE, Allan H, Mcdonald VM, 'EVALUATION OF COPD ONLINE: AN INTERACTIVE TRAINING PROGRAMME FOR PRIMARY CARE NURSES', RESPIROLOGY (2013) [E3]
2013 Baines KJ, Simpson JL, Mcdonald VM, Hsu AC, Gibson PG, 'DIFFERENTIAL AIRWAY GENE EXPRESSION IN COPD', RESPIROLOGY (2013) [E3]
Co-authors Alan Hsu, Peter Gibson, Katherine Baines, Jodie Simpson
2013 Mcdonald VM, Wood LG, Baines P, Higgins I, Gibson PG, 'OBESITY IN COPD PROTECTIVE FOR OSTEOPOROSIS?', RESPIROLOGY (2013) [E3]
Co-authors Isabel Higgins, Peter Gibson, Lisa Wood
2012 Fu J, McDonald VM, Gibson PG, Simpson JL, 'Systemic inflammation in older adults with asthma-COPD overlap syndrome', Abstracts. European Respiratory Society Annual Congress 2012 (2012) [E3]
Co-authors Peter Gibson, Jodie Simpson
2012 McDonald VM, Fu J, Simpson JL, Gibson PG, 'The longitudinal determinants of decline in obstructive airway diseases', Respirology (2012) [E3]
Co-authors Peter Gibson, Jodie Simpson
2012 McDonald VM, Wark PA, Roberts M, Spencer LM, Alison JA, Wood LG, Gibson PG, 'Development and audience testing of a COPD education DVD', Respirology (2012) [E3]
Co-authors Lisa Wood, Peter Wark, Peter Gibson
2012 Suthers BG, McDonald VM, Gibson PG, 'Leptin is associated with breathlessness in obstructive airways disease (OAD)', Respirology (2012) [E3]
Co-authors Peter Gibson
2012 Wark PA, Tooze MK, Cheese L, Whitehead BF, Gibson PG, McDonald VM, 'Viral infections trigger CF exacerbations and worsen infection with P Aeruginosa in adults and children', Respirology (2012) [E3]
Co-authors Peter Wark, Peter Gibson
2011 Sukkar MB, Wood LG, Tooze MK, Simpson JL, McDonald VM, Gibson PG, Wark PA, 'Deficiency of srage in asthma and COPD is selectively associated with neutrophilic airway inflammation', American Journal of Respiratory and Critical Care Medicine (2011) [E3]
Co-authors Peter Gibson, Peter Wark, Lisa Wood, Jodie Simpson
2011 McDonald VM, Higgins IJ, Wood LG, Gibson PG, 'Multidimensional assessment and individualized management (MDAIM) of obstructive airway diseases (OAD) in older adults - A pilot clinical trial', Respirology (2011) [E3]
Co-authors Lisa Wood, Isabel Higgins, Peter Gibson
2011 Sukkar M, Wood LG, Tooze MK, Simpson JL, McDonald VM, Gibson PG, Wark PA, 'Soluble RAGE is deficient in neutrophilic asthma and COPD', Respirology (2011) [E3]
DOI 10.1183/09031936.00022011
Citations Scopus - 62Web of Science - 53
Co-authors Peter Wark, Peter Gibson, Lisa Wood, Jodie Simpson
2011 McDonald VM, Simpson JL, Higgins IJ, Gibson PG, 'Mucus hypersecretion and chronic bronchitis in older adults with chronic obstructive airway diseases', Respirology (2011) [E3]
Co-authors Isabel Higgins, Peter Gibson, Jodie Simpson
2010 Smart JM, Wark PA, McDonald VM, Wood LG, 'Body composition in ex-smokers with and without airflow obstruction', Obesity Research and Clinical Practice (2010) [E3]
Co-authors Lisa Wood, Peter Wark
2010 Smart JM, Wark PA, McDonald VM, Wood LG, 'Low levels of body fat and obstructive airway disease in ex-smokers', Proceedings of the Nutrition Society of Australia (2010) [E3]
Co-authors Lisa Wood, Peter Wark
2010 McDonald VM, Higgins IJ, Simpson JL, Gibson PG, 'Is there an association between self reported activity limitation and exercise tolerance in COPD?', European Respiratory Society Annual Congress 2010. Abstracts (2010) [E3]
Co-authors Peter Gibson, Jodie Simpson, Isabel Higgins
2010 McDonald VM, Higgins IJ, Simpson JL, Gibson PG, 'Six minute walk tests: Are practice tests necessary?', European Respiratory Society Annual Congress 2010. Abstracts (2010) [E3]
Co-authors Jodie Simpson, Peter Gibson, Isabel Higgins
2010 McDonald VM, Higgins IJ, Wood LG, Gibson PG, 'Multidimensional assessment and individualised management of obstructive airway diseases (OAD) in older adults', European Respiratory Society Annual Congress 2010. Abstracts (2010) [E3]
Co-authors Lisa Wood, Isabel Higgins, Peter Gibson
2010 Pretto JJ, McDonald VM, Wark PA, Hensley MJ, 'An audit of clinical practice for COPD hospital admissions to eight Australian public hospitals', European Respiratory Society Annual Congress 2010. Abstracts (2010) [E3]
Co-authors Peter Wark, Michael Hensley
2010 McDonald VM, Pretto JJ, Wark PA, Hensley MJ, 'Low acuity COPD admissions: Are they avoidable?', Respirology (2010) [E3]
Co-authors Michael Hensley, Peter Wark
2010 McDonald VM, Simpson JL, Higgins IJ, Gibson PG, 'Is there an association between self reported acitivity limitation and exercise tolerance in COPD?', Respirology (2010) [E3]
Co-authors Isabel Higgins, Jodie Simpson, Peter Gibson
2010 Pretto JJ, McDonald VM, Wark PA, Hensley MJ, 'An audit of clinical practice for COPD hospital admissions', Respirology (2010) [E3]
Co-authors Michael Hensley, Peter Wark
2010 Simpson JL, McDonald VM, Gibson PG, 'The relationship between systemic inflammation, airway inflammation and airway obstruction in COPD', Respirology (2010) [E3]
Co-authors Peter Gibson, Jodie Simpson
2010 Simpson JL, McDonald VM, Gibson PG, 'Exhaled nitric oxide is not a marker of eosinophilic inflammation in older Australians', Respirology (2010) [E3]
Co-authors Peter Gibson, Jodie Simpson
2010 Smart JM, Wark PA, McDonald VM, Wood LG, 'CRP, body composition and lung function in ex-smokers', Respirology (2010) [E3]
Co-authors Peter Wark, Lisa Wood
2009 McDonald VM, Wood LG, Smart JM, Higgins IJ, Gibson PG, 'Sacropenia and sarcopenic obesity in older people with COPD?', Proceedings of the Nutrition Society of Australia (2009) [E3]
Co-authors Peter Gibson, Lisa Wood, Isabel Higgins
2009 McDonald VM, McElduff P, Simpson JL, Higgins IJ, Gibson PG, 'Multidimensional problem assessment of asthma and COPD in an older population: Patient-physician concordance', European Respiratory Journal (2009) [E3]
Co-authors Peter Gibson, Isabel Higgins, Patrick Mcelduff, Jodie Simpson
2009 Frith P, Pezullo L, Pejoski L, Hedley D, Allan H, Crockett A, et al., 'The economic impact of COPD in Australia', European Respiratory Journal (2009) [E3]
2009 McDonald VM, Wood LG, Smart J, Higgins I, Gibson PG, 'An Investigation of Sarcopenic Obesity in COPD.', AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE (2009) [E3]
Co-authors Isabel Higgins, Lisa Wood, Peter Gibson
2009 McDonald VM, Wood LG, Smart JM, Higgins IJ, Gibson PG, 'Does sarcopenic obesity exist in older people with COPD?', Respirology (2009) [E3]
DOI 10.1111/j.1440-1843.2009.01503_1.x
Co-authors Isabel Higgins, Peter Gibson, Lisa Wood
2009 McDonald VM, McElduff P, Simpson JL, Higgins IJ, Gibson PG, 'Multidimensional clinical problem assessment in asthma and COPD: Patient-physician concordance', Respirology (2009) [E3]
DOI 10.1111/j.1440-1843.2009.01502_7.x
Co-authors Jodie Simpson, Peter Gibson, Patrick Mcelduff, Isabel Higgins
2009 Clarke J, Cookson K, Gendle L, Bentley L, Wark PA, McDonald VM, 'Evaluation of patient acceptance of CF segregation and isolation policies', Respirology (2009) [E3]
DOI 10.1111/j.1440-1843.2009.01502_7.x
Co-authors Peter Wark
2008 Simpson JL, Hansbro PM, McDonald VM, Gibson PG, 'Age and disease related changes in airway inflammation and inflammatory subtype in older people with COPD', American Journal of Respiratory and Critical Care Medicine (2008) [E3]
Co-authors Philip Hansbro, Jodie Simpson, Peter Gibson
2008 Simpson JL, Hansbro PM, McDonald VM, Gibson PG, 'Age and disease related changes in airway inflammation in older people with COPD', Respirology (2008) [E3]
DOI 10.1111/j.1440-1843.2008.01252.x
Co-authors Peter Gibson, Philip Hansbro, Jodie Simpson
2008 McDonald VM, Higgins IJ, Gibson PG, 'The use of qualitative interviews to gain insight into older people with COPD and asthma', Respirology (2008) [E3]
DOI 10.1111/j.1440-1843.2008.01251.x
Co-authors Peter Gibson, Isabel Higgins
2008 McDonald VM, Simpson JL, Higgins IJ, Gibson PG, 'A problem based assessment of asthma and COPD in an older population', Respirology (2008) [E3]
DOI 10.1111/j.1440-1843.2008.01252.x
Co-authors Jodie Simpson, Peter Gibson, Isabel Higgins
2007 Collins CE, McDonald VM, Whitehead BF, Gibson PG, 'John Hunter Cystic Fibrosis Cohort 1993-2005', 7th Australasian Cystic Fibrosis Conference. Book of Abstracts (2007) [E3]
Co-authors Clare Collins, Peter Gibson
2007 McDonald VM, Simpson JL, Higgins IJ, Gibson PG, 'A problem based assessment of obstructive airways disease (OAD) in an elderly population', European Respiratory Society Annual Congress 2007. Abstracts (2007) [E3]
Co-authors Peter Gibson, Jodie Simpson, Isabel Higgins
2001 McDonald VM, Cookson K, Dymond L, Kesseil C, Pratt P, Gibson PG, 'Inhaler polvpharmacy use among patients with asthma', Respirology (2001)

Many patients with asthma use two or more drag classes. Poor inhalation technique limits drag efficacy. There has been an increase in the number and type of drug delivery systems ... [more]

Many patients with asthma use two or more drag classes. Poor inhalation technique limits drag efficacy. There has been an increase in the number and type of drug delivery systems available. This may accentuate the problems with poor inhalation technique and negate the advantage of drag delivery by inhalation. AIMS: The aims of this study are to describe the number of different devices used by patients with asthma, the adequacy of inhalation technique for each device and the effect of a structured education programme on technique and device selection. DESIGN: A cross sectional analytic survey. METHODS: Data was collected from patients attending the Asthma Management Service (AMS) between 1/1/00 and 30/9/00. Inhaler technique was assessed by an asthma educator and rated as adequate or inadequate. The number of devices used by each patient was analysed together with their proficiency of use. RESULTS: 123 patients were referred to the AMS and 112 (91%) attended an initial assessment. 54% were female and 25% were smokers. The age range was 17-79 years. 56% were on doses of ICS greater than 800mcgs/day. 74% of patients were using multiple devices. The patients were using an average of 1.9 different inhalation devices. Inadequate inhaler technique was present in 23% of pMDI users, 6% of spacer users, 29% of turbuhaler users, and 0% of Accuhaler users. Of those using multiple devices 26% were rated as inadequate with at least one of their devices. CONCLUSION: Inhaler polypharmacy exists as a unique problem among people with airways disease, and could lead to limited drag efficacy in a significant proportion of patients. There is a role for asthma education in the identification and management of this problem. :.

Co-authors Peter Gibson
2001 Kessell C, McDonald V, Pratt P, Cookson K, Wild K, Clifton V, Gibson PG, 'Evaluation of an asthma education programme delivered in an antenatal clinic', Respirology (2001)

Severe and poorly controlled asthma may lead to adverse outcomes for mothers and their babies. An asthma management and education programme was established in the Antenatal Clinic... [more]

Severe and poorly controlled asthma may lead to adverse outcomes for mothers and their babies. An asthma management and education programme was established in the Antenatal Clinic (ANC) of John Hunter Hospital to optimise asthma management in pregnant women with asthma. Aim: The aim of this study was to evaluate the effect of the Asthma Management Service in the John Hunter Hospital ANC. Design: Longitudinal analytic survey. Method: Women were enrolled in their first trimester and underwent an initial assessment of asthma severity, treatment and management skills. Deficits were corrected by skills education, medical assessment and treatment. Records were reviewed of pregnant women with asthma who attended the Asthma Management Service between January 1998 and December 1999. Results: 83 women were enrolled and 72 patients attended between 2 and 8 visits during pregnancy, depending upon asthma severity. Conclusion: After structured asthma education, there were significant improvements in asthma knowledge and management skills. The antenatal clinic is a opportune setting for asthma education among pregnant women with asthma. Asthma Control Visit 1 After Education p Value Night Symptoms 53% 42% 0.15 Morning Symptoms 66% 46% 0.01 Activity Limitation 35% 30% 0.65 Asthma Skills pMDI: Inadequate 13% 0% 0.001 Spacer: Inadequate 2% 0% 0.50 Medication Knowledge 47% 88% 0.0001 Action Plan 13% 78% 0.0001 Peak Flow Monitoring 8% 78% 0.0001.

Co-authors Vicki Clifton, Peter Gibson
Show 59 more conferences

Software / Code (1 outputs)

Year Citation Altmetrics Link
2011 Powell J, McDonald VM, Walters J, Effing T, MacDonald R, Hancock K, et al., 'COPD Online: An Interactive Training Program for Primary Care Nurses', 1.0, The Australian Lung Foundation, Sydney (2011) [G1]

Creative Work (1 outputs)

Year Citation Altmetrics Link
2011 McDonald VM, Wark PA, Gibson PG, Alison J, Spencer L, Wood LG, Roberts M, Living with COPD: Chronic Obstructive Pulmonary Disease, Newcastle (2011) [J2]
Co-authors Lisa Wood, Peter Gibson, Peter Wark

Report (1 outputs)

Year Citation Altmetrics Link
2016 Yang I, George J, Dabscheck E, Jenkins S, McDonald CF, McDonald VM, et al., 'The COPD-X Plan: Australian and New Zealand Guidelines for the management of Chronic Obstructive Pulmonary Disease', Australian Lung Foundation (2016)
Edit

Grants and Funding

Summary

Number of grants 42
Total funding $5,234,061

Click on a grant title below to expand the full details for that specific grant.


Highlighted grants and funding

National Clinical Centre of Research Excellence in Severe Asthma$2,448,108

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Conjoint Professor Peter Gibson, Professor Guy Marks, Professor Vanessa McDonald, Conjoint Professor Peter Wark, Conjoint Associate Professor Greg King, Dr Bruce Thompson, Associate Professor Helen Reddel, Professor John Upham, Dr Lorraine Smith, Professor Alan James
Scheme Centres of Research Excellence (CRE) - Centres of Clinical Research Excellence
Role Investigator
Funding Start 2014
Funding Finish 2019
GNo G1400017
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

20177 grants / $1,017,100

Targeting neutrophil extracellular traps to reduce inflammation in severe asthma$590,463

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Doctor Katie Baines, Conjoint Professor Peter Gibson, Professor Jodie Simpson, Professor Dominik Hartl, Professor Vanessa McDonald
Scheme Project Grant
Role Investigator
Funding Start 2017
Funding Finish 2019
GNo G1500231
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

Asthma and COPD Endotypes (ACE) - the impact of eosinophils$177,840

Funding body: AstraZeneca

Funding body AstraZeneca
Project Team Professor Vanessa McDonald, Conjoint Professor Peter Gibson
Scheme Research Grant
Role Lead
Funding Start 2017
Funding Finish 2019
GNo G1700651
Type Of Funding International - Non Competitive
Category 3IFB
UON Y

Severe Asthma Treatable Traits Respiratory Research Fellowship$100,000

Funding body: GlaxoSmithKline Australia

Funding body GlaxoSmithKline Australia
Project Team Professor Vanessa McDonald, Conjoint Professor Peter Gibson
Scheme Support Grant
Role Lead
Funding Start 2017
Funding Finish 2018
GNo G1700681
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

Imaging treatable traits$99,797

Funding body: Cyclopharm Limited

Funding body Cyclopharm Limited
Project Team Professor Vanessa McDonald, Conjoint Professor Peter Gibson, Doctor Natalie Rutherford, Conjoint Professor Peter Wark, Conjoint Associate Professor Christopher Grainge
Scheme Research Grant
Role Lead
Funding Start 2017
Funding Finish 2017
GNo G1700386
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

Patient Reported Outcome Measure in Severe Asthma (PROMISe): A New Tool That Measures Severe Asthma’s Impact on Quality of Life$20,000

Funding body: John Hunter Hospital Charitable Trust

Funding body John Hunter Hospital Charitable Trust
Project Team Professor Vanessa McDonald, Conjoint Professor Peter Gibson, Professor Janelle Yorke, Dr Robert Niven, Professor Paul Jones
Scheme Research Grant
Role Lead
Funding Start 2017
Funding Finish 2017
GNo G1700328
Type Of Funding Other Public Sector - State
Category 2OPS
UON Y

Patient Reported Outcome Measure in Severe Asthma (PROMISe): A New Tool That Measures Severe Asthma’s Impact on Quality of Life$20,000

Funding body: National Clinical CRE in Severe Asthma

Funding body National Clinical CRE in Severe Asthma
Project Team Professor Vanessa McDonald, Conjoint Professor Peter Gibson, Professor Janelle Yorke, Dr Robert Niven, Professor Paul Jones
Scheme Seed Research Project
Role Lead
Funding Start 2017
Funding Finish 2017
GNo G1700346
Type Of Funding Internal
Category INTE
UON Y

CoreScan Software - Dual Energy X-ray absorptiometry machine$9,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Doctor Bronwyn Berthon, Professor Lisa Wood, Doctor Katie Baines, Professor Vanessa McDonald
Scheme Early and Mid-Career Equipment Grant
Role Investigator
Funding Start 2017
Funding Finish 2017
GNo G1701222
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

20165 grants / $268,158

Targeted Management in Severe Asthma$178,158

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Professor Vanessa McDonald
Scheme Translating Research into Practice (TRIP) Fellowships
Role Lead
Funding Start 2016
Funding Finish 2017
GNo G1500640
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

CELL-DYN Ruby Hematology Analyser (Abbott Haemotology)$30,000

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Professor Vanessa McDonald, Conjoint Professor Peter Gibson, Professor Jodie Simpson, Conjoint Professor Peter Wark, Professor Lisa Wood, Doctor Vanessa Murphy
Scheme Equipment Grant
Role Lead
Funding Start 2016
Funding Finish 2016
GNo G1601306
Type Of Funding Other Public Sector - Commonwealth
Category 2OPC
UON Y

Development and Validation of the First Patient Reported Outcome Measure in Severe Asthma (PROMISe)$20,000

Funding body: National Clinical CRE in Severe Asthma

Funding body National Clinical CRE in Severe Asthma
Project Team Professor Vanessa McDonald, Conjoint Professor Peter Gibson, Professor Janelle Yorke
Scheme Seed Research Project
Role Lead
Funding Start 2016
Funding Finish 2016
GNo G1600921
Type Of Funding Internal
Category INTE
UON Y

Managing Inflammation in COPD (MiCOPD)$20,000

Funding body: Lung Foundation Australia

Funding body Lung Foundation Australia
Project Team Professor Vanessa McDonald, Conjoint Professor Peter Gibson, Professor Jodie Simpson, Conjoint Professor Peter Wark
Scheme Boehringer Ingelheim COPD Research Top-Up Grant
Role Lead
Funding Start 2016
Funding Finish 2017
GNo G1601013
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

Inflammation based management of severe asthma: utility of blood oesinophils$20,000

Funding body: National Clinical CRE in Severe Asthma

Funding body National Clinical CRE in Severe Asthma
Project Team Conjoint Professor Peter Wark, Professor Jodie Simpson, Professor Vanessa McDonald, Conjoint Professor Peter Gibson, Conjoint Associate Professor Christopher Grainge
Scheme Seed Research Project
Role Investigator
Funding Start 2016
Funding Finish 2016
GNo G1601079
Type Of Funding Internal
Category INTE
UON Y

20155 grants / $49,222

Physical Inactivity and Sedentary Behaviour in Severe Asthma: the new smoking.$25,222

Funding body: John Hunter Hospital Charitable Trust

Funding body John Hunter Hospital Charitable Trust
Project Team Professor Vanessa McDonald, Mrs Laura Cordova Rivera, Emeritus Professor Michael Hensley, Dr Paul Gardiner
Scheme Research Grant
Role Lead
Funding Start 2015
Funding Finish 2015
GNo G1500112
Type Of Funding Other Public Sector - State
Category 2OPS
UON Y

Research of the year Award$10,000

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Professor Vanessa McDonald
Scheme Award for Research Excellence
Role Lead
Funding Start 2015
Funding Finish 2015
GNo G1401521
Type Of Funding Internal
Category INTE
UON Y

(PROJECT)$10,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Professor Vanessa McDonald, Mrs Netsanet Negewo, Conjoint Professor Peter Gibson, Doctor Katie Baines
Scheme Jennie Thomas Medical Research Travel Grant
Role Lead
Funding Start 2015
Funding Finish 2015
GNo G1501430
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

2014 Vice Chancellors Award for Research Excellence - Faculty of Medicine and Health$2,000

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Professor Vanessa McDonald
Scheme Award for Research Excellence
Role Lead
Funding Start 2015
Funding Finish 2015
GNo G1401477
Type Of Funding Internal
Category INTE
UON Y

American Thoracic Society, Colorado USA, 15-20 May 2015$2,000

Funding body: University of Newcastle - Faculty of Health and Medicine

Funding body University of Newcastle - Faculty of Health and Medicine
Project Team Professor Vanessa McDonald
Scheme Travel Grant
Role Lead
Funding Start 2015
Funding Finish 2015
GNo G1500738
Type Of Funding Internal
Category INTE
UON Y

20147 grants / $2,574,211

National Clinical Centre of Research Excellence in Severe Asthma$2,448,108

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Conjoint Professor Peter Gibson, Professor Guy Marks, Professor Vanessa McDonald, Conjoint Professor Peter Wark, Conjoint Associate Professor Greg King, Dr Bruce Thompson, Associate Professor Helen Reddel, Professor John Upham, Dr Lorraine Smith, Professor Alan James
Scheme Centres of Research Excellence (CRE) - Centres of Clinical Research Excellence
Role Investigator
Funding Start 2014
Funding Finish 2019
GNo G1400017
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

The experiences and perceptions of people living with severe asthma. $42,000

Funding body: Asthma Australia

Funding body Asthma Australia
Project Team

Juliet Foster

Scheme Unrestricted research grant
Role Investigator
Funding Start 2014
Funding Finish 2016
GNo
Type Of Funding External
Category EXTE
UON N

Investigating the Phenotypes of Bronchiectasis$27,512

Funding body: John Hunter Hospital Charitable Trust

Funding body John Hunter Hospital Charitable Trust
Project Team Professor Vanessa McDonald, Conjoint Professor Peter Gibson, Mrs Netsanet Negewo
Scheme Research Grant
Role Lead
Funding Start 2014
Funding Finish 2014
GNo G1400084
Type Of Funding Other Public Sector - State
Category 2OPS
UON Y

The role of comorbidities and inflammation in Chronic Obstructive Pulmonary Disease (COPD)$20,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Mrs Netsanet Negewo, Professor Vanessa McDonald, Conjoint Professor Peter Gibson, Doctor Katie Baines
Scheme Postgraduate Research Scholarship
Role Lead
Funding Start 2014
Funding Finish 2015
GNo G1401393
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

Predicting who is at risk of worsening lung disease in Cystic Fibrosis$20,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Conjoint Professor Peter Wark, Doctor Katie Baines, Professor Vanessa McDonald, Conjoint Professor Peter Gibson, Associate Professor Scott Bell, Associate Professor David Reid
Scheme Project Grant
Role Investigator
Funding Start 2014
Funding Finish 2014
GNo G1401410
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

PULSE Early Career Researcher of the Year$14,591

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Professor Vanessa McDonald
Scheme PULSE Early Career Researcher of the Year Award
Role Lead
Funding Start 2014
Funding Finish 2017
GNo G1301332
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

TSANZ Annual Scientific Meeting, Adelaide AUS, 4-9 April 2014$2,000

Funding body: University of Newcastle - Faculty of Health and Medicine

Funding body University of Newcastle - Faculty of Health and Medicine
Project Team Professor Vanessa McDonald
Scheme Travel Grant
Role Lead
Funding Start 2014
Funding Finish 2015
GNo G1400090
Type Of Funding Internal
Category INTE
UON Y

20135 grants / $988,380

Inflammometry in Stable COPD; A Randomised Controlled Trial (RCT)$743,351

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Conjoint Professor Peter Gibson, Professor Vanessa McDonald, Professor Jodie Simpson, Conjoint Professor Peter Wark
Scheme Project Grant
Role Investigator
Funding Start 2013
Funding Finish 2016
GNo G1200185
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON Y

Managing Inflammatory Phenotypes in Stable COPD: A Randomised Control Trial$160,000

Funding body: Lung Foundation Australia

Funding body Lung Foundation Australia
Project Team Professor Vanessa McDonald
Scheme Boehringer Ingelheim Chronic Obstructive Pulmonary Disease Research Fellowship
Role Lead
Funding Start 2013
Funding Finish 2014
GNo G1300813
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

Managing Inflammatory Phenotypes in COPD$74,929

Funding body: Ramaciotti Foundations

Funding body Ramaciotti Foundations
Project Team Professor Vanessa McDonald
Scheme Establishment Grant
Role Lead
Funding Start 2013
Funding Finish 2013
GNo G1200730
Type Of Funding Grant - Aust Non Government
Category 3AFG
UON Y

36 GT3XPlus – Wireless Triaxial Activity Monitors, with Actilife 6 software – 1 licence for 6 monitors, soft heart rate straps and elastic belts for attachment$8,100

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Professor Vanessa McDonald
Scheme Equipment Grant
Role Lead
Funding Start 2013
Funding Finish 2014
GNo G1301309
Type Of Funding Other Public Sector - Commonwealth
Category 2OPC
UON Y

TSANZ Annual Scientific Meeting, Darwin Convention Centre, 23 - 27 March 2013$2,000

Funding body: University of Newcastle - Faculty of Health and Medicine

Funding body University of Newcastle - Faculty of Health and Medicine
Project Team Professor Vanessa McDonald
Scheme Travel Grant
Role Lead
Funding Start 2013
Funding Finish 2013
GNo G1300179
Type Of Funding Internal
Category INTE
UON Y

20122 grants / $54,454

Phenotype based management of severe persistent asthma$34,454

Funding body: John Hunter Hospital Charitable Trust

Funding body John Hunter Hospital Charitable Trust
Project Team Professor Vanessa McDonald, Doctor Katie Baines, Conjoint Professor Peter Gibson
Scheme Research Grant
Role Lead
Funding Start 2012
Funding Finish 2012
GNo G1200211
Type Of Funding Other Public Sector - State
Category 2OPS
UON Y

Phenotype based management of severe persistent asthma$20,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Professor Vanessa McDonald, Doctor Katie Baines, Conjoint Professor Peter Gibson
Scheme Research Grant
Role Lead
Funding Start 2012
Funding Finish 2012
GNo G1101169
Type Of Funding Contract - Aust Non Government
Category 3AFC
UON Y

20112 grants / $14,337

Phenotype based management of severe persistent asthma$10,337

Funding body: University of Newcastle

Funding body University of Newcastle
Project Team Professor Vanessa McDonald
Scheme Early Career Researcher Grant
Role Lead
Funding Start 2011
Funding Finish 2011
GNo G1101050
Type Of Funding Internal
Category INTE
UON Y

PULSE Education Prize$4,000

Funding body: Hunter Medical Research Institute

Funding body Hunter Medical Research Institute
Project Team Professor Vanessa McDonald
Scheme PULSE Education Prize
Role Lead
Funding Start 2011
Funding Finish 2011
GNo G1100817
Type Of Funding Contract - Aust Non Government
Category 3AFC
UON Y

20101 grants / $25,000

Investigating the Obesity Paradox in COPD$25,000

Funding body: John Hunter Hospital Charitable Trust Fund

Funding body John Hunter Hospital Charitable Trust Fund
Project Team

Vanessa McDonald

Scheme Research Grant
Role Lead
Funding Start 2010
Funding Finish 2011
GNo
Type Of Funding Other Public Sector - Local
Category 2OPL
UON N

20092 grants / $53,286

Development of an interactive DVD for COPD$35,000

Funding body: Department of Veterans` Affairs

Funding body Department of Veterans` Affairs
Project Team

Vanessa McDonald

Scheme Innovative Funding Projects
Role Lead
Funding Start 2009
Funding Finish 2011
GNo
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON N

Integrated Problem Based Management (IPBM) of Obstructive Airways Disease in Older People (OAD) $18,286

Funding body: John Hunter Hospital Charitable Trust Fund

Funding body John Hunter Hospital Charitable Trust Fund
Project Team

Vanessa McDonald

Scheme Research Grant
Role Lead
Funding Start 2009
Funding Finish 2010
GNo
Type Of Funding Other Public Sector - Local
Category 2OPL
UON N

20081 grants / $15,208

Management of Obstructive Airways Disease in Older People$15,208

Funding body: John Hunter Hospital Charitable Trust Fund

Funding body John Hunter Hospital Charitable Trust Fund
Project Team

Vanessa McDonald

Scheme Research Grant
Role Lead
Funding Start 2008
Funding Finish 2009
GNo
Type Of Funding Other Public Sector - Local
Category 2OPL
UON N

20074 grants / $148,195

PhD Scholarship$88,595

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team

Vanessa McDonald

Scheme Centres of Research Excellence (CRE) - Centres of Clinical Research Excellence
Role Lead
Funding Start 2007
Funding Finish 2010
GNo
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON N

Nitric Oxide Monitoring System (NIOX)$45,000

Funding body: NHMRC (National Health & Medical Research Council)

Funding body NHMRC (National Health & Medical Research Council)
Project Team Conjoint Professor Peter Gibson, Conjoint Associate Professor Vicki Clifton, Conjoint Professor Warwick Giles, Emeritus Professor Michael Hensley, Doctor Vanessa Murphy, Conjoint Professor Peter Wark, Professor Vanessa McDonald, Professor Jodie Simpson, Conjoint Associate Professor Bruce Whitehead, Laureate Professor Paul Foster, Professor Phil Hansbro, Professor Lisa Wood
Scheme Equipment Grant
Role Investigator
Funding Start 2007
Funding Finish 2007
GNo G0188193
Type Of Funding Other Public Sector - Commonwealth
Category 2OPC
UON Y

A model of care for a patient centred multi disciplinary problem based approach to airways disease in the elderly$9,600

Funding body: NSW Health

Funding body NSW Health
Project Team

Vanessa McDonald

Scheme Innovations Grant
Role Lead
Funding Start 2007
Funding Finish 2008
GNo
Type Of Funding Other Public Sector - State
Category 2OPS
UON N

A Problem Based Approach to the Management of Airways Disease in people over the age of 55 years$5,000

Funding body: John Hunter Hospital Charitable Trust Fund

Funding body John Hunter Hospital Charitable Trust Fund
Project Team

Vanessa McDonald

Scheme Research Grant
Role Lead
Funding Start 2007
Funding Finish 2008
GNo
Type Of Funding Other Public Sector - Local
Category 2OPL
UON N

20061 grants / $26,510

The role of respiratory virus infection in CF lung disease$26,510

Funding body: Australian Cystic Fibrosis Research Trust

Funding body Australian Cystic Fibrosis Research Trust
Project Team

Peter Wark

Scheme Cystic Fibrosis Research Grant
Role Investigator
Funding Start 2006
Funding Finish 2008
GNo
Type Of Funding Aust Competitive - Commonwealth
Category 1CS
UON N
Edit

Research Supervision

Number of supervisions

Completed5
Current7

Total current UON EFTSL

Masters0.4
PhD2.3

Current Supervision

Commenced Level of Study Research Title Program Supervisor Type
2017 PhD Characteristics of the Airway¿Systemic Innate Inflammation Axis in COPD and Severe Asthma PhD (Medicine), Faculty of Health and Medicine, The University of Newcastle Principal Supervisor
2016 Masters Investigation of Vitamin D¿s Significance to Severe Cardiovascular Disease M Philosophy (Nursing), Faculty of Health and Medicine, The University of Newcastle Co-Supervisor
2016 PhD Sleep Disturbance in Dialysis Patients PhD (Nursing), Faculty of Health and Medicine, The University of Newcastle Principal Supervisor
2016 PhD Assessment and Management of Clinically Severe Obese Older People with Respiratory Co-morbidities PhD (Nursing), Faculty of Health and Medicine, The University of Newcastle Principal Supervisor
2015 PhD Prescription of acute oxygen therapy in patients at risk of type 11 respiratory failure PhD (Nursing), Faculty of Health and Medicine, The University of Newcastle Principal Supervisor
2015 Masters An exploration of the diagnostic journey of children with Neuronal Ceroid Lipofuscinosis (NCL) M Philosophy (Nursing), Faculty of Health and Medicine, The University of Newcastle Principal Supervisor
2014 PhD Physical Activity and Sedentary Behaviour in Obstructive Airway Diseases PhD (Medicine), Faculty of Health and Medicine, The University of Newcastle Principal Supervisor

Past Supervision

Year Level of Study Research Title Program Supervisor Type
2017 Honours Advancing Precision-Medicine in Chronic Obstructive Pulmonary Disease (COPD): Biomarkers in clinical phenotypes and inflammatory endotypes Biological Sciences, Priority Research Centre (PRC) for Healthy Lungs | The University of Newcastle Principal Supervisor
2017 Honours Advancing Precision-Medicine in Chronic Obstructive Pulmonary Disease (COPD): Biomarkers in clinical phenotypes and inflammatory endotypes Biological Sciences, Priority Research Centre (PRC) for Healthy Lungs | The University of Newcastle Principal Supervisor
2017 PhD The Role of Comorbidities and Inflammation in COPD PhD (Medicine), Faculty of Health and Medicine, The University of Newcastle Co-Supervisor
2014 PhD Systemic Inflammation in Obstructive Airway Disease PhD (Medicine), Faculty of Health and Medicine, The University of Newcastle Co-Supervisor
2014 Honours Evaluation of a weight loss intervention in obese COPD Nutrition & Dietetics, The University of Newcastle Co-Supervisor
Edit

News

PHD Scholarship: Targeting Anxiety and Depression in Severe Asthma

July 14, 2017

The Faculty of Health  is offering a PhD scholarship for a researcher to investigate anxiety and depression in people suffering severe asthma, under the supervision of Professor Vanessa McDonald.

Leading respiratory nursing researcher awarded TSANZ Fellowship

March 29, 2017

Professor Vanessa McDonald is the first and only nurse to have been awarded the title of Fellow of the Thoracic Society of Australia and New Zealand (FThorSoc) for her excellence in respiratory health research.

Associate Professor Vanessa McDonald

Weight-loss study challenges COPD’s obesity puzzle

February 29, 2016

Faced with a clinical paradox where obesity seemingly offers a protective effect for Chronic Obstructive Pulmonary Disease (COPD), Hunter researchers have performed a world-first pilot study aimed at achieving weight loss without exacerbating respiratory symptoms.

VC's Awards 2014

Vice-Chancellor's Awards Winners

December 9, 2014

Each year the University of Newcastle celebrates the remarkable achievements of our staff at the Vice-Chancellor's Awards ceremony.

Vanessa McDonald

World COPD Day

November 19, 2013

Hunter Medical Research Institute respiratory researchers will offer free lung function tests and information sessions for members of the public to mark World COPD Day on Wednesday, November 19.

Phil Hansbro

HMRI 2013 Awards Night

November 7, 2013

Respiratory researcher Professor Phil Hansbro won the prestigious 2013 Award for Research Excellence tonight as more than $1.4 million in grant funding was awarded and acknowledged in the Hunter Medical Research Institute's 2013 Awards Night.

Professor Vanessa McDonald

Position

Professor
School of Nursing and Midwifery
Faculty of Health and Medicine

Focus area

Nursing

Contact Details

Email vanessa.mcdonald@newcastle.edu.au
Phone (02) 40420146
Fax (02) 4042 0046

Office

Room Level 2 West Wing
Building Hunter Medical Research Institute
Location Lot 1, Kookaburra Circuit New Lambton Heights NSW 2305 HMRI Mailing Address: Locked Bag 1000 New Lambton NSW 2305

,
Edit