Dr Karl Holden is based at Alder Hey Children’s Hospital. He is also a qualified doctor and paediatric registrar, having undertaken integrated clinical and academic training.
Project Information
Research Driver Programme: Inflammation and Immunity programme
Title: System-wide and data-driven approaches to improving asthma outcomes in children and young people (CYP)
Summary:
The aim of Karl’s PhD project is to assess if system-wide and data-driven approaches, being piloted in eight integrated care boards (ICBs) in England have been successful in:
- Improving clinical outcomes of asthma in CYP
- Reducing inequalities in these clinical outcomes
In the UK, most CYP living with asthma are treated in a primary care setting (seeing GPs and asthma nurses). This approach has been described as “fragmented and fatally fallible”, with the UK having the worst CYP asthma outcomes in Europe. Significant socioeconomic inequalities also exist. Even when national CYP asthma admission rates fall, the gaps between the least and most deprived areas increases.
In 2021, NHS England published the National Bundle of Care for Asthma. This document outlined system-wide infrastructure and pathways to improve asthma outcomes, with themes including data and digital (e.g. being able to use data to create at-risk registers). As a result, a national, pilot scheme is being undertaken where eight ICBs have received funding to recruit CYP asthma practitioners to facilitate:
- Work across the ICB and deliver key elements of the bundle;
- The use of risk stratification in primary care electronic health records to target intervention towards CYP at highest risk of poor outcomes
It is these interventions that Karl will be evaluating.
Alongside his PhD, Karl is also an associate Principal Investigator in a paediatric drug randomised control trial for severe asthma (The TREAT trial). Previous areas of research include:
- Biomarkers of disease activity in preschool wheeze, fungal sensitatisation and disease activity in childhood asthma;
- Involved with developing clinical characterisation protocol study for COVID-19 in adults, then children (Co-Investigator with the ISARIC programme)
- Effect of air quality (housing, indoor and outdoor) on respiratory health in children.
What is your motivation for undertaking this project and how will this funding impact your research?
I saw this as a fantastic opportunity to improve my research skills by being able to undertake a PhD exploring a public health level national intervention, aiming to improve outcomes for CYP with asthma and reduce inequalities in asthma.
