https://bura.brunel.ac.uk/handle/2438/8616 2026-11-13T07:06:23Z https://bura.brunel.ac.uk/handle/2438/34138 Title: Improving shared decision-making in bronchiectasis Authors: McCallion, Paul; Bradley, Judy M; Lewis, Adam; Robinson, Lisa; Lally, Joanne; De Soyza, Anthony Abstract: Bronchiectasis is a heterogeneous lung disease. There is an increasing focus on personalised medicine in bronchiectasis, with targeted pharmacological interventions for inflammation, immunology and infection. Airway clearance techniques (ACTs) are non-pharmacological treatments used to manage bronchiectasis. Approximately half of patients with bronchiectasis perform ACTs. There have been attempts to personalise ACT prescriptions, including consideration of patient physiology, disease status and psychosocial factors. Guidelines suggest that patient preference or choice should be considered when prescribing ACTs. There is a lack of literature showing patient preference or choice being taken into consideration when prescribing ACTs in bronchiectasis. This article discusses the role of shared decision-making (SDM), the potential use of SDM for ACTs in bronchiectasis to support patient choice of and adherence to ACTs and the steps involved in designing an SDM intervention for ACTs in bronchiectasis for future research. Development and use of an SDM intervention to support patient choice of ACT in bronchiectasis may result in a patient-centred, pragmatic approach to empower patients to be actively involved in their care, improve their knowledge on the importance of ACTs and support improvement in adherence to this essential therapy. 2025-09-03T00:00:00Z https://bura.brunel.ac.uk/handle/2438/34137 Title: Qualitative study of patients experiences and perceptions of stepping down asthma medication in primary care across England Authors: Bloom, Chloe I; Middleton, Jack; Lewis, Adam Abstract: Background: Guidelines recommend that asthma medication should be stepped down to the minimally effective dose that achieves symptom control. Stepping down aims to prevent adverse medication effects and unnecessary costs but is often not implemented in primary care, where most patients with asthma are managed. Little is known about the experiences and views of patients regarding stepping down. Methods: Patients with stable asthma, with regular use of a preventer inhaler, from general practitioner practices across England, participated in a survey and/or semi-structured interview. Questions explored the patient’s understanding of their asthma, views and knowledge of preventer inhalers, experiences and perceptions of stepping down asthma medication. Qualitative group-based multidisciplinary thematic analysis by two healthcare professionals and a patient were performed. Results: 143 patients responded to the survey, 63% were female, between the ages 18–80 years and including geographical areas across the UK, 17 of whom participated in an interview. Half of these patients with stable asthma, most with asthma for more than 10 years, had never had a discussion regarding stepping down asthma medication. Most stepping down that had occurred was related to seasonal changes in asthma control. Four overarching themes from the interviews were identified, (1) experiences of living with asthma and needing inhalers, (2) insufficient education regarding preventer inhalers, (3) stepping down is agreeable and possible and (4) current asthma care is suboptimal. Conclusion: Patients with stable asthma were able to self-manage their asthma well. They had little awareness of medication adverse effects and minimal experience of having their medication stepped down by a healthcare professional. Most were inclined to step down, if clinically safe to do so, indeed some had reduced their medication doses themselves, without professional guidance. Description: Data availability statement: Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.; Supplementary files are available online at: https://bmjopenrespres.bmj.com/content/12/1/e002898#supplementary-materials . 2025-02-03T00:00:00Z https://bura.brunel.ac.uk/handle/2438/34083 Title: Global Landscape of Research Impact Assessment: Current State and Opportunities Authors: Graham, Kathryn; Hanney, Stephen Abstract: This pre-reading background document was prepared for the Funders Forum: Aligning for Impact, on April 9-10, 2026, co-hosted by Wellcome and the Canadian Institutes of Health Research (CIHR), in partnership with the Impact Funders Forum. The document was produced to support objective two of the Forum, to “review research impact assessments to identify gaps and opportunities to advance knowledge and action”. It will also help inform subsequent objectives related to aligning around actions and identifying concrete next steps. Description: At head of title: Funder Forum: Aligning For Impact. Pre-reading Background Document.; A related blog, 'Assessing research impact: what do we know and what's next for funders?: A call for collective action', is available online at https://transforming-evidence.org/blog/assessing-research-impact-what-do-we-know-and-whats-next-for-funders. 2026-10-14T00:00:00Z https://bura.brunel.ac.uk/handle/2438/34072 Title: Invisibility problem: why current economic evaluations understate the value of sexual and reproductive health and rights, and three strategic shifts to address it Authors: Narasimhan, Manjulaa; Rasanathan, Jennifer JK; Allotey, Pascale; Ahmed, Sayem; Crankson, Shirley; Banstola, Amrit; Pokhrel, Subhash Abstract: Summary box: • Most economic evaluations of sexual and reproductive health and rights (SRHR) interventions capture only health-sector benefits, rarely accounting for cross-sectoral returns in education, labour, justice and social protection. • A 27% reduction in global SRHR financing in 2023, compounded by donor withdrawal since 2025, driven mainly by geopolitical pressures, is undermining progress across health, education, economic development and equity goals. • Better evidence is unlikely to reverse decisions made on economic grounds, but evaluations that make cross-sectoral returns visible give ministries beyond health a demonstrable stake in SRHR investment and standing to defend it. • We propose three strategic shifts to make the broader returns on SRHR investments more visible: adopting multisectoral and societal rather than a uniquely health-sector perspective; embedding life-course and intergenerational analysis and applying disaggregated approaches to address equity concerns, including those enabled by emerging analytical methods. Description: Data availability statement: Supplementary data is available from Reference 16. Ahmed S, Crankson S, Banstola A, et al. Summary data tables: a rapid scoping review of economic evaluations of sexual and reproductive health and rights. Brunel University of London 2025; doi:10.17633/rd.brunel.33455722 2026-10-20T00:00:00Z