Early Career Researcher overview
Project: STEP DOWN: Stopping Treatment Excess in asthma, using linked Primary care Data and evaluating patient’s Opinions, across the Whole Nation
Funded by: National Institute for Health and Care Research (NIHR)
Based at: Imperial College London
Email: Chloe.bloom06@imperial.ac.uk
Over the past decade, asthma medication has been prescribed at increasingly higher doses with many patients remaining on higher dose preventer inhalers for years. Step-down to lower doses occurs infrequently. Overtreatment may lead to adverse health and economic consequences. I aim to identify the magnitude of common serious side-effects from asthma medication, explore the barriers and facilitators for patients to stepping down and carry out a feasibility study for a future pragmatic trial to safely step-down adults on higher dose asthma medication within a primary care setting.
To undertake this project, I will use electronic healthcare records to measure the risk of pneumonia, osteoporosis, fractures, cataracts, glaucoma, diabetes, bruising and cardiovascular events. I will use a mixed-methods approach to survey and interview asthma patients. I will simultaneously conduct a feasibility study, evaluating pragmatism and recruitment.
My mentors include Professor Chris Griffiths, Centre Co-Director. I also have the support and guidance of 8 members of my Patient and Public Involvement (PPI) group. This is an NIHR Advanced Fellowship, funded for 4 years.
About me
Clinical Senior Lecturer in Respiratory Epidemiology and Honorary Respiratory Consultant at Imperial College Healthcare Trust.
Publications
Bloom CI et al. Asthma phenotypes and covid-19 risk: a population-based observational study. Am J Respir Crit Care Med. 2021 Oct 20. doi: 10.1164/rccm.202107-1704OC
Bloom CI et al. Risk of adverse outcomes in patients with underlying respiratory conditions admitted to hospital with COVID-19: a national, multicentre prospective cohort study using the ISARIC WHO Clinical Characterisation Protocol UK. Lancet Resp Med. 2021 Mar 4; doi: 10.1016/ S2213-2600(21)00013-8
Bloom, C. I., de Preux, L., Sheikh, A., & Quint, J. K. (2020). Health and cost impact of stepping down asthma medication for UK patients, 2001-2017: A population-based observational study. PLoS medicine, 17(7), e1003145. https://doi.org/10.1371/journal.pmed.1003145
Bloom, C. I., Saglani, S., Feary, J., Jarvis, D., & Quint, J. K. (2019). Changing prevalence of current asthma and inhaled corticosteroid treatment in the UK: population-based cohort 2006-2016. The European respiratory journal, 53(4), 1802130. https://doi.org/10.1183/13993003.02130-2018
Bloom, C. I., Palmer, T., Feary, J., Quint, J. K., & Cullinan, P. (2019). Exacerbation Patterns in Adults with Asthma in England. A Population-based Study. American journal of respiratory and critical care medicine, 199(4), 446–453. https://doi.org/10.1164/rccm.201808-1516OC
Bloom CI, Nissen F, Douglas IJ, et al, Exacerbation risk and characterisation of the UK’s asthma population from infants to old age, Thorax 2018;73:313-320.