Three-year study to collect and analyse data from 13,000 respiratory patients per year to improve and predict care outcomes for asthma and COPD
Project team from Singhealth, Duke NUS and GSK
A team of clinicians and researchers from the SingHealth Duke-NUS Academic Medical Centre (AMC) and GSK are embarking on a three-year real world data collaboration in Singapore. Involving about 13,000 respiratory patients a year, the project seeks to enhance clinical decision-making and improve the care of asthma and chronic obstructive pulmonary disease (COPD) patients in Singapore.
This $1.2 million study funded by GSK aims to create an integrated real world data ecosystem for research into respiratory diseases by accelerating the digitisation and integration of medical records of asthma and COPD patients. The data will be used to create digital tools for deployment to healthcare institutions like the Singapore General Hospital (SGH) and SingHealth Polyclinics to improve respiratory patient care and optimise treatment options. The healthcare institutions can also use these results to prioritise programmes and target areas that will improve patient outcomes and deliver cost-effective results.
Asthma and COPD - the need for research
Singapore has one of the highest asthma prevalence rates in the world, with around one-in-five children and five per cent of adults diagnosed with the condition. Singapore's asthma mortality rate is also three times that of other developed countries like the United States and New Zealand . This can be attributed to a variety of factors such as under-reporting of symptoms, poor adherence to treatment or inadequate self-management.
COPD, a serious respiratory disease that limits airflow to the lungs, was the 10th leading cause of death and hospital admissions in Singapore  in 2016. Current challenges in COPD care include lack of disease awareness, late detection and diagnosis, poor adherence to medication and high readmission rates.
Research is crucial to enhance the clinical outcomes for the two conditions. The SingHealth Duke-NUS AMC-GSK team expects that real-world evidence will provide insights into the specific factors that cause poor outcomes and thus improve asthma and COPD diagnosis and treatment. For example, improved strategies include educating patients and their families on self-care and effective use of care teams.
"Asthma and COPD can be life-threatening if not managed properly, but with the right interventions and management, complications and deaths are preventable and patients can enjoy a good quality of life," said Associate Professor Loo Chian Min, Chief Medical Informatics Officer, SingHealth and Senior Consultant, Department of Respiratory and Critical Care Medicine, SGH. "A study of this size should give us ample data to analyse so that we can improve the care management and clinical outcomes of these two chronic respiratory conditions for our patients."
With the data, the team will create electronic dashboards with key metrics to track asthma and COPD management, and real-time data linkages will also be used to create dynamic readmission risk models and predictive analytics. This will enable healthcare professionals to predict outcomes and risks to enable timely clinical intervention and patient education. For example, doctors will be able to identify high risk asthma or COPD patients and provide more intensive or tailored treatment for these groups.
"This is a golden opportunity to systematically evaluate a large group of patients in order to identify and aggressively care for those at high risk and to streamline asthma and COPD care overall," said Professor David Matchar, Director, Programme in Health Services and Systems Research, Duke-NUS Medical School and Co-Director, Health Services Research Institute, SingHealth Duke-NUS Academic Medical Centre.
This study is also the SingHealth Duke-NUS Health Services Research Institute's (HSRI) first large-scale public - private research collaboration. The institute aims to integrate cutting edge health services research into the Singapore health system.
"This ground-breaking project will utilise real-time aggregated patient data and advanced analytics to develop evidence-based strategies for asthma and COPD patient management within SingHealth. GSK is a global leader in respiratory research and real world evidence, and we look forward to sharing the knowledge and application of our unique expertise with our research partners in Singapore," said Dr Sumitra Shantakumar, Director, Real World Evidence and Epidemiology, R&D, GSK.
 ANNALS, Academy of Medicine, Singapore "Asthma in Singapore: Past, Present and Future" (https://www.annals.edu.sg/pdf/46VolNo3Mar2017/V46N3p81.pdf)
 Ministry of Health, Singapore Health Facts: Principal Causes of Death 2016