My major research area spans the clinical assessment and mechanisms of difficult asthma including identification and management of poor adherence to therapy. Difficult asthma represents 5 - 10% of adult asthmatics but this group utilises ca 60% of NHS asthma spend, with repeated unscheduled healthcare contact. Our initial programme of research developed and validated a multi-disciplinary systematic assessment / management model for difficult asthmatics. I founded and now co-ordinate the BTS UK Severe Asthma Network and National Registry on Difficult Asthma (see above). The Registry, as well as standardising UK specialist clinical services, facilitates research into the assessment and clinical management of difficult asthma and holds the NICE (UK) Bronchial Thermoplasty Registry. Our non-adherence research programme defined the significant scale of this problem in difficult asthma (30 - 50% of subjects) and our current research is developing methods to better identify and manage this problem in the clinic using biomarker based assessments of corticosteroid exposure and response.

A major evolving area is disease stratification to deliver personalised therapeutics in severe asthma and I lead the Medical Research Council UK Refractory Stratification Programme (RASP-UK). This programme will deliver  early ‘proof of concept' studies in stratified well phenotypes patients in severe asthma in partnership with the Industrial Partners in this programme. Our Group has substantial experience of Phase II / III clinical trials including study concept and design, establishment of methodology, final protocol review and data analysis.