PhD Treatable Traits for Asthma Management during Pregnancy

Asthma is common in pregnancy; associated with exacerbations and poor outcomes for the baby. This study will prospectively examine the prevalence and clinical relevance of a range of traits, including lung inflammation, common co-morbidities and behavioural factors in this population.

The project is part of a larger, multi-site study being conducted in Newcastle, Maitland, Gosford, Sydney, Wollongong, Canberra and Melbourne.

1. Prospective characterisation of treatable traits in pregnant women with asthma Antenatal care guidelines recommend identification and referral for treatment of several traits potentially relevant to asthma, including smoking, nutrition, physical activity, and poor mental health. However, little is known about whether recommended approaches are followed or successful in treating these traits. More research is needed to explore multi-dimensional assessment of traits relevant to asthma, and their treatment during pregnancy, in various antenatal care settings. Before an intervention trial for a broader treatable traits approach can be proposed, more work is needed to understand the prevalence of all treatable traits in pregnancy, their association with exacerbation risk, poor asthma control, and asthma related quality of life (i.e. their clinical relevance), as well as patient and clinician preferences in the context of antenatal models of care in Australia. The feasibility of treating traits is likely to be different in regional versus tertiary hospitals, and may also differ by model of care (e.g. midwife-led vs shared care with a GP vs private obstetric care). These are important considerations as we generate new knowledge to inform implementation of treatable trait approaches in the pregnancy setting.

Aim 1.1: To prospectively determine the prevalence of a range of treatable traits from the pulmonary, extra-pulmonary and behavioural domains throughout pregnancy in women with asthma

Aim 1.2: To determine which traits are associated with risk for exacerbation during pregnancy, poor asthma control and poor asthma-related quality of life.

Aim 1.3: To determine whether there is any difference in trait prevalence or clinical relevance in women from regional versus metropolitan/tertiary hospitals. Methods: Prospective cohort study with face to face visits at 3 time points during pregnancy. 2. Treatable trait priorities in pregnancy

Aim 2.1: To determine which traits are of the highest priority to pregnant women and clinicians.

Aim 2.2: To determine the level of patient to clinician agreement of treatable trait importance.

Aim 2.3: To assess the views of pregnant women and clinicians about implementation of a treatable trait model of care for asthma management in pregnancy.

Methods: A sub-group of participants will be asked to rate the importance of their individual traits. Clinicians (including midwives, obstetricians, obstetric physicians, GPs, respiratory physicians and respiratory nurses) will rate trait importance for 25 trait list case studies. Concordance of trait importance between patient and clinician, and between clinician groups will be determined. Qualitative semi-structured interviews will be conducted with 20 pregnant women, and 20 antenatal clinicians to assess views on implementation of a treatable traits model of care for asthma management in pregnancy. The successful candidate has the opportunity to be involved in all aspects of the larger study, and will be expected to actively participate in study 1 recruitment and data collection at the Newcastle and Maitland sites, and in overall statistical analysis. In addition, they will have the opportunity to be involved in qualitative data collection for study 2 at all study sites.

The candidate will need to be based in Newcastle. They will have training opportunities as part of the NHMRC-funded Centre of Excellence in Treatable Traits, and the Hunter Medical Research Institute’s Asthma and Breathing Research Program. The supervisor is part of the University of Newcastle’s College of Health, Medicine and Wellbeing, and School of Medicine and Public Health

PhD Scholarship details

Funding: $32,192 per annum (2024 rate) indexed annually. For a PhD candidate, the living allowance scholarship is for 3.5 years and the tuition fee scholarship is for four years. Scholarships also include up to $1,500 relocation allowance.

Supervisor: Associate Professor Vanessa Murphy

Available to: Domestic students

PhD

Eligibility Criteria

The applicant will need to meet the minimum eligibility criteria  for admission.

Application Procedure

Interested applicants should send an email expressing their interest along with scanned copies of their academic transcripts, CV, a brief statement of their research interests and a proposal that specifically links them to the research project.

Please send the email expressing interest to [email protected] by 5pm on 01 August 2024.